Understanding and reducing health disparities through social and behavioral research

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Understanding inter-relationships between social determinants and tobacco use With the increase in e-cigarette use in the US, we examined whether e-cigarette use can reduce disparities in cigarette smoking in the US. We analyzed the Tobacco Use Supplement of the Current Population Survey (TUS-CPS) and found that the prevalence of daily e-cigarette use, a behavior that is associated with smoking cessation, is low in the US adult smoker population. Additionally, the prevalence is particularly low among non-Hispanic Blacks, suggesting the e-cigarettes may increase smoking disparities by race. In a different study, we analyzed the Population Assessment of Tobacco and Health (PATH) study data to examine the association between secondhand smoke exposure and subsequent academic performance among youth. We found that youth who were exposed to more secondhand smoke (measured by hours per week) had lower subsequent academic performance compared to those who were not exposed to secondhand smoke. This finding suggests that secondhand smoke exposure could influence academic performance, which I an important factor for enrolling in post-secondary education. Investigate mediating and moderating factors associated with tobacco use disparities We continue to examine how tobacco marketing influence tobacco use behaviors. We analyzed data from the Population Assessment of Tobacco and Health (PATH) study and found that exposure to e-cigarette marketing is associated with subsequent e-cigarette experimentation among youth and young adult. In a focus group study with a racial/ethnically diverse group of young adult smokers, we explored their perceptions related to smoking cessation treatments, and found that many of them expressed negative perceptions toward these treatments. These findings indicate the need to better communicate efficacy of these treatment and facilitate access to them among young adult smokers, especially those in racial/ethnic minority populations. In collaboration with the PATH Study team, we examined how harm perceptions of tobacco products changes over time and how they relate to tobacco use behaviors. We found that perceived tobacco products to be harm was associated with not using the product, but use of product was also associated with lower harm perception subsequently. This highlight the importance of matching health risk messages with tobacco use behaviors to prevent tobacco use vs. promote cessation. In a separate analysis, we worked with the PATH Study team to examine if e-cigarette and pharmacotherapy use among smokers attempting to quit smoking are associated with long-term smoking cessation. We found that e-cigarette use, nor pharmacotherapy, was associated with long-term smoking cessation. This provides evidence on whether e-cigarettes should be used for smoking cessation, and highlight the limited efficacy of the current pharmacotherapy for smoking cessation. Investigate the impact of tobacco use patterns and health outcomes Through a collaboration with extramural investigators, we examined the Youth Risk Behavioral Survey data and found that e-cigarette use was associated with asthma among youth, independent of cigarette and marijuana use. This provides additional evidence on the possible health impact of e-cigarette on youth respiratory health. COVID-19 and Tobacco Use We have developed a study to examine how COVID-19 impact adult tobacco users, and how they have modified their tobacco use behaviors accordingly. The study has complete internal review and is schedule to launch in late FY2020.