Smokers' Decision-Making about Tobacco Use: The Interplay of Affective and Cognitive Factors with Product Characteristics

项目摘要 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.吸烟者通常报告与酒精共用，酒精使用和烟草使用之间的联系是 在多个层次的研究文献中都得到了很好的证实。经常在饮酒时同时使用烟草。 酒精，这会影响随后的共同使用行为和过渡。例如，戒烟尝试是 在酒精使用的背景下，成功的可能性较小，针对一种产品的使用的政策表明 对另一种使用的溢出效应。然而，关于电子尼古丁联合使用的研究有限。 传递系统(末端)或加热烟草制品(HTP)和酒精，以及酒精使用模式， 包括与烟草的共同使用，影响吸烟者的烟草使用轨迹和结果 结束了。同样不清楚的是，针对END和HTP的监管政策如何影响酒精使用。的目标是 该项目旨在为吸烟者使用烟草和酒精的模式提供及时的证据。 END或HTP；这些模式如何影响吸烟者拒绝END/HTP的决定，仅用它们取代少数几个 香烟，完全改用它们，或者用它们完全戒烟；并评估如何锻炼 餐馆和酒吧的税收和烟草使用限制会影响人们对酒精的既定偏好和影响 烟酒并用。在我们之前的研究的指导下，我们的目标1将检查酒精和烟草的共同使用 香烟和烟头/HTP双重吸烟者的行为，并测试烟酒联合使用是否影响 烟草使用转变--概率和长期结果。目标2将评估消费税的影响， 餐馆和酒吧的烟草使用限制，以及对烟草中可获得酒精口味的规定 产品对行为结果的影响，包括烟草和酒精的共同使用和消费水平。这些目标将 通过利用家长拨款对300名吸烟者进行的密集纵向研究来实现这一点 通过添加带有体积选择实验和焦点的附加评估，启动Ends或HTP使用 关于烟草和酒精的共同使用，并将与酒精有关的问题纳入对 纵向研究。本行政补充所生成的数据将提供更完整的理解 吸烟者使用END和HTP的决策过程和涉及的因素及其可能性 结束/HTP使用将导致完全戒烟或持续的双重使用，以及烟草如何 控制政策可能会对酒精使用产生溢出效应。这项研究的高度影响将由以下方面产生 研究结果，改善地方、州和联邦政策和法规的证据基础和质量 和可翻译的知识，指导未来的研究和临床实践，以鼓励减少双重用途和 更多人完全从燃烧的烟草产品转向END/HTP或完全停止所有烟草 产品。

Project Abstract This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 20-039. Smokers commonly report co-use with alcohol, and linkages between alcohol use and tobacco use are well-established at multiple levels in the research literature. Tobacco is often used concurrently while drinking alcohol, which influences subsequent co-use behaviors and transitions. For instance, smoking quit attempts are less likely to be successful in the context of alcohol use, and policies targeting use of one product have shown spillover effects on use of the other. However, there has been limited research on the co-use of electronic nicotine delivery systems (ENDS) or heated tobacco products (HTP) and alcohol, and whether alcohol use patterns, including co-use with tobacco, influences tobacco use trajectories and outcomes among smokers who use ENDS. It is similarly unclear how regulatory policies for ENDS and HTPs affect alcohol use. The objective of this project is to provide timely evidence on patterns of tobacco and alcohol co-use among smokers who use ENDS or HTP; how these patterns affect smokers’ decisions to reject ENDS/HTP, substitute them for only a few cigarettes, switch exclusively to them, or use them to completely quit using tobacco; and evaluate how excise taxes and tobacco use restrictions in restaurants and bars affect stated preferences for alcohol and impact tobacco and alcohol co-use. Guided by our prior research, our Aim 1 will examine alcohol and tobacco co-use behaviors among dual users of cigarettes and ENDS/HTP and test whether alcohol-tobacco co-use affects tobacco use transition-probabilities and long-term outcomes. Aim 2 will evaluate the impact of excise taxes, tobacco use restrictions in restaurants and bars, and regulations of the availability of alcohol flavors in tobacco products on behavioral outcomes including tobacco and alcohol co-use and consumption levels. These aims will be accomplished by leveraging the parent grant’s intensive longitudinal study of 300 smokers who recently initiated ENDS or HTP use by adding an additional assessment with a volumetric choice experiment and focus on tobacco and alcohol co-use and by embedding alcohol related questions in existing assessments of the longitudinal study. Data generated by this administrative supplement will provide a more complete understanding of the decision-making processes and factors involved in smokers’ use of ENDS and HTP and the likelihoods that ENDS/HTP use will lead to complete quitting of cigarettes or to sustained dual use, and how the tobacco control policies could have spillover effects on alcohol use. The high impact of this research will be produced by study findings that improve the evidentiary base and quality of local, state, and federal policies and regulations and translatable knowledge that guides future research and clinical practice to encourage less dual use and more switching exclusively from combusted tobacco products to ENDS/HTP or complete cessation of all tobacco products.