New, Emerging, and Traditional Tobacco Use in the Military

 说明(申请人提供)：美国军队是烟草使用的高危人群，因为他们的人口结构(年轻，主要是男性，少数族裔发病率高)，心理社会风险因素(叛逆和冒险行为，酗酒高发率)，部署压力，以及烟草行业的有针对性的营销。目前，超过30%的现役军人吸烟，而且这一比例自1998年以来一直在上升。军事人员被认为是一个高度脆弱的群体。提高我们对烟草产品在这一人群中的流行率、发生率和多样性的理解将提高科学知识，并为FDA烟草监管决策提供信息。我们得到了FDA的补充资金，用于收集初步过程和形成信息，以及在一小群评估传统和新出现的烟草产品的军事人员中进行仪器验证。在目前的应用中，我们建议对这些努力进行合理的扩展，扩大我们对新的和新兴的烟草产品的评估，以及伴随的烟草使用风险因素，并有足够的样本量来评估具有临床意义的小亚组(例如性别、种族)和烟草类型(例如电子烟)的差异。我们将通过在四个现役空军技术训练基地(AFB)进行三个时间点(基线、1年、2年)的调查来收集3万名飞行员、空军国民警卫队和预备役人员的数据。为了确定调查评估之间的最佳时间长度，我们将首先进行一次试点调查，以确定每三个月对参与者预备役人员进行评估所获得的新信息的重复性、可行性和数量。因此，本研究的具体目的是：(1)确定传统烟草产品、新出现的烟草产品和多种烟草使用行为的流行率和发生率；(2)确定与使用新出现的烟草产品、ST和小雪茄相关的社会认知(例如，自我效能)和情感因素(例如，感知、态度、信念)；(3)评估市场上声称减少致癌物暴露(例如，从香烟转向ST)如何影响人们对不同烟草产品使用的风险和危害的认知和信念；(4)评估对烟草营销战略(例如，免费样品和价格促销)的认识、他们如何获得有关烟草产品的信息，以及飞行员的烟草使用行为之间的联系；以及(5)直接比较(A)飞行员(仍在服役)和(B)国民警卫队/预备役军人(他们接受培训，然后重返平民生活)之间的烟草启动、恢复和烟草使用预测因素。这将使人们能够直接比较留在军事环境中的人和返回平民部门的人。

 DESCRIPTION (provided by applicant): The U.S. Military is a high-risk population for tobacco use given their demographics (young, predominantly male, high minority prevalence), psychosocial risk factors (rebelliousness and risk-taking behaviors, high prevalence of alcohol abuse), stress of deployment, and targeted marketing by the tobacco industry. Currently, more than 30% of active duty military personnel use tobacco and that prevalence has been increasing since 1998. Military personnel are considered a highly vulnerable population. Advancing our understanding of the prevalence, incidence and diversity of tobacco product use in this population will improve scientific knowledge and inform FDA tobacco regulatory decision-making. We were funded FDA supplemental funding to collect preliminary process and formative information as well as instrument validation in a small cohort of military personnel assessing traditional and new and emerging tobacco products. In the current application, we are proposing a logical extension of these efforts by expanding our assessment of new and emerging tobacco products, along with concomitant risk factors of tobacco use with a sufficient sample size to evaluate small, but clinically significant subgroup (e.g., gender, ethnicity) and tobacco type (e.g., e-cigarettes) differences. We will collect data on 30,000 Airmen, Air National Guard, and Reservists by administering surveys at three time-points (baseline, 1 year, 2 years) at the four active Technical Training Air Forces Bases (AFBs). To determine the optimal length of time between survey assessments, we will first conduct a pilot investigation to determine the reproducibility, feasibility, and amount of new information learned by evaluating participants Reservists every three months. Thus, the specific aims of the current study are to: (1) Determine the prevalence and incidence of traditional tobacco products, new and emerging tobacco products, and multiple tobacco use behaviors; (2) Determine social cognitive (e.g., self-efficacy) and affective factors (e.g., perceptions, attitudes, beliefs) associated with the use of new and emerging tobacco products, ST, and little cigars; (3) Evaluate how marketing claims of reduced carcinogen exposure (e.g., switching from cigarettes to ST) influence perceptions and beliefs about risk and harm of different tobacco product use; (4) Assess the association between awareness of tobacco marketing strategies (e.g., free samples and price promotions), how they receive information about tobacco products, and tobacco use behaviors among Airmen; and (5) To directly compare tobacco initiation, resumption, and predictors of tobacco use between (a) Airmen (who remain active duty) with (b) National Guard/Reservists (who train and then return to civilian life). This will allow a direct comparison of those who remain in the military environment versus those who return to the civilian sectors.