Effect of tobacco use patterns on toxicant exposure and successful cessation: a longitudinal study among US adult cigarette smokers

烟草使用模式对毒物暴露和成功戒烟的影响：美国成年吸烟者的纵向研究

• 批准号: 10493297
• 负责人: Ban A Majeed
• 金额: $ 23.36万
• 依托单位: AUGUSTA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-23 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10493297
• 关键词: Abstinence; Address; Adult; Age; American; Aromatic Polycyclic Hydrocarbons; Awareness; Behavior; Biological Markers; Bone Marrow; Cardiovascular Diseases; Caucasians; Cessation of life; Characteristics; Cigar; Cigarette; Cigarette Smoker; Cluster Analysis; Consumption; Cross-Sectional Studies; Data; Dependence; Development; Disease; Electronic cigarette; Environment; Esophagus; Evaluation; Exposure to; Family Smoking Prevention and Tobacco Control Act; Grant; Growth; Health; Health Campaign; Health Hazards; Heart failure; Hour; Human; Inhalation; Intake; Intervention; Kidney; Label; Light; Link; Longitudinal Studies; Lung; Lung diseases; Marketing; Mental Depression; Mental Health; Mental disorders; Methods; Mission; Modeling; Morbidity - disease rate; Myocardial Infarction; Nicotine; Nicotine Dependence; Nitrosamines; Oral cavity; Outcome; Pattern; Persons; Pharmaceutical Preparations; Population Assessment of Tobacco and Health; Product Labeling; Public Health; Relapse; Reporting; Research; Research Priority; Risk; Role; Science; Smoker; Smoking; Stroke; Sum; Surveys; Techniques; Time; Tobacco; Tobacco Dependence; Tobacco smoke; Tobacco use; Toxicant exposure; United States Food and Drug Administration; Uterus; Work; analytical method; authority; base; cancer type; cigarette smoking; combustible cigarette; electronic cigarette use; electronic cigarette user; follow-up; innovation; interest; mortality; nicotine exposure; novel; polytobacco; preventable death; response; smoking abstinence; smoking cessation; smoking initiation; success; tobacco control; tobacco exposure; tobacco products; tobacco regulation; tobacco toxicant; toxicant; trend; urinary; volatile organic compound

PROJECT SUMMARY Combustible cigarette smoking is the leading cause of preventable death and disease in the US. Each year, more than 400,000 Americans die due to reasons related to tobacco use. Strong scientific evidence exists linking smoking to elevated risk of pulmonary diseases, cardiovascular diseases (e.g. heart attack, heart failure, and stroke), and multiple types of cancer (e.g. of the oral cavity, lung, esophagus, kidney, uterus, and bone marrow). To curb these high rates of mortality and morbidity and protect the American people, the 2009 Family Smoking Prevention and Tobacco Control Act granted the Food and Drug Administration (FDA) the authority to regulate the manufacture, distribution, and marketing of all products that meet the statutory definition of tobacco products, defined as any product made or derived from tobacco and intended for human consumption. To inform science-based tobacco regulations, current rigorous research is necessary on the factors associated with toxicant exposure and successful quitting since past work is less applicable to today’s continually evolving tobacco market and use patterns. Tobacco use patterns now include a variety of flavored combustible (e.g., little cigars) and non-combustible tobacco products (e.g. ECIGs) that may be used concurrently (dual-/poly-product use). These patterns may produce different profiles of toxicant exposure (thus influencing health outcomes), and different levels of nicotine dependence (thus influencing cessation rates). This response to RFA-OD-19-022 uses state-of-the-art statistical techniques to analyze national longitudinal data from five waves of the Population Assessment of Tobacco and Health (PATH) Study, to identify classes of smokers in terms of their toxicant exposure and to understand trends in overtime patterns of nicotine dependence and tobacco use and their relationship with successful quitting. The two specific aims are to: 1) Conduct cluster analysis on tobacco biomarkers of adult current cigarette smokers and group smokers into clusters based on concentrations of tobacco toxicant biomarkers (i.e., urinary biomarkers of exposure to nicotine, TSNAs, PAHs, and VOCs) collected at Wave 3 of the PATH study. We will examine whether use patterns (e.g. flavor, exclusive, dual, and poly use), personal characteristics, and nicotine dependence vary by cluster membership. 2) Perform growth curve analysis to model change over time in nicotine dependence to identify and describe dependence trajectories (i.e. differential nicotine dependence patterns) during four consecutive waves and examine the relationship between these trajectories, overtime change in tobacco use patterns, and successful quitting (3+ m abstinence). In sum, this project addresses priority research questions and is directly relevant to the mission of the FDA’s CTP. Resultant data could be leveraged to inform product labeling and public health campaigns, especially those addressing toxicant exposure and dependence risk of dual/poly product use. Until consumers are fully informed about the risks they take when engaging in dual/poly tobacco product use, we can expect more and more of them to engage in this potentially hazardous behavior.

项目摘要 在美国，可燃香烟吸烟是可预防死亡和疾病的主要原因。每年， 由于与烟草使用有关的原因，超过40万美国人死亡。存在强有力的科学证据 将吸烟与肺部疾病，心血管疾病的升高风险联系起来（例如，心脏病发作，心脏病 失败，中风）和多种类型的癌症（例如口腔，肺，食道，肾脏，子宫和 骨髓）。为了遏制这些高死亡率和发病率并保护美国人民，2009年 家庭吸烟预防和烟草控制法授予食品药品监督管理局（FDA） 监管所有符合法定产品的产品的制造，分销和营销 烟草产品的定义，定义为源自烟草的任何产品，旨在人类 消耗。为了告知基于科学的烟草法规，当前的严格研究是必要的 由于过去的工作不适用于当今的毒性暴露和成功戒烟有关 继续发展烟草市场并使用模式。烟草使用模式现在包括各种调味料 可燃的（例如，小雪茄）和不可燃烧的烟草产品（例如ECIGS） 并发（双/多产品使用）。这些模式可能会产生不同的毒物暴露概况（因此 影响健康结果），以及不同水平的尼古丁依赖性（从而影响停止率）。 对RFA-OD-19-022的这种反应使用最先进的统计技术来分析国家纵向 来自烟草和健康（PATH）研究的五波浪潮的数据，以确定类别 就吸烟者而言，他们的毒性暴露并了解尼古丁的加班模式的趋势 依赖和烟草使用及其与成功安静的关系。两个具体的目标是：1） 对成人目前吸烟者和团体吸烟者的烟草生物标志物进行聚类分析 基于烟草有毒生物标志物浓度的簇（即，暴露于尿的生物标志物 在路径研究的波3中收集的尼古丁，TSNA，PAHS和VOC）。我们将检查是否使用 模式（例如，味道，独家，双重和多种用途），个人特征和尼古丁依赖性因素而异 集群会员资格。 2）执行生长曲线分析以模拟尼古丁依赖性的随时间变化对 识别并描述四个期间的依赖轨迹（即差异尼古丁依赖模式） 连续的波和检查这些轨迹之间的关系，加班的烟草使用变化 模式和成功的安静（3+ M节制）。总而言之，该项目解决了优先研究问题 并且与FDA CTP的任务直接相关。可以利用结果数据来告知产品 标签和公共卫生运动，尤其是那些针对有毒物品接触的人和依赖风险 双/多产品使用。直到消费者在从事双重/poly时会遇到的风险 烟草产品的使用，我们可以期望其中越来越多地参与这种潜在的危险行为。