AppalTRuST Project 1: Population based Cohort study of tobacco use prevalence in Appalachian KY

AppalTRUST 项目 1：基于人口的肯塔基州阿巴拉契亚山脉烟草使用流行率队列研究

• 批准号: 10665320
• 负责人: Mary Kay Rayens
• 金额: $ 29.81万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10665320
• 关键词: Address; Adult; Appalachian Region; Area; Attitude; Behavior; Catchment Area; Censuses; Characteristics; Cigar; Cigarette; Cities; Cohort Studies; County; Cues; Data; Disincentive; Disparity; Electronic cigarette; Enrollment; Equity; Funding; Future; Geographic Locations; Goals; Health; Heterogeneity; Income; Individual; Inequity; Interview; Kentucky; Knowledge; Longitudinal Studies; Longitudinal cohort; Longitudinal trends; Marketing; Masks; Measures; Menthol; Methods; Modeling; Nicotine; Participant; Pattern; Perception; Pharmaceutical Preparations; Policies; Positioning Attribute; Predisposition; Prevalence; Productivity; Publications; Reaction; Recording of previous events; Regulation; Research; Resources; Rest; Risk; Rural; Rural Appalachia; Rural Community; Rural Population; Shapes; Smokeless; Smokeless Tobacco; Surveys; Taxes; Testing; Time; Tobacco; Tobacco use; United States National Institutes of Health; Update; Urbanization; Variant; Visit; cigarette smoking; cigarillos; cohort; demographics; density; design; electronic cigarette use; health belief; health equity; heated tobacco products; hookah; informant; innovation; insight; low nicotine content cigarette; multidisciplinary; novel; peri-urban; policy implication; population based; recruit; residence; rural America; rural area; rurality; smoke-free policy; tobacco products; tobacco regulation; tobacco regulatory science; urban area

ABSTRACT – PROJECT 1 Rural populations, who use tobacco at almost double national rates, have largely been omitted from studies of the potential impact of tobacco regulations. AppalTRuST’s overarching goal is to investigate the impact of Federal Drug Administration Center for Tobacco Products (FDA CTP) regulatory changes on tobacco product use in rural communities and examine variation based on relative rurality. The FDA regulatory policies have an outsized potential to reduce tobacco-related disparities in rural Appalachia and the rest of rural America, given the relatively limited disincentives for use in these areas (i.e., few smoke-free laws and low tobacco taxes). The goal of Project 1 (P1) is to close the rural tobacco disparities knowledge gap by documenting tobacco use behaviors and related factors over time among Appalachian KY adults (18+ years) to inform current and future FDA regulations. P1 addresses the Scientific Domain of Behavior and will be guided by the Health Belief Model (HBM). The HBM provides a framework to evaluate associations of knowledge, attitudes, perceptions, and external cues with tobacco use behaviors. P1 will use the AppalTRuST Cohort to enroll 2,000 participants using a longitudinal cohort design that will collect participant data every 6 months for four years. We will recruit adults 18+ years from two catchment areas comprising 8 Appalachian KY counties; these two areas represent a range of rurality and will allow us to make not only catchment comparisons between a rural area and peri- urban one (i.e., partly urbanized rural areas), but also to assess for associations between tobacco use indicators and relative rurality within each catchment area. In addition, 40 participants from the Cohort per year will complete key informant interviews to assess opinions about tobacco products and regulations and allow us to make annual updates to the survey. We will address the following aims: (1) evaluate baseline prevalence and longitudinal trends in the use of conventional (cigarettes, smokeless tobacco, hookah, cigars/cigarillos, and pipes) and novel (e-cigarettes, nicotine pouches, heated tobacco products, and very low nicotine [VLN] cigarettes) tobacco products, including initiation, continuation, switching, cessation, and dual/poly-use among Appalachian adults, testing for the effect of rurality and controlling for individual- and county-level demographics; (2) assess changes over time in knowledge, attitudes, and perceptions relative to tobacco product characteristics (including flavors/menthol and VLN), among Appalachian KY adults, while evaluating the effect of rurality and controlling for demographics; and (3) explore perceived benefits, risks, and intentions to use novel tobacco products among current tobacco product users and individuals susceptible to initiating novel product use, with annual key informant interviews to capture reaction to changes in the product and regulatory landscape. We will evaluate the effects of the introduction of novel products and potential restrictions on flavored and high-nicotine products in rural communities so that regulatory decisions will be made using a health equity lens and be guided by a definition of rurality that is diverse and heterogeneous.

摘要 - 项目1 以几乎两倍的国家利率使用烟草的农村人口，从研究中省略了 烟草法规的潜在影响。 AppalTrust的总体目标是调查 联邦药物管理烟草产品中心（FDA CTP）烟草产品的监管更改 在粗糙的社区中使用并根据相对节奏检查变异。 FDA监管政策具有 减少阿巴拉契亚农村和美国其他地区与烟草相关差异的巨大潜力 在这些地区使用的相对有限的抑制剂（即很少的无烟法和低烟税）。 项目1（P1）的目标是通过记录烟草使用来缩小粗糙的烟草分布知识差距 阿巴拉契亚肯塔基州成年人（18岁以上）的行为和相关因素，以告知当前和未来 FDA法规。 P1解决了行为的科学领域，并将以健康信念模型为指导 （HBM）。 HBM提供了一个框架来评估知识，吸引，看法和 具有烟草使用行为的外部提示。 P1将使用AppalTrust队列招募2,000名参与者 使用纵向队列设计，该设计将每6个月收集每6个月的参与者数据。我们将招募 成人从两个集水区的成人18年以上，完成了8个阿巴拉契亚肯塔基州县；这两个领域代表 一系列粗糙度，将使我们不仅可以在粗糙区域和周期进行集水区比较 城市一个（即部分城市化的农村地区），但也要评估烟草使用之间的关联 每个集水区内的指标和相对粗糙度。此外，每年有40名参与者 将完成关键的线人访谈，以评估有关烟草产品和法规的意见，并允许我们 每年对调查进行更新。我们将解决以下目的：（1）评估基线患病率 以及使用传统的纵向趋势（香烟，无烟烟草，水烟，雪茄/雪茄， 和管道）和新颖（电子烟，尼古丁小袋，加热的烟草产品和非常低的尼古丁[VLN] 香烟）烟草产品，包括启动，延续，开关，停止和双重/多用途 阿巴拉契亚成年人，测试对个人和县级的粗糙度和控制的影响 人口统计学； （2）评估随着时间的流逝而变化，相对于烟草的知识，参加和看法 阿巴拉契亚肯塔基州成年人中的产品特征（包括口味/薄荷醇和VLN），同时评估 粗糙度和控制人口统计的影响； （3）探索感知的福利，风险和意图 在当前烟草产品使用者和容易发起的个人中使用新颖的烟草产品 新颖的产品使用，并进行年度关键线人访谈，以捕获对产品变化的反应和 监管景观。我们将评估引入新产品和潜力的影响 农村社区中对风味和高云母产品的限制，以便监管决策是 使用健康公平的镜头制成，并以潜水员和异质性的粗糙度定义为指导。