A Mixed Methods EMA Assessment of Cognition and Behavior among New ENDS Users

新 ENDS 用户认知和行为的混合方法 EMA 评估

• 批准号: 8605695
• 负责人: Jennifer Lynn Pearson
• 金额: $ 25.06万
• 依托单位: TRUTH INITIATIVE FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8605695
• 关键词: Adoption; Affect; Area; Attention; Behavior; Behavioral; Cellular Phone; Cigarette; Cigarette Smoker; Cognition; Cognitive; Complement; Data; Data Collection; Development; Devices; District of Columbia; Electronics; Enrollment; Environment; Evaluation; Expectancy; Familiarity; Future; Grant; Individual; Instruction; Interview; Laboratories; Laboratory Study; Life Experience; Location; Lung; Marketing; Menthol; Methods; Moods; Nature; Nicotine; Not Hispanic or Latino; Observational Study; Outcome; Participant; Pathway interactions; Pattern; Persons; Play; Prevalence; Process; Public Health; Publishing; Qualitative Methods; Race; Research; Research Methodology; Role; Sales; Sample Size; Sampling; Smoker; Smoking; Source; Stratification; Structure; Surveys; System; Telephone; Testing; Time; Tobacco; Tobacco Dependence; Tobacco use; base; case finding; cigarette smoking; craving; driving behavior; experience; follow-up; innovation; interest; male; preference; psychologic; public health relevance; smoking cessation; smoking restriction; social; social cognitive theory; systems research; tobacco advertising; tobacco control

DESCRIPTION: The universe of tobacco products is expanding, with new noncombustible products gaining popularity even as the reduction in prevalence of cigarette smoking slows or stalls. E-cigarettes, or Electronic Nicotine Delivery Systems (ENDS), are the most prevalent of these emerging noncombustible products. With sales increasing rapidly and more efficient pulmonary delivery devices under development, ENDS are likely to play an increasing role in the future tobacco market. Little is known about the cognitions and behaviors leading to or sustaining ENDS use. Smokers may use ENDS to subvert smoking restrictions (i.e. a bridge "product"), to reduce perceived smoking harms, or for cessation, possibly delaying use of proven treatments. With respect to daily ENDS users, the majority of information is limited to retrospective surveys and convenience samples of White males. Our research suggests Black smokers are less likely than White smokers to try or to use ENDS, perhaps due to a greater degree of perceived harm associated with ENDS, a preference for menthol, or cultural norms. However, with the recent purchase of Blue(c) e-cigarettes by Lorillard Tobacco Company (maker of Newport cigarettes), differential adoption of ENDS by race may not continue as the company markets mentholated ENDS to Black smokers. Thus, it is timely and critical to study how all smokers, including Blacks and menthol smokers, experience and initiate ENDS using valid, innovative research methods. Our research represents a first step towards understanding the immediate environmental contexts and psychological correlates associated with ENDS initiation in menthol and non-menthol smokers interested in trying ENDS. Our observational study features three weeks of concurrent ecological momentary assessment (EMA) and in-depth interview data collection, followed by a 30-day follow-up telephone contact to assess cigarette and ENDS use. We will enroll 100 daily cigarette smokers from the Washington, D.C. metro area. Since 80% of Black smokers prefer menthol cigarettes, the sample will be stratified into four groups (n=25 per group) by menthol use and race (non-Hispanic White and non-Hispanic Black), allowing us to disaggregate the influence of menthol preference from cultural norms/expectancies on ENDS initiation. Participants will use our preexisting EMA data collection system to collect data on tobacco use behaviors over the course of the three-week study. In Week 1, participants will collect baseline data on their usual smoking pattern. In Week 2, we will provide participants with a week's supply of ENDS and instructions to use the products at least three times daily. In Week 3, we will replenish participants' ENDS supply and encourage participants to use the products as they see fit. Participants will also take part in a semi-structured in-depth interview at the end of each week. Week 1 interviews will focus on a process evaluation of the EMA data collection experience, while the Week 2 and 3 interviews will focus on how ENDS-associated cognitions, expectancies and norms evolve with ENDS use and increasing familiarity with the product. Qualitative data from the interviews will complement the quantitative EMA data to examine the interplay between environment, cognitions, and behaviors driving ENDS initiation based on Social Cognitive Theory. Within-person aims will examine the longitudinal relationship between environmental context (e.g., location, presence of others), psychological state (e.g., mood), and tobacco dependence (e.g., craving) on an individual's ENDS use. Exploratory secondary aims include a between- person examination of the effects of race and menthol preference on ENDS initiation and will allow for exploration of interaction effects between the stratification variables by comparing our formative between-person EMA findings with between-case findings from in-depth interviews. This exploratory R21 will contribute to the emerging field of ENDS research by identifying potential mechanisms promoting ENDS initiation and predicting ENDS patterns of use, including whether ENDS displace or are used concurrently with cigarettes, or are used as aids to reduce harm or quit smoking. This study will be the first to examine ENDS use among Black and menthol smokers, two subpopulations of interest to the Center for Tobacco Products and tobacco control in general. The research will support a future R01 grant submission to more closely examine the causal pathways and long term behavioral outcomes following ENDS initiation.

描述：烟草产品的范围正在扩大，尽管吸烟流行率的下降速度减缓或停滞，但新型不燃产品越来越受欢迎。电子烟或电子尼古丁输送系统 (ENDS) 是这些新兴不可燃产品中最流行的。随着销量的快速增长以及更高效的肺部输送装置的开发，电子尼古丁传送系统可能在未来的烟草市场中发挥越来越重要的作用。对于导致或维持电子尼古丁传送系统使用的认知和行为知之甚少。吸烟者可以使用电子尼古丁传送系统来颠覆吸烟限制（即桥梁“产品”），以减少感知到的吸烟危害，或戒烟，可能会延迟使用经过验证的治疗方法。对于日常 ENDS 用户而言，大多数信息仅限于回顾性调查和白人男性的方便样本。我们的研究表明，黑人吸烟者比白人吸烟者尝试或使用电子尼古丁传送系统的可能性更小，这可能是因为与电子尼古丁传送系统相关的感知危害更大、对薄荷醇的偏好或文化规范。然而，随着罗瑞拉德烟草公司（纽波特卷烟制造商）最近购买 Blue(c) 电子烟，由于该公司向黑人吸烟者推销含薄荷醇的 ENDS，因此种族差异化的 ENDS 采用可能不会继续下去。因此，使用有效、创新的研究方法来研究所有吸烟者（包括黑人和薄荷醇吸烟者）如何体验和启动 ENDS 是及时且至关重要的。我们的研究代表了了解有兴趣尝试 ENDS 的薄荷醇和非薄荷醇吸烟者与 ENDS 启动相关的直接环境背景和心理相关性的第一步。我们的观察性研究包括三周同时进行的生态瞬时评估 (EMA) 和深入访谈数据收集，随后进行 30 天的后续电话联系，以评估卷烟和电子尼古丁传送系统的使用情况。我们将招募来自华盛顿特区都市区的 100 名日常吸烟者。由于 80% 的黑人吸烟者更喜欢薄荷醇香烟，因此样本将根据薄荷醇使用情况和种族（非西班牙裔白人和非西班牙裔黑人）分为四组（每组 n=25），从而使我们能够分解薄荷醇的影响文化规范/期望对 ENDS 启动的偏好。参与者将使用我们现有的 EMA 数据收集系统在为期三周的研究过程中收集有关烟草使用行为的数据。在第一周，参与者将收集其日常吸烟模式的基线数据。在第 2 周，我们将为参与者提供一周的 ENDS 供应量以及每天至少使用该产品 3 次的说明。在第三周，我们将补充参与者的 ENDS 供应，并鼓励参与者使用他们认为合适的产品。参与者还将在每周结束时参加半结构化的深度访谈。第一周的访谈将重点关注 EMA 数据收集体验的过程评估，而第二周和第三周的访谈将重点关注与 ENDS 相关的认知、期望和规范如何随着 ENDS 使用和对产品熟悉程度的提高而演变。访谈中的定性数据将补充定量 EMA 数据，以基于社会认知理论检验推动 ENDS 启动的环境、认知和行为之间的相互作用。人内目标将检查环境背景（例如位置、他人的存在）、心理状态（例如情绪）和烟草依赖（例如渴望）与个人使用电子尼古丁传送系统之间的纵向关系。探索性的次要目标包括对种族和薄荷醇偏好对 ENDS 启动的影响进行人与人之间的检查，并将通过将我们形成的人与人之间 EMA 研究结果与深入的案例间研究结果进行比较，探索分层变量之间的相互作用。采访。这一探索性 R21 将通过确定促进 ENDS 启动的潜在机制并预测 ENDS 使用模式（包括 ENDS 是否取代香烟或与香烟同时使用，或用作减少伤害或戒烟的辅助手段），为 ENDS 研究的新兴领域做出贡献。这项研究将首次调查黑人和薄荷醇吸烟者对电子尼古丁传送系统的使用情况，这是烟草制品和烟草控制中心感兴趣的两个亚人群。该研究将支持未来提交 R01 拨款，以更仔细地研究 ENDS 启动后的因果路径和长期行为结果。