Behavioral and Environmental Contributors to Tobacco Disparities in Rural Youth

说明(申请人提供)：农村人口的烟草使用是一个紧迫的公共卫生问题。生活在农村地区的个人不成比例地遭受烟草使用的影响，横断面调查一贯表明，与城市地区相比，农村地区吸烟和使用无烟烟草的流行率更高。虽然关于青少年吸烟的科学知识在过去几十年中有了显著增长，但这些知识的大部分主要是基于生活在城市地区的青年。这项拟议的工作利用明尼苏达州十多年的现有纵向数据来描述可能导致农村社区与烟草相关的差异的重要因素。本提案的目的是：(1)审查农村和城市青年在青春期和青春期吸烟和使用无烟烟草的进展差异，(2)评估农村和城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城市青年吸烟率和吸烟模式的差异。与城市青年相比，农村地区的青年表现出更高的启动率和更早的年龄，更频繁的使用模式，更少的戒烟尝试，以及更低的戒断率。此外，还假设农村青年在其社交网络中报告的吸烟水平更高，吸烟的社会接受度更高，更容易获得烟草，在大都市地区比青年更少受到烟草控制政策的影响，这些因素将与农村青年中更多的吸烟模式有关。我们还将检查与农村和城市青年烟草使用率差异相关的因素是否在佛罗里达州的大样本中具有可比性。我们假设，与明尼苏达州农村和城市青年吸烟率差异相关的因素在佛罗里达州将是相似的。拟议的方法是创新的，因为它包括一项重复的措施设计，对来自农村和大都市地区的青年进行了大样本调查，并提供了从青春期到成年的烟草使用行为的详细和频繁的数据，以及行为与可能影响农村青年吸烟和戒烟的多种社会因素之间的联系。拟议的项目预计将通过提供对横断面研究中观察到的与农村青年烟草差距有关的因素的详细了解，促进我们对农村青年中与烟草有关的差异的了解。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.