Background/Objectives: Alternative Tobacco and Nicotine Products (ATNPs) have gained widespread popularity. Although they are often promoted as lower-risk alternatives to traditional tobacco products, concerns remain regarding their association with risky behaviors among adolescents and young adults. This study examines the relationship between dietary and lifestyle habits and both ATNP use and intention to use ATNP among Italian participants in the MINERVA (My changINg lifEstyles our Research and eVeryone heAlth) international project. Methods: MINERVA is an observational, international, prospective cohort study. A study-specific questionnaire was administered to participants, who were recruited through informal snowball sampling. The questionnaire collected information on sociodemographic characteristics, lifestyle factors, dietary habits, and the use of both traditional tobacco products and ATNPs. Predictors of ATNP use and intention to use were assessed using logistic regression models. Results: Data from 7535 Italian participants were analyzed. Overall, 48% reported having ever used ATNP, and 14% of non-smokers and non-users expressed an intention to try these products. Significant predictors of ATNP use and intention to use included prior smoking, lower age, and having family members who smoke. Lifestyle factors such as frequent consumption of fast food, junk food, and alcoholic beverages were positively associated with both ATNP use and intention to use. Conversely, daily fruit and vegetable consumption was inversely associated with these outcomes. Conclusions: ATNP use and intention to use were associated with unhealthy dietary and lifestyle patterns. These findings highlight the importance of integrated public health strategies addressing substance use alongside broader lifestyle behaviors among adolescents and young adults.

Background: Traditional smoking is widely recognized as a public health issue, with established risks that include cardiovascular, respiratory, and cancer-related health impacts. Recently, alternative tobacco and nicotine products (ATNPs), such as electronic cigarettes, have gained popularity as potentially safer substitutes for traditional tobacco use. However, there remains uncertainty regarding the health effects of ATNPs, which require comprehensive research to evaluate their risks and potential benefits compared to conventional smoking. Objective: The aim of this multicenter observational study, MINERVA (My Changing Lifestyles Our Research and Everyone Health), is to examine the interplay between traditional smoking and the potential effect of switching to ATNPs in culturally diverse European countries. Methods: Data collection will be conducted through a structured web-based questionnaire and administered using a snowball sampling technique, which relies on the referrals and network connections of initial participants. A link will be provided for participants to access the questionnaire. Responders who express a willingness to participate in the study cohort will be recontacted at least twice a year to ensure continuity in their participation, and they will be asked to complete the same questionnaire during these follow-up assessments. This approach allows for the gathering of useful information over an extended period and the assessment of any changes or trends in the data that may emerge over time. Using social media for data collection, the research explores real-time attitudes and experiences related to smoking, with a particular focus on participants’ receptiveness to transitioning to nonconventional tobacco products. Statistical analysis will include descriptive statistics, and logistic regression models will examine associations. Nonlinear trends will be assessed using restricted cubic splines. Analyses will be conducted in R software with relevant statistical packages. Results: The MINERVA study began in June 2023, and data collection is still in progress. As of January 2025, 7535 participants had been enrolled in Italy, of whom 4862 have consented to a follow-up. Preliminary analyses are currently being conducted. Conclusions: The study underscores the importance of ongoing research to inform evidence-based policies and interventions, emphasizing the role of social media surveys in capturing diverse perspectives and facilitating longitudinal studies for a deeper understanding of the health implications of transitioning from traditional smoking to ATNPs. International Registered Report Identifier (IRRID): DERR1-10.2196/67163

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Traditional smoking is widely recognized as a public health issue, with established risks that include cardiovascular, respiratory, and cancer-related health impacts. Recently, alternative tobacco and nicotine products (ATNPs), such as electronic cigarettes, have gained popularity as potentially safer substitutes for traditional tobacco use. However, there remains uncertainty regarding the health effects of ATNPs, which require comprehensive research to evaluate their risks and potential benefits compared to conventional smoking. Objective: The aim of this multicenter observational study, MINERVA (My Changing Lifestyles Our Research and Everyone Health), is to examine the interplay between traditional smoking and the potential effect of switching to ATNPs in culturally diverse European countries. Methods: Data collection will be conducted through a structured web-based questionnaire and administered using a snowball sampling technique, which relies on the referrals and network connections of initial participants. A link will be provided for participants to access the questionnaire. Responders who express a willingness to participate in the study cohort will be recontacted at least twice a year to ensure continuity in their participation, and they will be asked to complete the same questionnaire during these follow-up assessments. This approach allows for the gathering of useful information over an extended period and the assessment of any changes or trends in the data that may emerge over time. Using social media for data collection, the research explores real-time attitudes and experiences related to smoking, with a particular focus on participants’ receptiveness to transitioning to nonconventional tobacco products. Statistical analysis will include descriptive statistics, and logistic regression models will examine associations. Nonlinear trends will be assessed using restricted cubic splines. Analyses will be conducted in R software with relevant statistical packages. Results: The MINERVA study began in June 2023, and data collection is still in progress. As of January 2025, 7535 participants had been enrolled in Italy, of whom 4862 have consented to a follow-up. Preliminary analyses are currently being conducted. Conclusions: The study underscores the importance of ongoing research to inform evidence-based policies and interventions, emphasizing the role of social media surveys in capturing diverse perspectives and facilitating longitudinal studies for a deeper understanding of the health implications of transitioning from traditional smoking to ATNPs. Trial Registration: