PROJECT 4: CURRENT AND EMERGING TOBACCO PRODUCTS IN A RURAL CONTEXT: INFLUENCES OF PRODUCT CHARACTERISTICS ON PERCEPTIONS, BEHAVIORS, AND BIOLOGIC EXPOSURES

项目总结/摘要 美国青少年吸烟率下降，但年轻人中没有出现类似的下降 无烟烟草（ST）的使用。在青少年和年轻人中， 多种烟草产品的混合近几十年来，ST的使用已从老年人转向年轻人， 人口统计学，与不断增加的行业营销和扩大ST产品的多样性相一致 特色这些新的ST产品包括不同类型，品牌，口味和不同程度的 生物可利用的尼古丁和致癌的亚硝胺。需要独立的数据来说明这些 ST和新兴烟草产品的区别特征有助于青年的观念，开始， 长期使用、多用途，最终暴露于尼古丁和致癌物。该项目将 通过三个具体目标来弥补这一研究空白：（1）确定ST和其他烟草产品的影响 特点，包括包装，表征风味，和产品设计，对农村青少年的 当前和新兴的无烟、可燃和替代燃料的可感知危害、可接受性和吸引力 烟草制品;（2）随着时间的推移，开始，结束， 强度变化、产品转换和多种用途）以及家庭和社会因素以及特定产品 特征预测行为的转变;（3）评估使用特定烟草产品的影响 和产品类型对农村青少年接触尼古丁和烟草特有亚硝胺的影响， 潜在的新产品。这项研究将包括一个以学校为基础的前瞻性队列的1500名青少年 参加农村高中，在24个月内进行了5次调查。青少年定性研究 他们的父母/监护人将被嵌套在队列中，以更深入地了解如何 产品特性和社会背景因素影响对产品的认知和行为决策， 烟草制品.收集的生物标志物将揭示尼古丁和亚硝胺的暴露如何随 使用模式的差异和产品的差异。这个项目将提高理解如何不同 ST和新兴烟草产品的特性通过测量影响行为和健康的影响， 感知、行为和暴露于尼古丁和亚硝胺。这个项目将产生证据 与当前和新兴烟草产品的潜在监管和公共宣传相关， 贡献行为和健康结果数据，用于影响的经济模型。这些证据将 告知FDA关于ST和其他烟草产品的特性的规定，以减少青少年吸烟 并告知FDA针对农村人口的沟通策略。

PROJECT SUMMARY/ABSTRACT Cigarette smoking among U.S. adolescents has declined, but similar declines have not occurred in youth smokeless tobacco (ST) use. There is also a growing trend among adolescents and young adults of poly-use of multiple tobacco products in combination. In recent decades, ST use has shifted from an older to a younger demographic, coincident with increasing industry marketing and expanding diversity in ST product characteristics. These new ST products include different types, brands, flavors, and varying levels of bioavailable nicotine and cancer-causing nitrosamines. There is a need for independent data on how these differentiating characteristics of ST and emerging tobacco products contribute to youth perceptions, initiation, established use, poly-use, and ultimately, exposure to nicotine and carcinogens over time. This project will address this research gap via three specific aims: (1) Identify the impact of ST and other tobacco product characteristics, including packaging, characterizing flavors, and product design, on rural adolescents' perceived harm, acceptability, and appeal of current and emerging smokeless, combustible, and alternative tobacco products to; (2) Prospectively characterize tobacco use behaviors over time (e.g., initiation, cessation, changes in intensity, product switching, and poly-use) and how family and social factors and specific product characteristics predict transitions in behavior; and (3) Evaluate the impact of use of specific tobacco products and product types on rural adolescents' exposure to nicotine and tobacco-specific nitrosamines, including use of potential new products. This study will include a school-based prospective cohort of 1500 adolescents attending rural high schools, followed for 5 survey waves over 24 months. Qualitative studies with adolescents and their parents/guardians will be nested in the cohort to provide greater depth of understanding of how product characteristics and socio-contextual factors influence perceptions and behavioral decisions regarding tobacco products. Collected biomarkers will reveal how exposure to nicotine and nitrosamines varies with differences in use patterns and difference in products. This project will improve understanding of how different characteristics of ST and emerging tobacco products impact behavior and health effects by measuring perceptions, behaviors, and exposure to nicotine and nitrosamines. This project will generate evidence relevant to potential regulation of and public communication on current and emerging tobacco products and will contribute behavioral and health outcome data for use in economic models of impact. Such evidence will inform FDA regulation of the characteristics of ST and other tobacco products so as to reduce youth initiation and inform FDA communication strategies for rural populations.