PROJECT SUMMARY/ABSTRACT Nearly 30% of all cancer deaths are attributable to tobacco use. Tobacco taxes have positively impacted the prevalence of tobacco use and subsequently the incidence of tobacco-related cancers. The objective of this project is to provide critical insight for tobacco control, by developing and testing a novel integrated tax proposal based on the abuse liability of tobacco and nicotine products in the unique Experimental Tobacco Marketplace (ETM), including how this proposal may interact with tobacco-related socioeconomic cancer disparities. The ETM is an experimental model to forecast, before implementation, the effects of potential public health policies on patterns of tobacco purchasing, including between-product substitution. The ETM places the mix of products, prices, and specific regulations under experimental control to provide estimates of policy impact under conditions that simulate “real-world” circumstances. To achieve these goals, three aims are proposed. Aim 1 will develop an integrated abuse liability ranking of commercial tobacco and nicotine products through a systematic review and a novel application of network meta-analysis. Aim 2 is a proof-of-concept study that will examine the impact of different tax strategies based on the abuse liability of tobacco products in a laboratory-based sample of cigarette smokers. Aim 3 will examine the equity of the most effective abuse liability dependent tax strategy by testing its effects in a nationally representative prospective sample of lower, medium and higher socioeconomic status smokers. These aims support the candidate’s long-term goal to become an independent researcher investigating the differential impact of policies on tobacco initiation, use and cessation among individuals who experience tobacco-related cancer disparities. To further support this goal, a mentored career development plan is proposed, consisting of training in the fields of advanced statistical methods including network meta-analysis, tobacco products abuse liability, government tax policies, and tobacco-related cancer disparities. The advice, guidance and technical expertise provided by the candidate’s mentoring team, collaborators and consultant, and the Virginia Tech’s supportive research environment will provide the resources necessary to successfully complete the research and training plans. Importantly, this K01 award will provide the training, mentoring, and research experiences needed for a highly competitive R01 application to compare the abuse liability dependent taxes to other existing tax proposals. As importantly, this proposal will provide the essential first step in launching an independent cancer-related research program focusing on developing and testing novel policies for the elimination of tobacco use and its unequaled harms.

PROJECT NARRATIVE Tobacco taxes are widely used and demonstrably effective in reducing mortality and morbidity including cancer related outcomes, but they may exacerbate tobacco-related socioeconomic disparities. This project will develop and test the health equity of an abuse liability dependent tax proposal in a sample of cigarette smokers from diverse socioeconomic background. The findings of this project will elucidate a novel tax proposal designed to reduce tobacco dependence and tobacco-related disparities.