Center for Pediatric Psychology, Department of Psychology, Oklahoma State University.
Department of Psychology, Oklahoma State University.
Health Psychol. 2021 Jan;40(1):51-61. doi: 10.1037/hea0001039.
To better understand mechanisms influencing health in African Americans (AAs), the aims of this study were (a) to identify longitudinal cigarette smoking classes among AAs across adolescence and into young adulthood; (b) to identify risk factors for smoking and how cardiometabolic health in adulthood differs by smoking class; and (c) to investigate whether smoking mediates the relation between adolescent risk factors and adult cardiometabolic health.
This study used 4 waves of nationally representative data, restricted to an AA subsample (N = 2,009). Participants self-reported on multilevel risk factors in adolescence and smoking across adolescence and young adulthood; cardiometabolic risk was assessed in adulthood. Growth mixture modeling and structural equation modeling were conducted.
Five classes emerged: nonsmoker; early onset, heavier smoking; later onset; early onset, light smoking; and maturing out or declining smoking. Predictors of class membership included living with individuals who smoke, having friends who smoke, and limited access to medical care. The early onset, light smoking class had the greatest cardiometabolic risk. Smoking class mediated the relation between living with people who smoke in adolescence and adult cardiometabolic risk.
Nuanced smoking patterns among AAs were identified, and 23% fell into classes characterized by an early onset and persistent smoking trajectory. The early onset, light smoking class had the greatest cardiometabolic risk in adulthood. The results suggest unique protective factors may be present for youth who remain nonsmokers even when their family smokes. Results have implications for health promotion and tobacco prevention efforts among AA families. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
为了更好地了解影响非裔美国人健康的机制，本研究旨在：(a) 确定非裔美国人在青少年期和青年期的纵向吸烟类别；(b) 确定吸烟的风险因素，以及成年后心血管代谢健康状况因吸烟类别而异的原因；(c) 探讨吸烟是否在青少年期风险因素与成年后心血管代谢健康之间起中介作用。
本研究使用了 4 波具有全国代表性的数据，仅限于非裔美国人亚样本（N=2009）。参与者在青少年时期自我报告了多层次的风险因素和整个青少年期及青年期的吸烟情况；成年后评估了心血管代谢风险。进行了增长混合物建模和结构方程建模。
出现了 5 个类别：不吸烟者；早期开始、吸烟量大；后期开始；早期开始、吸烟量轻；以及逐渐戒烟或减少吸烟。类别的预测因素包括与吸烟者同住、有吸烟的朋友以及获得医疗保健的机会有限。早期开始、吸烟量轻的类别具有最大的心血管代谢风险。吸烟类别中介了青少年时期与成年人心血管代谢风险之间的关系。
确定了非裔美国人吸烟模式的细微差别，并发现 23%的人属于具有早期开始和持续吸烟轨迹的类别。在成年期，早期开始、吸烟量轻的类别具有最大的心血管代谢风险。结果表明，即使在家庭吸烟者中，仍然保持不吸烟的年轻人可能存在独特的保护因素。结果对非裔美国家庭的健康促进和烟草预防工作具有重要意义。
