Understanding and reducing health disparities through social and behavioral research

了解社会决定因素与烟草使用之间的相互关系 随着美国电子烟使用的增加，我们研究了电子烟的使用是否可以减少美国吸烟的差异。我们分析了当前人口调查的烟草使用补充（TUS-CPS），发现美国成年吸烟者中每日使用电子烟的流行率较低，这是一种与戒烟相关的行为。此外，非西班牙裔黑人的患病率特别低，这表明电子烟可能会增加种族之间的吸烟差异。 在另一项研究中，我们分析了烟草与健康人口评估（PATH）研究数据，以研究青少年二手烟暴露与随后的学习成绩之间的关联。我们发现，暴露于更多二手烟的青少年（以每周小时数衡量）与未暴露于二手烟的青少年相比，随后的学习成绩较低。这一发现表明，二手烟暴露可能会影响学习成绩，这是进入中学后教育的重要因素。 调查与烟草使用差异相关的中介和调节因素 我们继续研究烟草营销如何影响烟草使用行为。我们分析了烟草与健康人口评估（PATH）研究的数据，发现接触电子烟营销与随后在青年和年轻人中进行的电子烟实验有关。 在一项针对不同种族/民族的年轻成年吸烟者的焦点小组研究中，我们探讨了他们对戒烟治疗的看法，发现他们中的许多人对这些治疗表示负面看法。这些研究结果表明，需要更好地宣传这些治疗的有效性，并促进年轻成年吸烟者，特别是种族/少数民族人群中的吸烟者获得这些治疗。 在与PATH研究团队的合作中，我们研究了烟草产品的危害认知如何随着时间的推移而变化，以及它们与烟草使用行为的关系。我们发现，认为烟草产品是有害的与不使用该产品有关，但使用该产品也与随后较低的危害感知有关。这突出了将健康风险信息与烟草使用行为相匹配的重要性，以预防烟草使用而不是促进戒烟。 在另一项分析中，我们与PATH研究团队合作，研究试图戒烟的吸烟者使用电子烟和药物治疗是否与长期戒烟有关。我们发现，电子烟的使用，也不是药物治疗，与长期戒烟有关。这为电子烟是否应该用于戒烟提供了证据，并强调了目前戒烟药物治疗的有限疗效。 调查烟草使用模式和健康结果的影响 通过与校外调查人员的合作，我们检查了青年风险行为调查数据，发现电子烟的使用与青年哮喘有关，独立于香烟和大麻的使用。这为电子烟对青少年呼吸系统健康可能产生的健康影响提供了额外的证据。 COVID-19与烟草使用 我们开展了一项研究，以研究COVID-19如何影响成年烟草使用者，以及他们如何相应地改变烟草使用行为。该研究已完成内部检讨，并计划于二零二零财政年度后期推出。

Understanding inter-relationships between social determinants and tobacco use With the increase in e-cigarette use in the US, we examined whether e-cigarette use can reduce disparities in cigarette smoking in the US. We analyzed the Tobacco Use Supplement of the Current Population Survey (TUS-CPS) and found that the prevalence of daily e-cigarette use, a behavior that is associated with smoking cessation, is low in the US adult smoker population. Additionally, the prevalence is particularly low among non-Hispanic Blacks, suggesting the e-cigarettes may increase smoking disparities by race. In a different study, we analyzed the Population Assessment of Tobacco and Health (PATH) study data to examine the association between secondhand smoke exposure and subsequent academic performance among youth. We found that youth who were exposed to more secondhand smoke (measured by hours per week) had lower subsequent academic performance compared to those who were not exposed to secondhand smoke. This finding suggests that secondhand smoke exposure could influence academic performance, which I an important factor for enrolling in post-secondary education. Investigate mediating and moderating factors associated with tobacco use disparities We continue to examine how tobacco marketing influence tobacco use behaviors. We analyzed data from the Population Assessment of Tobacco and Health (PATH) study and found that exposure to e-cigarette marketing is associated with subsequent e-cigarette experimentation among youth and young adult. In a focus group study with a racial/ethnically diverse group of young adult smokers, we explored their perceptions related to smoking cessation treatments, and found that many of them expressed negative perceptions toward these treatments. These findings indicate the need to better communicate efficacy of these treatment and facilitate access to them among young adult smokers, especially those in racial/ethnic minority populations. In collaboration with the PATH Study team, we examined how harm perceptions of tobacco products changes over time and how they relate to tobacco use behaviors. We found that perceived tobacco products to be harm was associated with not using the product, but use of product was also associated with lower harm perception subsequently. This highlight the importance of matching health risk messages with tobacco use behaviors to prevent tobacco use vs. promote cessation. In a separate analysis, we worked with the PATH Study team to examine if e-cigarette and pharmacotherapy use among smokers attempting to quit smoking are associated with long-term smoking cessation. We found that e-cigarette use, nor pharmacotherapy, was associated with long-term smoking cessation. This provides evidence on whether e-cigarettes should be used for smoking cessation, and highlight the limited efficacy of the current pharmacotherapy for smoking cessation. Investigate the impact of tobacco use patterns and health outcomes Through a collaboration with extramural investigators, we examined the Youth Risk Behavioral Survey data and found that e-cigarette use was associated with asthma among youth, independent of cigarette and marijuana use. This provides additional evidence on the possible health impact of e-cigarette on youth respiratory health. COVID-19 and Tobacco Use We have developed a study to examine how COVID-19 impact adult tobacco users, and how they have modified their tobacco use behaviors accordingly. The study has complete internal review and is schedule to launch in late FY2020.