Vocational Student Tobacco Use

描述（由申请人提供）：尽管1993年至2000年间，美国大多数人群的烟草使用率有所下降，但差距仍然存在。年轻人和社会经济地位最低的个人报告的烟草使用率最高。低社会经济地位增加了暴露于多种类型的压力，压力与烟草使用呈正相关。不幸的是，对低社会经济地位年轻人的压力-烟草使用关系的假定机制或中介的研究是可怕的。文献中还缺乏对种族/民族和文化因素在累积压力、抑郁症状和烟草使用之间关系中的调节作用的理解。本研究旨在：1)确定抑郁症状是否在低社会经济地位青年的生活事件压力积累、歧视压力、经济压力、角色过载和烟草使用之间起中介作用；b)探索可能调节累积压力和抑郁症状效应的文化因素。定量（调查）和定性（焦点小组访谈）方法将用于解决这些目标。大约900名不同种族的年轻成人学生参加了两项为期两年的高等职业教育课程，他们将被要求完成一项匿名调查，调查不同类型的压力、抑郁症状和吸烟情况。这些学生中的一部分将被要求参加焦点小组访谈，目的是了解涉及烟草使用的文化因素。该项目的具体目标将是：1)确定压力和抑郁症状的水平是否因烟草使用而异；2)在考虑到性别和收入后，检查累积压力、抑郁症状、烟草使用和种族/民族之间的关系；3)探索年轻人对他们为什么使用烟草以及压力和抑郁症状在烟草使用中的作用的看法的文化差异。这一拟议项目符合2010年健康人目标2，即减少健康差距和减少成年人吸烟的目标。在美国，吸烟仍然是导致可预防死亡的主要原因。每年有44万多成年人死于与烟草有关的疾病，吸烟是最常见的烟草使用形式，与许多癌症的发生有因果关系，包括但不限于肺癌、膀胱癌、肾癌、宫颈癌和食道癌。年轻人和社会经济地位最低的个人报告的烟草使用率最高，戒烟率最低。制定旨在减少这一人群烟草使用的有效预防和干预规划，需要了解导致他们使用烟草的因素。

DESCRIPTION (provided by applicant): Although the prevalence of tobacco use decreased for most segments of the US population between 1993 and 2000, disparities persist. Young adults and individuals in the lowest socioeconomic status (SES) categories report the highest rates of tobacco use. Low SES increases exposure to multiple types of stress and stress is positively associated with tobacco use. Unfortunately, studies examining the putative mechanisms, or mediators, of the stress-tobacco use relationship for low SES young adults are scare. Also lacking from the literature is an understanding of the roles of race/ethnicity and cultural factors as moderators of the relationships among cumulative stress, depressive symptoms, and tobacco use. This application aims to: 1) determine whether depressive symptoms mediate the relationship between an accumulation of life events stress, discrimination stress, financial stress, role overload and tobacco use in low SES young adults and b) Explore the cultural factors that may moderate the cumulative stress and depressive symptoms effects. Quantitative (survey) and qualitative (focus group interviews) methodologies will be used to address these aims. Approximately 900 ethnically diverse young adult students enrolled in two 2-year post-secondary vocational programs will be asked to complete an anonymous survey examining varying types of stress, depressive symptoms, and tobacco use. A subset of these students will be asked to participate in focus group interviews aimed at understanding the cultural factors involved in tobacco use. The Specific Aims of the project will be to: 1) determine if levels of stress and depressive symptoms vary across tobacco use 2) examine the relationships among cumulative stress, depressive symptoms, tobacco use, and race/ethnicity, after accounting for gender and income and 3) explore cultural differences in young adult perceptions of why they use tobacco and the roles of stress and depressive symptoms in their tobacco use. This proposed project is consistent with the Healthy People 2010 Goal #2 of reducing health disparities and the objective of reducing cigarette smoking by adults. Tobacco use remains the leading cause of preventable death in the United States. Each year more than 440,000 adults die from tobacco-related diseases and smoking, the most common form of tobacco use, is causally linked to the development of numerous cancers including, but not limited to, lung, bladder, kidney, cervical, and esophageal. Young adults and individuals in the lowest socioeconomic status categories report the highest rates of tobacco use and the lowest rates of cessation. Development of effective prevention and intervention programs aimed at reducing tobacco use in this population require an understanding of the factors that contribute to their tobacco use.