Examining Social Influences on Young Adult Smoking and Cessation Trajectories

描述（由申请人提供）：青年期（18-24岁）是一个关键的发展过渡时期，为改变吸烟行为轨迹提供了巨大的机会，从而对公共卫生产生重大影响。特别是年轻的成年吸烟者，在青少年预防和成人戒烟干预方面都没有取得成功。据报道，青年人开始吸烟的比率和向常规吸烟过渡的比率最近有所上升，同时这一年龄组的“社交吸烟”现象也很普遍（51%-62%）。社会吸烟青年（SSYAs）的长期烟草使用行为尚不清楚，但可能有大约一半的人在青年时期会升级为更重的卷烟使用，或者他们的社会吸烟模式将在整个成年期保持稳定。SSYAs为戒烟带来了重大挑战和机遇，但这需要更好地了解导致风险的潜在可改变因素。目前的项目使用初级社会化理论（PST）来解决社会发展和青年吸烟行为的交叉点，确定社会吸烟的特征和导致社会吸烟的风险途径，这是年轻人中非常普遍的吸烟模式。PST假设个体主要从少数随着生命周期转变而动态变化的社会影响中学习规范和异常行为。对青年期的主要社会化影响是环境（工作、学校）、同伴群体、大家庭以及在这一发展时期创造的新的家庭背景。本研究的目的是深入研究SSYAs的特征，其潜在的吸烟风险轨迹，以及戒烟干预的可能途径。该提案利用了来自当代美国年轻人（18-24岁）的两个大型队列的信息，这些信息提供了吸烟行为轨迹、社会对吸烟的影响以及社会和环境对年轻人“当下”吸烟行为的影响的丰富数据。这两个队列是：1)全国18-24岁的年轻人样本（基线时n = 864）传统青年队列研究，为期三年，每半年进行一次评估；2)在青年期随访的高危青少年组（5年随访时n = 1027； NCI计划项目2P01CA098262），使用三次年度评估和两周的每日生态瞬间评估（EMA）的组合。研究的第一阶段将使用潜在类别分析来定义两个队列中的ssya（目标1），第二阶段将将该定义应用于两个队列的轨迹分析，探索ssya与其他年轻成年吸烟者的烟草使用模式（目标2和3）。研究的第三阶段采用了一种精细的方法来探索社会影响对吸烟和戒烟行为的近端影响，以及社会吸烟作为这种影响的调节因素的潜力（目标4）。本研究通过阐明维持或阻碍这一重要群体吸烟行为的社会因素，为开发更有效的SSYAs原发性和继发性癌症预防干预措施奠定了基础。

DESCRIPTION (provided by applicant): Young adulthood (ages 18-24) is a critical developmental transition and provides an enormous opportunity to alter trajectories of smoking behavior for a large public health impact. Young adult smokers, in particular, have eluded both youth prevention and adult cessation intervention efforts. Recent increases in the rate of young adult smoking initiation and rate of transition to regular smoking have been reported along with the high prevalence of the phenomenon of "social smoking" in this age group (51%-62%). The long-term tobacco use behaviors of social smoking young adults (SSYAs) are unknown, but it is likely that approximately half will escalate to heavier cigarette use during young adulthood or that their pattern of social smoking will remain stable throughout adulthood. SSYAs present both a vital challenge and an opportunity for smoking cessation, but this requires a better understanding of potentially modifiable factors that contribute to risk. The current project uses primary socialization theory (PST) to address the intersection of social development and smoking behavior in young adulthood, identifying characteristics of and risk pathways leading from social smoking, a highly prevalent pattern of smoking among young adults. PST posits that individuals learn normative and deviant behavior mainly from a small number of social influences that change dynamically with lifespan transitions. The primary socialization influences in young adulthood are environmental (work, school), peer clusters, extended family, and the new family contexts created in this developmental period. The goal of the current study is to examine, in-depth, the characteristics of SSYAs, their potential smoking risk trajectories, and possible avenues for smoking cessation intervention. The proposal leverages information from two large contemporary cohorts of U.S. young adults (aged 18-24) with rich data on trajectories of cigarette smoking behavior, social influences on smoking, and social and contextual influences on "in the moment" smoking behavior among young adults. The two cohorts are: 1) a national sample of young adults aged 18-24 (n = 864 at baseline) Legacy Young Adult Cohort Study with semi- annual assessments over three years and 2) an at-risk group of adolescents followed during young adulthood (n = 1,027 at 5-year follow-up; NCI Program Project 2P01CA098262) using a combination of three annual assessments and two week-long sessions of daily ecological momentary assessment (EMA). Phase I of the study will use latent class analysis to define SSYAs in both cohorts (Aim 1) and Phase II will apply this definition to trajectory analyses in both cohorts, exploring tobacco use patterns among SSYAs compared to other young adult smokers (Aims 2 and 3). Phase III of the study takes a fine-grained approach to explore the proximal effect of social influences on smoking and cessation behavior and the potential of social smoking to serve as a moderator of this effect (Aim 4). This research lays the groundwork for developing more effective primary and secondary cancer prevention interventions for SSYAs by elucidating the social factors that maintain or impede smoking behavior in this important group.