Understanding the growth in moist snuff: a mixed methods study

描述（由申请人提供）：虽然美国的卷烟消费量持续下降，但美国最受欢迎的无烟烟草（SLT）——湿鼻烟的消费量在过去十年中增长了50%。此外，最大的增长发生在过去五年。据信，导致湿鼻烟增长的因素包括湿鼻烟品牌的价格差异，以及与香烟相比的价格差异，以及行业积极的营销努力，利用清洁室内空气法，并支持与香烟同时使用。然而，大多数调查很少收集包括湿鼻烟在内的SLT使用数据，而且调查内容很少超出当前使用范围。因此，控烟界尚未观察到其他数据来源所指出的SLT消费普遍增加的趋势。尽管事实上1992年NCI关于SLT的专著强烈建议所有国家烟草调查包括SLT使用的问题以及评估使用动机、风险认知和戒烟尝试的问题。在NCI专著出版的近二十年里，评估SLT使用模式和监测趋势所需的数据仍然非常缺乏，最近使用的增加表明了极大的需求。本探索性研究提案描述了一项计划，以解决关于使用湿鼻烟和无烟烟草的知识库中的差距。因此，我们将：1)开展焦点小组，了解烟草使用者对湿鼻烟特点和品牌的看法；2)开发和完善一项调查工具，该工具将进行认知测试，以评估湿鼻烟的流行程度以及影响其使用的因素，包括知识、态度、动机和风险认知；3)对约1,560名烟草使用者进行具有全国代表性的人口网络调查。包括至少460名目前使用湿鼻烟的人。因此，这项拟议研究的意义在于它有可能更好地了解湿鼻烟的使用及其使用者的态度和看法，这对于告知和指导烟草控制工作至关重要。

DESCRIPTION (provided by applicant): While cigarette consumption in the U.S. continues to decline, consumption of moist snuff, the most popular form of smokeless tobacco (SLT) in the U.S. has increased 50 percent over the past decade. Moreover, the greatest increases occurred in the last five years. Factors believed to have contributed to the growth of moist snuff include price differentials by moist snuff brand and compared to cigarettes as well as aggressive industry marketing efforts exploiting clean indoor air laws and endorsing concurrent use with cigarettes. However, data on SLT use, including moist snuff, is collected infrequently, if at all, on most surveys and survey content rarely extends beyond current use. Hence, the tobacco control community has yet to observe trends in the widespread increase in SLT consumption noted in other data sources. This is despite the fact that the 1992 NCI monograph on SLT strongly recommended that all national tobacco surveys include questions on SLT use as well as questions to assess motivation to use, risk perceptions, and quit attempts. In the nearly two decades since the NCI monograph was published, the data needed to assess patterns of SLT use and monitor trends are still sorely lacking and the recent increases in use point to a great need. This exploratory research proposal describes a plan to address gaps in the knowledge base regarding use of moist snuff and smokeless tobacco. Accordingly, we will: 1) conduct focus groups to understand tobacco users' perceptions of moist snuff features and brands, 2) develop and refine a survey instrument, which will undergo conduct cognitive testing, to assess the prevalence of moist snuff and the factors that are influencing its use including knowledge, attitudes, motivation, and risk perceptions, and 3) conduct a nationally representative population-based Web survey of approximately 1,560 tobacco users, including a minimum of 460 current moist snuff users. Thus, the significance of this proposed research is its potential to generate a better understanding of moist snuff use as well as the attitudes and perceptions of its users which is vital to informing and directing tobacco control efforts. PUBLIC HEALTH RELEVANCE: The purpose of this research project is to better understand the patterns and trends of smokeless tobacco use, particularly use of moist snuff. The relevance of the proposed research to public health is its ability to address important gaps in knowledge of moist snuff use as well as the attitudes and perceptions of its users which is vital to informing and directing tobacco control efforts.