Project 2

项目摘要 项目2（P2）：AYAs中不燃烟草产品使用的纵向模式（共同领导人， Barrington-Trimis/Hughes-Halbert）。 P2检查口服尼古丁产品（ONP）和电子烟在不良纵向AYA烟草中的作用 产品使用结果，以及驱动这些结果的产品特征和人群。完成 为此，P2将：a）将正在进行的青少年前瞻性队列（n= 2，619）的半年期调查扩展到年轻人， 成年期; B）建立一个新的青少年队列（n= 2 500），每半年对14-18岁的青少年进行一次调查。 在这两个队列中，调查将测量ONP、电子烟和其他产品的模式和产品特征。 烟草产品使用在每一波，辅以一种新的离散选择任务，将评估内隐 对各种口味和尼古丁浓度的ONP和电子烟的偏好。目标1：确定 ONP的使用是否与随后开始使用电子烟和可燃烟草的风险相关， AYA之间的升级。我们假设ONP的使用频率将预测随后的电子烟， 可燃烟草用途：（a）引发，（B）频率，（c）强度。目标2：识别产品 增加AYA使用升级和依赖风险的新型ONP和电子烟的特征 症状我们假设AYA ONP和电子烟使用频率和强度的进展风险， 和依赖症状水平将更高的AYA谁使用和有隐式偏好ONP和电子- 具有以下特征的香烟：（a）非常高的尼古丁浓度与高或低的尼古丁浓度;（B） 模糊命名的概念风味剂，明确命名的水果、薄荷醇、薄荷或冰+水果混合风味剂与 无香料产品或烟草香料;以及（c）促进更分散使用的设计。目标3：评估 不同人群中ONP启动、使用升级和多种产品使用的差异模式。我们 假设社会经济或性/性别少数地位较低的AYAs将面临更高的风险：（a） 开始使用ONP，（B）ONP使用频率和强度随时间的递增，和（c）多种产品的使用（过去 30天使用ONP+其他产品）。对监管的影响：如果我们发现某些产品 类（例如，ONP）、产品特性（例如，香料、尼古丁、谨慎的设计），或群体（例如， 性少数地位）与AYA中纵向尼古丁使用的不良结果相关，针对这些 法规限制中的产品（例如，营销否认、强制执行）可能产生益处。也就是说， 法规可以阻止那些开始使用不可燃产品的AYA朝着更不利的方向发展， 使用模式，包括在历史上受到健康差距的边缘化AYA群体。 FDA科学领域：行为，成瘾，营销。

PROJECT SUMMARY Project 2 (P2): Longitudinal Patterns of Non-Combustible Tobacco Product Use in AYAs (Co-Leaders, Barrington-Trimis/Hughes-Halbert). P2 examines the role of oral nicotine products (ONPs) and e-cigarettes in adverse longitudinal AYA tobacco product use outcomes, and the product characteristics and populations driving these outcomes. To accomplish this, P2 will: a) extend semi-annual surveys in an ongoing prospective cohort of adolescents (n=2,619) into young adulthood; b) establish a new adolescent cohort (n=2,500) who will be surveyed semiannually from age 14-18. In both cohorts, surveys will measure patterns and product characteristics of ONPs, e-cigarettes, and other tobacco products used at each wave, supplemented with a novel discrete choice task that will assess implicit preferences for ONPs and e-cigarettes in various flavors and nicotine concentrations. Aim 1 is to determine whether ONP use is associated with subsequent risk of e-cigarette and combustible tobacco use initiation and escalation among AYAs. We hypothesize that ONP use frequency will predict subsequent e-cigarette and combustible tobacco use: (a) initiation, (b) frequency, and (c) intensity. Aim 2 is to identify the product characteristics of novel ONPs and e-cigarettes that increase risk for AYA use escalation and dependence symptoms. We hypothesize that risk of progression in AYA ONP and e-cigarette use frequency and intensity, and dependence symptom levels will be higher in AYAs who use and have implicit preferences for ONPs and e- cigarettes with the following characteristics: (a) very high vs. high or low nicotine concentrations; (b) ambiguously-named concept flavors, explicitly-named fruit, menthol, mint, or ice+fruit hybrid flavors vs. unflavored products or tobacco flavors; and (c) designs that promote more discrete use. Aim 3 is to evaluate differential patterns of ONP initiation, use escalation, and poly-product use across diverse populations. We hypothesize that AYAs with low socioeconomic or sexual/gender minority statuses will be at higher risk of: (a) ONP use initiation, (b) escalation in ONP use frequency and intensity across time, and (c) poly-product use (past 30 day use of ONP+other products) across time. Implications for regulation: If we find that certain product classes (e.g., ONPs), product characteristics (e.g., flavors, nicotine, discreet designs), or populations (e.g., sexual minority status) are associated with adverse longitudinal nicotine use outcomes in AYAs, targeting these products in regulatory restrictions (e.g., marketing denials, enforcement) may yield benefits. Namely, such regulations could deter AYAs who start using non-combustible products from progressing toward more adverse patterns of use, including marginalized AYA groups historically subject to health disparities. FDA Scientific Areas: Behavior, Addiction, Marketing.