PROJECT SUMMARY/ABSTRACT The goal of this research is to identify neurobehavioral makers of tobacco use risk among young adult (YA) African American (AA) vapers and examine how these patterns of neural activation are impacted by social disadvantages and chronic stressors experienced in this population. Findings are expected to advance understanding of the neurocognitive mechanisms underlying tobacco use trajectories among YA AA vapers in the rural South and inform efforts to reduce racial disparities in tobacco harm. Given the accumulating evidence that vaping conveys 5-fold additional risk for smoking initiation and other tobacco use escalation, recent YA increases in use are alarming, threatening a resurgence of dependence that may reverse decades of tobacco control success. Vape product manufacturers engage in practices outlawed for cigarettes, targeting YA, low socioeconomic status, and minority groups, perpetuating tobacco disparities in these vulnerable populations. One of these practices, adding flavor, makes vaping more palatable to YA and broadens the impact of primary nicotine reinforcement through frequent paired associations. Coupled with targeted marketing and a YA AA preference for menthol flavor, the disproportionate environmental vulnerabilities and high rates of tobacco-related mortality and morbidity underscore the urgent need to identify mechanisms pertaining to how adversity contributes to tobacco use escalation. Functional magnetic resonance imaging (fMRI) generates information complementary to traditional behavioral risk assessments, with direct observations of the neural substrates that underlie the subjective states known to perpetuate addiction. It also enables unprecedented isolation of effects in key neural networks associated with flavor and drug effects. The proposed project aims to identify novel neuromarkers of tobacco use escalation risk, determine whether sociocultural adversity is associated with these markers, and to examine the mechanisms by which these factors may interact. We propose to recruit 60 YA AA non-smoking vapers from rural Georgia. Three fMRI cue reactivity paradigms will be administered to probe critical neurobehavioral systems with high potential to account for individual differences in tobacco use escalation risk. Cues will include 1) vaping and smoking; 2) vape product packaging with and without flavors; and 3) Public Service Announcements with and without a focus on flavor harms. Resulting neuromarkers will be examined for associations with traditional markers (e.g., craving) that would suggest validity, and relationships with measures of contextual adversity. Findings are expected to advance understanding of mechanisms that predispose YA AA vapers to escalated tobacco use and suggest specific neural and contextual factors that can be addressed in prevention strategies to forestall tobacco use escalation (e.g., advertising, public service announcements, regulation of flavors). Results are also expected to support proof of concept for a future R01 application on neurobehaviorally informed preventions to deter escalation in tobacco use among vulnerable YA AA vapers.

PROJECT NARRATIVE This research is expected to yield novel neurobehavioral makers of tobacco use escalation risk among rural young adult African American vapers and advance understanding of how these neuromarkers are impacted by social disadvantages and chronic stressors that are experienced in this population. Findings are expected to reveal neurocognitive mechanisms that underlie tobacco use trajectories and racial disparities in tobacco harm. The study is designed to suggest actionable strategies for prevention scientists and regulators to address a critical need in this vulnerable population (e.g., advertising, public service announcements, flavor regulation).