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: 10368470
• 负责人: Ban A Majeed
• 金额: $ 20.38万
• 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 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10368470
• 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; 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.

项目概要 在美国，吸烟是每年可预防的死亡和疾病的主要原因。 超过 400,000 名美国人因与烟草使用相关的原因而死亡。 将吸烟与肺部疾病、心血管疾病（例如心脏病发作、心脏病）风险升高联系起来 衰竭和中风）以及多种类型的癌症（例如口腔癌、肺癌、食道癌、肾癌、子宫癌和癌症） 为了遏制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》授予美国食品和药物管理局 (FDA) 监管所有符合法定产品的制造、分销和营销的权力 烟草制品的定义，定义为由烟草制成或衍生并供人类使用的任何产品 为了为基于科学的烟草监管提供依据，目前有必要对烟草消费进行严格的研究。 与有毒物质接触和成功戒烟相关的因素，因为过去的工作不太适用于今天 烟草使用模式现在包括各种口味 可能使用的可燃（例如小雪茄）和不可燃烟草制品（例如 ECIG） 同时（双/多产品使用）可能会产生不同的有毒物质暴露情况（因此）。 健康结果），以及尼古丁依赖的不同影响水平（从而影响戒烟率）。 对 RFA-OD-19-022 的回应使用最先进的统计技术来分析国家纵向 来自五波人口烟草与健康评估 (PATH) 研究的数据，以确定烟草类别 吸烟者的有毒物质暴露情况并了解尼古丁的超时模式趋势 依赖和烟草使用及其与成功戒烟的关系这两个具体目标是：1) 对当前成年吸烟者和吸烟者群体的烟草生物标志物进行聚类分析 基于烟草毒物生物标志物浓度的聚类（即接触烟草的尿液生物标志物） 我们将检查在 PATH 研究的第 3 波中收集的尼古丁、TSNA、PAH 和 VOC。 模式（例如口味、独占、双重和多用途）、个人特征和尼古丁依赖因人而异 2) 进行生长曲线分析以模拟尼古丁依赖性随时间的变化。 识别并描述四个过程中的依赖轨迹（即不同的尼古丁依赖模式） 连续波并检查这些轨迹之间的关系，烟草使用随时间的变化 模式和成功戒烟（3+m 戒烟）总而言之，该项目解决了优先研究问题。 并且与 FDA CTP 的使命直接相关 可以利用结果数据来为产品提供信息。 标签和公共卫生运动，特别是那些解决有毒物质暴露和依赖风险的运动 直到消费者充分了解他们在使用双/聚产品时所承担的风险。 随着烟草制品的使用，我们可以预期越来越多的人会从事这种潜在的危险行为。