P01 Project 1

Examining transitions between cigarettes and other nicotine delivery products among adults in countries with different regulatory environments: the ITC Nicotine Product Adult Survey

Co-Leaders: Geoffrey T. Fong, PhD, University of Waterloo; Andrew Hyland, PhD, Roswell Park Comprehensive Cancer Center


Project 1 proposes to continue longitudinal data collection in different countries to examine behavioral changes and how different policy environments are associated with changes in the marketplace of products and regulatory policies. The US, Canada, Australia, and England will continue the surveys conducted as part of the current P01, while Japan, Republic of Korea, and New Zealand, universally recognized for their recent and ongoing changes in the tobacco/nicotine landscape, will be added to bring the total to 7 countries.

Project 1’s first two Specific Aims are: 1) to describe how the patterns of cigarette smoking, NVP use, and HTP use differ among smokers and recent ex-smokers both over time and between important sub-groups, and to identify and quantify the factors that are related to those transitions; 2) to examine how differences in current and future policies for cigarettes, NVPs, and HTPs across countries and to the extent they exist, differences within each country, are related to differences in patterns of use of cigarettes, NVPs, and HTPs over time. Japan and Korea have seen rapid growth in HTPs but with different approaches for vapor products. New Zealand, among the most progressive countries on tobacco/nicotine product regulations, has just announced (April 2021) their intention to implement a set of landmark policies to achieve their Smokefree 2025 goal (e.g., reducing nicotine to very low levels, prohibiting filters, significantly reducing smoked tobacco product retailers), while positioning alternative nicotine delivery systems as possible substitutes. The ITC Project has existing relationships in the US, Canada, Australia, and England, which have been part of the ITC Project since inception in 2002 with 10+ waves of data collected in each; three waves of the ITC Japan Survey; a first wave of the ITC Korea Survey in 2020; and three waves of the ITC New Zealand Survey. These additional countries will create a unique and extraordinary natural experiment across 7 countries whose trajectory across 5 years will be analyzed through the powerful tools of the ITC longitudinal cohort surveys. Project 1’s third Specific Aim—to examine the relative impact of policies on adults and youth—is shared with Project 2 (Youth surveys) with common measures and overlap in young adult samples, allowing comparisons of policy impact on adults and youth. Project 1 will also be linked with Project 3 (providing participants for the experimental research in Project 3) and Project 4 (providing inputs on behavioral transitions for policy forecasting).