Improving U.S. health policy regarding water-pipe tobacco smoking

改善美国有关水烟吸烟的卫生政策

• 批准号: 8690307
• 负责人: Brian A. Primack
• 金额: $ 20.1万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-18 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8690307
• 关键词: Accounting; Address; Adult; Advocacy; Advocate; Affect; Air; Area; Attitude; Behavior; Belief; Businesses; Carbon Monoxide; Cardiovascular Diseases; Categories; Cigarette; Code; Complex; Consensus; Controlled Environment; County; Data; Family Smoking Prevention and Tobacco Control Act; Flavoring; Future; Goals; Health; Health Policy; Human Resources; Individual; Influentials; Interest Group; Interview; Knowledge; Label; Laboratories; Language; Laws; Legal; Link; Literature; Malignant Neoplasms; Mediation; Municipalities; Nicotine; Nicotine Dependence; Pattern; Pennsylvania; Phase; Policies; Policy Making; Population; Positioning Attribute; Prevalence; Price; Process; Public Health; Recruitment Activity; Regulation; Reporting; Research; Research Personnel; Smoke; Statutes and Laws; Structure; Tars; Taxation; Text; Time; Tobacco; Tobacco smoking; Tobacco use; Work; Youth; authority; cigarette smoking; college; design; evidence based guidelines; federal policy; high school; hookah; improved; insight; member; public health relevance; public policy on tobacco; pulmonary function; rural area; socioeconomics; suburb; tobacco control; university student

While cigarette smoking is declining in the U.S., an emerging form of tobacco use, waterpipe tobacco smoking (WTS), is increasing. WTS is now nearly as common as cigarette use for college students, and it is also prevalent among high school and non-college adult populations. Because as many as 50% of WTS users do not smoke cigarettes, it affects many who would otherwise have been tobacco na¿ve. This is of particular concern because a typical WTS session may deliver over 100 times the smoke volume of a single cigarette. Although clean indoor air policies and regulations have rapidly propagated throughout the U.S., more than 90% of these laws do not address WTS, possibly fueling increased WTS. Furthermore, the recently enacted FDA Family Smoking Prevention and Tobacco Control Act (FSPTCA, HR 1256) does not specifically include WTS in its stipulations. Therefore, we designed this project to generate in-depth information urgently needed to inform and clarify federal and state policy in this area. States often serve as laboratories for federal policy, and because states and municipalities directly regulate the businesses that sell tobacco, effective WTS policy will require combined state and federal authority. As a microcosm of the U.S.-both in terms of geopolitics and tobacco control policies-Pennsylvania is the ideal state to study these topics. Therefore, we designed a two-phase project which will enable us to provide detailed, evidence- based recommendations for future tobacco-control legislation that will take into account the complex dynamics of WTS and will allow us to proactively engage with policy leaders around WTS. First, we will comprehensively analyze all relevant extant tobacco policies of each of the 8 official Health Districts (HDs) sanctioned by PA. For each HD, we will simultaneously examine laws on the municipal and county level, including how they interact with state and federal policy. We will systematically assess how language within these texts applies to WTS regarding each of the primary ways tobacco is regulated, including use restrictions, youth access, price (e.g., taxation), flavorings, and labeling. Second, we will explore WTS and its associated legal issues with influential individuals who have been and/or may be in the future involved in tobacco-related legislation in Pennsylvania in the past, including (1) legislators and staff; (2) public health officials; and (3) advocacy group leaders. We will use structured templates for in-depth interviews to explore particular issues such as (1) knowledge, attitudes, and beliefs related to WTS; (2) clarification of intentions and realities of specific provisions and/or exemptions of prior legislation (3) perceived consequences of any legislation passed; and (4) interactions between municipal, state, and FSPTCA provisions. Synthesis of information from document analyses and in-depth interviews will directly inform optimal policy-making on multiple levels to reduce WTS.

虽然美国的吸烟率正在下降，但水烟是一种新兴的烟草使用形式 吸烟（WTS）现在在大学生中几乎与吸烟一样普遍， 而且在高中和非大学成年人口中也很普遍，因为多达 50%。 WTS 用户不吸烟，这影响了许多本来会吸烟的人。这是 特别值得关注，因为典型的 WTS 会话可能会产生超过 100 倍的烟雾量 单支香烟。 尽管清洁室内空气政策和法规已在美国各地迅速传播，但更多 超过 90% 的法律并未涉及 WTS，这可能会助长 WTS 的增加。 颁布的 FDA 家庭吸烟预防和烟草控制法案（FSPTCA，HR 1256）没有 特别将WTS纳入其规定中，因此我们设计这个项目是为了生成深度。 为告知和澄清该领域的联邦和州政策而迫切需要的信息通常是各州的职责。 联邦政策实验室，并且因为州和市直接监管企业 作为烟草销售的一个缩影，有效的 WTS 政策需要州和联邦的联合授权。 美国——无论是地缘政治还是控烟政策——宾夕法尼亚州都是理想的留学州 因此，我们设计了一个两阶段的项目，这将使我们能够提供详细的证据- 对未来烟草控制立法的建议将考虑到复杂的情况 WTS 的动态，将使我们能够主动与 WTS 的政策领导者进行接触。 首先，我们将全面分析 8 个官方现行的所有相关烟草政策。 PA 批准的卫生区 (HD) 对于每个卫生区，我们将同时审查有关该卫生区的法律。 市和县一级，包括他们如何与州和联邦政策互动。 评估这些文本中的语言如何适用于 WTS，了解烟草的每种主要方式 监管，包括使用限制、青少年准入、价格（例如税收）、调味品和标签。 其次，我们将与具有影响力的个人探讨 WTS 及其相关的法律问题。 过去已经和/或将来可能参与宾夕法尼亚州的烟草相关立法， 包括 (1) 立法者和工作人员；(2) 公共卫生官员；以及 (3) 我们将使用宣传小组领导人。 用于深入访谈的结构化模板，以探讨特定问题，例如（1）知识、态度、 与 WTS 相关的信念；(2) 具体条款和/或的意图和现实的澄清； 先前立法的豁免 (3) 所通过的任何立法的预期后果；以及 (4) 相互作用； 市、州和 FSPTCA 规定之间的信息综合 深度访谈将直接为多个层面的最佳决策提供信息，以减少WTS。