Examining transitions between cigarettes and other nicotine delivery products among adults in countries with different regulatory environments: the ITC Nicotine Product Adult Survey

摘要/摘要 目前的P01赠款支持建立国际烟草控制政策评价(国贸中心) 项目四国家吸烟和吸食调查，首个关于吸烟和尼古丁的国际队列研究 蒸发产品(NVP)的使用，在P01赠款支持的三个国家进行(美国 [美国]、加拿大、英国和澳大利亚，并得到其他资金的支持)。进行了三次浪潮， 2016、2018和2020年的平均间隔时间为19个月。在此续订申请中，我们通过 与尼古丁市场非凡的国际扩张相匹配，增加了对热的关注 除香烟和非烟草副产品外，烟草产品(HTP)。我们建议在#年继续进行成人队列调查。 美国(n=2,150)、加拿大(n=2,150)和英国(n=2,300)，间隔19个月，在 未来5年，将大幅扩大，增加来自其他4个ITC国家的成人队列调查，这些国家是 由拟议赠款以外的资金来源支助的国家：日本(n=4500)和大韩民国 (n=4,700)，烟草业采用HTP的中心国家；新西兰 (n=1,600)，已将NVP纳入其“终局”战略；澳大利亚，继续其 对这些替代尼古丁输送系统(AND)采取更严格的方法(n=1,500；赠款申请 待定)。由此产生的7个国家的ITC尼古丁产品成人(NPA)调查(总计n=18,900)将代表 创新的国际评估体系，将使研究团队能够进行全面的 关于尼古丁产品的使用以及香烟和尼古丁产品之间的过渡的研究方案， 基于ITC项目18年来在进行严格烟草控制评估方面的全球经验 政策，采用准实验分析方法。NPA调查将提供重要证据 在未来五年内促进对尼古丁产品和政策的科学和了解，这是 尼古丁产品市场肯定会经历一段动态变化的时期。美国的类似研究，如 人口评估烟草与健康(PATH)是有限的，因为它们不容易允许交叉- 与国家行动局调查一样，使用协调一致的措施进行国家比较。这个创新的项目有三个 具体目标：1)描述不同烟草产品之间的使用模式和使用过渡 吸烟者和最近戒烟者随着时间的推移以及国家内部和国家之间的关键用户特征； 2)审查当前和未来政策的差异(例如，税收、香料禁令、产品标准、健康 警告)对于香烟、NVP和HTP，与这些产品的使用模式的差异有关 时间；以及3)审查政策对成人和青年的相对影响(这是项目的一个具体目标 2)。鉴于可能对尼古丁产品使用产生的影响，还将探讨两个探索性目标：(A) 研究随着时间的推移，新冠肺炎大流行如何影响这7个国家的吸烟和吸食；以及 (B)审查随时间推移大麻与吸烟、蒸发和HTP使用之间的相互作用。

SUMMARY/ABSTRACT The current P01 grant supported the creation of the International Tobacco Control Policy Evaluation (ITC) Project Four Country Smoking and Vaping Survey, the first international cohort study of smoking and nicotine vaping product (NVP) use, which was conducted in three countries supported by the P01 grant (United States [US], Canada, England, plus Australia, which was supported by other funding). Three waves were conducted, an average of 19 months apart, in 2016, 2018, and 2020. In this renewal application, we build on that work by matching the extraordinary international expansion of the nicotine marketplace by adding a focus on heated tobacco products (HTPs) in addition to cigarettes and NVPs. We propose to continue the adult cohort survey in US (n=2,150), Canada (n=2,150), and England (n=2,300) for 3 additional waves, 19 months apart, over the next 5 years, with a substantial expansion by adding adult cohort surveys from 4 other ITC countries, which are being supported by funding sources outside this proposed grant: Japan (n=4,500) and the Republic of Korea (n=4,700), countries that are the epicenter of the tobacco industry's introduction of HTPs; New Zealand (n=1,600), which has incorporated NVPs into their “endgame” strategy; and Australia, which continues its more restrictive approach to these Alternative Nicotine Delivery Systems (ANDS) (n=1,500; grant application pending). The resulting 7-country ITC Nicotine Product Adult (NPA) Survey (total n=18,900) will represent an innovative international evaluation system that will allow the research team to conduct a comprehensive research program on the use of nicotine products, and transitions between cigarettes and nicotine products, building on the ITC Project's 18-year global experience in conducting rigorous evaluation of tobacco control policies, employing quasi-experimental analytic methods. The NPA Survey will provide important evidence to advance the science and understanding of nicotine products and policies during the next five years, which is certain to be a period of dynamic change in the nicotine product marketplace. Similar studies in the US such as the Population Assessment Tobacco and Health (PATH) are limited since they do not readily permit cross- country comparisons using harmonized measures as the NPA survey does. This innovative Project has three Specific Aims: 1) to describe patterns use of and transitions of use across different tobacco products among smokers and recent ex-smokers both over time and by key user characteristics within and between countries; 2) to examine how differences in current and future policies (e.g., taxes, flavor bans, product standards, health warnings) for cigarettes, NVPs, and HTPs are related to differences in patterns of use of these products over time; and 3) to examine the relative impact of policies on adults and youth (a Specific Aim shared with Project 2). Two exploratory aims will also be addressed given their likely impact on nicotine product use: (a) to examine how the COVID-19 pandemic is affecting smoking and ANDS use in the 7 countries over time; and (b) to examine the interplay between cannabis and smoking, vaping, and HTP use over time.