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

项目摘要 种族和族裔少数群体以及SES低的个人不成比例地经历与烟草相关的健康 不平等，包括慢性病和过早死亡。多种烟草的使用--作为并发操作 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(结束)--有 近年来，在新兴的成年烟草使用者中，特别是少数族裔，出现了上升趋势。研究的前提是 基于少数群体中与烟草有关的持续健康差距和对因素的不充分了解 导致使用多种烟草或造成相对危害的。对NIH声明的需求的影响(PAR-17-473) 进行全面的社会环境调查，以增进我们的知识，这项研究将 应用新的社会-空间方法，揭示个人、邻里、县、 以及与美国新兴成年人中的多用途相关的州一级背景。具体目标将有新的突破 关注不同的风险(目标1)、过渡(目标2)和背景的调节作用(目标3) 不同种族、民族和低SES人群的烟草使用情况。压倒一切的假设是，少数人在多种多样的 烟草的使用不是仅仅通过个人因素来解释的，而是受到以下因素的影响 新兴成年人生活、工作、学习和娱乐的环境。通过Aim 1，我们希望揭开 关于不同类别烟草使用者的相对个人风险或危害的新信息，以及 产品，跨越少数群体-潜在地为新的生物学和行为研究提供信息。每个目标 2，我们将确定随着时间的推移，影响从单一用途向双重用途或多用途转变的因素，其中 TURN可能会告知如何防止某些烟草产品，特别是最有害的烟草产品升级 可燃产品。根据目标3，因为我们预计使用多种烟草最好的解释是 结合个人和社会环境因素，我们希望揭示丰富的新知识 语境的影响。我们无疑会发现个人的人口统计和行为因素 解释一次、两次和多次使用结果的显著差异百分比。然而，想象一下， 如果我们不仅能够发现有助于烟草控制的社会环境领域， 而且这些领域内的因素也解释了剩余的百分比--以及跨不同种族的， 种族，和低社会经济地位的人口。这些知识对与烟草相关的健康差距的潜在影响 是高的。

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.