Virginia Tech-Carilion Fralin Biomedical Research Institute, Virginia Tech, Roanoke, VA, USA.
Center for Biostatistics and Health Data Science, Virginia Tech, Roanoke, VA, USA.
Nicotine Tob Res. 2022 Aug 6;24(9):1487-1497. doi: 10.1093/ntr/ntac106.
The present study examines the contributions of individual-level health determinants on young adult tobacco use initiation to improve understanding of racial and ethnic distinctions and to inform effective tobacco prevention strategies.
Using time-to-event analyses, the 10-wave (2011-2016) Truth Initiative Young Adult Cohort, a probability-based, nationally representative sample of the US young adults aged 18-34 years (N = 7 665), provides data to examine differences in variables that influence tobacco uptake, by race and ethnicity.
Among Non-Hispanic White young adults, having fewer peers who smoke cigarettes is protective against any tobacco initiation, whereas hazard of tobacco initiation increases for males, having low confidence to resist smoking, and having higher proclivity for sensation seeking. Depressive and anxiety symptoms increase uptake hazard most in the Non-Hispanic All Other Races group and least among Non-Hispanic Black individuals. Among Hispanic young adults, being female and perceiving tobacco as harmful are notably protective while being male is a notable uptake hazard. Unlike other groups, higher income levels do not lower hazards among Hispanic individuals. Cannabis use and overestimating the smoking rate among peers increase hazard least among Hispanic individuals. In the Non-Hispanic All Other Races group, aging is least protective; hazard increases notably if individuals engage in regular alcohol or cannabis use.
Tobacco prevention efforts are critical during young adulthood. Specific tobacco uptake hazard and protective factors exist by race and ethnicity and should be considered when developing selective young adult prevention, particularly among groups with the highest risk for tobacco initiation during this life stage.
Rising rates of tobacco initiation among the US young adults necessitate expanded efforts to prevent tobacco use initiation and progression beyond youth. Results highlight nuanced and differential tobacco uptake hazards by race and ethnicity for late initiation and sustained non-tobacco use among young adults. The study confirms existing evidence on tobacco use patterns and contributes to new knowledge on risk and protective factors. Tobacco prevention and control interventions, including policies, tailored in more meaningful ways could reduce tobacco use disparities among those most disproportionately affected.
本研究通过考察个体健康决定因素对青年成人吸烟起始的影响，旨在增进对种族和民族差异的理解，并为有效的烟草预防策略提供信息。
利用时间事件分析，基于概率的全国代表性样本 Truth Initiative 青年成人队列，包括年龄在 18-34 岁的美国年轻人（N=7665 人），在 10 个波次（2011-2016 年）的数据，考察了不同种族和民族影响吸烟行为的变量差异。
在非西班牙裔白人青年成人中，吸烟同伴较少对任何吸烟起始都有保护作用，而男性、对抵制吸烟的信心较低、对寻求刺激的倾向较高则会增加吸烟起始的危险。抑郁和焦虑症状在非西班牙裔所有其他种族群体中对增加吸烟起始的危险最大，而在非西班牙裔黑人中则最小。在西班牙裔青年成人中，女性和认为烟草有害是显著的保护因素，而男性则是显著的吸烟起始危险。与其他群体不同，较高的收入水平并不能降低西班牙裔人群的危险。在西班牙裔人群中，大麻使用和高估同伴的吸烟率对增加危险的影响最小。在非西班牙裔所有其他种族群体中，年龄增长的保护作用最小；如果个体经常饮酒或使用大麻，危险会显著增加。
在青年成人中，烟草预防工作至关重要。根据种族和民族的不同，存在特定的烟草起始危险和保护因素，在制定针对青年成人的选择性预防措施时应予以考虑，特别是在这个生命阶段吸烟起始风险最高的群体中。
美国青年成人吸烟起始率上升，需要扩大努力，防止烟草使用在青年期之后的继续使用和起始。结果突出了种族和民族差异对青年成人晚期起始和持续非吸烟的细微和不同的吸烟起始危险。本研究证实了现有的烟草使用模式证据，并为风险和保护因素提供了新的知识。烟草预防和控制干预措施，包括政策，可以更有意义地进行调整，从而减少受影响最严重的人群中的烟草使用差异。
