Differences in the influence of family background and social activities on smoking of minority and white high school seniors, 1976-2004

Smokeless and dual tobacco use among males surviving childhood cancer: a report from the Childhood Cancer Survivor Study

Cancer survivors experience treatment-related complications that can be exacerbated by tobacco use. This study reports the prevalence of smokeless and dual tobacco use, compares these rates to the U.S. population, and examines tobacco risk factors among males surviving childhood cancer. Data from the Childhood Cancer Survivor Study (CCSS) 2007 survey were used (N = 3378). Standardized incidence ratios (SIR) were obtained by comparing CCSS data with the National Survey on Drug Use and Health. Logistic regression was used to evaluate associations between risk factors and tobacco use. Among male survivors, 8.3% and 2.3% were current smokeless tobacco and dual tobacco users, respectively. Survivors were less likely than population males to report smokeless tobacco [SIR = 0.64; 95% confidence interval (CI), 0.57-0.72) or dual tobacco (SIR = 0.37; CI, 0.29-0.46) use; however, non-White survivors aged 35 to 49 years were more likely to use smokeless tobacco (SIR = 2.32; CI, 1.27-3.90). Smokeless tobacco use was associated (P < 0.05) with younger age at diagnosis, lower education, being married or divorced/separated, and not living in the Northeastern United State, whereas history of cardiovascular- and/or pulmonary-toxic treatment was protective. Dual tobacco use was associated with younger age at diagnosis, lower education, divorce/separation, and high psychologic distress. Having active heart or circulatory conditions was protective. Although smokeless tobacco/dual tobacco use is generally low among childhood cancer survivors, these findings suggest that tobacco use screening should be expanded to include smokeless tobacco use, and that smokeless tobacco-specific education and cessation interventions should be provided to users. Screening and intervening for smokeless tobacco/dual tobacco use in childhood cancer survivors will reduce tobacco-related morbidity and mortality.

The most critical unresolved issues associated with race, ethnicity, culture, and substance use

This paper discusses the limitations of previous research on race, ethnicity, culture, and substance use. The study offers the following recommendations for future research in this area: (1) move beyond simple comparisons of mutually exclusive groups, (2) focus on the meaning of an ethnic label to the individual, (3) consider the complex interactions between an individual's cultural identity and the cultural context, (4) understand and acknowledge the researcher's inherent biases, and (5) translate research findings into practice and policy change.

Integrated schools, segregated curriculum: effects of within-school segregation on adolescent health behaviors and educational aspirations

OBJECTIVES

We examined the extent to which within-school segregation, as measured by unevenness in the distribution of Black and White adolescents across levels of the English curriculum (advanced placement-international baccalaureate-honors, general, remedial, or no English), was associated with smoking, drinking, and educational aspirations, which previous studies found are related to school racial/ethnic composition.

METHODS

We analyzed data from wave 1 of the National Longitudinal Study of Adolescent Health, restricting our sample to non-Hispanic Blacks (n=2731) and Whites (n=4158) who from 1994 to 1995 attended high schools that enrolled Black and White students.

RESULTS

White female students had higher predicted probabilities of smoking or drinking than did Black female students; the largest differences were in schools with high levels of within-school segregation. Black male students had higher predicted probabilities of high educational aspirations than did White male students in schools with low levels of within-school segregation; this association was attenuated for Black males attending schools with moderate or high levels of within-school segregation.

CONCLUSIONS

Our results provide evidence that within-school segregation may influence both students' aspirations and their behaviors.