Behavioral and Environmental Contributors to Tobacco Disparities in Rural Youth

描述（由申请人提供）：农村人口吸烟是一个紧迫的公共卫生问题。生活在农村地区的个人受到烟草使用的不成比例的影响，横断面调查不断显示，与大都市地区相比，农村地区吸烟和无烟烟草使用的流行率更高。虽然关于青少年烟草使用的科学知识在过去几十年中有了显著增长，但其中大部分知识主要是基于生活在城市地区的青少年。拟议的工作利用明尼苏达州十多年来现有的纵向数据来描述可能导致农村社区烟草相关差异的重要因素。当前提案的目的是：(1)研究农村和都市青年在青春期和青年期吸烟和无烟烟草使用进展方面的差异；(2)评估农村和都市地区的社会和烟草控制环境有何不同，以及这些环境如何解释农村和都市青年吸烟率和吸烟模式的差异。据推测，与都市青年相比，农村地区的青年有更高的开始率和更早的年龄，更严重的使用模式，更少的戒烟尝试和更低的戒烟率。进一步假设农村青年在其社会网络中报告的吸烟水平较高，吸烟的社会可接受性更高，更容易获得烟草，接触到的烟草控制政策比大都市地区的青年少，这些因素将与农村青年更严重的使用模式有关。我们还将研究与农村和都市青年吸烟率差异相关的因素在佛罗里达州的大量不同青年样本中是否具有可比性。我们假设，与明尼苏达州农村和都市青年吸烟率差异相关的因素将在佛罗里达州具有可比性。所提出的方法是创新的，因为它包括一项重复测量设计，其中包括来自农村和大都市地区的大量青年样本，以及从青春期到青年期烟草使用行为的详细和频繁数据，以及行为与可能影响农村青年烟草使用和戒烟的众多社会因素之间的联系。拟议的项目有望通过提供在横断面研究中观察到的与农村青年中烟草差异相关的因素的详细了解，促进我们对农村青年中烟草相关差异的理解。重要的是，拟议的项目将为设计旨在减少农村人口烟草使用的有效干预措施提供证据基础。

DESCRIPTION (provided by applicant): Tobacco use in rural populations is a pressing public health issue. Individuals living in rural areas suffer disproportionately from tobacco use, with cross-sectional surveys consistently showing higher prevalence rates of cigarette smoking and smokeless tobacco use in rural areas compared to metropolitan areas. While the scientific knowledge about adolescent tobacco use has grown significantly in the past several decades, most of this knowledge is based primarily on youth living in urban areas. The proposed work utilizes over a decade of existing longitudinal data from Minnesota to characterize important factors that may contribute to tobacco-related disparities in rural communities. The aims of the current proposal are to: (1) examine differences in the progression of cigarette smoking and smokeless tobacco use among rural and metropolitan youth during adolescence and young adulthood and (2) assess how the social and tobacco control environments differ in rural and metropolitan areas, and how these account for differences in rates and patterns of smoking among rural and metropolitan youth. Youth in rural areas are hypothesized to show higher rates of initiation and at earlier ages, heavier use patterns, fewer quit attempts, and lower rates of cessation compared to metropolitan youth. Rural youth are further hypothesized to report higher levels of smoking among their social networks, greater social acceptability of smoking, greater access to tobacco, and exposure to fewer tobacco control policies than youth in metropolitan areas and that these factors will relate to heavier patterns of use among rural youth. We will also examine if factors associated with differences in rates of tobacco use among rural and metropolitan youth are comparable in a large diverse sample of youth from Florida. We hypothesize that the factors associated with differences in rates of smoking among rural and metropolitan youth in Minnesota will be comparable in Florida. The proposed approach is innovative because it includes a repeated measures design with a large sample of youth from rural and metropolitan areas, along with detailed and frequent data about tobacco use behaviors from adolescence to young adulthood, as well as links between behavior and a multitude of social factors that may affect tobacco use and cessation among rural youth. The proposed project is expected to advance our understanding of tobacco-related disparities among rural youth by providing a detailed understanding of factors associated with tobacco disparities in rural youth that have been observed in cross-sectional studies. Importantly, the proposed project will provide an evidence base for designing effective interventions aimed at reducing tobacco use in rural populations.