Examining uptake and use patterns of cigarettes and other nicotine delivery products among youth in countries with different regulatory environments: ITC Nicotine Product Youth and Young Adult Survey

总结/摘要 青年和青年是烟草使用的关键时期。在过去二十年的大部分时间里， 在美国和其他西方国家的年轻人中，包括加拿大（CA）和 英国（EN）。相比之下，尼古丁电子烟产品（NVP）经历了快速增长，现在是 青少年和年轻人使用的最普遍的尼古丁产品。NVP的长期公共卫生影响 在年轻人中的使用是广泛争论的，包括它对吸烟行为的影响，无论是作为一个“门户”， 吸烟或“取代”香烟使用的手段。尼古丁市场有望进一步多样化， 加热烟草产品（HTPs）的出现，如美国的万宝路热棒，以及新型口服尼古丁 产品.这些新颖的产品在多大程度上吸引年轻人，并遵循与 NVP是一个关键问题。政策环境正在发生变化，以应对迅速演变的 产品市场。一系列新的尼古丁和烟草政策正在实施过程中， 美国、加拿大和欧洲，其中大多数旨在减少年轻人的使用。不同监管 各国采取的方法在尼古丁和烟草政策方面进行了一系列“自然实验”， 来评估他们对年轻人的影响。这项研究包括重复的横断面研究， 每年对美国、加利福尼亚州和加利福尼亚州的青年和年轻人（16-29岁）进行全国抽样调查， EN.所有三个国家都使用相同的方法和措施来提供直接可比的估计数 随着时间这项研究将扩大国际烟草控制政策评价目前的重点 项目（ITC）青年调查将包括青年人（20-29岁），并将在四轮年度调查的基础上再接再厉 在2017年至2020年期间进行。该研究有三个主要目的：1）研究国际差异， 吸烟，NVP和HTP在年轻人中的使用; 2）检查国家一级政策对 年轻人吸烟和吸电子烟的流行率和模式;以及3）研究以下方面的相对影响： 青少年与成年吸烟者的政策。总的来说，拟议的项目是独特的定位，以审查 烟草和尼古丁在年轻人中使用的变化，在这一关键时期， 和政策格局正在迅速演变。国家间设计提供了一个独特的框架， 评估具体政策的影响，以及新的HTPs和口服尼古丁产品的出现。 最后，项目2能够很好地研究各国之间更广泛的背景差异，例如 大麻合法化。

SUMMARY/ABSTRACT Youth and young adulthood are critical periods for tobacco use. For most of the past two decades, smoking has steadily declined among young people in the US and other Western countries, including Canada (CA) and England (EN). In contrast, nicotine vaping products (NVPs) have experienced rapid growth and are now the most prevalent nicotine product used by youth and young adults. The long-term public health impact of NVP use among young people is widely debated, including its impact on smoking behavior as either a `gateway' into smoking or a means to `displace' cigarette use. The nicotine market is poised to diversify further with the emergence of heated tobacco products (HTPs), such as Marlboro Heatsticks in the US, and novel oral nicotine products. The extent to which these novel products appeal to young people and follow a similar trajectory as NVPs represents a critical question. The policy environment is changing in response to the rapidly evolving product market. A range of new nicotine and tobacco policies are in the process of being implemented in the US, CA and EN, most of which are targeted at reducing use among young people. The different regulatory approaches across countries creates a series of `natural experiments' in nicotine and tobacco policy, which can be used to evaluate their impact on young people. The proposed study consists of repeated cross-sectional surveys conducted annually with national samples of youth and young adults (aged 16-29) in the US, CA and EN. The same methods and measures are used in all three countries to provide directly comparable estimates over time. The study would expand the current focus of the International Tobacco Control Policy Evaluation Project (ITC) Youth surveys to include young adults (20-29) and will build on the four annual surveys waves conducted between 2017 and 2020. The study has three primary aims: 1) to examine international variations in smoking, NVP, and HTP use among young people; 2) to examine the impact of national-level policies on prevalence and patterns of smoking and vaping among young people; and 3) to examine the relative impact of policies on youth versus adult smokers. Overall, the proposed Project is uniquely positioned to examine changes in tobacco and nicotine use among young people during a critical period in which both the product and policy landscape is rapidly evolving. The between-country design provides a unique framework for assessing the impact of specific policies, as well as the emergence of novel HTPs and oral nicotine products. Finally, Project 2 is well-positioned to examine broader contextual differences across countries, such as the legalization of cannabis.