Golinelli Daniela, Tucker Joan S, Shadel William G
RAND Corporation, Santa Monica, CA;
RAND Corporation, Santa Monica, CA.
Nicotine Tob Res. 2016 Dec;18(12):2283-2287. doi: 10.1093/ntr/ntw131. Epub 2016 May 9.
Several studies have reported pronounced racial/ethnic differences in smoking behavior among homeless youth. Better understanding the factors underlying racial/ethnic differences in daily smoking among homeless youth may help inform programs to reduce smoking in this population.
Data come from a probability sample of homeless youth in Los Angeles County collected between 2008 and 2009. The sample includes 116 African American, 99 Hispanic, and 119 White youth with ages ranging from 13 to 24 years. Chi-square tests were used to test the differences in daily smoking among African American, Hispanic, and White youth. Propensity score and doubly robust methods were used to produce a less biased estimate of the association between daily smoking and race/ethnicity after having removed the effect of potential confounders.
The daily smoking rate for White youth was 70.1%, more than 31 percentage points than the rates for either African American or Hispanic youth. Propensity score analysis revealed that the majority of the racial/ethnic differences in smoking rates could be explained by differences in homelessness severity, although background characteristics and comorbidity were relevant as well.
As programs are developed to reduce smoking among homeless youth, results suggest that additional outreach may be needed to engage White youth in services. Also, smoking prevention programs may benefit from incorporating a social network-based approach that assists youth in fostering relationships with lower-risk peers, as well as addressing other forms of substance use. Incorporating these elements may help reduce the large racial/ethnic disparities in daily smoking among homeless youth.
This report extends the small existing literature on racial/ethnic differences in smoking among homeless youth in two important respects. First, it confirms differences in daily smoking, an important indicator of dependence, across racial/ethnic groups. Second, it seeks to understand the extent to which differences in smoking can be explained by demographic characteristics (other than race/ethnicity), background factors, homelessness severity, and comorbidity characteristics known to be associated with substance use among homeless youth.
多项研究报告称，无家可归青少年的吸烟行为存在明显的种族/族裔差异。更好地了解无家可归青少年日常吸烟的种族/族裔差异背后的因素，可能有助于为减少该人群吸烟的项目提供信息。
数据来自2008年至2009年在洛杉矶县抽取的无家可归青少年概率样本。样本包括116名非裔美国青少年、99名西班牙裔青少年和119名白人青少年，年龄在13至24岁之间。卡方检验用于检验非裔美国青少年、西班牙裔青少年和白人青少年在日常吸烟方面的差异。倾向得分法和双重稳健法用于在消除潜在混杂因素的影响后，对日常吸烟与种族/族裔之间的关联进行偏差较小的估计。
白人青少年的日常吸烟率为70.1%，比非裔美国青少年或西班牙裔青少年的吸烟率高出31多个百分点。倾向得分分析表明，吸烟率的大部分种族/族裔差异可以由无家可归严重程度的差异来解释，尽管背景特征和合并症也有关系。
在制定减少无家可归青少年吸烟的项目时，结果表明可能需要更多的外展工作来让白人青少年参与服务。此外，吸烟预防项目可能会受益于采用基于社交网络的方法，这种方法有助于青少年与低风险同龄人建立关系，并解决其他形式的物质使用问题。纳入这些要素可能有助于减少无家可归青少年日常吸烟中巨大的种族/族裔差异。
本报告在两个重要方面扩展了现有的关于无家可归青少年吸烟的种族/族裔差异的少量文献。第一，它证实了各种族/族裔群体在日常吸烟方面的差异，日常吸烟是依赖性的一个重要指标。第二，它试图了解吸烟差异在多大程度上可以由人口特征（种族/族裔除外）、背景因素、无家可归严重程度以及已知与无家可归青少年物质使用相关的合并症特征来解释。
