Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721, MA, Bilthoven, the Netherlands.
Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721, MA, Bilthoven, the Netherlands.
Regul Toxicol Pharmacol. 2021 Dec;127:105077. doi: 10.1016/j.yrtph.2021.105077. Epub 2021 Nov 5.
Many new tobacco and related products (nTRP) have emerged on the market, with unknown health risks. Here, we present a conceptual model containing the factors and relations between them that contribute to the nTRP's health effects. Factors that determine attractiveness, addictiveness and toxicity of nTRP were defined based on previous assessments, literature, and expert discussions. Our model will aid in identifying key risk factors contributing to increased risk of adverse health effects for a product in a qualitative manner. Additionally, it can gauge attractiveness for specific user groups, as a determinant for population prevalence of use. Our model can be used to identify aspects of nTRP that require attention for public information or product regulation. As an example, we applied this to JUUL, a popular e-cigarette in the US. Aspects of concern for JUUL are its attractive and discrete shape, user-friendly prefilled pods, flavors, high aerosol nicotine levels, and liquids containing nicotine salts instead of free-based nicotine. The addictiveness and especially attractiveness are sufficiently high to have a large potential impact on population health due to its contribution to use and hence exposure. Products and their use can change over time; therefore market research and monitoring are crucial.
许多新的烟草和相关产品（nTRP）已经出现在市场上，其健康风险未知。在这里，我们提出了一个包含有助于 nTRP 健康影响的因素及其关系的概念模型。基于以前的评估、文献和专家讨论，确定了决定 nTRP 吸引力、成瘾性和毒性的因素。我们的模型将有助于定性地识别导致产品不良健康影响风险增加的关键风险因素。此外，它还可以衡量特定用户群体的吸引力，作为人口普遍使用的决定因素。我们的模型可用于确定需要关注的 nTRP 方面，以提供公众信息或产品监管。例如，我们将此应用于美国流行的电子烟 JUUL。JUUL 令人关注的方面是其具有吸引力和独特形状的外观、用户友好的预装烟弹、口味、高气溶胶尼古丁含量以及含有尼古丁盐而不是游离尼古丁的液体。由于其对使用的贡献，成瘾性特别是吸引力非常高，可能对人口健康产生重大影响。产品及其使用会随着时间而变化；因此，市场研究和监测至关重要。
