Assessing the Impact of Flavor Restrictions on Smoking and Vaping

项目3摘要 在美国，至少有6个州和数百个地方已经限制或禁止销售调味电子产品 尼古丁输送系统(END)，以减少青少年蒸发。然而，这些政策效果的证据 对个人行为的影响好坏参半，一些研究将其与可燃香烟使用量的增加联系起来 (“吸烟”)。对这些法规对同期卷烟影响的全国概括性估计， 雪茄、雪茄和烟蒂的用途--美国最受欢迎的三种烟草/尼古丁产品--需要澄清 政策对这些行为以及相关健康的直接影响和模型长期影响 结果和差距。因此，重点关注中描述的行为和影响分析科学领域 RFA-OD-22-004，我们将应用准实验研究设计--旨在产生因果关系的方法 在没有随机分配给具有全国代表性的受限使用调查数据的情况下的估计 关于成年人和青少年以及零售销售数据的数据，以澄清这种风味限制的影响。 将这些数据集与州和本地Ends风味限制的数据进行匹配，Aim 1将估计Ends风味 限制措施对青少年和成年人吸烟和蒸发的影响，敏感性检查测试是否有效 估计值因政策属性而异(例如，零售商豁免)。考虑城市化和城市化的不同影响 社会经济地位(SES)，然后Aim 2将测试城市和 农村司法管辖区；评估地理因素对此的解释程度(例如，距离 允许风味末端销售的司法管辖区)与居民特征的差异(例如，SES)；以及， 评估吸烟和吸电子烟对城乡和社会经济地位差异的影响。作为一种联邦风味 限制措施的影响可能因州和地方烟草控制政策不同的地区而有所不同，目标3将 评估在烟草控制较多和较少的地区之间，香精限制的影响有何不同 策略环境。这些结果将被用来评估联邦口味的有效性 禁令，因为观察到当地政策的变化。最后，为了进一步协助食品和药物管理局 评估新政策的效果，Aim 4将使用零售销售数据提供对新联邦口味的快速分析 法规与烟草/尼古丁产品销售的关系(例如，禁止销售薄荷香烟或非薄荷醇香烟 烟草味雪茄)，并考虑与新的非尼古丁调味品的销售之间的联系， 用于香烟、雪茄和/或烟头，以便了解它们的可用性是否/如何改变 风味法则的影响。因此，这项研究将阐明香料限制对青少年和成人心脏病发病率的影响 香烟、雪茄和最终用途，提供关键参数，为我们中心的风味限制建模提供信息。 长期的公共健康影响，以帮助CTP评估FDA风味政策的影响。

PROJECT 3 Abstract In the US, at least six states and hundreds of localities have restricted or banned sales of flavored electronic nicotine delivery systems (ENDS) in order to reduce youth vaping. Yet the evidence on these policies’ effects on individual behavior is mixed, and some studies link them to increases in combustible cigarette use (“smoking”). Nationally generalizable estimates for such regulations’ effects on contemporaneous cigarette, cigar, and ENDS use—the three most popular tobacco/nicotine products in the US—are needed to clarify the policies’ immediate impacts and model longer run effects on these behaviors as well as related health outcomes and disparities. Thus, focusing on the Behavior and Impact Analysis scientific domains described in RFA-OD-22-004, we will apply quasi-experimental research designs—methods designed to produce causal estimates in the absence of randomized assignment—to nationally representative, restricted-use survey data on adults and adolescents as well as retail sales data, in order to clarify such flavor restrictions’ effects. Matching these datasets to data on state and local ENDS flavor restrictions, Aim 1 will estimate ENDS flavor restrictions’ effects on youth and adult smoking and vaping, with sensitivity checks testing whether effect estimates vary with policy attributes (e.g., retailer exemptions). To consider differential effects by urbanicity and socioeconomic status (SES), Aim 2 will then test whether responses to flavor restrictions vary across urban vs. rural jurisdictions; assess the extent to which this might be explained by geographic factors (e.g., proximity to jurisdictions that allow flavored ENDS sales) vs. differences in resident characteristics (e.g., SES); and, estimate implications for both urban-rural and SES disparities in smoking and vaping. As a federal flavor restriction’s impacts may differ across areas with distinct state and local tobacco control policies, Aim 3 will assess how flavor restrictions’ effects differ between localities with more vs. less restrictive tobacco control policy environments. Those results will be used to estimate implications for the effectiveness of a federal flavor ban, given observed variation in local policies. Finally, to further aid the Food and Drug Administration in evaluating new policies’ effects, Aim 4 will use retail sales data to provide rapid analyses of new federal flavor regulations’ relationships to tobacco/nicotine product sales (e.g., banning sales of menthol cigarettes or non- tobacco flavored cigars) and consider associations with sales of newer non-nicotine flavoring products, intended for use with cigarette, cigar, and/or ENDS, in order to understand if/how their availability modifies flavor laws’ effects. Thus, this research will clarify flavor restrictions’ effects on youth and adult rates of cigarette, cigar, and ENDS use, providing key parameters to inform our Center’s modeling of flavor restrictions’ long-term public health impacts, in order to aid CTP in assessing the impact of FDA flavor policies.