Predictors of Smokeless Tobacco and Dual Use in the US Military

描述（由申请人提供）：目前的申请是对PAR-12-010的回应，题为“NIH竞争性修订申请与家庭吸烟预防和烟草控制法相关的研究”（R01）。目前的申请将通过RFA-CA-08-024（“无烟烟草（ST）使用、预防和戒烟的措施和决定因素”），题为“无烟烟草和军事双重用途的预测因素”（R01CA141567），大大扩展当前资助的父母赠款的目标。这项拨款正在追踪3万名空军飞行员，通过两年的随访来确定ST使用、吸烟和双重（ST和香烟）使用的开始。考虑到年轻人，战斗部署的压力，以及烟草业对士兵的针对性营销，美国军队是烟草使用的高危人群。我们的队列吸烟患病率为31%，ST使用率为14%，双重烟草使用的患病率超过ST使用的患病率。在过去的18年里，我们招募了8万多名军人参与我们的烟草相关研究。我们目前的建议有两个主要目的。首先，我们建议解决美国军队中新出现的烟草使用趋势问题。具体而言，我们将：确定新型和新兴烟草制品的基线和随访流行率和预测因素，包括(a)鼻烟和“可溶解性”（即丸剂、棒状和条状）等烟草制品；(b)电子尼古丁输送装置；, www.blucigs.com);(c)水管（“水烟”）；(d)自己卷烟（RYO）；(2)确定美国空军中这些新型和新兴烟草制品相对于吸烟的基线和随访患病率以及感知健康益处和感知危害减少的预测因素；(3)评估减少危害行为的自然历史（例如，通过使用新的和新兴的产品戒烟）以及危害升级（例如，从非吸烟者到吸烟者）；(4)评估军事人员用来接收和沟通烟草及相关健康问题信息的沟通渠道。我们的第二个主要目标是经济有效地收集5000名新一批现役人员的上述数据。当我们积累新的基线参与者时，我们将在为期9个月的父母补助金中使用新的问卷来补充这一队列。我们将对这大约12000名飞行员进行为期一年的跟踪调查。总而言之，通过与FDA合作扩展nih资助的项目，我们将继续获得有关目前正在销售的新型和新兴烟草制品不断变化的流行率和预测因素的全面数据。

DESCRIPTION (provided by applicant): The current application is in response to PAR-12-010 entitled "NIH Competitive Revision Applications for Research Relevant to the Family Smoking Prevention and Tobacco Control Act" (R01). The current application will significantly expand the aims of a currently funded parent grant via RFA-CA-08-024 ("Measures and Determinants of Smokeless Tobacco (ST) Use, Prevention, and Cessation") entitled "Predictors of smokeless tobacco and dual use in the military" (R01CA141567). The grant is tracking 30,000 Air Force Airmen to determine the onset of ST use, smoking and dual (ST and cigarettes) use through 2 years of follow-up. The US Military is an extremely high-risk population for tobacco use given the youth, stress of combat deployment, and targeted marketing by the tobacco industry of the soldiers. Our cohort has a cigarette smoking prevalence rate of 31%, a ST use rate of 14%, and the prevalence of dual tobacco use exceeding that of ST use. Over the past 18 years, we've recruited over 80,000 military personnel into our tobacco-related studies. Our current proposal has two major aims. First, we propose to address the issue of new and emerging tobacco use trends in the US military. Specifically, we will: Determine baseline and follow-up prevalence and predictors of new and emerging tobacco products including (a) ST products such as snus and "dissolvables" (i.e., orbs, sticks, and strips); (b) electronic nicotine delivery devices (ENDDs; ie., www.blucigs.com); (c) waterpipe ("Hookah"); and (d) roll your own (RYO) cigarettes; (2) Determine baseline and follow-up prevalence and predictors of the perceived health benefits and perceived harm reduction of these new and emerging tobacco products relative to cigarette smoking among US Airmen; (3) Evaluate the natural history of harm reduction behavior (e.g., quit cigarette smoking by using a new and emerging product) as well has harm escalation (e.g., nonsmoker to smoker).; and (4) Assess the communication channels that military personnel use to receive information and communicate about tobacco and related health issues. Our second major aim would be to cost-effectively collect the above data on a new cohort of 5000 active duty personnel. We will supplement this cohort by using the new questionnaire in the parent grant for the 9-month period when we are accruing new baseline participants. We will follow this total cohort of approximately 12,000 Airmen for one year. In summary, by extending this NIH-funded project by partnering with the FDA, we will have continued comprehensive data on the changing prevalence and predictors of new and emerging tobacco products currently being marketed. PUBLIC HEALTH RELEVANCE: Tobacco companies are introducing new and emerging tobacco delivery products at an alarming rate. We need to have insight to who is at risk for adopting these products, and why, so targeted public health interventions can be developed.