Modeling the Impact of Tobacco Use and Regulations on Vulnerable Populations

模拟烟草使用和法规对弱势群体的影响

• 批准号: 10666148
• 负责人: Rafael Meza
• 金额: $ 49.36万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-14 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10666148
• 关键词: Address; Affect; Age; Alaska Native; American Indians; Attention; Behavior; Black race; Cigar; Cigar Smoking; Cigarette; Collaborations; Consultations; Data; Data Analyses; Disparate; Education; Educational Status; Electronic Nicotine Delivery Systems; Ethnic Origin; Ethnic Population; Foundations; Future; Health; Hispanic; Hispanic Populations; Individual; Menthol; Modeling; Monitor; National Health Interview Survey; Nicotine; Not Hispanic or Latino; Outcome; Pattern; Policies; Policy Analysis; Policy Maker; Population; Population Assessment of Tobacco and Health; Prevalence; Public Health; Quasi-experiment; Race; Regulation; Relapse; Research; Socioeconomic Status; Subgroup; Surveys; Tobacco; Tobacco use; United States Food and Drug Administration; Update; Variant; Vulnerable Populations; Work; cigarette smoking; college; data modeling; ethnic minority; health disparity; high school; higher education; models and simulation; mortality; polytobacco use; population survey; racial disparity; racial minority; racial population; sex; smoking initiation; smoking prevalence; socioeconomics; systematic review; tobacco flavor; tobacco products; tobacco regulation

PROJECT 4 Abstract Tobacco use varies greatly by race/ethnicity and socioeconomic status (SES) in the US, with unacceptably high cigarette smoking rates in American Indian Alaska Native and low education populations, as well as vulnerable subpopulations at the intersection of race/ethnicity and SES (e.g. non-Hispanic Black (NHB) and non-Hispanic White (NHW) individuals with a high school degree or less). Use of cigars and electronic nicotine delivery systems (ENDS) are highest among NHB and NHW individuals respectively. Tobacco use trajectories are further complicated by characterizing flavors in cigarettes (menthol), cigars, and ENDS, the use of which is concentrated in specific subpopulations. Policymakers are considering flavor restriction policies and other tobacco regulations but lack detailed scientific information about how such policies could affect the US population and vulnerable subgroups. To address this need, we will develop validated tobacco simulation models to project the impact of flavor restrictions on tobacco use and downstream health outcomes among vulnerable racial/ethnic and socioeconomic subgroups. While existing simulation models consider cigarette smoking, with some now also assessing ENDS use, cigar smoking has yet to be included in such models, despite its important implications for tobacco-related health disparities. This project aims to characterize cigarette, cigar, and ENDS patterns of use by race/ethnicity, education, and for vulnerable subgroups at their intersection (Aim 1). We will develop simulation models of cigarette, cigar, and ENDS use for (a) key race/ethnicity groups (NHB, NHW, Hispanics and AIAN), (b) four different education groups (less than high school, high school degree or GED, some college, and college degree or more) and (c) for groups at the intersection of race/ethnicity and education (NHB, NHW, Hispanic individuals of low vs. high educational attainment) (Aim 2). We will estimate the effects of flavor restrictions on cigarette, cigar, and ENDS use by race/ethnicity and education using information from quasi-experimental studies, systematic reviews, and expert consultations (Aim 3). Finally, we plan to project the impact of flavor restrictions on US patterns of tobacco product use and downstream mortality outcomes by race/ethnicity and education, and for key vulnerable groups at their intersection (Aim 4). This will provide a strong foundation for studying the impact of other potential regulations on tobacco-related health outcomes in vulnerable subgroups. As part of the Center for the Assessment of the Tobacco Regulations (CAsToR), this project will provide the Food and Drug Administration (FDA) with much needed external modeling research that evaluates: 1) the impact of flavor restrictions on tobacco use behaviors (Scientific domain: Behavior); 2) the long-term impact of tobacco products and flavor restrictions on health (Scientific domain: Health Effects); and 3) the potential differential impacts of flavor restrictions on key vulnerable populations and tobacco-related health disparities (Scientific domain: Impact Analysis).

项目 4 摘要 在美国，烟草使用因种族/族裔和社会经济地位 (SES) 的不同而存在很大差异，令人难以接受 美洲印第安人、阿拉斯加原住民和低教育人群吸烟率较高，以及 种族/族裔和 SES 交叉点的弱势群体（例如非西班牙裔黑人 (NHB) 和 具有高中或以下学历的非西班牙裔白人 (NHW) 个人）。使用雪茄和电子尼古丁 递送系统 (ENDS) 在 NHB 和 NHW 个体中分别最高。烟草使用轨迹 通过表征香烟（薄荷醇）、雪茄和 ENDS 的风味，使问题变得更加复杂，其用途是 集中于特定亚人群。 政策制定者正在考虑口味限制政策和其他烟草法规，但缺乏详细的科学依据 有关此类政策如何影响美国民众和弱势群体的信息。为了解决这个问题 根据需要，我们将开发经过验证的烟草模拟模型，以预测口味限制对烟草的影响 弱势种族/族裔和社会经济亚群体中的烟草使用及其下游健康结果。 虽然现有的模拟模型考虑了吸烟，有些现在还评估电子尼古丁传送系统的使用，但雪茄 尽管吸烟对烟草相关的健康具有重要影响，但尚未将其纳入此类模型中 差异。该项目旨在按种族/民族描述卷烟、雪茄和电子烟电子烟的使用模式特征， 教育，以及处于其交叉点的弱势群体（目标 1）。我们将开发仿真模型 (a) 主要种族/族裔群体（NHB、NHW、西班牙裔和 AIAN）使用香烟、雪茄和 ENDS，(b) 四种 不同的教育群体（高中以下、高中学历或 GED、一些大学和大学 学位或以上）和（c）针对种族/族裔和教育交叉的群体（NHB、NHW、西班牙裔） 低教育程度与高教育程度的个体）（目标 2）。我们将估计口味限制对的影响 使用来自准实验的信息按种族/民族和教育程度分类香烟、雪茄和电子烟的使用情况 研究、系统评价和专家咨询（目标 3）。最后，我们计划预测风味的影响 按种族/民族对美国烟草产品使用模式和下游死亡率结果的限制 教育，以及关键弱势群体的交叉点（目标 4）。这将为 研究其他潜在法规对弱势亚群体烟草相关健康结果的影响。 作为烟草法规评估中心 (CAsToR) 的一部分，该项目将提供 美国食品和药物管理局 (FDA) 开展急需的外部模型研究来评估：1) 口味限制对烟草使用行为的影响（科学领域：行为）； 2）长期影响 烟草制品和香料对健康的限制（科学领域：健康影响）； 3）潜力 口味限制对关键弱势群体的不同影响以及与烟草相关的健康差异 （科学领域：影响分析）。