Socioeconomic status and smoking exposure in Appalachia

阿巴拉契亚地区的社会经济状况和吸烟暴露

• 批准号: 8181854
• 负责人: JOSHUA E MUSCAT
• 金额: $ 32.15万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8181854
• 关键词: Accounting; Address; Affect; Air; Appalachian Region; Behavior; Biological; Biological Markers; Biological Markers; Breathing; Cancer Control; Carbon Monoxide; Carcinogens; Cigarette; Cigarette Smoker; Cohort Studies; Communities; Cotinine; Diet; Disease; Dose; Early Diagnosis; Early treatment; Educational Background; Environment; Exposure to; Goals; Habits; Incidence; Intake; Laboratory Study; Length; Life Style; Lung; Mainstreaming; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Medically Underserved Area; Nicotine; Occupational Status; Occupations; Patient Self-Report; Pattern; Pennsylvania; Persons; Population; Population Heterogeneity; Prevention strategy; Prostate; Psychological Stress; Recording of previous events; Reporting; Research Personnel; Risk; Risk Factors; Salivary; Screening procedure; Smoke; Smoker; Smoking; Smoking Behavior; Socioeconomic Status; Stress; Study Section; Testing; Tobacco; Tobacco smoke; Toxin; United States National Institutes of Health; Variant; base; cancer prevention; cancer risk; cigarette smoking; instrumentation; interdisciplinary approach; low socioeconomic status; malignant breast neoplasm; malignant mouth neoplasm; medically underserved; mortality; prospective; psychologic; research study; smoke inhalation; smoking prevalence; social inequality; socioeconomics

DESCRIPTION (provided by applicant): Social inequalities are an important predictor of disease incidence, including cancer. Persons with low socioeconomic status (SES) have increased rates of lung and other tobacco-related cancers. Although smoking prevalence is higher in persons with lower levels of education and occupational status, smoking prevalence does not explain this excess risk. In prospective cohort studies, the associations between low SES and elevated lung cancer risk persist after adjustment for smoking amount and duration. The investigators' overall hypothesis is that the unaccounted increased risk in populations with lower SES is due to higher smoke exposure that cannot be accounted for by self-reported smoking habits. Their previous laboratory studies demonstrate that there is a wide degree of variation in biological exposure to tobacco smoke toxins and carcinogens per cigarette smoked. The investigators propose to conduct a community-based participatory study in the medically underserved area of Appalachian Pennsylvania to determine the relationship between SES and the dose of inhaled mainstream smoke and the dose of biological markers of tobacco smoke exposure. Specific aims are: Specific Aim 1. Determine whether SES is associated with smoking puffing behaviors including puff volume, duration, interval, and length of cigarette smoked. Specific Aim 2. Determine whether SES is associated with biomarkers of smoking exposure including salivary cotinine and expired carbon monoxide. This addresses the SES hypothesis using biological measures of dose in addition to environmental measures such as puffing dose. Specific Aim 3. Correlate environmental and biological measures of smoke exposure. This aim will determine whether levels of mainstream smoke exposure, as estimated by puffing profiles are determinants of the biological levels of cigarette smoke exposure, and whether this relationship differs by SES. This brings together aims 1 and 2 to comprehensively address the SES hypothesis. Specific Aim 4. Determine the effects of psychological stress, as assessed by psychological scales and salivary stress biomarkers, on smoking puffing parameters and salivary cotinine levels. The proposed research study will be conducted in Appalachia, Pennsylvania (PA), a NIH-designated medically underserved but socioeconomically diverse population. The investigators predict that lower SES is associated with higher smoke intake as determined by topography and smoke biomarkers, and that this finding will help to explain the long-observed patterns of lung cancer incidence disparities. PUBLIC HEALTH RELEVANCE: A major objective of cancer control efforts is to understand the causes of social inequalities in cancer rates. Cigarette smokers of lower socioeconomic status (SES) have increased rates of lung cancer and other tobacco-related diseases than smokers of higher SES. Because smoking is a modifiable behavior, findings that demonstrate more intensive smoking and greater exposure to tobacco smoke among low SES smokers may be helpful in developing more effective and targeted smoking control efforts.

描述（由申请人提供）：社会不平等是疾病（包括癌症）发病率的重要预测因素。社会经济地位 (SES) 较低的人患肺癌和其他与烟草相关的癌症的发病率较高。尽管教育水平和职业地位较低的人吸烟率较高，但吸烟率并不能解释这种过高的风险。在前瞻性队列研究中，在调整吸烟量和持续时间后，低 SES 与肺癌风险升高之间的关联仍然存在。研究人员的总体假设是，社会经济地位较低的人群中不明原因的风险增加是由于较高的烟雾暴露造成的，而这不能用自我报告的吸烟习惯来解释。他们之前的实验室研究表明，每吸一支烟，对烟草烟雾毒素和致癌物质的生物暴露存在很大程度的差异。研究人员提议在宾夕法尼亚州阿巴拉契亚医疗服务匮乏的地区进行一项基于社区的参与性研究，以确定 SES 与吸入主流烟雾的剂量以及烟草烟雾暴露的生物标记物的剂量之间的关系。具体目标是： 具体目标 1. 确定 SES 是否与吸烟行为相关，包括吸烟量、持续时间、间隔和吸烟时间。具体目标 2. 确定 SES 是否与吸烟暴露的生物标志物（包括唾液可替宁和过期一氧化碳）相关。这解决了 SES 假说，除了环境测量（例如吸烟剂量）之外，还使用生物剂量测量。具体目标 3. 将烟雾暴露的环境和生物测量方法关联起来。这一目标将确定通过抽吸曲线估计的主流烟雾暴露水平是否是香烟烟雾暴露生物水平的决定因素，以及这种关系是否因 SES 而异。这将目标 1 和 2 结合起来，全面解决 SES 假设。具体目标 4. 通过心理量表和唾液压力生物标志物评估，确定心理压力对吸烟参数和唾液可替宁水平的影响。拟议的研究将在宾夕法尼亚州阿巴拉契亚 (PA) 进行，该地区是 NIH 指定的医疗服务匮乏但社会经济多样化的人群。研究人员预测，较低的社会经济地位与较高的烟雾摄入量有关，这一点是由地形和烟雾生物标志物决定的，这一发现将有助于解释长期观察到的肺癌发病率差异的模式。 公共卫生相关性：癌症控制工作的一个主要目标是了解癌症发病率社会不平等的原因。与社会经济地位较高的吸烟者相比，社会经济地位较低的吸烟者患肺癌和其他烟草相关疾病的几率更高。由于吸烟是一种可改变的行为，因此证明低社会经济地位吸烟者吸烟更频繁、接触烟草烟雾更多的研究结果可能有助于制定更有效、更有针对性的控烟工作。