Prospective effects of electronic cigarette marketing on expectancies and behavior

 描述（由申请人提供）：吸烟是美国死亡的主要原因，也是癌症死亡的首要原因。人们担心，过去几十年来吸烟人数的减少现在受到非传统烟草产品日益普及的挑战，如电子尼古丁输送系统（ENDS），通常被称为电子烟。使用ENDS对公共卫生的影响还没有得到很好的理解，包括其对吸烟开始，再摄取和维持的合理影响。目前，ENDS在美国面临有限的监管，特别是ENDS营销不受监管。然而，使用ENDS的流行率正在迅速增加，特别是在年轻人（18-25奥尔兹）中，他们似乎是ENDS营销的主要目标。目前对ENDS营销的研究大多是定性的，集中在描述广告或零售营销的内容。这些研究表明，正在推广ENDS，以吸引青年/年轻人，并作为香烟的更安全的替代品。但是，关于ENDS营销对年轻人的信念和态度的影响，以及这些信念和态度如何促进ENDS的使用，并进而促进香烟的使用，几乎没有证据。阐明ENDS营销如何影响年轻人的ENDS使用和吸烟行为的机制，可以为制定ENDS营销法规以及ENDS/烟草控制媒体干预措施提供具体指导。例如，可以向政策和媒体干预提供信息，说明需要控制和打击人口与发展战略营销的哪些方面。本研究将采用纵向设计和双过程理论框架，以确定结果预期和内隐态度在解释ENDS营销对大学生ENDS和香烟使用进展的影响中的作用，包括香烟使用的启动和再摄取。在我们初步研究的指导下，我们特别关注4个积极的结果预期：社会增强（例如，用于获得知名度），影响监管（例如，用于调节感觉），积极的感官体验（例如，用于享受风味），以及积极的健康后果。与双过程框架相一致，该框架假定自发或自动过程在决策过程中与更有意识的反射过程平行，我们假设营销对ENDS和香烟使用的影响由4种类型的预期（联合代表反射系统）和内隐态度（代表自发系统）介导或解释。自发过程从未被评估为烟草产品营销对一般行为，特别是ENDS营销影响的中介。多波纵向设计将促进严格的因果推理有关的机制，如何结束营销运作，以及帮助调查营销的作用，在年轻人的信仰，态度和行为的变化随着时间的推移。因此，本研究将采用新应用于ENDS研究的强有力的理论和方法论方法和措施[例如，内隐联想测试（IAT）]来生成目前不存在的高质量信息。

 DESCRIPTION (provided by applicant): Cigarette smoking is a leading cause of mortality in the United States and the foremost cause of cancer deaths. There are concerns that the decrease in cigarette smoking attained over the last several decades is now challenged by the increasing popularity of non-traditional tobacco products such as Electronic Nicotine Delivery Systems (ENDS), commonly referred to as e-cigarettes. The effects of ENDS use on public health are not well understood, including its plausible effects on cigarette use initiation, re-uptake, and maintenance. Currently, ENDS face limited regulations in the U.S. ENDS marketing in particular is not regulated. However, the prevalence of ENDS use is rapidly increasing, especially among young adults (18-25 year olds) who appear to be the main target of ENDS marketing. Current studies on ENDS marketing have been mostly qualitative, focused on characterizing the contents of advertising or retail marketing. These studies suggest that ENDS are being promoted to attract youth/young adults and as safer alternatives to cigarettes. But there is little evidence available on the effects of ENDS marketing on young adults' beliefs and attitudes and how those beliefs and attitudes promote ENDS use, and by extension, cigarette use. Elucidating the mechanisms of how ENDS marketing operates to impact young adults' ENDS use and smoking behavior could provide specific directions to the development of regulations on ENDS marketing as well as ENDS/tobacco control media interventions. For example, policies and media interventions could be informed as to which aspects of ENDS marketing need to be controlled and countered. This research will employ longitudinal design and the dual- process theoretical framework to determine the roles of outcome expectancies and implicit attitudes in explaining the effects of ENDS marketing on ENDS and cigarette use progression among college students, including cigarette use initiation and re-uptake. Guided by our preliminary research, we specifically focus on 4 positive outcome expectancies: social enhancement (e.g., use to gain popularity), affect regulation (e.g., use to regulate feelings), positive sensory experience (e.g., use to enjoy flavors), and positive health consequences. Consistent with the dual-process framework, which posits that spontaneous or automatic processes act parallel in decision-making to more conscious, reflective processes, we hypothesize that the effects of marketing on ENDS and cigarette use are mediated or explained by the 4 types of expectancies, jointly representing the reflective system, and by implicit attitudes, representing the spontaneous system. Spontaneous processes have never been assessed as mediators of the effects of tobacco product marketing on behavior in general and of ENDS marketing in particular. The multi-wave longitudinal design will facilitate rigorous causal inferences regarding the mechanisms of how ENDS marketing operates as well as help investigate marketing's role in young adults' changes in beliefs, attitudes and behavior over time. Thus, this research will employ powerful theoretical and methodological approaches and measures newly applied to ENDS research [e.g., Implicit Association Test (IAT)] to generate high quality information that currently does not exist.