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Martin C, Estes J, Ickes M. Engaging Appalachian Youth: Lessons Learned From a Virtual Tobacco Prevention and Advocacy Training. Health Promot Pract 2023:15248399231196858. [PMID: 37724531 DOI: 10.1177/15248399231196858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Engaging youth is recommended as a key component of comprehensive tobacco control to bring voice to youth perspective and to connect to community impact. Yet, limited research exists to showcase practical lessons learned in supporting skill development and engagement of youth. This practice note describes how a tailored prevention and advocacy virtual training can serve to engage and empower rural Appalachian high school students to participate in tobacco control efforts. Specifically, we describe the implementation and practical lessons learned from a two-session virtual tobacco prevention and advocacy training led by college facilitators. Participating high school students (N = 20) strongly agreed that tobacco use was a major problem facing their community and that addressing tobacco use should be prioritized. After participating in the training, students' interpersonal confidence improved and participation in self-reported advocacy increased. Students also liked the virtual platform, interaction with college students, and the opportunity to apply information learned. Youth-focused tailored training promotes skill-building and enhances self-efficacy to engage in tobacco control. Youth engagement should be integral to supporting community health initiatives, including tobacco prevention.
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Miller CC, Xiao M, Lay DJ, Miley SN, Vanderford NL, Ickes MJ. The Impact of a Virtual Tobacco Prevention and Advocacy Training Among Youth in Appalachian Kentucky Communities. Tob Use Insights 2023; 16:1179173X221150747. [PMID: 36844175 PMCID: PMC9944190 DOI: 10.1177/1179173x221150747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/19/2022] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Engaging youth is an important component of comprehensive tobacco control programs. PURPOSE This paper describes the impact of a virtual tobacco prevention training program to encourage and prepare youth in Appalachia to support tobacco prevention policies, to strengthen interpersonal confidence to address tobacco use within their communities and enhance advocacy self-efficacy for tobacco control. METHODS A two-part evidence-informed peer-led tobacco prevention and advocacy training was implemented among 16 high school students from Appalachian counties in Kentucky. The initial training (January 2021) included an overview of the e-cigarette landscape, advocacy skills related to policy change, developing messages to decision makers, and media advocacy. A follow-up session (March 2021) included a breakdown of advocacy skills and overcoming barriers. RESULTS Overall, participants held strong beliefs that tobacco use is an issue that needs to be addressed in their community. There was a statistically significant average difference in student interpersonal confidence between baseline and post-surveys (t = 2.016, P = .062 < .1). Students who participated in at least 1 of the provided advocacy events indicated higher self-reported advocacy. CONCLUSION Youth in Appalachia expressed an interest to advocate for stronger tobacco policy in their communities. Youth who participated in the tobacco advocacy policy trainings reported improvements in attitudes, interpersonal confidence, advocacy self-efficacy, and self-reported advocacy. Youth engagement in tobacco policy advocacy is promising and needs to be further supported.
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Affiliation(s)
- Claire C Miller
- Department of Kinesiology and
Health Promotion, University of
Kentucky, Lexington, KY, USA.
College of Education, University of
Kentucky, Lexington, KY, USA.
Department of Toxicology and Cancer Biology, College of
Medicine, University
of Kentucky, Lexington, KY, USA
| | - Min Xiao
- Department of Kinesiology and
Health Promotion, University of
Kentucky, Lexington, KY, USA.
College of Education, University of
Kentucky, Lexington, KY, USA.
Department of Toxicology and Cancer Biology, College of
Medicine, University
of Kentucky, Lexington, KY, USA
| | - Dillon J Lay
- Department of Kinesiology and
Health Promotion, University of
Kentucky, Lexington, KY, USA.
College of Education, University of
Kentucky, Lexington, KY, USA.
Department of Toxicology and Cancer Biology, College of
Medicine, University
of Kentucky, Lexington, KY, USA
| | - Sierrah N Miley
- Department of Kinesiology and
Health Promotion, University of
Kentucky, Lexington, KY, USA.
College of Education, University of
Kentucky, Lexington, KY, USA.
Department of Toxicology and Cancer Biology, College of
Medicine, University
of Kentucky, Lexington, KY, USA
| | - Nathan L Vanderford
- Department of Kinesiology and
Health Promotion, University of
Kentucky, Lexington, KY, USA.
College of Education, University of
Kentucky, Lexington, KY, USA.
Department of Toxicology and Cancer Biology, College of
Medicine, University
of Kentucky, Lexington, KY, USA
| | - Melinda J Ickes
- Department of Kinesiology and
Health Promotion, University of
Kentucky, Lexington, KY, USA.
College of Education, University of
Kentucky, Lexington, KY, USA.
Department of Toxicology and Cancer Biology, College of
Medicine, University
of Kentucky, Lexington, KY, USA
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Ickes M, Hester JW, Wiggins AT, Rayens MK. Juul use among emerging adults transitioning from high school to college. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:53-60. [PMID: 33577416 DOI: 10.1080/07448481.2021.1873790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 12/18/2020] [Accepted: 01/03/2021] [Indexed: 06/12/2023]
Abstract
Objective: Assess the prevalence, perceptions, sociodemographic/personal factors that influence Juul use among incoming freshmen.Participants: Incoming undergraduate students (N = 1,706) attending a public university in the southeastern U.S.Methods: Cross-sectional survey administered August 2018. Bivariate relationships assessed using chi-square test of association. Multinomial logistic regression to determine factors associated with Juul use status.Results: 41% had ever used Juul, 24% had used within the past month. Among current users, one-third had used 20-30 days. Risk factors for current use: heterosexual orientation (relative to other sexual orientation) AOR = 2.16, 95% CI: 1.20-3.91), those who planned to join sorority/fraternity (relative to those who did not plan to; AOR = 2.15, 95% CI: 1.59-2.90), current smokers (relative to nonsmokers; AOR = 24.39, 95% CI: 7.52-76.92), current marijuana users (compared with nonusers of marijuana; AOR = 6.45, 95% CI: 3.92-10.64) and alcohol users (compared with nondrinkers; AOR = 7.81, 95% CI: 5.75-10.54).Conclusion: Prevention and treatment efforts are needed for emerging adults transitioning to college.
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Affiliation(s)
- Melinda Ickes
- Tobacco Policy, BREATHE, Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
| | - Jakob W Hester
- University of Kentucky Health and Wellness, Lexington, KY, USA
| | - Amanda T Wiggins
- Data Management & Outcomes, BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Mary Kay Rayens
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
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Mamudu HM, Nwabueze CA, Yang JS, Mackey TK, Ahuja M, Smith A, Weierbach FM, McNabb M, Minnick C, Jones A. Social media and use of electronic nicotine delivery systems among school-going adolescents in a rural distressed Appalachian community. Prev Med Rep 2022; 29:101953. [PMID: 36161107 PMCID: PMC9501989 DOI: 10.1016/j.pmedr.2022.101953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/11/2022] [Accepted: 08/14/2022] [Indexed: 11/28/2022] Open
Abstract
Electronic nicotine delivery systems (ENDS) are the most used tobacco products among middle and high schoolers in the United States (U.S.). Familial relations and access play a major role in uptake among adolescents; yet the role of social media in this phenomenon in the context of communities impacted by tobacco-related health disparities is understudied. In Spring 2019, data were collected from adolescents in 8th and 9th grades in a school located in a rural distressed county in Tennessee to assess social media's role in ENDS uptake. Descriptive and multivariable statistical analyses were performed to delineate factors associated with ENDS use. Of a total of 399 respondents, 12.5 % reported current ENDS use and 22.1 % indicated having ever discussed ENDS on social media. Closed messaging platforms (Snapchat) and video platforms (Facebook/Instagram/You Tube) were the most reported form of social media used (8.31 % and 8.31 % respectively). Social media use was positively associated with both ever ENDS use (odds ratio [OR] = 2.9) and current ENDS use (OR = 3.98). Parental advice against ENDS use was positively associated with ever ENDS use. In conclusion, social media use was positively associated with both ever and current ENDS use, and Snapchat was the most popular platform among this population of students. The results indicate that youth social media engagement may lead to exposure that can influence ENDS uptake. Future studies are needed to further examine these associations among distressed communities.
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Affiliation(s)
- H M Mamudu
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson, City, TN, USA
- College of Public Health, East Tennessee State University, Johnson, City, TN, USA
| | - C A Nwabueze
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson, City, TN, USA
| | - J S Yang
- Department of Public Health, California State University, Fullerton, KHS 161 A, 800 N. State College Blvd, Fullerton, CA, 92831, USA
| | - T K Mackey
- Global Health Program, Department of Anthropology, University of California, San Diego, La Jolla, CA, USA
| | - M Ahuja
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson, City, TN, USA
- College of Public Health, East Tennessee State University, Johnson, City, TN, USA
| | - A Smith
- College of Public Health, East Tennessee State University, Johnson, City, TN, USA
| | - F M Weierbach
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson, City, TN, USA
- College of Nursing, East Tennessee State University, Johnson City, TN, USA
| | - M McNabb
- Northeast Regional Office of Tennessee Department of Health, Johnson City, TN, USA
| | - C Minnick
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson, City, TN, USA
- College of Public Health, East Tennessee State University, Johnson, City, TN, USA
| | - A Jones
- Department of Sociology & Department of Epidemiology, Milken School Institute of Public Health, The George Washington University, Washington, DC, USA
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Blank MD, Ozga JE, Romm KF, Douglas A, Alexander L, Doogan NJ, Wilson M, Dino G. Geographic isolation predicts tobacco product use among youth: A latent class analysis. J Rural Health 2022; 38:373-381. [PMID: 33978979 PMCID: PMC8586053 DOI: 10.1111/jrh.12583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of the current study was to evaluate associations between geographic rurality and tobacco use patterns among adolescents. METHODS High school students (N = 566) from north-central Appalachia reported on their lifetime and/or current use of cigarettes, electronic cigarettes (ECIGs), cigars, and smokeless tobacco. Geographic rurality was measured via the Isolation scale, whereby residential ZIP Codes determined the degree to which respondents have access to health-related resources. Latent class analysis (LCA) was used to identify discrete classes of adolescent tobacco users based on their use of tobacco products. Then, associations between participants' geographic rurality and class membership were evaluated using a series of multinomial logistic regressions. FINDINGS LCA classified participants as Nonusers, Current ECIG Users, Cigarette/ECIG Experimenters, and Polytobacco Users. Individuals with higher Isolation scores were more likely to be Polytobacco Users and Cigarette/ECIG Experimenters than Nonusers, and were more likely to be Polytobacco Users than Current ECIG Users. CONCLUSIONS The continuous Isolation scale used in the present study predicted polytobacco use patterns among adolescents in a manner that is consistent with, while simultaneously expanding upon, prior work. Tobacco control practices and policies should be viewed through a lens that considers the unique needs of geographically isolated areas.
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Affiliation(s)
- Melissa D. Blank
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
- WV Prevention Research Center, West Virginia University, Morgantown, West Virginia, USA
| | - Jenny E. Ozga
- Department of Behavioral Medicine & Psychiatry, West Virginia University, Morgantown, West Virginia, USA
| | - Katelyn F. Romm
- Department of Prevention and Community Health, George Washington University, Milken Institute School of Public Health, Washington, DC, USA
| | - Ashley Douglas
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Linda Alexander
- Department of Social & Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - Nathan J. Doogan
- Government Resources Center, Ohio State University, Columbus, Ohio, USA
| | - Michael Wilson
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Geri Dino
- WV Prevention Research Center, West Virginia University, Morgantown, West Virginia, USA
- Department of Social & Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
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Mamudu HM, Shahani D, Jones A, Ahuja M, Adeniran E, Weierbach F, Swindle J, Liu Y, Keener J, Blair CJ, McNabb M, Asare M, Wood DL, Ferketich A. Exploring Patterns of the Use of Electronic Nicotine Delivery Systems among Adolescents in High-Risk Appalachian (U.S.A) Communities. Subst Use Misuse 2022; 57:167-174. [PMID: 34927538 DOI: 10.1080/10826084.2021.1990333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Electronic nicotine delivery systems (ENDS) use among adolescents in the United States (U.S.) has surpassed conventional tobacco products (CTPs), including cigarettes. Increasingly, ENDS are used concurrently with CTPs and substances such as cannabis. However, few studies involve Central Appalachia, a region with historically high rates of tobacco and other substance use. Objective: To examine prevalence of concurrent use of ENDS and cannabis among school-going adolescents in Appalachian Tennessee and delineate associations between ENDS use and substance-related risk behavior (cannabis use), social relations (peer use), and school-related risk behavior (academic performance). Methods: Data were obtained from a survey conducted with youth aged 13-17 years in 2018 in a county in Appalachian Tennessee (n = 280). A multivariable logistic regression model was fit to evaluate associations between ENDS and cannabis use, and other factors. Results: Overall, lifetime ENDS and cannabis prevalence estimates were 31.1% and 18.6%, respectively. Lifetime ENDS users had increased odds of also being lifetime cannabis users [OR = 9.22, 95% confidence interval (CI): 3.44-24.75]. Lifetime ENDS users had increased odds of reporting ENDS use among peers [OR = 12.11; 95% CI: 5.40-27.12] and lower academic performance (OR associated with mostly C or D vs. A grades was 4.28, 95% CI: 1.68-10.90). Conclusion: This study found an association between ENDS and cannabis use among adolescents in Appalachian Tennessee exists. Additionally, peer use and academic performance were associated with ENDS use. The findings have implications for public health intervention planning to address not only ENDS but also substance use among Appalachian youth.
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Affiliation(s)
- Hadii M Mamudu
- East Tennessee States University, Johnson City, Tennessee, USA
| | - Disha Shahani
- George Washington University, Washington, District of Columbia, USA
| | - Antwan Jones
- George Washington University, Washington, District of Columbia, USA
| | - Manik Ahuja
- East Tennessee States University, Johnson City, Tennessee, USA
| | - Esther Adeniran
- East Tennessee States University, Johnson City, Tennessee, USA
| | | | - Jean Swindle
- East Tennessee States University, Johnson City, Tennessee, USA
| | - Ying Liu
- East Tennessee States University, Johnson City, Tennessee, USA
| | - Janet Keener
- East Tennessee States University, Johnson City, Tennessee, USA
| | - Cynthia J Blair
- East Tennessee States University, Johnson City, Tennessee, USA
| | | | | | - David L Wood
- East Tennessee States University, Johnson City, Tennessee, USA
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Ozga JE, Romm KF, Turiano NA, Douglas A, Dino G, Alexander L, Blank MD. Cumulative disadvantage as a framework for understanding rural tobacco use disparities. Exp Clin Psychopharmacol 2021; 29:429-439. [PMID: 34014742 PMCID: PMC9752977 DOI: 10.1037/pha0000476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Traditional tobacco product (cigarettes and smokeless tobacco) and polytobacco use rates are significantly higher among rural adolescents and adults compared to their nonrural counterparts. Such disparities are due to several factors that promote tobacco use initiation and continuation, including individual-level psychopharmacological factors and structural-level factors such as fewer tobacco control efforts (e.g., fewer smoke-free policies and lower tobacco excise taxes), targeted tobacco marketing, less access to health-relevant resources, and more positive cultural norms surrounding tobacco use in rural communities. In this review, we use cumulative disadvantage theory as a framework for understanding how psychopharmacological and structural-level factors serve as drivers of tobacco use in rural areas. We start by describing how structural-level differences between rural-nonrural communities impact psychopharmacological influences and, when available, how these factors influence tobacco use. We conclude by discussing the interplay between factors, providing suggestions for ways to assess our application of cumulative disadvantage theory empirically and making recommendations for research and policy implementation in rural areas. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jenny E. Ozga
- Department of Behavioral Medicine and Psychiatry, West Virginia University
| | - Katelyn F. Romm
- Milken Institute School of Public Health, George Washington University
| | - Nicholas A. Turiano
- Department of Psychology, West Virginia University
- West Virginia Prevention Research Center, West Virginia University
| | | | - Geri Dino
- Department of Social and Behavioral Sciences, Clinical and Translational Sciences Institute, West Virginia University
- West Virginia Prevention Research Center, West Virginia University
| | - Linda Alexander
- Department of Social and Behavioral Sciences, Clinical and Translational Sciences Institute, West Virginia University
| | - Melissa D. Blank
- Department of Psychology, West Virginia University
- West Virginia Prevention Research Center, West Virginia University
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Mattingly DT, Hart JL, Vu THT, Walker KL. Appalachian youth e-cigarette harm perceptions and tobacco use. POPULATION MEDICINE 2021; 3. [PMID: 34485919 PMCID: PMC8411871 DOI: 10.18332/popmed/132120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION E-cigarettes are the most popular tobacco product among youth. Although harm perceptions have been linked to youth e-cigarette use, little research focuses on vulnerable populations, such as Appalachian youth. This study examines associations between e-cigarette harm perceptions and tobacco use among a sample of Appalachian youth. METHODS Using data from the 2014–2016 Youth Appalachian Tobacco Study (n=1074), distributions of six e-cigarette harm perceptions by tobacco use (never, ever non-e-cigarette, ever e-cigarette) were examined, and multivariable multinomial logistic regression was used. RESULTS Nearly one-fourth (23.4%) of the sample were ever e-cigarette users. More e-cigarette users were male (53.4%) and in high school (57.0%). Fewer e-cigarette users strongly agreed that e-cigarettes cause health problems (15.1%), breathing problems (20.3%), and oral health problems (18.7%) and that e-cigarettes are addictive (25.1%), compared to never and non-e-cigarette users. More e-cigarette users strongly agreed (32.3%) that e-cigarettes are healthier alternatives to cigarettes compared to never (24.1%) and non-e-cigarette (25.7%) users. Regression models indicate that e-cigarette users had greater odds of strongly disagreeing with e-cigarettes being harmful or addictive, compared to never users. E-cigarette users had approximately six-fold odds of strongly disagreeing with e-cigarettes causing health problems (OR=6.12; 95% CI: 3.16–11.90) and two times greater odds of disagreeing with e-cigarettes being addictive (OR=2.09; 95% CI: 1.07–4.08) compared to never users. CONCLUSIONS Appalachian youth ever e-cigarette users perceive e-cigarettes as less harmful and less addictive compared to never users. Better informing youth, especially youth tobacco users, of the harms associated with e-cigarettes is vital.
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Affiliation(s)
- Delvon T Mattingly
- Department of Communication, University of Louisville, Louisville, United States
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
| | - Thanh-Huyen T Vu
- American Heart Association Tobacco Center for Regulatory Science, Dallas, United States.,Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, United States
| | - Kandi L Walker
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
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Ickes MJ, Zidzik O, Vanderford NL. Engaging Rural High School Youth in E-cigarette Prevention and Advocacy. ONLINE JOURNAL OF INTERPROFESSIONAL HEALTH PROMOTION 2021; 3:3. [PMID: 35814171 PMCID: PMC9256968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Tobacco Use Status and Temptation to Try E-Cigarettes among a Sample of Appalachian Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136755. [PMID: 34201718 PMCID: PMC8267625 DOI: 10.3390/ijerph18136755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 11/24/2022]
Abstract
E-cigarettes are commonly used tobacco products among youth populations, including Appalachian youth. However, knowledge of the extent to which tobacco use status relates to temptation to try e-cigarettes is limited. Data from the Youth Appalachian Tobacco Study (n = 1047) were used. Temptation to try e-cigarettes was derived from a 12-item situational inventory. Tobacco use status was defined as never, ever non-e-cigarette, and ever e-cigarette use. A factorial ANOVA was used to estimate the adjusted association between tobacco use status and the e-cigarette use temptation scale. Two-way interaction terms between tobacco use status and gender, and tobacco use status and race/ethnicity, were plotted to depict effect modification. Approximately 10% of youth were ever non-e-cigarette users and 24% were ever e-cigarette users. Never and ever non-e-cigarette user middle schoolers had higher temptation to try e-cigarettes than their high school counterparts. The same relationship was found among never and ever e-cigarette users living in households with tobacco users. The ANOVA results suggest a positive, monotonic relationship between tobacco use status and temptation to try e-cigarettes, and that the adjusted group means differ by gender and race/ethnicity. The findings can inform tobacco prevention interventions for youth at higher risk for e-cigarette use, especially youth who have not yet tried e-cigarettes.
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Mattingly DT, Pfeiffer JA, Walker KL, Hart JL. Sex differences in associations between receiving and sharing tobacco-related information and tobacco product use among Appalachian Youth. POPULATION MEDICINE 2021; 2. [PMID: 33629078 PMCID: PMC7899165 DOI: 10.18332/popmed/125911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Given that Appalachian youth tobacco use rates are higher than the US national average, it is important to understand whether sex differences shape associations between receiving and sharing product information and using tobacco. METHODS Middle and high school students in rural Appalachia (n=1038) were surveyed about tobacco-related perceptions and behaviors, including ways youth receive and share conventional tobacco-related and e-cigarette-related information. Youth were characterized as tobacco users (i.e. ever or current users of cigarettes, smokeless tobacco, or e-cigarettes) or never users. Descriptive characteristics were compared by tobacco use and sex. Adjusted logistic regression models evaluated associations between communication channels and tobacco use. Models were stratified by sex to examine effect modification. RESULTS Approximately one-third of Appalachian youth (33.8%) were tobacco users and use varied by sex (males: 54.4%; females: 45.6%). Male (OR=1.75; 95% CI: 1.18-2.60) and female (OR=2.30; 95% CI: 1.53-3.47) youth who received e-cigarette-related information through friends and family (FF) had higher odds of tobacco use. Additionally, females who received e-cigarette-related information through public displays and digital media had nearly two-fold increased odds of tobacco use. Although sharing conventional tobacco-related and e-cigarette-related information through FF was associated with increased odds of tobacco use among both sexes, these relationships were stronger among females. CONCLUSIONS Although specific communication channels were associated with tobacco use, associations involving receiving and sharing e-cigarette information were more pronounced in female tobacco users. Consideration of sex differences in how youth receive and share tobacco-related information may benefit tobacco prevention interventions.
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Affiliation(s)
- Delvon T Mattingly
- Department of Communication, University of Louisville, Louisville, United States
| | - Jack A Pfeiffer
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Kandi L Walker
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
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Ickes MJ, Sampson S, Parsons J, Rayens MK, Xiao M, Fisher A, Mundy M, Hahn EJ. Tobacco-Free Ambassador Partnership: Empowering Youth Advocates in Appalachian Communities. Health Promot Pract 2020; 21:98S-109S. [PMID: 31908203 DOI: 10.1177/1524839919880563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Kentucky youth (14.3%) smoke more cigarettes as compared to the U.S. average (8.8%), and Appalachian communities suffer disproportionately from tobacco-related diseases such as lung cancer. Training youth to become advocates is an effective strategy to improve health equity. This article describes the development and impact of a youth advocacy program to promote tobacco control policies in Appalachian Kentucky. Phase I (2017-2018): two ½-day trainings followed by monthly meetings with one high school (n = 20 youth). Trainings provided information on tobacco use, consequences, industry tactics, evidence-based tobacco control, and advocacy skills. Results provided support for expansion to Phase II (2018-20119): A 1-day training followed by monthly information sharing implemented in three counties (N = 80). Youth were surveyed before and 6-months posttraining during both phases. Phase I: At posttraining, 85% of youth believed they could reduce the amount of tobacco use in their community versus 66% at baseline. More students tried at least once to convince school or government officials to be more concerned about tobacco use (77% vs. 47%). Phase II: More students supported tobacco policies at posttraining survey and realized policies are an effective strategy to reduce tobacco use. At posttraining survey, students reported greater interpersonal confidence talking with others about tobacco-related issues, with a 24% increase in confidence talking with adults in their communities, as well as greater advocacy self-efficacy. Youth in Appalachia demonstrate desire to influence tobacco use and policy to improve health equity. Findings reinforce the need for collaborative public health interventions to promote ongoing training and support for youth living in high-risk communities.
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Affiliation(s)
| | | | | | | | - Min Xiao
- University of Kentucky, Lexington, KY, USA
| | - Amy Fisher
- University of Kentucky, Lexington, KY, USA
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Roberts ME, Teferra AA, Keller-Hamilton B, Patterson JG, Ferketich AK. Shared and unique risk factors for tobacco use among rural versus urban adolescents. Prev Med 2020; 140:106239. [PMID: 32853669 PMCID: PMC7680386 DOI: 10.1016/j.ypmed.2020.106239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Megan E Roberts
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States of America.
| | - Andreas A Teferra
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States of America
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, 3650 Olentangy River Rd, Columbus, OH 43214, United States of America
| | - Joanne G Patterson
- The Ohio State University Comprehensive Cancer Center, 400A Cunz, 1841 Neil Ave, Columbus, OH 43210, United States of America
| | - Amy K Ferketich
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States of America
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Minary L, Agrinier N, Dugas EN, Sylvestre MP, O'Loughlin J. The Natural Course of Cigarette Smoking among Adolescent Daily Smokers in France and Quebec. Tob Use Insights 2020; 13:1179173X20943549. [PMID: 32922106 PMCID: PMC7446263 DOI: 10.1177/1179173x20943549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 06/25/2020] [Indexed: 11/25/2022] Open
Abstract
Objective: To describe the natural course of cigarette smoking and nicotine dependence (ND) over 1-year in daily smokers ages 15 to 17 living in different social contexts. Method: Cigarette smoking and ND indicators were measured at baseline and 3- and 12-months thereafter among 95 daily smokers with a total of 123 observations from the Nicotine Dependence in Teens (NDIT) Study in Quebec, Canada, and in 111 daily smokers from the TABagisme chez les ADOlescents (TABADO) Study in Lorraine, France. Results: NDIT and TABADO participants initiated smoking a mean (SD) of 3.9 (1.6) and 3.7 (2.0) years prior to baseline, respectively. Despite baseline differences in age, sex, age at initiation, number of cigarettes smoked per day and social context, 85% of participants in both samples reported cravings and responded “yes” to “felt like you really need a cigarette”. Mean (SD) number of cigarettes smoked per day increased from 9.4 (8.1) to 11.8 (8.0) over 1 year in NDIT (adjusted mean difference (95% CI) = 2.4 (0.8, 3.0)), and from 11.5 (6.5) to 13.5 (6.7) in TABADO (adjusted mean difference (95% CI) = 2.0 (0.8, 3.1)). However, most ND indicators in both samples were stable over time and cessation was infrequent. Conclusion: Despite notable differences across samples, the natural course of cigarettes smoked per day, ND symptoms and cessation was similar, suggestive of an underlying biologic rather than social process. To quit, adolescents who smoke daily will likely need (pharmacologic) intervention to counter the biological mechanisms underpinning ND, as well as complementary strategies targeting the social context such as creating social environments favoring cessation success.
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Affiliation(s)
| | - Nelly Agrinier
- Université de Lorraine, APEMAC, Nancy, France.,CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
| | - Erika N Dugas
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Sylvestre
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada
| | - Jennifer O'Loughlin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada
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15
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Mattingly DT, Hart JL, Wood LA, Walker KL. Sociodemographic differences in single, dual, and poly tobacco use among Appalachian youth. Tob Prev Cessat 2020; 6:45. [PMID: 33083678 PMCID: PMC7549506 DOI: 10.18332/tpc/124782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/10/2020] [Accepted: 06/29/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Patterns of youth tobacco use, including use of multiple products, have likely shifted as e-cigarettes have grown in popularity. However, there is limited understanding of dual and poly tobacco use and the associated disparities, especially among Appalachian youth. METHODS We analyzed Youth Appalachian Tobacco Study data (n=1116) to estimate prevalence of current (past-30 day) cigarette, e-cigarette, and smokeless tobacco use by gender, race/ethnicity, age, school type, state, smartphone use, and number of household tobacco users. We created a pattern of tobacco use variable (i.e. never, former, single, dual, poly) based on all possible combinations of the included products. Using multivariable multinomial logistic regression (outcome reference: never use), we evaluated associations between sociodemographic characteristics and patterns of tobacco use. RESULTS Former (16.2%) was the most common tobacco use group, followed by single (10.8%), dual (4.5%), and poly (2.4%) use. Dual and poly use were more prevalent among males, Whites/Caucasians, older participants, and participants living in households with tobacco users. Kentucky residents (vs New York) had higher odds of dual use (OR=5.15; 95% CI: 1.72–15.44), and youth who used smartphones for ≥20hours/week (vs <20 hours/week) had greater odds of poly use (OR=3.02; 95% CI: 1.34–6.80). CONCLUSIONS Differences in single, dual, and poly tobacco use were evidenced by sociodemographic characteristics. Additional inquiry should further examine these disparities so that tobacco prevention interventions can be appropriately tailored.
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Affiliation(s)
- Delvon T Mattingly
- Department of Communication, University of Louisville, Louisville, United States
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States.,School of Medicine, Envirome Institute, University of Louisville, Louisville, United States
| | - Lindsey A Wood
- Department of Communication, University of Louisville, Louisville, United States.,School of Medicine, Envirome Institute, University of Louisville, Louisville, United States
| | - Kandi L Walker
- Department of Communication, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States.,School of Medicine, Envirome Institute, University of Louisville, Louisville, United States
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16
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Mattingly DT, Pfeiffer J, Tompkins LK, Rai J, Sears CG, Walker KL, Hart JL. Associations between Appalachian youth tobacco consumption and communication channel use. Tob Prev Cessat 2020; 6:21. [PMID: 32548358 PMCID: PMC7291911 DOI: 10.18332/tpc/118234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/02/2020] [Accepted: 02/17/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Youth tobacco use rates in Appalachia exceed the US national average, and e-cigarette use has increased. Thus, further research is needed to understand how these youth receive and share product information. METHODS Middle and high school students in rural Appalachia were surveyed (N=1103). The primary outcome, tobacco use, was categorized as: never users, cigarette-only users, smokeless-only users, e-cigarette-only users, and polytobacco users. Associations between receiving or sharing conventional tobacco-related or e-cigarette-related information via specific communication channels and tobacco use were assessed. RESULTS Participants who received tobacco information from friends and family (FF) (OR=1.87; 95% CI: 1.35–2.57), public displays (PUB) (OR=1.49; 95% CI: 1.09–2.05), and digital media (DIG) (OR=1.95; 95% CI: 1.41–2.70) and e-cigarette information via the same communication channels, FF (OR=2.65; 95% CI: 1.93–3.65), PUB (OR=1.62; 95% CI: 1.17–2.26), and DIG (OR=2.24; 95% CI: 1.61–3.12), had greater odds of being polytobacco users, compared to never users. Participants who received e-cigarette-related information from FF (OR=2.42; 95% CI: 1.42–4.13) and PUB (OR=2.13; 95% CI: 1.25–3.65) had greater odds of being e-cigarette-only users compared to never users. Participants who shared e-cigarette-related information with FF had greater odds of being e-cigarette-only users (OR=3.16; 95% CI: 1.80–5.58) and polytobacco users (OR=4.48; 95% CI: 3.16–6.35) compared to never users. CONCLUSIONS Receiving and sharing tobacco-related and e-cigarette-related information via multiple communication channels is associated with e-cigarette and polytobacco use among Appalachian youth. Several channels may need to be utilized in health campaigns to influence youth.
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Affiliation(s)
- Delvon T Mattingly
- Department of Communication, University of Louisville, Louisville, United States
| | - Jack Pfeiffer
- Department of Communication, University of Louisville, Louisville, United States
| | - Lindsay K Tompkins
- Department of Communication, University of Louisville, Louisville, United States.,American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
| | - Jayesh Rai
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, United States.,School of Medicine, Diabetes and Obesity Center, University of Louisville, Louisville, United States
| | - Clara G Sears
- Department of Communication, University of Louisville, Louisville, United States.,American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
| | - Kandi L Walker
- Department of Communication, University of Louisville, Louisville, United States.,American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States.,School of Medicine, Envirome Institute, University of Louisville, Louisville, United States
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, United States.,American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States.,School of Medicine, Envirome Institute, University of Louisville, Louisville, United States
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Perry CL, Creamer MR, Chaffee BW, Unger JB, Sutfin EL, Kong G, Shang C, Clendennen SL, Krishnan-Sarin S, Pentz MA. Research on Youth and Young Adult Tobacco Use, 2013-2018, From the Food and Drug Administration-National Institutes of Health Tobacco Centers of Regulatory Science. Nicotine Tob Res 2020; 22:1063-1076. [PMID: 31127298 PMCID: PMC7457341 DOI: 10.1093/ntr/ntz059] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/16/2019] [Indexed: 12/21/2022]
Abstract
The Tobacco Regulatory Science Program is a collaborative research effort between the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). In 2013, the NIH funded 14 Tobacco Centers of Regulatory Science (TCORS), which serve as partners in establishing research, training, and professional development programs to guide FDA. Each of the fourteen TCORS, and two other NIH-funded research programs, the Center for the Evaluation of Nicotine in Cigarettes (CENIC) and the Consortium on Methods Evaluating Tobacco (COMET), pursued specific research themes relevant to FDA's priorities. A key mandate for FDA is to reduce tobacco use among young people. This article is a review of the peer-reviewed research, including published and in-press manuscripts, from the TCORS, CENIC, and COMET, which provides specific data or other findings on youth (ages 10-18 years) and/or young adults (ages 18-34 years), from 2013 to 2018. Citations of all TCORS, CENIC, and COMET articles from September 2013 to December 2017 were collected by the TCORS coordinating center, the Center for Evaluation and Coordination of Training and Research. Additional citations up to April 30, 2018 were requested from the principal investigators. A scoring rubric was developed and implemented to assess study type, primary theme, and FDA priority area addressed by each article. The major subareas and findings from each priority area are presented. There were 766 articles in total, with 258 (34%) focusing on youth and/or young adults. Findings relevant to FDA from this review concern impact analysis, toxicity, health effects, addiction, marketing influences, communications, and behavior. IMPLICATIONS The Tobacco Centers of Regulatory Science, CENIC, and COMET have had a high output of scientific articles since 2013. These Centers are unique in that the FDA supports science specifically to guide future regulatory actions. The 258 articles that have focused on youth and/or young adults are providing data for regulatory actions by the FDA related to the key priority areas such as the addictiveness of non-cigarette products, the effects of exposure to electronic cigarette marketing on initiation and cessation, and the impact of flavored products on youth and young adult tobacco use. Future regulations to reduce tobacco use will be guided by the cumulative evidence. These Centers are one innovative mechanism to promote important outcomes to advance tobacco regulatory science.
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Affiliation(s)
- Cheryl L Perry
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | - MeLisa R Creamer
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | | | - Jennifer B Unger
- Keck School of Medicine,University of Southern California, Los Angeles, CA
| | | | | | - Ce Shang
- Oklahoma Tobacco Research Center, Stephenson Cancer Center
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Stephanie L Clendennen
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | | | - Mary Ann Pentz
- Keck School of Medicine,University of Southern California, Los Angeles, CA
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Ziller EC, Lenardson JD, Paluso NC, Talbot JA, Daley A. Rural-Urban Differences in the Decline of Adolescent Cigarette Smoking. Am J Public Health 2019; 109:771-773. [PMID: 30897002 DOI: 10.2105/ajph.2019.304995] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine change over time in cigarette smoking among rural and urban adolescents and to test whether rates of change differ by rural versus urban residence. METHODS We used the 2008 through 2010 and 2014 through 2016 US National Survey of Drug Use and Health to estimate prevalence and adjusted odds of current cigarette smoking among rural and urban adolescents aged 12 to 17 years in each period. To test for rural-urban differences in the change between periods, we included an interaction between residence and time. RESULTS Between 2008 to 2010 and 2014 to 2016, cigarette smoking rates declined for rural and urban adolescents; however, rural reductions lagged behind urban reductions. Controlling for socioeconomic characteristics, rural versus urban odds of cigarette smoking did not differ in 2008 through 2010; however, in 2014 through 2016, rural youths had 50% higher odds of smoking than did their urban peers. CONCLUSIONS Differential reductions in rural youth cigarette smoking have widened the rural-urban gap in current smoking rates for adolescents. Public Health Implications. To continue gains in adolescent cigarette abstinence and reduce rural-urban disparities, prevention efforts should target rural adolescents.
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Affiliation(s)
- Erika C Ziller
- Erika C. Ziller, Jennifer Dunbar Lenardson, Nathan C. Paluso, and Jean A. Talbot are with the Maine Rural Health Research Center, University of Southern Maine, Portland. Angela Daley is with the School of Economics, University of Maine, Orono
| | - Jennifer Dunbar Lenardson
- Erika C. Ziller, Jennifer Dunbar Lenardson, Nathan C. Paluso, and Jean A. Talbot are with the Maine Rural Health Research Center, University of Southern Maine, Portland. Angela Daley is with the School of Economics, University of Maine, Orono
| | - Nathan C Paluso
- Erika C. Ziller, Jennifer Dunbar Lenardson, Nathan C. Paluso, and Jean A. Talbot are with the Maine Rural Health Research Center, University of Southern Maine, Portland. Angela Daley is with the School of Economics, University of Maine, Orono
| | - Jean A Talbot
- Erika C. Ziller, Jennifer Dunbar Lenardson, Nathan C. Paluso, and Jean A. Talbot are with the Maine Rural Health Research Center, University of Southern Maine, Portland. Angela Daley is with the School of Economics, University of Maine, Orono
| | - Angela Daley
- Erika C. Ziller, Jennifer Dunbar Lenardson, Nathan C. Paluso, and Jean A. Talbot are with the Maine Rural Health Research Center, University of Southern Maine, Portland. Angela Daley is with the School of Economics, University of Maine, Orono
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