Predicting and Understanding the Use of Nicotine Products In a Rapidly Evolving Nicotine Marketplace: The International Nicotine Product, Policy, and Market (INPAM) Study

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OVERALL SUMMARY/ABSTRACT The proposed renewal of this P01 builds upon the longstanding International Tobacco Control (ITC) Policy Evaluation Project, which has used cross-country comparisons and a common mediation model to evaluate the behavioral impacts of national-level tobacco control policies. The current P01 has extensively researched and documented the transitions between cigarettes and nicotine vaping products and how policies impact their use. For the renewal period, we are adding heated tobacco products, thus extending our previous two-product model to three products, but otherwise maintaining a similar team structure and research approach. The goal of this P01 renewal application is to address the question “What have different countries done to regulate tobacco products and how has this impacted tobacco use behaviors?” Our common integrated theoretical framework enables us to examine how and why policies and industry actions exert effects, as well as explore under what conditions products or policy interventions might translate into actual population-level impacts. We focus on the well-established 4 `P's' – product, price, placement, and promotion, and how public health policy and industry actions impact consumer perceptions, behavior, and ultimately health endpoints. Comparing the experiences of different countries with varying regulatory approaches is intended to inform United States public policy, based upon the best science available to maximize population health. To accomplish this, we propose to analyze policies and industry actions in different jurisdictions to answer the following three integrated questions: 1) Does the policy/industry action have an impact? (causality); 2) Under what conditions is it effective? (moderation); and 3) How is it effective? (mediation). The proposed studies assess direct and indirect or unintended effects that can affect the overall impact of a policy or action. We propose to conduct this work with four inter-related Projects, an Administrative Core, and two Shared Resource Cores, which collectively will: 1) track cohorts of adult tobacco users in 7 countries; 2) conduct repeated cross sectional surveys of youth and young adults in 3 countries; 3) utilize the Experimental Tobacco Marketplace to evaluate the effects of product availability, policy actions, and the illicit marketplace; and 4) perform statistical modeling using input from the Projects to predict consumer response. The three P01 specific aims are to: 1) understand how policies and industry actions impact consumer behavior; 2) develop scientific methods for assessing response to policies; and 3) forecast population impact of different policy approaches.