Vaping Nicotine and Cannabis Across Adolescence and Young Adulthood

青少年和青年时期吸食尼古丁和大麻

• 批准号: 10747805
• 负责人: Jessica Louise Barrington-Trimis
• 金额: $ 13.07万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10747805
• 关键词: Address; Adolescence; Adolescent and Young Adult; Adverse effects; Aftercare; Age; Age Months; Award; Back; Behavioral; Cannabinoids; Cannabis; Characteristics; Chronic; Cigarette; Community Health; Cross-Sectional Studies; Data; Decision Making; Dedications; Dependence; Development; Disease; Drug usage; Education; Electronics; Emotional; Environment; Epidemic; Expectancy; Female; Flavoring; Freedom; Friends; Future; Gender; Health; Individual; Inhalation; Intervention; Interview; JUUL; Left; Life Experience; Malignant Neoplasms; Marijuana Smoking; Measures; Modeling; Moods; Motivation; Nicotine; Oils; Oral; Outcome; Parents; Participant; Pattern; Persons; Plants; Play; Policies; Population; Predisposition; Prevention; Prevention strategy; Problem behavior; Proliferating; Public Health; Relapse; Reporting; Research; Rewards; Risk; Risk Factors; Role; Schools; Self Administration; Smoking; Social Environment; Stress; Students; Surveys; Technology; Testing; Tobacco; Tobacco use; Tobacco-Related Carcinoma; Uncertainty; Variant; Waxes; Women' s Health; Youth; adverse outcome; aged; biopsychosocial; catalyst; cigarette smoking; cohort; combustible tobacco; coping; craving; design; deviant; electronic cigarette use; emerging adult; emotion regulation; empowerment; experience; experimental study; flexibility; habituation; health goals; heated tobacco products; high-risk adolescents; insight; intergenerational; male; marijuana use; marijuana vaping; multiple drug use; nicotine exposure; nicotine use; ninth grade; novel; parent grant; parent project; pleasure; polysubstance use; prevent; programs; progression risk; public health priorities; recruit; response; self esteem; smoking initiation; social; substance use; theories; therapy design; tobacco products; trend; uptake; vaping; vaping nicotine; young adult

PROJECT SUMMARY (PARENT AWARD R01CA229617) In 2015, evidence that e-cigarette use ("vaping") in adolescents and young adults (AYAs) had increased and was associated with increased risk of cigarette smoking initiation generated concern in the public health community. Subsequent research has left the field with several critical questions, including: (1) whether vaping truly has a causal effect on smoking or merely reflects a common liability toward deviancy among 'high-risk' AYAs with emotional or behavioral problems, (2) whether an emerging wave of new vaping products, including new nicotine products such as JUUL, and an increasingly diverse class of products dedicated to vaping cannabis plant, oils, and waxes, may increase the appeal and addictive potential of vaping, and (3) whether there exist particular characteristics of vaping products and biopsychosocial mechanisms that underlie the risk of AYA vaping initiation, progression, and transition to other forms of drug use that could be targeted in prevention efforts. The uncertainties regarding the impact of AYA vaping have left policy officials with little evidence to determine if AYA vaping should be prioritized in public health programs, and if so, the most effective strategies for prevention. To address the evidence needs and provide a flexible framework for future study of the impact of various vaping products on the AYA tobacco product and cannabis use burden, we will test a novel 'catalyst model' of AYA vaping. The catalyst model proposes two steps, which we will evaluate in Aims 1 and 2 of this proposal. Step 1 (AIM 1 ). To determine whether (a) AYAs with fewer emotional-behavioral risk factors who have been previously deterred from drug use in traditional (non-vaporized) forms are at risk of vaping initiation, (b) the unique qualities and product features of vaping (e.g., concealability, flavors, appealing technology, social acceptability, low perceived harm) increase risk of AYA vaping, and (c) features of vaping products disproportionately increase the risk of vaping initiation for low-risk AYAs. Step 2 (AIM 2). To determine whether (a) vaping increases the risk of cross-product transitions involving initiation of other vaping products, or combustible nicotine or cannabis, as well as increases risk of progression to problematic drug use outcomes, including dependence, poly-drug use, and chronic drug use through early adulthood, (b) rewarding effects from exposure to nicotine, cannabinoids, and other product components (e.g. flavorings) increases risk of cross-product transitions and problematic drug use outcomes, and (c) product characteristics modify this association. To test the model, we will leverage data collected from participants from age 14-19 (2013-2018) from our existing cohort and follow participants into early adulthood (20-23, from 2019-2023; N-2000). We will also recruit a new cohort of 9th grade students at age 14 (N=2500) at the same schools as part of a cohort-sequential design that will apply causal inference analytic approaches to determine whether observed associations are likely causal. Collectively, this project will provide critical information regarding the priority and potential targets of public health efforts aimed at reducing the potential adverse public health effects resulting from AYA vaping, including tobacco-related cancer.

项目总结（PAXIA AWARD R 01 CA 229617） 2015年，有证据表明青少年和年轻人（AYAs）使用电子烟（“vaping”）的情况有所增加，并且与吸烟开始的风险增加有关，这引起了公共卫生界的关注。随后的研究给该领域留下了几个关键问题，包括：（1）vaping是否真的对吸烟有因果关系，或者仅仅反映了具有情绪或行为问题的“高风险”AYA对偏差的共同责任，（2）是否出现了一波新的vaping产品，包括新的尼古丁产品，如JUUL，以及越来越多样化的一类专门用于vaping大麻植物的产品，油和蜡可能会增加电子烟的吸引力和成瘾潜力，以及（3）是否存在电子烟产品的特定特征和生物心理社会机制，这些特征构成了AYA电子烟开始，进展和过渡到其他形式的药物使用的风险，这些风险可能是预防工作的目标。关于AYA vaping影响的不确定性使得政策官员几乎没有证据来确定AYA vaping是否应该在公共卫生计划中优先考虑，如果是的话，最有效的预防策略。 为了满足证据需求，并为未来研究各种电子烟产品对AYA烟草产品和大麻使用负担的影响提供灵活的框架，我们将测试一种新型的AYA电子烟“催化剂模型”。催化剂模型提出了两个步骤，我们将在本提案的目标1和2中对其进行评估。步骤1（AIM 1）。为了确定（a）以前曾被阻止以传统（非汽化）形式使用药物的情感行为风险因素较少的AYA是否有开始使用vaping的风险，（B）vaping的独特品质和产品特征（例如，隐蔽性、风味、吸引人的技术、社会可接受性、低感知伤害）增加了AYA vaping的风险，以及（c）vaping产品的特征不成比例地增加了低风险AYA开始vaping的风险。步骤2（AIM 2）.为了确定（a）电子烟是否会增加交叉产品转换的风险，包括开始使用其他电子烟产品或可燃尼古丁或大麻，以及增加进展为有问题的药物使用结果的风险，包括依赖性，多种药物使用和成年早期的慢性药物使用，（B）暴露于尼古丁，大麻素，和其他产品成分（如调味剂）增加了交叉产品转换和有问题的药物使用结果的风险，以及（c）产品特性改变了这种关联。为了测试该模型，我们将利用从现有队列中收集的14-19岁（2013-2018）参与者的数据，并跟踪参与者进入成年早期（20-23，从2019- 20-23; N-2000）。我们还将在同一所学校招募一批14岁的9年级学生（N=2500），作为队列顺序设计的一部分，该设计将应用因果推理分析方法来确定观察到的关联是否可能是因果关系。总的来说，该项目将提供有关公共卫生工作的优先事项和潜在目标的关键信息，旨在减少AYA vaping造成的潜在不利公共卫生影响，包括烟草相关癌症。