Mantey Dale S, Janda-Thomte Kathryn M, Alexander Adam C, Omega-Njemnobi Onyinye, Kelder Steven H
UTHealth, University of Texas School of Public Health, Department of Health Promotion and Behavioral Science, Austin, TX, United States.
UTHealth, University of Texas School of Public Health, Department of Epidemiology, Human Genetics & Environmental Sciences, Austin, TX, United States.
Prev Med Rep. 2024 Oct 18;47:102901. doi: 10.1016/j.pmedr.2024.102901. eCollection 2024 Nov.
Economic disparities in tobacco use and dependence are well-documented among adults but not adolescents. This study aims to examine economic disparities in patterns of tobacco use among a nationally representative sample of high school students in Spring 2021.
We analyzed data from n = 6750 US high school student via the 2021 Adolescent Behaviors and Experiences Survey (ABES). We estimated the association between experiencing homelessness and food insecurity (analyzed independently) and current (past 30-day) and daily (all 30 days) use of four tobacco products (e-cigarettes; cigarettes; cigars; smokeless). Models controlled for sex, race/ethnicity, age, and sexual identity.
Overall, ∼1.8 % experienced homelessness and 23.7 % experienced food insecurity. Experiencing homeless was significantly associated with greater odds of current use for e-cigarette (aOR: 3.43), cigarettes (aOR: 5.58), cigars (aOR: 10.47), and smokeless tobacco (aOR: 4.41) as well as greater risk for daily use of e-cigarettes (aOR: 2.66), cigarettes (aOR: 10.94), and cigars (aOR: 5.23) but not smokeless tobacco (aOR: 2.48; 95 %CI: 0.51-12.16). Food insecurity was significantly associated with greater odds of current use of e-cigarettes (aOR: 2.00), cigarettes (aOR: 2.15), and cigars (aOR: 2.44) but not smokeless (aOR: 1.04; 95 % CI: 0.56-1.93). No association was observed between food insecurity and daily tobacco use.
Substantial economic disparities in tobacco use were observed in a nationally representative sample of high school students. Interventions should consider prioritizing economic determinants of health during adolescence, including a focus on preventing youth tobacco use as well as addressing upstream determinants of homelessness and food insecurity.
烟草使用和依赖方面的经济差异在成年人中已有充分记录，但在青少年中尚无相关研究。本研究旨在调查2021年春季全国代表性高中生样本中烟草使用模式的经济差异。
我们通过2021年青少年行为与经历调查（ABES）分析了n = 6750名美国高中生的数据。我们估计了经历无家可归和粮食不安全（分别分析）与当前（过去30天）和每日（整个30天）使用四种烟草制品（电子烟、香烟、雪茄、无烟烟草）之间的关联。模型控制了性别、种族/族裔、年龄和性取向。
总体而言，约1.8%的学生经历过无家可归，23.7%的学生经历过粮食不安全。经历无家可归与当前使用电子烟（调整后比值比：3.43）、香烟（调整后比值比：5.58）、雪茄（调整后比值比：10.47）和无烟烟草（调整后比值比：4.41）的几率显著增加以及每日使用电子烟（调整后比值比：2.66）、香烟（调整后比值比：10.94）和雪茄（调整后比值比：5.23）的风险增加显著相关，但与无烟烟草（调整后比值比：2.48；95%置信区间：0.51 - 12.16）无关。粮食不安全与当前使用电子烟（调整后比值比：2.00）、香烟（调整后比值比：2.15）和雪茄（调整后比值比：2.44）的几率显著增加相关，但与无烟烟草无关（调整后比值比：1.04；95%置信区间：0.56 - 1.93）。未观察到粮食不安全与每日烟草使用之间的关联。
在全国代表性的高中生样本中观察到烟草使用方面存在显著的经济差异。干预措施应考虑在青少年时期优先关注健康的经济决定因素，包括重点预防青少年烟草使用以及解决无家可归和粮食不安全的上游决定因素。
