Marketing and Explanatory Processes in Tobacco Progression Among Vulnerable Youth

描述（由申请人提供）：以前已经发现了接触烟草营销和青年烟草使用之间的重要联系。然而，以前关于烟草营销影响的纵向研究并没有把重点放在特别脆弱的人群或处于青春期后期过渡期的青年身上，因为烟草使用实验往往会升级并巩固为终身习惯。以前的纵向研究也没有调查可能的解释过程（干预认知过程/介质），通过营销暴露对烟草使用轨迹的影响。本项目的重点是一个脆弱的，较低的社会经济地位，多民族（主要是西班牙裔和非西班牙裔白色）的青年人口的吸烟率大大高于国家标准，在年龄段，在烟草习惯发生巨大变化（16至20）。必须有某种原因来解释这一人群中烟草使用率大幅上升的原因，在社会经济地位较低的社区零售店进行烟草营销是一种很有可能的原因。该项目还评估了关键的可信解释过程，这些过程在多个学科的基础研究中有很好的基础。一些可以解释营销效果的最可信的过程，以前在这个领域没有研究过，已经得到了神经，认知和行为分析水平的多条独立证据的一致支持-不仅仅是调查或心理测量证据。对关键年龄段的弱势人群的营销效果的研究，加上对一些最可信的解释过程的研究，将为FDA提供明确的监管指导，说明对销售点烟草营销（POS）的任何新法规的需求。有确凿的证据表明，POS在社会经济地位较低的社区和弱势群体中具有特别强的、可解释的影响，这将有力地表明监管改革。为了研究这些影响和可信的过程，本项目在加州南部多种族人群中的1000名弱势青年中实施了队列顺序设计。该提案中的三个设计特征对于为POS烟草广告和烟草使用之间的任何联系提供强有力的推断尤为重要，这是支持FDA政策决策所必需的。首先，该设计允许对变量之间的时间关系进行最严格的测试，迄今为止，这是因果关系的关键标准之一。其次，对干预变量的检验将为可信的因果机制提供支持，这也得到了广泛的基础研究的支持。最后，对潜在的混杂因素和协变量进行全面评估和彻底评价。该项目提供了迄今为止关于烟草营销对老年人影响的最严格、可能最具信息量的研究。结果可能会揭示为什么一些年龄较大的青少年有相当高的吸烟率（超过全国平均水平的两倍），导致未来的严重健康风险。因此，该项目具有很大的潜力，对保护青少年的公共健康产生重大的监管影响。1

DESCRIPTION (provided by applicant): Important links between exposure to tobacco marketing and tobacco use in youth have previously been uncovered. However, previous longitudinal research on tobacco marketing effects has not focused on particularly vulnerable populations or on youth during transitions in later adolescence when tobacco use experimentation often escalates and consolidates into life-long habits. Previous longitudinal research also has not investigated likely explanatory processes (intervening cognitive processes/mediators) through which marketing exposure has effects on tobacco use trajectories. The present project focuses on a vulnerable, lower SES, multi-ethnic (primarily Hispanic and non-Hispanic White) population of youth with substantially higher rates of smoking than the national norm, during ages in which dramatic changes in tobacco habits occur (16 to 20). Something must explain the substantially higher rates of tobacco use escalation in this population, and tobacco marketing at retail outlets in lower SES neighborhoods is one strong possibility. This project also evaluates key credible explanatory processes, well grounded in basic research across several disciplines. Some of the most credible processes that can explain marketing effects, not previously studied in this domain, have received consistent support from multiple lines of independent evidence across neural, cognitive, and behavioral levels of analysis --not merely survey or psychometric evidence. The study of marketing effects in a vulnerable population over critical ages, coupled with research on some of the most credible explanatory processes, will provide clear regulatory guidance to the FDA about any needs for new regulations on point-of- sale tobacco marketing (POS). Regulatory changes would be strongly suggested by firm evidence that POS has especially strong, explainable effects in lower SES neighborhoods and vulnerable populations. To investigate these effects and credible processes this project implements a cohort-sequential design in 1000 vulnerable youth from a multi-ethnic population in southern California. Three design features in this proposal are especially important to provide strong inference for any link between POS tobacco advertising and tobacco use, which is needed to support FDA policy decisions. First, the design allows the most rigorous testing of the temporal relationship among the variables, to date, one of the key criteria for causality. Second, testing for the intervening variables will provide support for plausible causal mechanisms also buttressed by extensive basic research. Finally, potential confounders and covariates are comprehensively assessed and thoroughly evaluated. The project provides the most rigorous, potentially most informative study to date about tobacco marketing effects in older youth. Results are likely to reveal why some older adolescents have substantially higher smoking rates (more than double the national average), leading to critical health risks in the future. Thus, the project has a strong potential for major regulatory implications for protecting the public health in adolescents. 1