Examining uptake and use patterns of cigarettes and other nicotine delivery products among youth in countries with different regulatory environments: ITC Nicotine Product Youth and Young Adult Survey

摘要/摘要 青年和青年时期是烟草使用的关键时期。在过去二十年的大部分时间里，吸烟 在美国和其他西方国家的年轻人中，包括加拿大(CA)和 英格兰(恩)。相比之下，尼古丁蒸发产品(NVP)经历了快速增长，现在是 年轻人和年轻人使用的最流行的尼古丁产品。NVP对公共卫生的长期影响 在年轻人中使用这种药物引起了广泛的争论，包括它对吸烟行为的影响，作为一种进入 吸烟或“取代”香烟使用的手段。尼古丁市场准备进一步多样化，因为 加热烟草产品(HTP)的出现，如美国的万宝路热棒和新型口服尼古丁 产品。这些新奇产品在多大程度上吸引年轻人，并遵循与 NVP代表了一个关键问题。政策环境正在发生变化，以应对快速发展的 产品市场。一系列新的尼古丁和烟草政策正在实施过程中 美国、CA和EN，其中大多数旨在减少年轻人的使用。不同的监管机构 各国的方法在尼古丁和烟草政策中创造了一系列的“自然实验”，这可以 被用来评估它们对年轻人的影响。拟议的研究由重复的横断面研究组成 每年在美国、加利福尼亚州和美国对青少年和年轻人(16-29岁)进行全国抽样调查 嗯。所有三个国家都使用相同的方法和衡量标准来提供直接可比的估计数。 随着时间的推移。这项研究将扩大目前国际烟草控制政策评价的重点 国际贸易中心青年调查项目将包括20-29岁的年轻人，并将在四次年度调查浪潮的基础上再接再厉 在2017至2020年间进行。这项研究有三个主要目的：1)考察 在年轻人中吸烟、NVP和HTP的使用；2)检查国家层面的政策对 青少年吸烟和吸食电子烟的流行率和模式；以及3)研究 关于青少年与成年吸烟者的政策。总体而言，拟议的项目处于独特的位置，可以研究 在烟草和尼古丁产品的关键时期，年轻人中烟草和尼古丁使用的变化 政策格局正在迅速演变。国家间设计提供了一个独特的框架 评估具体政策的影响，以及新的HTP和口服尼古丁产品的出现。 最后，项目2能够很好地检查国家间更广泛的背景差异，例如 大麻合法化。

SUMMARY/ABSTRACT Youth and young adulthood are critical periods for tobacco use. For most of the past two decades, smoking has steadily declined among young people in the US and other Western countries, including Canada (CA) and England (EN). In contrast, nicotine vaping products (NVPs) have experienced rapid growth and are now the most prevalent nicotine product used by youth and young adults. The long-term public health impact of NVP use among young people is widely debated, including its impact on smoking behavior as either a `gateway' into smoking or a means to `displace' cigarette use. The nicotine market is poised to diversify further with the emergence of heated tobacco products (HTPs), such as Marlboro Heatsticks in the US, and novel oral nicotine products. The extent to which these novel products appeal to young people and follow a similar trajectory as NVPs represents a critical question. The policy environment is changing in response to the rapidly evolving product market. A range of new nicotine and tobacco policies are in the process of being implemented in the US, CA and EN, most of which are targeted at reducing use among young people. The different regulatory approaches across countries creates a series of `natural experiments' in nicotine and tobacco policy, which can be used to evaluate their impact on young people. The proposed study consists of repeated cross-sectional surveys conducted annually with national samples of youth and young adults (aged 16-29) in the US, CA and EN. The same methods and measures are used in all three countries to provide directly comparable estimates over time. The study would expand the current focus of the International Tobacco Control Policy Evaluation Project (ITC) Youth surveys to include young adults (20-29) and will build on the four annual surveys waves conducted between 2017 and 2020. The study has three primary aims: 1) to examine international variations in smoking, NVP, and HTP use among young people; 2) to examine the impact of national-level policies on prevalence and patterns of smoking and vaping among young people; and 3) to examine the relative impact of policies on youth versus adult smokers. Overall, the proposed Project is uniquely positioned to examine changes in tobacco and nicotine use among young people during a critical period in which both the product and policy landscape is rapidly evolving. The between-country design provides a unique framework for assessing the impact of specific policies, as well as the emergence of novel HTPs and oral nicotine products. Finally, Project 2 is well-positioned to examine broader contextual differences across countries, such as the legalization of cannabis.