The Effects of Minnesota State and Local Programs on Young Adult Tobacco Use

描述(由申请人提供)：本提案是对CA86191基金续期申请的重新提交，该基金最初由NCI于2000年在特别RFA“州和社区烟草控制干预研究”项下提供资金，然后于2004年续签。明尼苏达州青少年社区队列研究(MACC)是一项以人群为基础的队列研究，招募了4,825名12至16岁的青少年(明尼苏达州N=4,220人，对比州N=605人)。自2000-2001年以来，参与者每六个月通过电话调查他们的烟草使用情况以及相关的态度和信念，在15轮中得出14个数据点(MACC 1包括1-6轮，MACC 2包括8-15轮，第7轮因资金缺口而被省略)。获得了额外的资金，以继续进行另一轮的数据收集，以具体评估明尼苏达州全州无烟空气法对青少年吸烟的短期影响(MACC3，第17轮；2008年10月至2009年3月)。在第17轮中，参与者年龄在18岁到25岁之间。我们已经申请了ARRA的行政补充资金，以进行第19轮(2009年10月至2010年3月)。反腐败委员会的队列具有一些独特和重要的特点。与许多针对年轻人的研究不同，这一群体包括没有上大学的年轻人和正在上大学的年轻人。国家和州一级的数据显示，烟草使用在未上大学的年轻人中更为普遍，需要进行研究，以评估烟草预防计划和政策可能如何影响这一群体。关于青少年期间的吸烟态度和行为，MACC队列中收集了详细和频繁的数据。使用复杂的数据分析技术，我们可以提供比许多以前的研究(数据收集点之间的间隔更长)更详细的关于青春期和成年期烟草使用开始和发展的信息。MACC队列的庞大规模使我们能够检查烟草预防计划和政策对青年亚群的不同影响，更精确地表征烟草进展模式，识别不太常见的进展模式，并区分年龄、队列和时期影响。最后，我们将烟草使用的个人数据与烟草政策、学校课程、媒体曝光率和他们所在社区的其他环境特征联系起来。使用这些相关数据并扩大这一队列将使我们能够检查青少年接触各种计划和政策对青少年烟草使用的长期影响。我们还能够评估年轻人接触新的计划和政策(例如，明尼苏达州的无烟空气法)对吸烟行为和态度的影响。我们建议在2010-2011年至2012-2013年期间跟随反腐败委员会的队列再进行三次年度观察(第21轮、第23轮和第25轮；反腐败委员会第4轮)。我们计划增加有关饮酒和接触酒精政策的措施。利用这些数据，我们将能够检查烟酒使用之间的复杂相互作用，以及烟酒政策在年轻人中的交叉影响。 公共卫生相关性：继续MACC的研究将使我们能够检查青少年接触烟草计划和政策对年轻人烟草使用的影响。通过收集有关酒精使用和酒精政策的更多信息，我们将能够研究烟草和酒精使用之间的复杂相互作用，以及烟草和酒精政策在年轻人中的交叉影响。

DESCRIPTION (provided by applicant): This proposal is a resubmission of a request for renewal of the grant CA86191, first funded by NCI in 2000 under a special RFA "Research in State and Community Tobacco Control Interventions", and then renewed in 2004. The Minnesota Adolescent Community Cohort (MACC) Study is a population-based cohort study that enrolled 4,825 youth (N=4,220 from Minnesota and N=605 from comparison states) aged 12 to 16. Participants were surveyed by telephone every six months since 2000-2001 about their tobacco use and related attitudes and beliefs, resulting in 14 data points over 15 rounds (MACC 1 includes Rounds 1-6, MACC 2 includes Rounds 8-15, Round 7 omitted due to funding gap). Additional funding was obtained to continue data collection for one additional round to specifically assess the short-term effect of Minnesota's statewide smoke-free air law on young adult smoking (MACC 3, Round 17; October 2008-March 2009). During Round 17 participants were age 18 to 25. We have requested ARRA administrative supplement funding to conduct Round 19 (October 2009-March 2010). The MACC cohort has a number of unique and important features. Unlike many studies of young adults, this cohort includes young adults who are not attending college as well as those who are attending college. National and state-level data show that tobacco use is more prevalent among young adults who are not attending college and studies are needed to assess how tobacco prevention programs and policies may affect this group. Detailed and frequent data have been collected on the MACC cohort regarding smoking attitudes and behaviors during adolescence. Using sophisticated data analytic techniques, we can provide more detailed information about the initiation and progression of tobacco use during adolescence and young adulthood than many previous studies (that have had lengthier intervals between data collection points). The large size of the MACC cohort enables us to examine differential effects of tobacco prevention programs and policies on subgroups of young adults, characterize patterns of tobacco progression with greater precision, identify less common patterns of progression, and distinguish age, cohort, and period effects. Finally, we have linked individual data on tobacco use to tobacco policies, school curricula, media exposure and other environmental characteristics of their communities over time. Using these linked data and extending this cohort will enable us to examine the long-term effects of adolescent exposure to various programs and policies on young adult tobacco use. We are also able to assess the effects of young adult exposure to new programs and policies (e.g., Minnesota's smoke-free air law) on smoking behavior and attitudes. We propose to follow the MACC cohort for an additional three annual observations from 2010-2011 to 2012-2013 (Rounds 21, 23, and 25; MACC 4). We plan to add measures concerning alcohol use and exposure to alcohol policies. Using these data, we will be able to examine the complex interplay between tobacco and alcohol use and the crossover effects of tobacco and alcohol policies in young adults. PUBLIC HEALTH RELEVANCE: Continuing the MACC Study will allow us to examine the effects of adolescent exposure to tobacco programs and policies on young adult tobacco use. By collecting additional information about alcohol use and alcohol policies, we will be able to study the complex interplay between tobacco and alcohol use and the crossover effects of tobacco and alcohol policies in young adults.