Parental Influences on Tobacco Use among Sexual Minority Young Adults in a New Market and Policy Landscape

项目摘要/摘要 青年时期(YA)是从事包括吸烟在内的危险行为和建立生活方式的关键时期 对健康有长期影响。近几十年来，美国的烟草使用情况发生了变化，减少了 香烟使用量增加，同时替代烟草产品(ATP；电子烟、雪茄、 无烟烟草，水烟)。这些复杂性由于不断演变的烟草政策背景和 多种烟草使用的增加。这些产品的使用对弱势群体的影响不成比例，包括性 少数族裔雅族。确定传统和三磷酸腺苷使用中的性取向差异的机制至关重要 为减少使用和差异的干预措施提供信息。然而，在机制方面存在很大差距。 这就解释了这些差异。YA烟草使用的重要预测因素是育儿行为和心理健康问题， 考虑到社区和社会的众多，这可能会对性少数族裔雅族产生特别强烈的影响 在此期间对烟草使用的影响。这份F32应用程序旨在催化Romm博士在职业生涯中的成就 目标-建立一个独立的研究计划，致力于阐明健康风险的多水平决定因素 在易受伤害的青少年和YA人群中进行行为调查，并告知预防和减少此类行为的干预措施 行为。这项建议充分利用了罗姆博士现有的技能和经验，并提供了高级培训 多层次行为理论、健康差异和干预研究；2)为她的专业人员提供指导支持 开发；以及3)指导和独立研究的资源，以促进以下方面的新颖研究：a) 一个特别脆弱的人口--性少数群体；b)解释性取向的多层次机制 YA烟草使用的差异；以及c)传统和ATP的使用，这与当今不断演变的烟草高度相关 背景。更具体地说，培训将直接提高Romm博士执行3项计划所需的技能和专业知识 研究的目的是：1)检验性取向(区分异性恋、双性恋和男/女同性恋)与 YA男性和女性使用传统和ATP的变化；2)记录不同的关联 男性和女性少数性别者与异性雅族人的育儿行为和烟草使用情况；以及3)确定 父母教养行为对烟草使用行为影响的中介和调节变量 异性恋的雅斯。这项拟议的研究利用了发展框架、社会认知理论和少数群体 压力理论，以及多种研究方法，包括为期一年的纵向调查设计和定性访谈。 最终，这项提议将推动一位有前途的年轻调查员的高影响力职业生涯，并为以家庭为基础的 在快速发展的烟草格局中减少YA烟草使用中的性取向差异的干预措施。

PROJECT SUMMARY/ABSTRACT Young adulthood (YA) is a critical period for engaging in risk behaviors, including tobacco use, and establishing lifestyles with long-term health implications. The landscape of tobacco use in the US has changed in recent decades, with decreases in cigarette use coupled with increases in the use of alternative tobacco products (ATPs; electronic cigarettes, cigars, smokeless tobacco, hookah). These complexities are further compounded by an evolving tobacco policy context and increases in polytobacco use. The use of these products disproportionately impacts vulnerable subgroups, including sexual minority YAs. Identifying mechanisms accounting for sexual orientation disparities in traditional and ATP use is critical for informing interventions to reduce use and disparities. However, there is a substantial gap regarding the mechanisms that explain these disparities. Important predictors of YA tobacco use are parenting behaviors and mental health problems, which may have particularly strong influences for sexual minority YAs, given the multitude of community and social impacts on tobacco use during this time. This F32 application aims to catalyze Dr. Romm’s achievement of her career goal – to establish an independent research program devoted to elucidating multilevel determinants of health-risk behaviors among vulnerable adolescent and YA populations and inform interventions to prevent and reduce such behaviors. This proposal capitalizes on Dr. Romm’s existing skills and experience, and provides 1) training in advanced multilevel behavioral theories, health disparities, and intervention research; 2) mentored support for her professional development; and 3) resources for mentored and independent research to advance novel research at the intersection of: a) a particularly vulnerable population – sexual minority YAs; b) multilevel mechanisms that explain sexual orientation disparities in YA tobacco use; and c) use of both traditional and ATPs, highly relevant within today’s evolving tobacco context. More specifically, the training will directly enhance the skills and expertise Dr. Romm requires to execute the 3 research aims, to: 1) examine sexual orientation (distinguishing heterosexual, bisexual, and gay/lesbian) in relation to changes in use of traditional and ATPs among YA men and women; 2) document differential associations between parenting behaviors and tobacco use among male and female sexual minority versus heterosexual YAs; and 3) identify mediators and moderators of the impact of parenting behaviors on tobacco use behaviors among sexual minority versus heterosexual YAs. The proposed research leverages a developmental framework, sociocognitive theory and minority stress theory, and multiple research methods, including a 1-year longitudinal survey design and qualitative interviews. Ultimately, this proposal will advance a high-impact career of a promising young investigator and inform family-based interventions to reduce sexual orientation disparities in YA tobacco use within the rapidly evolving tobacco landscape.