E-Cigarettes: Dynamic Patterns of Use and Health Effects

描述(申请人提供)：吸烟和烟草依赖每年在美国导致无数疾病和近50万人死亡，其中包括三分之一的癌症死亡。一项名为电子烟(e-cigs)的新技术在美国得到了迅速的采用。电子烟可以让使用者吸入尼古丁蒸汽。在考虑监管政策的时候，关于电子烟使用及其影响的现有数据极其有限。拟议的研究将提供基于实时报告的深入、纵向数据，这些数据将解决美国食品和药物管理局的关键优先事项，包括了解电子烟使用与以下之间的关系：1)尼古丁依赖；2)传统香烟(CC)使用的减少；3)与健康相关的结果，如暴露和致癌物质的生物标志物以及急性和长期的肺部健康；以及4)尝试戒烟和成功戒烟。具体地说，我们将进行一项为期两年的纵向队列研究，研究对象包括只吸CCS的吸烟者(N=150)和同时使用电子烟和CCS的吸烟者(N=250)。我们将使用最先进的生态瞬时评估来确定：1)e-CIG和CC使用的动态模式和相关结果(例如，依赖、戒断症状、奖励值、CC戒烟尝试和戒烟成功)；2)间歇性(情感、背景、社会)和稳定的个人因素(生活方式因素、人口统计学)变量，这些变量与e-CIG和CC的使用和相关结果有显著差异；以及3)烟草和致癌物质暴露的目标生物标记物以及其他与健康相关的结果(例如，肺功能)。受试者内部的数据(来自双重用途组)和组间比较(双重用途与独占CC使用)都将使我们能够使用多种强大的分析方法来处理这一独特且信息丰富的数据集。这项研究将提供必要的信息，让监管机构以及研究人员、临床医生和烟草使用者了解现实世界中电子烟的使用模式，以及这种使用与CC吸烟以及吸烟造成的健康风险之间的关系。因此，这项创新性的研究将收集实时数据，为调查公众提供强有力的实证基础 在新出现的政策讨论的关键时期使用电子烟对健康的影响。

DESCRIPTION (provided by applicant): Smoking and tobacco dependence cause myriad diseases and almost half a million deaths in the United States each year, including one-third of all cancer deaths. A new technology, electronic cigarettes (e-cigs), which allow the user to inhale nicotine vapor, has seen rapid adoption in the US. The extant data on e-cig use and its effects are extremely limited at a time when regulatory policies are being considered. The proposed research will provide in-depth, longitudinal data, based on real-time reports, which will address key priorities for the US Food and Drug Administration, including understanding the relations between e-cig use and: 1) nicotine dependence; 2) reductions in conventional cigarette (CC) use; 3) health-related outcomes such as biomarkers of exposure and carcinogens and acute and long-term pulmonary health; and 4) attempts to quit CC use and the success of those attempts. Specifically, we will conduct a 2-year longitudinal cohort study comprising smokers who exclusively smoke CCs (N=150) and dual users of e-cigs and CCs (N=250). We will use state-of- the-art ecological momentary assessments to determine: 1) dynamic patterns of e-cig and CC use and related outcomes (e.g., dependence, withdrawal symptoms, reward value, and CC quit attempts and quitting success); 2) episodic (affective, contextual, social) and stable person-factor (lifestyle factors, demographics) variables that covary meaningfully with e-cig and CC use and related outcomes; and 3) targeted biomarkers of tobacco and carcinogen exposure as well as other health-related outcomes (e.g., pulmonary function). Both within- subjects data (from the dual use group) and intergroup comparisons (dual use vs. exclusive CC use) will allow us to use multiple powerful analytic approaches with this unique and informative dataset. This research will provide essential information to inform regulatory bodies, as well as researchers, clinicians, and tobacco users, about the patterns of real-world e-cig use and how such use is related to CC smoking and the health risks caused by smoking. Thus, this innovative research will collect real-time data that should provide a strong empirical foundation to examine the public health effects of e-cig use during this critical period of emerging policy discussions.