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

• 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
• 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

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）：申请是响应RFA-CA-08-024，标题为“无烟烟草使用，预防和停止的措施和决定因素”（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共同应用。无烟烟草（ST）被口服食用，未燃烧。从2004年到2006年，美国人= 12岁的美国人的ST使用率显着增加（3.0％比3.3％）。据估计，ST的使用是人类暴露于致癌亚硝基胺的最大外源性来源，并且与口腔和口腔癌以及心血管疾病和脑血管疾病有关。有证据表明，与仅吸烟的人相比，使用ST和香烟报告的烟草用户可能会增加心血管事件的风险。 Phillip Morris USA和R.J.雷诺（Reynolds）是世界上最大的两名香烟制造商，进入了St Market。菲利普·莫里斯（Phillip Morris USA）开发了“万宝路Snus”和R.J.雷诺（Reynolds）推出了“骆驼鼻”。两种产品都旨在吸引吸烟者，并有可能破坏由干净的室内空气政策和增加香烟消费税的启动的戒烟尝试。同时，越来越多地提出ST作为减少吸烟者的危害策略。因此，预计ST的流行率将来会增加。采用和使用ST的最高风险群体之一是美国军方。正如RFA中所示的那样，“ 1994 - 95年对美国军事人员的一项调查发现，现役的白人中约有24％使用了无烟烟草。”更多更新的结果表明，所有军事人员中有14.5％定期使用ST，21.6％的18-24岁白人是使用者，空军正在违背军方的世俗趋势，因为ST使用量正在上升。此外，我们合作的研究表明，ST用户的压倒性百分比是“双重用户”，即ST和其他烟草产品的常规用户（请参阅以前的工作）。我们怀疑双重使用的高流行率部分是由于大多数军事基地对吸烟的限制。由于双重用户的尼古丁暴露较高，并且相对于独家使用香烟或ST的人戒烟的可能性较小，因此在军队中获得这些人的发作和停止数据是很高的重中之重。基于此背景，我们提出以下特定目的： （1）在德克萨斯州圣安东尼奥市的拉克兰空军基地的基本军事训练（BMT）中注册大约30,000名空军新兵。 （2）在BMT结束时进行基线评估，这是所有新兵免费八周的烟草。 （3）评估ST和双烟草使用（ST +香烟吸烟）的起始和两年的随访。