# Modeling the Impact of Tobacco Use and Regulations on Vulnerable Populations

> **NIH NIH U54** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $420,886

## Abstract

PROJECT 4 Abstract
Tobacco use varies greatly by race/ethnicity and socioeconomic status (SES) in the US, with unacceptably
high cigarette smoking rates in American Indian Alaska Native and low education populations, as well as
vulnerable subpopulations at the intersection of race/ethnicity and SES (e.g. non-Hispanic Black (NHB) and
non-Hispanic White (NHW) individuals with a high school degree or less). Use of cigars and electronic nicotine
delivery systems (ENDS) are highest among NHB and NHW individuals respectively. Tobacco use trajectories
are further complicated by characterizing flavors in cigarettes (menthol), cigars, and ENDS, the use of which is
concentrated in specific subpopulations.
Policymakers are considering flavor restriction policies and other tobacco regulations but lack detailed scientific
information about how such policies could affect the US population and vulnerable subgroups. To address this
need, we will develop validated tobacco simulation models to project the impact of flavor restrictions on
tobacco use and downstream health outcomes among vulnerable racial/ethnic and socioeconomic subgroups.
While existing simulation models consider cigarette smoking, with some now also assessing ENDS use, cigar
smoking has yet to be included in such models, despite its important implications for tobacco-related health
disparities. This project aims to characterize cigarette, cigar, and ENDS patterns of use by race/ethnicity,
education, and for vulnerable subgroups at their intersection (Aim 1). We will develop simulation models of
cigarette, cigar, and ENDS use for (a) key race/ethnicity groups (NHB, NHW, Hispanics and AIAN), (b) four
different education groups (less than high school, high school degree or GED, some college, and college
degree or more) and (c) for groups at the intersection of race/ethnicity and education (NHB, NHW, Hispanic
individuals of low vs. high educational attainment) (Aim 2). We will estimate the effects of flavor restrictions on
cigarette, cigar, and ENDS use by race/ethnicity and education using information from quasi-experimental
studies, systematic reviews, and expert consultations (Aim 3). Finally, we plan to project the impact of flavor
restrictions on US patterns of tobacco product use and downstream mortality outcomes by race/ethnicity and
education, and for key vulnerable groups at their intersection (Aim 4). This will provide a strong foundation for
studying the impact of other potential regulations on tobacco-related health outcomes in vulnerable subgroups.
As part of the Center for the Assessment of the Tobacco Regulations (CAsToR), this project will provide the
Food and Drug Administration (FDA) with much needed external modeling research that evaluates: 1) the
impact of flavor restrictions on tobacco use behaviors (Scientific domain: Behavior); 2) the long-term impact of
tobacco products and flavor restrictions on health (Scientific domain: Health Effects); and 3) the potential
differential im...

## Key facts

- **NIH application ID:** 10932124
- **Project number:** 5U54CA229974-07
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Rafael Meza
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $420,886
- **Award type:** 5
- **Project period:** 2018-09-14 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10932124

## Citation

> US National Institutes of Health, RePORTER application 10932124, Modeling the Impact of Tobacco Use and Regulations on Vulnerable Populations (5U54CA229974-07). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10932124. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*