Pathways and Processes to Co-occurring Obesity and Tobacco Use in Emerging Adults

摘要 青少年和年轻人中的肥胖和烟草使用仍然是最紧迫的公共卫生问题 美国的担忧；两者都与健康领域的普遍下降有关。从 青春期到青壮年--即将成年--是检查这些健康状况的关键时期-- 风险；在这一发育阶段经常出现有问题的物质使用，在此期间出现肥胖状态 月经是慢性肥胖症的预测。肥胖症与药物使用共同发生的研究表明 肥胖与烟草使用之间的联系；然而，这种共同发生的途径和过程 都不清楚。此外，目前尚不清楚肥胖和烟草使用之间的联系是否延伸到电子烟。 香烟/蒸气的使用，这在过去十年中激增。目前的研究试图找出 肥胖和烟草使用(吸烟、吸烟)共同发生的发育途径和风险过程 使用香烟/蒸气)。这项研究旨在收集纵向健康风险调查数据 (两年内五个时间点)来自N=1,450名年轻人(18-24岁)的概率样本，登记为 加州州立大学长滩分校的本科生。参与者将从以下地点招募 随机抽取班级，要求他们在两年内完成五项在线调查。这项调查 包括体重状况、营养、体力活动、自我调节、社会关系、 心理社会适应和物质使用。鉴于从青春期到青壮年的过渡是 以重大的生活变化为特征，以及神经认知和社会情感挑战，关键 斯坦伯格的双重系统模型，里马尔和雷亚尔的规范社会行为理论，以及 Lazarus和Folkman的压力和应对交易模型构建了研究的概念模型。钥匙 研究目标包括：(1)确定肥胖和烟草使用同时发生的程度 成年期并确定(肥胖→烟草使用；烟草使用→肥胖)共同发生的途径；(2) 确定共同发生的肥胖和烟草使用的潜在过程，包括生物行为(冲动， 感觉寻求)、社会背景(社会接受、体重污名、不正常的同伴关系)以及 社会心理因素(抑郁、社交焦虑、感受到的压力)；以及(3)评估是否肥胖 来自特定种族/性别群体的新兴成年人吸烟的风险更高或更低 和/或电子烟/电子烟的使用。由于肥胖和烟草使用都给医疗保健带来了沉重的负担 系统，确定肥胖与成年初期吸烟有关的途径和过程 很可能对旨在缓解共生现象的预防和干预努力产生重大影响 健康--生命早期的风险。

Abstract Obesity and tobacco use among adolescents and young adults remain two of the most pressing public health concerns in the U.S.; both are linked to pervasive declines across health domains. The transition from adolescence to young adulthood – emerging adulthood - presents a critical period for examining these health- risks; problematic substance use often emerges during this developmental stage and obesity status during this period is predictive of chronic obesity. Research on co-occurring obesity and substance use points to a strong link between obesity and tobacco use; however, the pathways and processes underlying this co-occurrence are unclear. Furthermore, it is unknown whether links between obesity and tobacco use extend to e- cigarette/vaping use, which has surged in popularity in the past decade. The current study seeks to identify developmental pathways and risk processes to co-occurring obesity and tobacco use (cigarette smoking, e- cigarette/vaping use) during emerging adulthood. The study aims to collect longitudinal health-risk survey data (five timepoints over two years) from a probability sample of N = 1,450 young adults (18-24 years) enrolled as undergraduates at California State University, Long Beach (CSULB). Participants will be recruited from randomly sampled classes and asked to complete five online surveys over a two-year period. The survey includes questions on weight status, nutrition, physical activity, self-regulation, social relationships, psychosocial adjustment, and substance use. Given that the transition from adolescence to young adulthood is characterized by significant life changes, along with neurocognitive and socio-emotional challenges, key aspects of Steinberg’s Dual-Systems Model, Rimal and Real’s Theory of Normative Social Behavior, and Lazarus and Folkman’s Transactional Model of Stress and Coping frame the study’s conceptual model. Key study aims include: (1) determine the extent to which obesity and tobacco use co-occur during emerging adulthood and identify the pathways (obesity → tobacco use; tobacco use → obesity) to co-occurrence; (2) identify processes underlying co-occurring obesity and tobacco use, including biobehavioral (impulsivity, sensation-seeking), socio-contextual (social acceptance, weight stigma, deviant peer affiliation), and psychosocial (depression, social anxiety, perceived stress) components; and (3) evaluate whether obese emerging adults from specific ethnic/gender groups are at higher or lower risk of engaging in cigarette smoking and/or e-cigarette/vaping use. As both obesity and tobacco use place severe burdens on the health care system, identifying pathways and processes by which obesity is related to tobacco use in emerging adulthood is likely to have significant implications for prevention and intervention efforts aimed at mitigating co-occurring health-risks earlier in the lifespan.