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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy; giulia.lorenzoni@unipd.it (G.L.); [honoria.ocagli@unipd.it](honoria.ocagli@unipd.it) (H.O.); [noor.khan@ubep.unipd.it](noor.khan@ubep.unipd.it) (N.M.K.); [francesca.angioletti@ubep.unipd.it](francesca.angioletti@ubep.unipd.it) (F.A.); [konstantina.pilali@ubep.unipd.it](konstantina.pilali@ubep.unipd.it) (K.-T.P.); [matteo.martinato@unipd.it](matteo.martinato@unipd.it) (M.M.)  \n2 Department of Translational Medicine, University of Naples Federico II, 80131 Naples, Italy; [danila.azzolina@unina.it](danila.azzolina@unina.it)  \n3 Department of Actuarial Sciences, Hacettepe University, 06800 Ankara, Turkey; [aslihansenturkacar@gmail.com](aslihansenturkacar@gmail.com)  \n4 Centre for Biostatistics, Epidemiology and Public Health, Department of Clinical and Biological Sciences, University of Torino, 10043 Orbassano, Italy; paola.berchialla@unito.it  \n* Correspondence: [dario.gregori@unipd.it](dario.gregori@unipd.it); Tel.: +39-049-8275384; Fax: +39-02-700445089 † These authors contributed equally to this work.  \n‡ These authors contributed equally to this work.  \nAbstract  \nBackground/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 nonsmokers 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.  \nKeywords: electronic nicotine delivery systems; heat-not-burn; dietary habits; lifestyle; cohort study  \n1. Introduction  \nAlternative tobacco and nicotine products (ATNPs), i.e., elec","cbCaijaNn9Jg4r0C","https://ap.wps.com/l/cbCaijaNn9Jg4r0C","pdf",302933,17,"English","# Abstract\n## Background/Objectives\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What is the MINERVA project used for in this study?\",\"answer\":\"The MINERVA project is an observational, international, prospective cohort study. It supports an analysis of how dietary and lifestyle habits relate to ATNP use and intention among Italian participants.\"},{\"question\":\"Which factors were significant predictors of ATNP use and intention?\",\"answer\":\"Significant predictors included prior smoking, lower age, and having family members who smoke. Lifestyle patterns such as frequent fast food, junk food, and alcohol consumption were positively associated with both outcomes.\"},{\"question\":\"How did fruit and vegetable consumption relate to ATNP outcomes?\",\"answer\":\"Daily fruit and vegetable consumption was inversely associated with ATNP use and intention, contrasting with the positive associations observed for unhealthy food and alcohol-related habits.\"}]","Lifestyle Habits and Alternative Tobacco and Nicotine Products - Results from the MINERVA Project | PDF",1790761819,43]