Behavioral and Environmental Contributors to Tobacco Disparities in Rural Youth

描述（由申请人提供）：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受到烟草使用的影响，横断面调查始终显示，与大城市地区相比，农村地区吸烟和使用无烟烟草的流行率较高。虽然在过去几十年中，有关青少年吸烟的科学知识有了显著增长，但大多数知识主要是基于生活在城市地区的青年。拟议的工作利用了明尼苏达州十多年的现有纵向数据，以描述可能导致农村社区烟草相关差异的重要因素。本提案的目的是：（1）检查农村和城市青年在青春期和成年初期吸烟和无烟烟草使用进展的差异;（2）评估农村和城市地区的社会和烟草控制环境如何不同，以及这些环境如何解释农村和城市青年吸烟率和模式的差异。农村地区的青年被假设为显示较高的启动率和在较早的年龄，较重的使用模式，较少的戒烟尝试，并与城市青年相比，较低的戒烟率。进一步假设，农村青年在其社交网络中报告的吸烟水平较高，社会对吸烟的接受程度较高，获得烟草的机会较多，接触烟草控制政策的机会少于大都市地区的青年，这些因素将与农村青年的使用模式有关。我们还将研究与农村和城市青年烟草使用率差异相关的因素是否在来自佛罗里达的大量不同青年样本中具有可比性。我们假设，与明尼苏达州农村和大城市青年吸烟率差异相关的因素在佛罗里达也具有可比性。拟议的方法是创新的，因为它包括一个重复的措施设计，从农村和大城市地区的青年的大样本，沿着的详细和频繁的数据，烟草使用行为从青春期到青年成年，以及行为之间的联系和众多的社会因素，可能会影响烟草使用和戒烟的农村青年。拟议的项目预计将通过详细了解与横截面研究中观察到的农村青年烟草差异相关的因素，促进我们对农村青年烟草相关差异的理解。重要的是，拟议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.