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Dai HD, Subica A, Mattingly DT, Harlow A, Leventhal AM. Association of Race-Ethnicity Intersection With Disparities in Cigarette Smoking in U.S. Adults. Nicotine Tob Res 2024; 26:1066-1071. [PMID: 38401167 PMCID: PMC11260889 DOI: 10.1093/ntr/ntae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/18/2023] [Accepted: 02/13/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION Detailed estimates of disparities in cigarette smoking across single- and multi-race groups and their intersections with ethnicity are lacking. This study estimates the prevalence of self-reported current smoking among intersecting adult race-ethnicity groups in the United States. AIMS AND METHODS The analysis uses 2018-2019 data from the Tobacco Use Supplement-Current Population Supplement (TUS-CPS; n = 137 471). Self-reported Hispanic origin and race were recoded into 19 mutually exclusive race-by-ethnicity intersecting groups. Weighted race-ethnicity group smoking prevalence were compared to the overall population prevalence and one another. RESULTS Compared to the U.S. population current smoking prevalence (11.4% [95% CI = 11.2% to 11.6%]), smoking was particularly higher in non-Hispanic American Indian/Alaska Native (AI/AN) groups (20.7% [95% CI = 17.8% to 24.0%]) and non-Hispanic multiracial AI/AN/White (24.4% [95% CI = 20.3% to 29.1%]) and AI/AN/Black (22.4% [95% CI = 14.4% to 33.2%]) groups. Non-Hispanic single-race Asian (5.0% [95% CI = 4.4% to 5.6%]) and Hispanic single-race White (7.2% [95% CI = 6.7% to 7.7%]) smoking prevalence undercut the overall U.S. population prevalence. In pairwise comparisons, smoking prevalence was higher in various non-Hispanic single- and multi-race AI/AN groups than non-AI/AN groups and was lower in various Hispanic groups than non-Hispanic groups. CONCLUSIONS Smoking prevalence disparities are not monolithic across complex diversity of race and ethnicity in the United States. Accurate identification of priority populations in need of targeted tobacco control efforts may benefit by acknowledging multinomial heterogeneity across intersecting racial and ethnic identities. IMPLICATIONS Understanding racial and ethnic disparities in cigarette smoking can inform national strategies for reducing health inequities. This study examines cigarette smoking disparities among 19 adult intersecting race-ethnicity groups in the United States using the 2018-2019 TUS-CPS data. Results show higher smoking rates in some non-Hispanic American Indian/Alaska Native and Black groups, while lower rates are seen in Asian and Hispanic individuals. These findings emphasize the need for disaggregated data to tackle smoking disparities and guide targeted prevention efforts.
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Affiliation(s)
- Hongying Daisy Dai
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Andrew Subica
- School of Medicine, University of California, Riverside, CA, USA
| | - Delvon T Mattingly
- Center for Health Equity Transformation, College of Medicine, University of Kentucky, Lexington, KY, USA
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Alyssa Harlow
- USC Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- USC Tobacco Center of Regulatory Science, University of Southern California, Los Angeles, CA, USA
| | - Adam M Leventhal
- USC Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- USC Tobacco Center of Regulatory Science, University of Southern California, Los Angeles, CA, USA
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Assari S, Zare H. Socioeconomic Status Partially Mediates the Effects of Structural Racism on Youth Tobacco Use Initiation. GLOBAL JOURNAL OF EPIDEMIOLOGY AND INFECTIOUS DISEASE 2024; 4:44-59. [PMID: 39239120 PMCID: PMC11376199 DOI: 10.31586/gjeid.2024.1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
Background Recent research has identified structural racism-systemic policies and practices that perpetuate racial inequalities-as a significant social determinant of population health. Studies utilizing data from the Adolescent Brain Cognitive Development (ABCD) study have shown an association between higher levels of state-level structural racism and increased tobacco use among youth in the United States. However, there has been limited exploration of the psychosocial mediators of this relationship, particularly in the context of youth aged 10-16 years. Objective This study aimed to assess the roles of socioeconomic status (SES), tobacco susceptibility, and perceived discrimination as potential mediators in the relationship between state-level structural racism and youth tobacco initiation rates. Methods We analyzed data from the ABCD study, a nationally representative longitudinal survey of 11,698 youth followed from ages 9/10 to 15/16. These data were combined with state-level indicators of structural racism. We employed structural equation modeling (SEM) to investigate the mediators of the association between structural racism and self-reported initiation of tobacco use, while controlling for individual and state-level covariates. Results Our findings indicate that higher levels of structural racism were associated with increased rates of tobacco initiation among youth. This relationship was partially mediated by lower SES, but not by perceived discrimination or tobacco susceptibility. Conclusion The association between structural racism and youth tobacco initiation appears to be influenced in part by the lower SES prevalent in states with higher levels of racism. These results highlight the need for addressing both racism and SES inequalities as key strategies for reducing tobacco disparities among youth.
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Affiliation(s)
- Shervin Assari
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA, United States
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- School of Business, University of Maryland Global Campus (UMGC), Adelphi, United States
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Nian H, Odland R, Mindlin S, Ammar L, Tindle H, Miller A, Ryckman K, Xie E, Hartert TV, Snyder BM, Brunwasser SM, Wu P. Demographic characteristics, perinatal smoking patterns, and risk for neonatal health complications among pregnant smokers in the United States who begin using electronic cigarettes during pregnancy: A descriptive study using population-based surveillance data. Nicotine Tob Res 2024:ntae119. [PMID: 38779997 DOI: 10.1093/ntr/ntae119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Health agencies have called for research evaluating e-cigarette (EC) use in supporting prenatal smoking cessation. This study aimed to describe (a) characteristics of smokers who begin using ECs during pregnancy, (b) how frequently smokers reduce or eliminate pre- and post-natal combustible cigarette (CC) use, and (c) risk for neonatal health complications among smokers who initiate ECs during pregnancy. METHODS Pregnant women using CCs exclusively pre-pregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified as dual users (used both ECs and CCs) or EC replacers (used ECs exclusively). RESULTS Of 29,505 pregnant smokers, 1.5% reported using ECs during the last 3 pregnancy months. Among them, 29.7% became EC-exclusive users. EC initiators were disproportionately non-Hispanic White. Relative to quitters, EC initiators had lower income, were less likely to be married, have intended pregnancies, receive first-trimester prenatal care, and participate in a federal assistance program. Compared to CC-exclusive users, EC initiators overall, and dual users specifically, were more likely to reduce pre- and post-natal CC usage relative to pre-pregnancy levels. EC initiators' risk for neonatal health complications fell between quitters and CC-exclusive users, though differences were not statistically significant. CONCLUSIONS Although EC initiators reduced CC use more than CC-exclusive users, only 29.7% reported complete CC cessation, and there was insufficient evidence of reduction in neonatal health complications relative to CC-exclusive users. Currently, ECs should not be considered a viable gestational smoking cessation strategy. IMPLICATIONS Health agencies have identified a critical need for research evaluating the use of e-cigarettes in supporting prenatal smoking cessation. Using the US Pregnancy Risk Assessment Monitoring System surveillance study data, we provide real-world evidence that prenatal e-cigarette initiation as a smoking cessation tool is used infrequently among pregnant combustible cigarettes smokers. Most using e-cigarettes in the last three months of pregnancy also used combustible cigarettes.
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Affiliation(s)
- Hui Nian
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachel Odland
- Rowan University Department of Psychology, Glassboro, NJ, USA
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | - Samantha Mindlin
- Rowan University Department of Psychology, Glassboro, NJ, USA
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | - Lin Ammar
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Hilary Tindle
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- The Vanderbilt Center for Tobacco, Addiction and Lifestyle, Vanderbilt University Medical Center, Nashville, TN, USA
- Geriatric Research Education and Clinical Centers, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Angela Miller
- Division of Population Health Assessment, Tennessee Department of Health, Nashville, TN, USA
| | - Kelly Ryckman
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health - Bloomington, Bloomington, IN, USA
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Ethan Xie
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- University of California at Berkeley, Berkeley, CA, USA
| | - Tina V Hartert
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brittney M Snyder
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Steven M Brunwasser
- Rowan University Department of Psychology, Glassboro, NJ, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pingsheng Wu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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JaKa MM, Ziegenfuss JY, Dinh JM, Jacobson LJ, Kottke TE, Knudson SM, Heim CC, Gallagher JM, Campbell KD, Rivard RL, Pronk NP. Evidence to support health system prioritization of health behaviors in the COVID-19 era. Prog Cardiovasc Dis 2024; 83:77-83. [PMID: 38423235 DOI: 10.1016/j.pcad.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 02/24/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Since the COVID-19 pandemic health systems have shifted necessarily from chronic to infectious disease treatment, but chronic disease remains critical. One large health system uniquely tracks member health behaviors. This analysis compares data from select months of an ongoing monthly cross-sectional survey before and during the pandemic. METHODS Responses in April 2019 (pre-pandemic), April 2020 (early pandemic) or April 2021 (later pandemic) were included in the primary analysis (N = 252). Differences in meeting health behavior guidelines were analyzed via logistic regression. RESULTS A significant decline was seen for physical activity (19% not meeting guidelines pre-pandemic vs. 41% later pandemic) but not fruit/vegetable, alcohol, or sleep from early to later pandemic. Prevalence of women not meeting tobacco guidelines increased from early (5%) to later pandemic (10%) while prevalence in men decreased (10% vs 4% respectively). The percent of people not thinking about the good things that happen to them fluctuated closely with reports of new COVID-19 cases. CONCLUSIONS Findings show the nuance of changing health behaviors throughout the pandemic. Results should be used by health systems to tailor support based on insights from the pandemic experience.
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Affiliation(s)
- Meghan M JaKa
- Center for Evaluation & Survey Research, HealthPartners Institute, 8170 33(rd) Ave S, Bloomington, MN 55425, United States of America.
| | - Jeanette Y Ziegenfuss
- Center for Evaluation & Survey Research, HealthPartners Institute, 8170 33(rd) Ave S, Bloomington, MN 55425, United States of America
| | - Jennifer M Dinh
- Center for Evaluation & Survey Research, HealthPartners Institute, 8170 33(rd) Ave S, Bloomington, MN 55425, United States of America
| | - Laura J Jacobson
- Center for Evaluation & Survey Research, HealthPartners Institute, 8170 33(rd) Ave S, Bloomington, MN 55425, United States of America
| | - Thomas E Kottke
- HealthPartners Institute, 8170 33(rd) Ave S, Bloomington, MN 55425, United States of America; HealthPartners, 8170 33rd Ave S, Bloomington, MN 55425, United States of America
| | - Susan M Knudson
- HealthPartners, 8170 33rd Ave S, Bloomington, MN 55425, United States of America
| | - Chad C Heim
- HealthPartners, 8170 33rd Ave S, Bloomington, MN 55425, United States of America
| | - Jason M Gallagher
- HealthPartners, 8170 33rd Ave S, Bloomington, MN 55425, United States of America
| | - Kevin D Campbell
- HealthPartners, 8170 33rd Ave S, Bloomington, MN 55425, United States of America
| | - Rachael L Rivard
- Center for Evaluation & Survey Research, HealthPartners Institute, 8170 33(rd) Ave S, Bloomington, MN 55425, United States of America
| | - Nicolaas P Pronk
- HealthPartners Institute, 8170 33(rd) Ave S, Bloomington, MN 55425, United States of America; HealthPartners, 8170 33rd Ave S, Bloomington, MN 55425, United States of America
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Ball J, Zhang J, Stanley J, Waa A, Crengle S, Edwards R. Addressing Intergenerational Inequity in Tobacco-Harm: What Helps Children of Smokers to Remain Nonsmokers? Nicotine Tob Res 2024; 26:102-110. [PMID: 37586082 PMCID: PMC10734381 DOI: 10.1093/ntr/ntad148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/27/2023] [Accepted: 08/14/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Children of people who smoke are more likely to take up smoking themselves. In Aotearoa New Zealand (NZ), adolescent smoking declined dramatically between 2000 and 2016 despite limited change in parental smoking, demonstrating that the cycle can be broken. AIMS AND METHODS This study aimed to identify modifiable factors associated with never smoking in Year 10 students (14-15 years) who had at least one caregiver who smoked. We used data from the Youth Insights Survey (2016 and 2018, pooled, N = 5,422) and identified students with at least one caregiver (mother, father, grandparent, other caregiver) who smoked (N = 2,205). To investigate modifiable factors potentially associated with nonsmoking we used logistic regression with marginally adjusted prevalence estimates. RESULTS Overall, 41% of students had at least one caregiver who smoked. In this group, the majority (65%) had never smoked themselves. After adjustment, never-smoking was more prevalent among students attending low-deprivation (more affluent) schools (73% had never smoked) compared to high-deprivation schools (44%); students not exposed to others' smoking inside the home (72%) or in cars (70%) in the past week compared to those exposed (59% and 51%, respectively); and students whose parents would be upset if they were caught smoking (68% vs 49% for those whose parents would not be upset), or who had high self-esteem (69% vs 55% for those with low self-esteem). CONCLUSIONS Modifiable factors independently associated with non-smoking in adolescents with caregiver(s) who smoked were: nonexposure to smoking inside the home and in cars, parental expectations of nonsmoking, and high self-esteem. IMPLICATIONS Even in countries like NZ with relatively low adult smoking rates, children's exposure to caregiver smoking may be prevalent, particularly in structurally disadvantaged populations. This study suggests that action to promote smokefree homes and cars, build high self-esteem in young people, and communicate expectations of non-smoking are likely to help children of people who smoke to remain nonsmokers. A comprehensive approach that also addresses "upstream" factors (eg, socioeconomic deprivation) and underlying causes of structural inequity (eg, institutional racism) is needed. Such policy and community action may help to break intergenerational cycles of tobacco use and health inequity.
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Affiliation(s)
- Jude Ball
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jane Zhang
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - James Stanley
- Dean’s Department, University of Otago, Wellington, New Zealand
| | - Andrew Waa
- Eru Pōmare Māori Health Research Centre, University of Otago, Wellington, New Zealand
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, New Zealand
| | - Richard Edwards
- Department of Public Health, University of Otago, Wellington, New Zealand
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Carlson DM, Yarns BC. Managing medical and psychiatric multimorbidity in older patients. Ther Adv Psychopharmacol 2023; 13:20451253231195274. [PMID: 37663084 PMCID: PMC10469275 DOI: 10.1177/20451253231195274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/14/2023] [Indexed: 09/05/2023] Open
Abstract
Aging increases susceptibility both to psychiatric and medical disorders through a variety of processes ranging from biochemical to pharmacologic to societal. Interactions between aging-related brain changes, emotional and psychological symptoms, and social factors contribute to multimorbidity - the presence of two or more chronic conditions in an individual - which requires a more patient-centered, holistic approach than used in traditional single-disease treatment guidelines. Optimal treatment of older adults with psychiatric and medical multimorbidity necessitates an appreciation and understanding of the links between biological, psychological, and social factors - including trauma and racism - that underlie physical and psychiatric multimorbidity in older adults, all of which are the topic of this review.
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Affiliation(s)
- David M. Carlson
- Department of Psychiatry/Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Brandon C. Yarns
- Department of Psychiatry/Mental Health, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Bldg. 401, Rm. A236, Mail Code 116AE, Los Angeles, CA 90073, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
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Anvari-Clark J, Rose T. Financial Behavioral Health and Investment Risk Willingness: Implications for the Racial Wealth Gap. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105835. [PMID: 37239561 DOI: 10.3390/ijerph20105835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/29/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
Financial behavioral health (FBH) influences numerous socio-ecological domains, affecting investment risk willingness and consequent wealth levels. The experience of FBH by racial group is unknown, and findings of differences between Black and White investors' risk willingness are mixed. The study's aims are to establish an FBH measure and explore its application to risk willingness by racial group. The study used a subset of data from FINRA's 2018 National Financial Capability Study, including Black (n = 2835) and White (n = 21,289) respondents. Through factor analysis, 19 items were confirmed for the FBH measure; the measure was then applied to investment risk willingness using structural equation modeling (SEM). Invariance analyses showed that the FBH model had an excellent fit for White respondents but not Black respondents. The SEM analysis determined that FBH accounted for 37% of the variance in risk willingness (R2 = 0.368; β = 0.256, p < 0.001). Racial group affiliation was a negligible predictor of risk willingness (β = -0.084, p < 0.001). This project contributes an empirical basis for FBH, emphasizes the importance of FBH for investment risk willingness, and elucidates that racial group differences in risk willingness could be an unlikely contributor to the wealth gap.
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Affiliation(s)
- Jeffrey Anvari-Clark
- Department of Social Work, University of North Dakota, Grand Forks, ND 58202, USA
| | - Theda Rose
- School of Social Work, University of Maryland, Baltimore, MD 21201, USA
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Mills SD, Golden SD, O'Leary MC, Logan P, Hassmiller Lich K. Using systems science to advance health equity in tobacco control: a causal loop diagram of smoking. Tob Control 2023; 32:287-295. [PMID: 34535509 PMCID: PMC9466654 DOI: 10.1136/tobaccocontrol-2021-056695] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/11/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Develop and use a causal loop diagram (CLD) of smoking among racial/ethnic minority and lower-income groups to anticipate the intended and unintended effects of tobacco control policies. METHODS We developed a CLD to elucidate connections between individual, environmental and structural causes of racial/ethnic and socioeconomic disparities in smoking. The CLD was informed by a review of conceptual and empirical models of smoking, fundamental cause and social stress theories and 19 qualitative interviews with tobacco control stakeholders. The CLD was then used to examine the potential impacts of three tobacco control policies. RESULTS The CLD includes 24 constructs encompassing individual (eg, risk perceptions), environmental (eg, marketing) and structural (eg, systemic racism) factors associated with smoking. Evaluations of tobacco control policies using the CLD identified potential unintended consequences that may maintain smoking disparities. For example, the intent of a smoke-free policy for public housing is to reduce smoking among residents. Our CLD suggests that the policy may reduce smoking among residents by reducing smoking among family/friends, which subsequently reduces pro-smoking norms and perceptions of tobacco use as low risk. On the other hand, some residents who smoke may violate the policy. Policy violations may result in financial strain and/or housing instability, which increases stress and reduces feelings of control, thus having the unintended consequence of increasing smoking. CONCLUSIONS The CLD may be used to support stakeholder engagement in action planning and to identify non-traditional partners and approaches for tobacco control.
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Affiliation(s)
- Sarah D Mills
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shelley D Golden
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Meghan C O'Leary
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paige Logan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kristen Hassmiller Lich
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Asadi A, Fakhri Y, Salimi Y, Daglioglu N, Tahmasebifard M, Aghajarinezhad M. Nicotine consumption rate through wastewater-based epidemiology: a systematic review, meta-analysis and probabilistic risk assessment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:63416-63426. [PMID: 37084052 PMCID: PMC10119841 DOI: 10.1007/s11356-023-27017-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/10/2023] [Indexed: 05/03/2023]
Abstract
Wastewater-based epidemiology (WBE), as a rapid tool, is used to measure and monitor illicit drug consumption in the population. This method is also used to bridge biomarkers of exposure, contaminants, and human health. Smoking cigarettes and tobacco use are everyday habits in nowadays community. This systematic review and meta-analysis aimed to calculate nicotine consumption globally. The related studies were retrieved within international databases including Scopus, Google Scholar, and Web of Science, up to February 2021. It included twenty-one articles containing 87 measurements covering 275.3 million people with total wastewater samples of 2250. Results showed that the highest and lowest nicotine consumption rate (mg/1000 inh./day) was in Portugal (5860) and Vietnam (1201), respectively. The global pooled nicotine consumption rate was 2476 mg/1000 inh./day (95% CI (2289-2663). Based on WBE results, the average daily cigarette smoked per smoker is 14 (95% CI: 10-18 cigarettes/inh./day), close to the value of 14.2 reported by the survey and interview studies. Risk assessment of the nicotine consumption rate through WBE was calculated by the margin of exposure (MOE) approach. In total, 82% of nicotine consumption measurements were located in the "risk" level (MOE < 100), and 18% of the MOE values were between 100-1000. The results reveal that nicotine consumption risks need immediate global and local action strategies. Finally, these findings are helpful for healthcare agencies and policy-makers to take action against tobacco use prevalence.
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Affiliation(s)
- Anvar Asadi
- Department of Environmental Health Engineering, Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Environmental Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yadolah Fakhri
- Food Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Yahya Salimi
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nebile Daglioglu
- Institute of Forensic Sciences, Department of Forensic Toxicology, Ankara University, Ankara, Turkey
| | - Mina Tahmasebifard
- Students Research Committee, Department of Epidemiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Aghajarinezhad
- Students Research Committee, Department of Epidemiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Choi K, Jones JT, Ruybal AL, McNeel TS, Duarte DA, Webb Hooper M. Trends in Education-Related Smoking Disparities Among U.S. Black or African American and White Adults: Intersections of Race, Sex, and Region. Nicotine Tob Res 2023; 25:718-728. [PMID: 36239224 PMCID: PMC10032197 DOI: 10.1093/ntr/ntac238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Despite its overall decline in the United States, trends in cigarette smoking could vary by intersection with demographic characteristics. We explored trends in education-related disparities in current smoking among U.S. adults by race (Black or African American and White), sex, and U.S. census region. AIMS AND METHODS Data were from U.S. civilian non-institutionalized adults (aged ≥18 years) who self-identified as Black or African American and White and participated in the 1995-2019 Tobacco Use Supplement to the Current Population Survey. We estimated average annual percent changes in current cigarette smoking by the intersections of race, sex, census region, and educational attainment. We calculated educated-related prevalence differences in current cigarette smoking by subtracting the prevalence of bachelor's degrees from that of RESULTS Education-related disparities in current cigarette smoking increased over time, especially among Black or African American male (PD1995-1996 = 22.8%; PD2018-2019 = 27.2%) and female adults (PD1995-1996 = 12.1%; PD2018-2019 = 16.5%). By region, Black or African American male adults in the Midwest showed the largest increase in education-related current cigarette smoking disparities, followed by Black or African American male and female adults in the South, and White male and female adults in the Midwest. These findings were because of small to no declines in the prevalence of current cigarette smoking among those with CONCLUSION AND RELEVANCE The gap in the prevalence of current cigarette smoking by education widened over time, especially among Black or African American adults in certain regions. IMPLICATIONS Despite the decline in the prevalence of current cigarette smoking in the U.S. population overall, such public health gain may not benefit all individuals equally. Using the data from a U.S. representative serial cross-sectional survey study during 1995-2019, we found that disparities in current cigarette smoking prevalence between those with
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Affiliation(s)
- Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Jamal T Jones
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, Maryland, USA
| | - Andrea L Ruybal
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, Maryland, USA
| | | | - Danielle A Duarte
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Monica Webb Hooper
- Office of the Director, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
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11
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Jackson A, Fleischli ME, Haeny AM, Rose SW, Fagan P, Krishnan-Sarin S, Gerrard M, Gibbons FX. Association of Non-Cigarette Tobacco Advertisements and Racial Discrimination With Non-Cigarette Tobacco Product Use Among Black Adults. Nicotine Tob Res 2023; 25:781-787. [PMID: 36169563 PMCID: PMC10032198 DOI: 10.1093/ntr/ntac226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 09/11/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Black communities are targeted by more cigarette advertisements than White communities and racial discrimination among Black people is related to cigarette use. However, little is known about these factors with non-cigarette tobacco product use among Black adults. Therefore, this study assessed the association of non-cigarette advertisement exposure and racial discrimination with use of non-cigarette tobacco products among Black adults. AIMS AND METHODS Black adults (n = 533) from The Family and Community Health Study in 2016 were asked if they had seen advertisements for e-cigarettes, snus pouches, filtered cigars, large cigars, cigarillos, dissolvable tobacco, smokeless tobacco, hookah, and tobacco pipe and if they used these in the past month. For products with the highest past month use and significant correlations with advertisement exposure, separate logistic regression models were performed that evaluated the association between advertisement exposure, racial discrimination, and non-cigarette tobacco product use while controlling for cigarette use, sex, socioeconomic status, and age. RESULTS Use of cigarillos, large cigars, and hookah were higher than other non-cigarette tobacco products assessed. Logistic regressions revealed that more advertisement exposure in the past month was associated with higher odds of using cigarillos, large cigars, and hookah (p < .01). More experiences of racial discrimination were associated with past month cigarillo use, but not hookah or large cigars (p < .01). CONCLUSIONS Non-cigarette tobacco advertisement exposure was associated with the use of non-cigarette tobacco products. Experiences of racial discrimination were associated with the most used non-cigarette tobacco product among Black adults, cigarillos. IMPLICATIONS This is the first time that a specific type of cigar (ie cigarillos) has been associated with experiences of racial discrimination among Black adults. Efforts to reduce non-cigarette tobacco marketing and eradicate exposure to racial discrimination among Black adults may aid in eliminating tobacco-related health disparities.
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Affiliation(s)
- Asti Jackson
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Mary E Fleischli
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Angela M Haeny
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Shyanika W Rose
- Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, USA
| | - Pebbles Fagan
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | | | - Meg Gerrard
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Frederick X Gibbons
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
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12
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Clawson AH, Cole AB, Ruppe NM, Nwankwo CN, Blair AL, Berlin KS, Naifeh MM. Smoking across adolescence and adulthood with cardiovascular risk among American Indian peoples. Health Psychol 2022; 41:912-922. [PMID: 36048076 PMCID: PMC9829078 DOI: 10.1037/hea0001227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE American Indian peoples (AIs) have high smoking rates and cardiovascular risk factor burden. The present study aimed to (a) investigate latent smoking classes across adolescence and adulthood, (b) investigate adolescent predictors of smoking classes, and (c) assess how smoking class is related to adult cardiovascular risk in a sample of AIs. METHOD A sample of AIs (N = 338) from the National Adolescent to Adult Health Study self-reported on smoking across four assessment waves (W1: 7th-12th grade; W2: 8th-12th grade; W3: ages 18-26; W4: ages 24-32). The socioecological framework for addressing tobacco-related disparities was used to identify potential adolescent (W1) risk and resource factors. C-reactive protein, blood pressure, and lipids were collected at W4. Growth mixture modeling and regressions were used. RESULTS Six smoking classes were identified: light smoking (36%), nonsmoking (23%), escalating, adult daily smoking (13%), chronic heavy smoking (12%), escalating, young adult daily smoking (9%), and reducing smoking (7%). Risk factors for being in the chronic heavy smoking class included peer smoking and older age at W1. Compared with the chronic heavy smoking class, AIs in the reducing smoking class lived in in more impoverished neighborhoods during adolescence. Relative to several classes with less smoking, being in the chronic heavy smoking class was associated with higher C-reactive protein and less favorable lipid levels. W1 social support was a resource factor for adult diastolic blood pressure and some lipids. CONCLUSIONS Socioecologically informed tobacco interventions have the potential to reduce smoking and cardiovascular risk among AIs, and bolstering social support may be important. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Ashley H. Clawson
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
| | - Ashley B. Cole
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
| | - Nicole M. Ruppe
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
| | - Cara N. Nwankwo
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
| | - Alexandra L. Blair
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
| | - Kristoffer S. Berlin
- The University of Memphis, Psychology, 202 Psychology, Memphis, TN 38152
- University of Tennessee Health Science Center, Memphis, Pediatrics, Memphis, TN
| | - Monique M. Naifeh
- Department of Pediatrics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
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13
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Clawson AH, Cole AB, Kurien CS, Blair AL. Racial and ethnic differences in distress, discrimination, substance use coping, and nicotine use among parents during COVID-19. J Ethn Subst Abuse 2022:1-24. [PMID: 36227608 PMCID: PMC10097833 DOI: 10.1080/15332640.2022.2128960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study identified contributing factors for tobacco-related inequities among parents (N = 331) during COVID-19. Compared to non-Hispanic White parents, Asian, Black, and multiracial parents experienced greater discrimination. Parents with a nicotine use history experienced greater discrimination and substance use coping relative to tobacco abstainers. Among parents who used nicotine during the pandemic (n = 45), experiencing financial loss, having COVID-19, and greater worries were positively associated with nicotine reductions during COVID-19. Being female, increased family members with COVID-19, discrimination, and substance use coping were negatively associated with nicotine reductions. Tobacco interventions that reduce substance use coping and increase alternative coping are needed.
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Affiliation(s)
- Ashley H. Clawson
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
| | - Ashley B. Cole
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
| | | | - Alexandra L. Blair
- Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, Oklahoma, 74078
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14
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Heris C, Scully M, Chamberlain C, White V. E-cigarette use and the relationship to smoking among Aboriginal and Torres Strait Islander and non-Indigenous Australian Secondary Students, 2017. Aust N Z J Public Health 2022; 46:807-813. [PMID: 36121281 DOI: 10.1111/1753-6405.13299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Estimate the prevalence of e-cigarette use (vaping) among Aboriginal and Torres Strait Islander adolescents and explore the relationship between vaping and tobacco use. METHODS N=18,199 students aged 12-17 years (n=1,097 Aboriginal and Torres Strait Islander) participating in the 2017 Australian Secondary Students' Alcohol and Drug (ASSAD) Survey self-reported their e-cigarette and lifetime, past month and past week smoking behaviours. RESULTS Twenty-two per cent of Aboriginal and Torres Strait Islander students (14% all) reported having ever used e-cigarettes. Significantly greater odds of e-cigarette use among Aboriginal and Torres Strait Islander students was observed overall, but not among regular (past month/week) smokers. There were significant associations between e-cigarette use and any level of smoking for all students (p<0.001), with no variation by Indigenous status. While e-cigarette use was more common among smokers, 28% of Aboriginal and Torres Strait Islander ever-vapers (35% all ever-vapers) were never smokers. CONCLUSIONS There is substantial prevalence of e-cigarette ever-use among Australian secondary students, including Aboriginal and Torres Strait Islander students, and a strong relationship with tobacco use. IMPLICATIONS FOR PUBLIC HEALTH Policies facilitating e-cigarette access must not undercut tobacco control efforts for adolescents, particularly Aboriginal and Torres Strait Islander people who continue to experience higher smoking rates.
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Affiliation(s)
- Christina Heris
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria
| | - Catherine Chamberlain
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria.,Judith Lumley Centre, La Trobe University, Melbourne, Victoria.,NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch, Western Australia
| | - Victoria White
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria.,School of Psychology, Deakin University, Burwood, Victoria
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15
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Donaldson CD, Stupplebeen DA, Fecho CL, Ta T, Zhang X, Williams RJ. Nicotine vaping for relaxation and coping: Race/ethnicity differences and social connectedness mechanisms. Addict Behav 2022; 132:107365. [PMID: 35605411 DOI: 10.1016/j.addbeh.2022.107365] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/13/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022]
Abstract
The current study examined race- and ethnicity-based differences in the reasons that youth report for vaping, with an emphasis on understanding the relationship between race/ethnicity and vaping for relaxation and stress/anxiety coping. This work also sought to go beyond examining race-based differences as a cause of tobacco-use disparities by assessing social connectedness factors that mediate relationships between race/ethnicity and vaping for relaxation and coping. Research questions were tested using data from the 2019-2020 California Student Tobacco Survey, a representative school-based survey of 10th and 12th grade public school students throughout schools in California. Overall, 7.78% of the sample reported using nicotine vapes in the past 30 days. The final sample included 11,112 high school student current vape users. The most important reason that youth vaped was for relaxation and stress/anxiety coping, with racial and ethnic minorities most likely to report this vaping motivation. Analyses of the structural mechanisms underlying the relationship between race/ethnicity and vaping reasons showed that minority youth reported lower school, peer, and family connectedness when compared to White youth. Lower school and family connectedness were in turn correlated with being motivated to vape to relax or relieve stress and anxiety, and lower overall mental health. Findings imply that future intervention efforts might profitably focus on reducing stressors associated with relaxation and stress/anxiety coping motivations and highlight the importance of connectedness for indirectly decreasing vape use risk by improving negative mood and mental health.
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Affiliation(s)
- Candice D Donaldson
- California Tobacco Control Program, California Department of Public Health, Sacramento, CA, United States.
| | - David A Stupplebeen
- California Tobacco Control Program, California Department of Public Health, Sacramento, CA, United States
| | - Cassandra L Fecho
- California Tobacco Control Program, California Department of Public Health, Sacramento, CA, United States; Cal-EIS Program, California Department of Public Health, Sacramento, CA, United States
| | - Tiffany Ta
- California Tobacco Control Program, California Department of Public Health, Sacramento, CA, United States
| | - Xueying Zhang
- California Tobacco Control Program, California Department of Public Health, Sacramento, CA, United States
| | - Rebecca J Williams
- California Tobacco Control Program, California Department of Public Health, Sacramento, CA, United States
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16
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Weinberger AH, Steinberg ML, Mills SD, Dermody SS, Heffner JL, Kong AY, Pang RD, Rosen RL. Assessing Sex, Gender Identity, Sexual Orientation, Race, Ethnicity, Socioeconomic Status, and Mental Health Concerns in Tobacco Use Disorder Treatment Research: Measurement Challenges and Recommendations From a Society for Research on Nicotine and Tobacco Pre-conference Workshop. Nicotine Tob Res 2022; 24:643-653. [PMID: 34622932 PMCID: PMC8962699 DOI: 10.1093/ntr/ntab201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022]
Abstract
This paper reports on topics discussed at a Society for Research on Nicotine and Tobacco pre-conference workshop at the 2019 annual Society for Research on Nicotine and Tobacco meeting. The goal of the pre-conference workshop was to help develop a shared understanding of the importance of several tobacco-related priority groups in tobacco use disorder (TUD) treatment research and to highlight challenges in measurement related to these groups. The workshop focused on persons with minoritized sex, gender identity, and sexual orientation identities; persons with minoritized racial and ethnic backgrounds; persons with lower socioeconomic status (SES); and persons with mental health concerns. In addition to experiencing commercial tobacco-related health disparities, these groups are also underrepresented in tobacco research, including TUD treatment studies. Importantly, there is wide variation in how and whether researchers are identifying variation within these priority groups. Best practices for measuring and reporting sex, gender identity, sexual orientation, race, ethnicity, SES, and mental health concerns in TUD treatment research are needed. This paper provides information about measurement challenges when including these groups in TUD treatment research and specific recommendations about how to measure these groups and assess potential disparities in outcomes. The goal of this paper is to encourage TUD treatment researchers to use measurement best practices in these priority groups in an effort to conduct meaningful and equity-promoting research. Increasing the inclusion and visibility of these groups in TUD treatment research will help to move the field forward in decreasing tobacco-related health disparities. Implications: Tobacco-related disparities exist for a number of priority groups including, among others, women, individuals with minoritized sexual and gender identities, individuals with minoritized racial and ethnic backgrounds, individuals with lower SES, and individuals with mental health concerns. Research on TUD treatments for many of these subgroups is lacking. Accurate assessment and consideration of these subgroups will provide needed information about efficacious and effective TUD treatments, about potential mediators and moderators, and for accurately describing study samples, all critical elements for reducing tobacco-related disparities, and improving diversity, equity, and inclusion in TUD treatment research.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marc L Steinberg
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Sarah D Mills
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah S Dermody
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Jaimee L Heffner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA,USA
| | - Amanda Y Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Raina D Pang
- Department of Preventive Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Rachel L Rosen
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
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17
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Maddox R, Bovill M, Waa A, Gifford H, Tautolo ES, Nez Henderson P, Martinez S, Clark H, Bradbrook S, Calma T. Reflections on Indigenous commercial tobacco control: 'The dolphins will always take us home'. Tob Control 2022; 31:348-351. [PMID: 35241610 DOI: 10.1136/tobaccocontrol-2021-056571] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Raglan Maddox
- Modewa Clan, Milne Bay, Papua New Guinea
- Aboriginal and Torres Strait Islander Health Group, National Centre for Epidemiology and Public Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Michelle Bovill
- Wiradjuri, New South Wales, New South Wales, Australia
- School of Health and Medicine, Hunter Medical Research Institute, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Andrew Waa
- Ngāti Hine/Ngāpuhi, Aotearoa, New Zealand
- Eru Pomare Māori Health Research Unit, University of Otago, Wellington, New Zealand
| | - Heather Gifford
- Ngāti Hauiti, Aotearoa, New Zealand
- Research for Māori Health and Development, Whakauae Research Services, Whanganui, New Zealand
| | - El-Shadan Tautolo
- Samoa/Ngāti Tapuniu, Samoa, Samoa
- AUT Pacific Health Research Centre, Auckland University of Technology, Auckland, New Zealand
| | - Patricia Nez Henderson
- Navajo Nation (Diné), Turtle Island, Arizona, USA
- Black Hills Center for American Indian Health, Rapid City, South Dakota, USA
| | - Sydney Martinez
- Cherokee Nation Citizen, Tahlequah, Oklahoma, USA
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Hershel Clark
- Navajo Nation (Diné), Turtle Island, Arizona, USA
- Black Hills Center for American Indian Health, Rapid City, South Dakota, USA
| | - Shane Bradbrook
- Ngāi Tāmanuhiri, Rongowhakaata, Ngāti Kahungunu, Aotearoa, New Zealand
| | - Tom Calma
- Elder from the Kungarakan tribal group and a member of the Iwaidja tribal group, Northern Territory, South Australia, Australia
- Office of the National Coordinator, Tackling Indigenous Smoking, Canberra, Australian Capital Territory, Australia
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18
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Durkin SJ, Brennan E, Wakefield MA. Optimising tobacco control campaigns within a changing media landscape and among priority populations. Tob Control 2022; 31:284-290. [PMID: 35241601 DOI: 10.1136/tobaccocontrol-2021-056558] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/17/2021] [Indexed: 11/04/2022]
Abstract
Reviews published over the past decade confirm tobacco control campaigns can be effective for influencing adult and youth tobacco use behaviours, with strengthening evidence for high cost-effectiveness. Evidence is also accumulating for positive campaign effects on interpersonal discussions, social norms and policy support that can help motivate and sustain quitting and reduce uptake. Research needs over the next decade centre on the rapidly changing media environment and the equity of campaign effects among high smoking prevalence communities. The field needs specific evidence on: how to measure total campaign reach and frequency across the diverse range of media platforms and channels; the optimum mix of traditional, digital and social media to achieve behaviour change, especially among high smoking prevalence communities; the relative reach and impact of the wide variety of integrated, digital and social media message delivery methods; the relative effectiveness of messages that aim to build capacity to quit and optimum methods for combining motivational and capacity-building messages, especially for high prevalence groups who face additional barriers to staying quit; the ongoing effectiveness of traditional versus new versions of messages highlighting tobacco industry practices; the influence of e-cigarette use on tobacco control campaign effects; and the effectiveness of different types of campaigns aiming to prevent e-cigarette uptake and motivate e-cigarette cessation. Research is also needed to investigate the potential for campaigns to influence the public's understanding and support for endgame tobacco control policies and for campaign elements that may influence the social and environmental contexts surrounding smokers that support and maintain behaviour change.
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Affiliation(s)
- Sarah J Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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19
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Rahman T, Baker AL, Gould GS, Palazzi K, Lambkin D, Kennedy M. Factors Associated with Smoke-Free Pregnancy among Aboriginal and Torres Strait Women and Their Experience of Quitting Smoking in Pregnancy: A Mixed Method Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11240. [PMID: 34769756 PMCID: PMC8583423 DOI: 10.3390/ijerph182111240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/10/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022]
Abstract
Smoke-free pregnancies have long-term health benefits for mothers and babies. This paper quantitatively examines factors associated with smoke-free pregnancies among Aboriginal and Torres Strait Islander women (hereafter Aboriginal women) and qualitatively explores their smoking cessation (SC) experiences during pregnancy. An Aboriginal-led online cross-sectional study on SC was conducted with Aboriginal women and in partnership with Aboriginal communities, between July and October 2020. The present analysis includes participants who made a pregnancy-related quit attempt (N = 103). Chi-squared tests, logistic regression models, and thematic analysis of free-form text responses were performed. The adjusted odds of having smoke-free pregnancies were 4.54 times higher among participants who used Aboriginal Health Services (AHS) (AOR = 4.54, p-value 0.018). Participants living in urban settings had 67% lower odds of having smoke-free pregnancies compared to their regional/remote counterparts (AOR = 0.33, p-value 0.020). Qualitative data revealed strong motivations to reduce tobacco-related harms to the fetus and variability in quitting experiences at different stages of and across pregnancies. Smoking cessation care (SCC) can support Aboriginal women meaningfully if their quitting experiences are considered in SCC development and implementation. Consistent funding for AHS-led SCC is needed to garner health benefits for Aboriginal peoples. More research into urban versus regional/remote differences in maternal SC is recommended.
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Affiliation(s)
- Tabassum Rahman
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Amanda L. Baker
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Gillian S. Gould
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW 2450, Australia;
| | - Kerrin Palazzi
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - David Lambkin
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Michelle Kennedy
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
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