Poly-tobacco use and minority health: Differential risks, transitions, and socio-environmental context

项目摘要 少数种族和少数民族以及社会经济地位低的个人不成比例地经历与烟草有关的健康 不平等，包括慢性病和过早死亡。混合烟草的使用-作为同时 使用三种或三种以上不同的烟草产品，包括电子尼古丁输送系统（ENDS）， 近年来，新出现的成年烟草使用者，特别是少数群体，人数有所增加。研究的前提是 基于少数民族之间与烟草有关的健康差异持续存在，以及对这些因素的了解不足， 导致聚烟草使用或相对危害的因素。对NIH声明需求的影响（PAR-17-473） 为了进行全面的社会环境调查，以增进我们的知识，这项研究将 应用一种新的社会空间方法来揭示个人，邻里，县， 以及与美国新兴成年人使用聚乙烯相关的州一级背景。具体目标将带来新的 轻的差异风险（目标1），过渡（目标2），和背景的调节作用（目标3）的多， 不同种族、民族和低社会经济地位人群的烟草使用情况。最重要的假设是，少数民族的差异，多， 烟草的使用不能仅仅通过个别因素来解释，而是受到以下因素的相互作用的影响： 新兴成年人生活、工作、学习和娱乐的环境。通过目标1，我们希望发现 关于不同类别烟草使用者之间相对个人风险或危害的新信息， 产品，在少数群体中，可能为新的生物学和行为学研究提供信息。根据目标 2，我们将确定随着时间的推移影响从单用途到双用途或多用途过渡的因素， 反过来可能会告诉如何防止升级到某些烟草产品，特别是最有害的 易燃产品。根据目标3，因为我们预计，混合烟草的使用将最好地解释为 结合个人和社会环境因素，我们希望发现丰富的新知识， 背景影响我们将毫无疑问地发现，个人的人口统计和行为因素 解释了单次、双重和聚乙烯使用结局的显著差异百分比。然而，想象一下， 如果我们不仅能够发现社会环境领域的贡献， 而且这些领域内的因素解释了剩余的种族歧视， 少数民族和低社会经济地位人口。这些知识对烟草相关健康差异的潜在影响 很高

Project Summary Racial and ethnic minorities and individuals of low SES disproportionately experience tobacco-related health inequities, including chronic illness and premature death. Poly-tobacco use—operationalized as the concurrent use of three or more different tobacco products, including electronic nicotine delivery systems (ENDS)—has seen an uptick among emerging adult tobacco users in recent years, notably minorities. The study premise is based the persistent tobacco-related health disparities among minorities and inadequate knowledge of factors that contribute poly-tobacco use or the relative harm. Bearing implications for NIH’s stated need (PAR-17-473 ) for comprehensive socio-environmental investigation as means to advance our knowledge, the study will apply a novel socio-spatial approach to uncover the unique contributions of individual, neighborhood-, county-, and state-level contexts associated with poly use among US emerging adults. The specific aims will shed new light on differential risks (Aim 1), transitions (Aim 2), and the moderating effects of context (Aim 3) of poly- tobacco use across race, ethnicity and low SES. The overriding hypothesis is that minority differences in poly- tobacco use are not explained solely through individual factors but are influenced by the interplay of environments in which emerging adults live, work, study, and play. Through Aim 1, we expect to uncover new information about the relative individual risks or harm among different categories of tobacco users and products, across minority groups—potentially informing both new biological and behavioral studies. Per Aim 2, we will determine factors that influence the transitions from single to dual or poly use over time, which in turn may inform how to prevent escalation to certain tobacco products, especially the most harmful combustible products. Pursuant of Aim 3, because we expect that poly-tobacco use will be best explained by a combination of personal and socio-environmental factors, we expect to uncover rich, new knowledge about contextual influences. We will undoubtedly uncover that individual demographic and behavioral factors explain a significant percentage of the variance in single, dual, and poly use outcomes. Imagine, however, the advancements in tobacco control if we could uncover not only the contributing socio-environmental domains, but also the factors within those domains that explain the remaining percentage—and across diverse racial, ethnic, and low SES populations. The potential impact of such knowledge on tobacco-related health disparities is high.