An intersectional examination of early tobacco use among White and Black adolescents

项目总结 吸烟是白人和黑人之间可预防的健康差距的一个突出原因。 烟草使用主要是在青春期确立的。尽管终生使用烟草的流行率较低 与白人相比，黑人青少年一旦开始吸烟，就不太可能戒烟。 从长远来看，黑人个人不成比例地遭受与烟草相关的死亡和疾病的痛苦。意义重大 在确定普通人群中烟草使用的风险和保护因素方面取得了进展。 这些因素通常在标准的烟草控制战略中得到解决。然而，相对于白人， 黑人个人面临着从标准烟草控制战略中获得的收益减少。我们的中心假设是 上述收益减少的原因是多层次风险和风险之间复杂而动态的相互关系 白人和黑人青少年吸烟的保护性因素各不相同。当前的方法是 了解烟草使用并不调查这些相互关系，这是 制定有针对性的干预措施，有效减少黑人青少年的烟草使用。在这 我们将使用一个有理论基础和创新的概念模型来研究黑白 烟草使用在多个交叉领域和影响程度上的差异。我们将使用青少年 作为路径研究的一部分收集的数据，这是具有全国代表性的最大规模的纵向队列研究 烟草产品在美国的使用情况。我们的目标包括横断面和纵向检查。 路径数据的四波。首先，我们将确定风险和保护因素组合的差异 在黑人和白人青少年之间。这些分析将解释黑人中独特的风险因素 青少年解释了在烟草使用开始、使用的产品类型以及 使用频率。第二，我们将检查风险和保护因素在以下方面的进展差异 白人和黑人青少年之间的时间。这些分析将阐明独特的风险模式和 随着时间的推移的保护因素及其与长期烟草使用的关系。这项研究的发现将推动 我们对黑人个人从标准烟草控制方法中获益减少的理解。此外， 这项发展研究将为临床和公共卫生干预确定新的潜在治疗靶点。 发展。因此，该项目的发现将对烟草领域产生持续和强大的影响-- 相关的健康差距研究。

PROJECT SUMMARY Tobacco use is a prominent cause of preventable health disparities between White and Black individuals. Tobacco use is primarily established in adolescence. Although the lifetime prevalence of tobacco use is lower for Black than it is for White individuals, Black adolescents are less likely to quit tobacco once they initiate use. In the long run, Black individuals suffer disproportionately from tobacco-related death and disease. Significant progress has been made in identifying risk and protective factors for tobacco use in the general population. These factors are commonly addressed in standard tobacco control strategies. However, relative to Whites, Black individuals face diminished gains from standard tobacco control strategies. Our central hypothesis is that said diminished gains are explained by complex and dynamic interrelations between multi-level risk and protective factors for tobacco use that vary between White and Black adolescents. Current approaches for understanding tobacco use do not investigate these interrelations, which is a critical barrier for the development of targeted interventions that effectively mitigate tobacco use among Black adolescents. In this proposal we will employ a theoretically grounded and innovative conceptual model to examine Black-White differences in tobacco use across multiple intersecting domains and levels of influence. We will use adolescent data collected as part of the PATH study, the largest nationally representative longitudinal cohort study of tobacco product use in the US. Our aims include cross-sectional as well as longitudinal examinations across the four waves of PATH data. First, we will identify differences in the combination of risk and protective factors between Black and White adolescents. These analyses will explicate how unique risk factors among Black adolescents explain cross-sectional Black-White differences in tobacco use onset, types of products used, and frequency of use. Second, we will examine differences in the progression of risk and protective factors over time between White and Black adolescents. These analyses will elucidate unique patterns of risk and protective factors over time and their relation to tobacco use in the long run. This study’s findings will advance our understanding of diminished gains for Black individuals from standard tobacco control approaches. Further, this developmental study will identify new potential therapeutic targets for clinical and public health intervention development. Thus, findings from this project will have a sustained and powerful impact on the field of tobacco- related health disparities research.