College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States of America.
College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States of America.
Prev Med. 2020 Nov;140:106239. doi: 10.1016/j.ypmed.2020.106239. Epub 2020 Aug 24.
Researchers have proposed numerous factors that may contribute to rural adolescents' heightened risk for tobacco use. Some of these include well-known risk factors for tobacco use, whereas others concern factors unique to rural populations, reflecting norms and values ("rural culture") that accept and encourage tobacco use. This study aimed to test a broad range of tobacco-use risk factors to determine which were a) universal risk factors for both urban and rural adolescents vs. b) unique risk factors for rural adolescents. Data came from a prospective cohort study of 1220 adolescent males in Ohio who were aged 11-16 (average = 14 years) when surveyed at baseline (2015-2016). Follow-up surveys occurred every 6 months. The present study examined tobacco-use outcomes-prevalent use and incident use-by the two-year follow-up (2017-2018). Findings indicated a higher prevalence of ever-use of cigarette and smokeless tobacco among rural, vs. urban, adolescents at baseline. By the two-year follow-up, the urban/rural difference was attenuated but remained. Stratified multivariable logistic regression indicated that some baseline risk factors were associated with subsequent tobacco use for both rural and urban adolescents. Having an adult tobacco user in the home (for prevalent use) and susceptibility to a male family member offer of tobacco products (for both prevalent and incident use) were associated with tobacco use only for rural adolescents. These findings align with qualitative work demonstrating that masculinity and an intergenerational tobacco culture are important to male adolescents. This unique rural profile should be considered when developing prevention efforts.
研究人员提出了许多可能导致农村青少年吸烟风险增加的因素。其中一些因素包括众所周知的吸烟风险因素，而另一些因素则涉及农村人口特有的因素，反映了接受和鼓励吸烟的规范和价值观（“农村文化”）。本研究旨在测试广泛的烟草使用风险因素，以确定哪些因素是：a）城市和农村青少年共有的普遍风险因素，与 b）农村青少年特有的风险因素。数据来自俄亥俄州一项针对 1220 名 11-16 岁（平均 14 岁）青少年男性的前瞻性队列研究，他们在基线（2015-2016 年）接受了调查。随后每 6 个月进行一次随访调查。本研究通过两年后的随访（2017-2018 年）检查了烟草使用结果——普遍使用和新使用情况。研究结果表明，农村青少年在基线时的吸烟和无烟烟草使用率高于城市青少年。到两年后的随访时，城乡差异有所减弱，但仍存在。分层多变量逻辑回归表明，一些基线风险因素与农村和城市青少年随后的烟草使用有关。家中有成年人吸烟（普遍使用）和对男性家庭成员提供烟草产品的易感性（普遍使用和新使用）仅与农村青少年的烟草使用有关。这些发现与定性工作一致，表明男性气质和代际烟草文化对男性青少年很重要。在制定预防措施时，应考虑这种独特的农村情况。
