Age of Initiation of Tobacco Products among USA Youth and Young Adults: Administrative Supplement

项目总结 本申请是为了回应被确认为非CA-CA的特殊利益通知(NOSI)而提交的 20-039.该项目直接涉及侧重于理解知识的研究优先领域， 态度和行为对开始联合使用多种烟草产品(TP)和 青少年酗酒及其相关因素。鉴于烟草产品组合最多的是 该项目在年轻人中很流行，重点是(一)香烟、电子烟和酗酒，以及(二) 香烟、雪茄(c-c)和酗酒，以改善公共健康和预防疾病，例如 癌症。就本提案而言，共同使用定义为过去30天内使用所有产品，同时， 在同一波人群烟草与健康评估(PATH)研究中。前瞻性地 估计开始的年龄，定义为在过去30天内首次报告多次使用TP和酗酒 在第一波参与中从未使用过这三种产品的年轻人是创新的，因为 在我们对它们共同使用的了解上存在研究差距。我们的补充研究是一项前瞻性的二级分析 在美国年轻人(12-17岁)中，前四波从不吸烟的人中，e- 香烟、雪茄和狂饮，在他们参与PATH的第一波中。父级拨款有三项 目标。目标1：在从未使用过TPS的12-17岁年轻人中，估计 前瞻性研究他们开始TPS的年龄，并找出与开始TPS年龄相关的危险因素 香烟和每一种NCTP：电子烟、雪茄、水烟和无烟烟草。目标2：与 目标1但在18-24岁的年轻人中，他们从未在第一波中使用过TPS。目标3： 青少年和12-24岁的年轻人，他们从未在第一波中使用TPS，以确定轨迹和 从第一波到第四波的TPS发病时间的转变，并确定与以下因素相关的风险因素 这些轨迹和过渡。本附录增加了目标4：在12-17岁的青年中 这些TPS和酒精的使用者永远不会在他们参与Path的第一波浪潮时前瞻性地评估他们的 开始(即第一次报告)年龄(I)超过30天使用避孕药和酗酒，以及(Ii)超过30天使用 C-C和酗酒，使用生存分析，并确定与联合使用相关的风险因素。我们 计划探索各种社会人口、人际和个人内部因素对这些结果的影响。 很少有研究可以用跨越青年和青年的纵向数据来估计联合使用的开始年龄 成年人。这包括跟踪未成年(即青年)参与者的结果及其开始年龄， 在小路上成长为年轻人。该项目加强了关于共同使用多个TPS和 使用一项全国性的纵向研究，并利用当代数据反映了 不断演变的TP环境。此外，这些结果对烟草控制也至关重要，因为最近的研究表明， 与酒精一起使用TPS会增加两者的使用量，并可能解释未来的癌症风险和死亡。

PROJECT SUMMARY This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 20-039. This project directly addresses the research priority areas that focus on understanding the knowledge, attitudes, and behaviors that contribute to the age of initiation of co-use of multiple tobacco products (TP) and binge drinking in youth, and their associated factors. Given the tobacco product combinations that are most prevalent among youth, this project focuses on (i) cigarettes, e-cigarettes (c-ecig) and binge drinking, and (ii) cigarettes, cigarillos (c-c) and binge drinking to improve public health outcomes and prevent disease, such as cancer. For the purposes of this proposal, co-use is defined as past 30-day use of all products, simultaneously, in the same wave in the Population Assessment of Tobacco and Health (PATH) study. Prospectively estimating the age of initiation, defined as first past 30-day report of multiple TP use and binge drinking among youth who reported never use of the three products at their first wave of participation is innovative given the research gap in what we know about their co-use. Our supplemental study is a prospective secondary analysis of the first four waves of PATH among U.S. youth (12-17 years old) who reported never use of cigarettes, e- cigarettes, cigarillos and binge drinking, at their first wave of participation in PATH. The parent grant has three aims. Aim 1: Among youth ages 12-17 years old who are never users of TPs at wave 1, to estimate prospectively their age of initiation of TPs and to identify the risk factors associated with the age of initiation of cigarettes and each one of the NCTPs: e-cigarettes, cigars, hookah, and smokeless tobacco. Aim 2: same as aim 1 but among young adults ages 18-24 years old who are never users of TPs at wave 1. Aim 3: Among youth and young adults ages 12-24 who are never users of TPs at wave 1, to identify the trajectories and transitions in the onset of TPs across time, from waves 1 to 4, and to identify the risk factors associated with these trajectories and transitions. This supplement adds Aim 4: Among youth ages 12-17 years old who are never users of these TPs and alcohol at their first wave of participation in PATH, to prospectively estimate their age of initiation (i.e., first report) of (i) past 30-day use of c-ecig and binge drinking, and (ii) past 30-day use of c-c and binge drinking, using survival analyses, and to identify the risk factors associated with their co-use. We plan to explore a variety of socio-demographic, interpersonal and intrapersonal factors with these outcomes. Few studies can estimate the age of initiation of co-use with longitudinal data that span youth and young adults. This includes tracking outcomes and their age of initiation of underage (i.e., youth) participants that become young adults in PATH. This project strengthens the evidence regarding co-use of multiple TPs and binge drinking using a national longitudinal study and takes advantage of contemporary data that reflects the evolving TP landscape. Also, the results are essential for tobacco control as recent studies indicate that the use of TPs with alcohol increases the amount of use of both and may explain future cancer risk and deaths.