Predictors of Smokeless Tobacco and Dual Use in the US Military

无烟烟草和美国军队双重用途的预测

基本信息

批准号：
8707009
负责人：
Robert C Klesges
金额：
$ 74.41万
依托单位：
UNIVERSITY OF TENNESSEE HEALTH SCI CTR
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-02 至 2015-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8707009
关键词：
12 year old Adoption Air American Behavior Behavioral Burn injury Camels Cardiovascular Diseases Cerebrovascular Disorders Cigarette Cigarette Smoker Clinic Collaborations Data Enrollment Event Exposure to Frequencies Future Harm Reduction Health Health Sciences High Prevalence Individual Joints Manufacturer Name Measures Medicine Military Personnel Nicotine Nitrosamines Oral Policies Prevalence Recruitment Activity Relative (related person)Reporting Research Smoke Smokeless Smokeless Tobacco Smoker Smoking Source Surveys Taxes Tennessee Time Tobacco Tobacco use Training United States Universities Update War Work aged base cardiovascular risk factor cigarette smoking college design exposed human population follow-up high risk male malignant mouth neoplasm men response smoking cessation snus social tobacco advertising tobacco prevention trend

项目摘要

DESCRIPTION (provided by applicant): The application is in response to RFA-CA-08-024, entitled "Measures and Determinants of Smokeless Tobacco Use, Prevention, and Cessation" (R01). This is a joint application between the University of Tennessee Health Science Center, the United States Air Force, and Mayo Clinic College of Medicine. Smokeless tobacco (ST) is tobacco consumed orally and not burned. The prevalence of ST use among Americans aged =12 years has increased significantly from 2004 to 2006 (3.0% vs. 3.3%). ST use is estimated to be the greatest exogenous source of human exposure to carcinogenic nitrosamines and has been associated with oral and extra-oral cancer as well as cardiovascular and cerebrovascular disease. Evidence exists suggesting the tobacco users who report using both ST and cigarettes (i.e., "dual users") may be at increased risk for cardiovascular events compared to those who smoke only cigarettes. Phillip Morris USA and R.J. Reynolds, two of the world's largest cigarette manufacturers, have entered the ST market. Phillip Morris USA has developed "Marlboro Snus" and R.J. Reynolds has launched "Camel Snus." Both products have been designed to appeal to smokers and potentially undermine cigarette smoking cessation attempts motivated by clean indoor air policies and increased cigarette excise taxes. At the same time, ST is also increasingly being proposed as a harm reduction strategy for cigarette smokers. As such, it is anticipated that the prevalence of ST will increase in the future. One of the highest risk groups for adoption and use of ST is the U.S. military. As indicated in the RFA, "A survey of U.S. military personnel in 1994-95 found that approximately 24% of white men on active duty used smokeless tobacco." More updated results indicate that 14.5% of all military personnel regularly use ST, 21.6% of white males aged 18-24 are users, and the Air Force is going against secular trends in the military in that ST use is on the rise. Moreover, research from our collaboration is showing that the overwhelming percentage of ST users are "dual users," regular users of ST and other tobacco products (see Previous Work). We suspect that the high prevalence of dual use is partially due to the restrictions placed on smoking at most military bases. Since dual users have a higher estimated nicotine exposure and are less likely to quit smoking relative to those who use cigarettes or ST exclusively, obtaining onset and cessation data on these individuals in the military is a very high priority. Based on this background, we propose the following Specific Aims: (1) To enroll approximately 30,000 Air Force recruits from Basic Military Training (BMT) at Lackland Air Force Base in San Antonio, TX. (2) To conduct a baseline assessment at the end of BMT, a time when all recruits have been tobacco free for eight weeks. (3) To evaluate ST and dual tobacco use (ST + cigarette smoking) initiation and cessation at a one and two-year follow-up.

描述（由申请人提供）：该申请是对 RFA-CA-08-024 的回应，题为“无烟烟草使用、预防和戒烟的措施和决定因素”(R01)。这是田纳西大学健康科学中心、美国空军和梅奥诊所医学院之间的联合申请。无烟烟草（ST）是口服而不是燃烧的烟草。从 2004 年到 2006 年，12 岁以下美国人中 ST 使用率显着增加（3.0% vs. 3.3%）。据估计，无烟烟草的使用是人类接触致癌亚硝胺的最大外源性来源，并且与口腔和口腔外癌症以及心脑血管疾病有关。有证据表明，与只吸卷烟的人相比，同时使用无烟烟草和卷烟的烟草使用者（即“双重使用者”）发生心血管事件的风险可能更高。菲利普莫里斯美国公司和 R.J.全球最大的两家卷烟制造商雷诺兹已进入ST市场。菲利普·莫里斯美国公司开发了“万宝路鼻烟”和 R.J.雷诺兹推出了“骆驼鼻烟”。这两种产品的设计目的都是为了吸引吸烟者，并可能破坏清洁室内空气政策和增加卷烟消费税所推动的戒烟努力。与此同时，ST 也越来越多地被提议作为吸烟者的减害策略。因此，预计未来 ST 的患病率将会增加。采用和使用 ST 的最高风险群体之一是美国军队。正如 RFA 所指出的，“1994-95 年对美国军事人员的一项调查发现，大约 24% 的现役白人使用无烟烟草。”最新的结果表明，14.5% 的军事人员经常使用 ST，18-24 岁的白人男性中有 21.6% 是使用者，而空军则与军队中的长期趋势相反，ST 的使用呈上升趋势。此外，我们合作的研究表明，绝大多数无烟烟草使用者是“双重使用者”，即无烟烟草和其他烟草制品的经常使用者（参见之前的工作）。我们怀疑双重用途的高流行部分是由于大多数军事基地对吸烟的限制。由于与只吸香烟或无烟烟草的人相比，双重使用者的尼古丁暴露量估计较高，并且戒烟的可能性较小，因此获得这些军人的发病和戒烟数据是当务之急。基于这一背景，我们提出以下具体目标： (1) 招收大约 30,000 名空军新兵，在德克萨斯州圣安东尼奥市的拉克兰空军基地接受基础军事训练 (BMT)。 (2) 在 BMT 结束时进行基线评估，此时所有新兵都已戒烟八周。 (3) 在一年和两年的随访中评估无烟烟草和双重烟草使用（无烟烟草+吸烟）的开始和戒烟。