Determinants Of Tobacco Use Research Articles

Exploring In-School Adolescent Smoking Behaviors: A Comparative Study of Rural and Urban Contexts in Anambra, Nigeria

The use of tobacco among adolescents is a big public health issue in low- and middle-income countries of the world including Nigeria. The aim of this study was to compare prevalence and determinants of tobacco use among in-school adolescents’ resident in urban and rural secondary schools in Anambra State. A cross-sectional analytical design was observed using multi stage random sampling to sample 360 students from some selected schools. A pretested, semi structured questionnaire adapted from the Global School Health Survey (GSHS) was used to collect data. The data was analyzed by descriptive and inferential statistics. Similar prevalence of tobacco use was found in both the urban (6.3%) and in the rural (6.5%) sites, without significance in either (p=1.000). Participation in protective factors including health education programs in which participants are educated on smoking dangers and sexually transmitted diseases (STDs) in particular was associated with non-smoking behavior significantly more in urban areas. On the other hand, being urban adolescents who reported tobacco use showed significantly association with risk factors such as poor school environment and bullying. Consequently, no difference in rates of tobacco use occur between urban and rural adolescents, despite differences in protective and risk factors. Recommendations aimed at strengthening health education, and improving school environments and reducing bullying are suggested to reduce adolescent smoking in these settings. Effective tobacco control of Nigerian adolescents requires targeting of public health interventions on the basis of the socio-cultural context.

Trend and determinants of tobacco use among Indian males over a 22-year period (1998-2021) using nationally representative data.

Tobacco consumption is associated with an increased risk of morbidity and mortality. India is one of the largest consumers of tobacco worldwide. We assessed the trend of tobacco use among Indian males over a period of 20 years using data obtained from four rounds of the National Family Health Survey (NFHS). Data on tobacco usage and relevant socioeconomic variables obtained from NFHS rounds 2 to 5 over the period 1998-2021, was used for analysis. Specifically, data were available for 138,951 males from NFHS-2, 74,369 males from NFHS-3, 112,222 males from NFHS-4, and 101,839 males from NFHS-5. Significance of association between various socio-economic factors and tobacco usage was ascertained using a multicategory logistic regression model. Among all the forms of tobacco, smokeless tobacco was predominantly used by Indian males. The proportion of smokers and those using both smoke and smokeless forms peaked during NFHS-3, followed by a consistent dip; however, the use of smokeless tobacco plateaued from NFHS-4 to NFHS-5. NFHS-5 shows that 19.2% of Indian males smoked, 27.0% used smokeless tobacco, and 6.3% used both. Tobacco use has declined significantly over the last two decades. Tobacco usage is noticeably higher among the elderly, Muslims, and those from the backward classes, while it was considerably lower for individuals belonging to the educated and wealthier segment. There has been a steady decline in tobacco use in India over the past 22 years, specifically in the smoke-form category. However, smokeless tobacco use remains nearly unaffected. The outcome of this study might aid policymakers in devising targeted tobacco control policies and improving existing ones.

Tobacco use and khat chewing among adolescents in Yemen: a large-scale school-based cross-sectional study

ObjectiveThe present study sought to assess the prevalence and determinants of tobacco use (cigarette smoking and shisha use) and khat chewing among Yemeni adolescents, and to evaluate their knowledge and attitudes toward these habits.MethodsThis school-based cross-sectional study was conducted among 13 to 19-year-old students attending middle/high schools (both private and public) across five main cities in Yemen. Data were collected using self-administered questionnaires comprising questions/items related to sociodemographic data, cigarette smoking, shisha use, khat chewing, and knowledge on and attitudes toward these habits. Bivariate and multivariate analyses were used to explore the most determinant factors.ResultsA total of 7505 students were recruited from 42 schools across five major cities in Yemen. The prevalence rates of khat chewing, cigarette smoking, and shisha use were 42.4%, 6.8%, and 19.3%, respectively. Compared to females, male subjects reported significantly higher prevalence of khat chewing (51.4% vs. 23.5%, p < 0.001), shisha use (20.3% vs. 17.2%, p < 0.01), and cigarette smoking (8.8% vs. 2.6%, p < 0.001). Male gender, older age, poor knowledge, khat chewing, parents’ low education level, and parents’ and peers’ smoking habits were significant determinants of adolescents’ cigarette smoking status. Private education, male gender, older age, poor knowledge, parents’ low education level, and parents’ and peers’ khat chewing habits were significant determinants of adolescents’ khat chewing status. The participant’s knowledge of and attitudes toward tobacco use and khat chewing were inadequate.ConclusionThe prevalence of khat chewing, shisha use, and to lesser extent cigarette smoking among Yemeni adolescents is high that needs immediate intervention. The results highlight the urgent need to implement prevention strategies to tackle these habits among the youth in Yemen.

It's not just Black and White: Identifying the combined influence of multi-level determinants of tobacco use among Black adolescents.

Black individuals are disproportionately affected by tobacco-related illnesses. Although tobacco use is often initiated in adolescence and risk factors thereof originate from multiple domains of influence, investigations of tobacco use among Black adolescents seldom consider these multiple domains simultaneously. These examinations are needed to identify the influence of co-occurring risk factors on tobacco use and inform comprehensive tobacco prevention and treatment programs. Our study sought to identify the combined influence of factors across multiple domains on tobacco use among Black adolescents. Participants were Non-Hispanic Black (N = 1,801) adolescent (age 12-17 years) respondents from Wave 1 of the Population Assessment of Tobacco and Health study. Latent class analysis identified unique response patterns to items assessing risk of tobacco use across sociocultural, environmental, psychological, and behavioral (e.g., alcohol use) domains. Subsequent logistic regressions compared the odds of ever and current tobacco use between the classes. Four latent classes were identified. According to item response probabilities they were named: Low Risk (LR: 36.5%), Low Psychological (LP: 19.0 %), High Psychological (HP: 30.4%) and High Social, Psychological, and Behavioral (HSPB: 14.1%) risk. The odds of ever and current tobacco use were highest among adolescents in the HSPB latent class compared to the other latent classes (odds ratio: 6.5 to 42.1). Adolescents with the highest odds of tobacco use endorse multiple risks including feeling distress, perceiving tobacco as beneficial for handling stress, and using substances, and may prioritize the management of negative emotions over perceived health consequences from tobacco use. Multi-level interventions that incorporate the development of coping strategies for effectively handling negative affect may prove highly effective in preventing tobacco use among Black adolescents.

Determinants of tobacco use among pregnant women in sub-Saharan Africa. A multilevel mixed-effect logistic regression model.

Although it is known that maternal tobacco use during pregnancy substantially declined in higher-income countries, information on the magnitude and determinants of tobacco use among pregnant women in sub-Saharan Africa (SSA) remains limited. Establishing evidence on maternal tobacco during pregnancy is crucial for guiding targeted interventions in SSA. This study aimed to determine the overall prevalence of tobacco use and its determinants among pregnant women in SSA countries. The study used data from Demographic and Health Surveys conducted in 33 countries across SSA from 2010 and 2021. Our analysis included a total weighted sample of 40,291 pregnant women. A multilevel logistic regression model was used to identify factors associated with maternal tobacco use during pregnancy. The measure of association between explanatory variables and the outcome was reported using adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The pooled prevalence of tobacco use among pregnant women in SSA was 1.76% (95% CI: 1.41, 2.12). Our findings showed that pregnant women in the age groups of 25-34 years (AOR 1.44; 95% CI: 1.14, 1.82) and 35+ years (AOR 2.18; 95% CI: 1.68, 2.83) had higher odds of tobacco use during pregnancy. Pregnant women who attained primary education (AOR 0.57; 95% CI: 0.46, 0.70) and secondary or higher education (AOR 0.39; 95% CI: 0.30, 0.53) were associated with lower odds of tobacco use. Similarly, pregnant women who resided in households with a high wealth index (AOR 0.36; 95% CI: 0.55 0.90) and those with media exposure (AOR 0.81; 95% CI: 0.67, 0.99) were less likely to use tobacco during pregnancy. This study revealed that the overall prevalence of maternal tobacco use during pregnancy was relatively low in SSA, but some countries exhibited higher estimates. To address this, it is crucial to implement targeted smoking prevention and cessation strategies, particularly for young pregnant women, those facing socioeconomic disadvantages, and those with lower educational status.

Youthful Choices: A Secondary Analysis of the NFHS-5 Data to Examine Tobacco Use in Indian Adolescent Girls and Young Women

Background and aim: Tobacco use among adolescents and young women is a global health concern. This study investigates the prevalence and determinants of tobacco use among adolescents and young women in India. Methods: Based on data from the National Family Health Survey-5, this study explored tobacco use among 241,180 young women aged 15–24 in India. The research investigated determinants of current tobacco use, encompassing any tobacco use in any form, smoked and smokeless tobacco (SLT). Independent variables include demographics, religion, caste, region, education, occupation, body mass index, wealth index, alcohol consumption, and media exposure. We used multivariable logistic regression models to estimate the adjusted odds ratio (OR) and 95% confidence intervals (95%CI). Results: Findings revealed that 1.3% of the population are current tobacco users, with 1.2% using SLT and 0.14% smoking. Significant determinants included age, urban residence, religion, scheduled tribe status, wealth index, education, alcohol co-use, region, and pregnancy/lactation status. Young women (young women, 3.5% &gt; adolescents, 1.5%; OR 1.78, 95%CI 1.65, 1.92), urban dwellers (OR 1.38, 95%CI 1.32, 1.43), and alcohol users (OR 5.6, 95%CI 4.88, 6.33) exhibited higher odds of tobacco use. In contrast, education (higher education OR 0.15, 95%CI 0.13, 0.18) and higher socioeconomic status (richest OR 0.3, 95%CI 0.22, 0.31) were protective factors. Conclusion: Our research offered valuable insights into tobacco use among young Indian women. To effectively curb tobacco use in this population, it is imperative to address the identified determinants and vulnerabilities through tailored public health strategies and policies.

Tobacco use and behaviour among South African adolescents and young adults: systematic review and meta-analysis

ObjectiveTobacco use, particularly the initiation of smoking during adolescence and young adulthood, represents a significant public health concern in South Africa. This study aims to conduct a comprehensive review of...

Prevalence and Associated Factors of Cigarette Smoking among South African Adolescents and Young Adults: A Systematic Review and Meta-Analysis Protocol.

Tobacco use, particularly the initiation of smoking during adolescence and young adulthood, represents a significant public health concern in South Africa. The influence of socio-cultural factors, marketing strategies of the tobacco industry, and accessibility of tobacco products have all been implicated in this context. This systematic review and meta-analysis protocol aims to scrutinise the body of literature on this issue, providing a comprehensive understanding of the patterns and determinants of tobacco use among South African adolescents and young adults, with an eye towards informing more effective policy interventions. The available literature for studies on tobacco use will be systematically searched and reviewed. Five international scholarly databases, namely PubMed, MEDLINE, EMBASE, Global Health, and Scopus, will be searched. Peer-reviewed studies will be included if they are conducted in South Africa or South African provinces and if they include the prevalence of tobacco use among adolescents and young adults aged between 12 and 24 years. The results of such an analysis can guide future policy designs, enabling them to be more targeted and thus more effective. The findings can also have implications for shaping global tobacco control strategies, given the transferability of successful interventions across different populations and cultural contexts. This protocol has been registered in the PROSPERO database (ID: CRD42023428369).

Tobacco Use among School-Age Adolescents in Indonesia: Findings from the 2015 Indonesia Global School-Based Student Health Survey.

Although Indonesia has a considerable proportion of adolescent smokers, nationally representative studies of its determinants remain limited. The 2015 Indonesian Global School-Based Student Health Survey (GSHS) was conducted with school-age adolescents and provided information about smoking behavior. This study aimed to examine the prevalence, determinants, and correlates of tobacco use among adolescents in Indonesia using the GSHS survey. A secondary data analysis of a cross-sectional study was conducted using data from the 2015 Indonesian GSHS. Multivariate logistic regression was used to assess the determinants and correlates of tobacco use. Our analysis showed that 9.1% of school-age adolescents had used tobacco products in the past 30 days. Most were 13-15 years (61.7%) and had attempted to stop smoking (92.4%). After adjusting for covariates, significant risk factors associated with tobacco smoking were older age groups (prevalence odds ratio [POR], 3.01-9.40; 95% confidence interval [CI], 1.71-23.1), male (POR, 13.7; 95% CI, 8.71-21.5), psychological distress (POR, 1.41; 95% CI, 1.05-1.90), smoking exposure (POR, 1.98-2.15; 95% CI, 1.35-3.42), and when both parents smoked (POR, 2.96; 95% CI, 1.78-4.94). In addition, tobacco use was associated with other risky behaviors, including sex with multiple partners, using drugs, drinking alcohol, and being involved in physical fights. Tobacco use is high among Indonesian adolescents. This prevalence highlights the need for a more stringent tobacco control policy and tailored cessation programs for adolescents by considering important modifiable determinants of tobacco use among adolescents, including risky smoking-related behaviors.

Prevalence and Determinants of Tobacco Use in the Undergraduate Students of Nursing in Peshawar, KP

The plants of tobacco contain habit-forming chemical substances known as nicotine. Tobacco products are available in different forms like Smoke Tobacco (ST) and Smokeless tobacco (SLT). Common STs are cigarette, pipe tobacco (hookah), cigar, and e-cigarette. Objective: To find the prevalence and determinants of tobacco use among undergraduate nursing students. Methods: A quantitative, cross-sectional descriptive study was carried out among undergraduate nursing students. The convenient sampling technique was adopted. The sample size was calculated by Raosoft software with a known population of 1800, having a margin of error of 5%, a confidence interval of 95%, and a calculated sample size of 317. Results: Majority of the participants in this study were Male, out of total 317 participants, 135 (42.6%) of the participants, (male 51.4% and female 23.8% used tobacco) while 174 (54.9%) never tried to use tobacco. Among the tobacco users (135)25.9% smoked tobacco only (male, 31.6%: female, 14.3%), 4.1% used naswar only (male, 6.1%: female, 0%), and 5.4% (male, 6.6%: female, 1.9%) of the participants used both cigarette and naswar, and 6.9% (male, 7.1: 6.7%) of the participants used other forms of tobacco products. Conclusions: In conclusion, it was found that tobacco use among nursing students of different colleges in Peshawar is common. Male students are more prone to become users because of family members, friends and college fellows’ behaviors. Most of them tried in the age of 10 to 20 years.

Multi-Level Influences of Smoke-Free Policies in Subsidized Housing: Applying the COM-B Model and Neighborhood Assessments to Inform Smoke-Free Policies.

Smoke-free policies in multi-unit housing are associated with reduced exposure to secondhand smoke (SHS); however, attitudes toward comprehensive smoke-free policies among residents in subsidized multi-unit housing are unknown. In this mixed-methods study, we explored the socio-ecological context for tobacco and cannabis use and attitudes toward policies restricting indoor use of these products through interviews with residents (N = 134) and staff (N = 22) in 15 federally subsidized multi-unit housing in San Francisco, California. We conducted a geo-spatial and ethnographic environmental assessment by mapping alcohol, cannabis, and tobacco retail density using ArcGIS, and conducted systematic social observations of the neighborhood around each site for environmental cues to tobacco use. We used the Capability, Opportunity, and Motivation behavior (COM-B) model to identify factors that might influence implementation of smoke-free policies in multi-unit housing. Knowledge and attitudes toward tobacco and cannabis use, social norms around smoking, neighborhood violence, and cannabis legalization were some of the social-ecological factors that influenced tobacco use. There was spatial variation in the availability of alcohol, cannabis, and tobacco stores around sites, which may have influenced residents' ability to maintain smoke-free homes. Lack of skill on how to moderate indoor smoking (psychological capability), lack of safe neighborhoods (physical opportunity), and the stigma of smoking outdoors in multi-unit housing (motivation) were some of the barriers to adopting a smoke-free home. Interventions to increase adoption of smoke-free policies in multi-unit housing need to address the co-use of tobacco and cannabis and commercial and environmental determinants of tobacco use to facilitate smoke-free living.

Determinants of Tobacco Use among Immigrant Workers Around a University in South India – A Qualitative Approach

Background: According to the global adult tobacco survey – prevalence of smokeless tobacco (SLT) use in India is highest in the world and 60% of tobacco users in India currently use SLT products. The prevalence of SLT use among women in Karnataka is 14.7%, among immigrant women daily wage workers is 87.2%. There is paucity of information about tobacco consumption among females, especially which calls for an urgent need to address the issue. Aim: The aim of this study was to examine underlying factors which initiated SLT use and their knowledge levels about its ill effects among immigrant daily wage workers in a University setting of South India. Settings and Design: This was a qualitative study conducted at office sites (n = 6) within University Premises of Manipal, Karnataka. Materials and Methods: The focus group and interview guides were semi-structure in nature and developed in the context of a guide to a conversation/discussion. It covered all research questions that could be answered by this qualitative approach. Statistical Analysis: Thematic analysis was used to report and interpret the findings. Results and Conclusion: A total of six focus group discussion’s (n = 55 participants) and 20 in-depth interview’s (n = 20 participants) were conducted. Themes emerged – “Factors for uptake of SLT use,” “Poor knowledge on adverse effects of SLT use,” “Easy Availability and Accessibility,” and “Thoughts and Suggestions on quitting.” Reappraising social determinants in access to tobacco prevention and cessation support services to migrant construction workers may be a promising strategy to reduce health harms of SLT use.

Social determinants of tobacco use among tribal communities in India: Evidence from the first wave of Longitudinal Ageing Study in India.

Evidence on tobacco use among indigenous communities is scarce with available literature based either on a specific region or a particular tribe. Considering the large tribal population in India, it is pertinent to generate evidence on tobacco use among this community. Using nationally representative data, we aimed to estimate the prevalence of tobacco use and assess its determinants and regional variations among older tribal adults in India. We analysed data from Longitudinal Ageing Study in India (LASI), wave-1 conducted in 2017-18. A sample of 11,365 tribal individuals aged ≥ 45 years was included in this study. Descriptive statistics was used to assess the prevalence of smokeless tobacco (SLT), smoking, and any form of tobacco use. Separate multivariable regression models were executed to assess the association of various socio-demographic variables with different forms of tobacco use, reported as adjusted odds ratio (AOR) with 95% confidence interval. The overall prevalence of tobacco use was around 46%, with 19% of smokers and nearly 32% smokeless tobacco (SLT) users. Participants from the lowest MPCE quintile group had a significantly higher risk of consuming (SLT) [AOR: 1.41 (95% CI: 1.04-1.92)]. Alcohol was found to be associated with both smoking [AOR: 2.09 (95% CI: 1.69-2.58)] and (SLT) [AOR: 3.05 (95% CI: 2.54-3.66)]. Relatively higher odds of consuming (SLT) were associated with the eastern region [AOR: 6.21 (95% CI: 3.91-9.88)]. This study highlights the high burden of tobacco use and its social determinants among the tribal population in India, which can help tailor anti-tobacco messages for this vulnerable population to make tobacco control programs more effective.

Prevalence and determinants of smoking among students and staff of the Polydisciplinary Faculty of Taza, Sidi Mohamed Ben Abdellah University, Morocco

Smoking remains a major public health concern and an alarming social phenomenon, particularly in developing countries and especially among the increasingly young population. This study aimed to determine the prevalence of smoking among students and staff at the Polydisciplinary Faculty of Taza, assess their attitudes towards tobacco, and examine the determinants of tobacco use. A cross-sectional survey was conducted among students and pedagogical, administrative, and technical staff (PATS), during three months in 2012 and two months in 2018. The participation rate was 59.6% in 2012 (105 out of 175), 60.2% in 2018 (106 out of 176) for PATS, 60.5% in 2012 (908 out of 1501), and 63.5% in 2018 (1139 out of 1794) for students. Prevalence in 2012 was higher than in 2018 (9.1% in 2012 versus 4.4% in 2018 for students and 17.1% in 2012 versus 8.5% in 2018 for PATS). Ex-smokers made up 4.4% of students in 2012 and 4.3% in 2018, while 6.7% in 2012 and 11.3% in 2018. Smoking was significantly higher (t-test) for males than for females in both periods and for both categories (P<0.001). The average age of smoking initiation was earlier for both categories surveyed. Dependency levels were high in 33.2% of students in 2012 and 11.1% of students in 2018, as well as 20.5% of PATS in 2012 and 9.4% of PATS in 2018. The most common means of withdrawal were willingness for PATS and family support for students. The findings of the present investigation highlight the importance of awareness-raising and educational activities and, above all, of strengthening motivation and support for those who wish to quit smoking.

Socio-cultural determinants of tobacco consumption: a study of migrant and local workers in a district of Punjab, India

Although the use of tobacco in the state of Punjab is below the national statistics of India, according to Global Adult Tobacco Survey (GATS) 2016 Report, its consumption has increased. Also, what sets it apart from rest of the nation is the cultural as well as the religious taboo associated with tobacco use. The case of Punjab is also peculiar because of the socio demographic profile of the region which has changed since Green Revolution. Having said that, use of tobacco is a social phenomenon and it becomes important to place tobacco use in a social and cultural context. The aim of the study is to explore the socio -cultural determinants of tobacco use within local and migrant groups in a district of Punjab. The tobacco users in the district were divided into groups of local and migrant labourers and focus group discussion was carried out with them. There were various social correlates of tobacco use in the district which saw variations within and across these groups. The socio demographic factors of age, gender, religion and place of residence were related to the use of tobacco and presented similarities and variations across the groups. The study concluded that tobacco prevention and control policies should include cultural interventions to change current traditional practices and social determinants which influence the use of tobacco.

The determinants of adolescent smokers in Indonesia

In Indonesia, the prevalence of adolescence smokers is high. The situation might be worse during the epidemiological transition. This study aimed to estimate the sociodemographic factors related to tobacco use (light, moderate, and heavy) among adolescent in school age in Indonesia. This cross-sectional study used the raw data from the secondary data of Indonesia Global Youth of Tobacco Survey (GYTS), 2019. This study only included the 9,992 adolescent smokers in school age as the sample. School was selected based on the proportional probability based on the number of students. The class was selected by random sampling method and the students in that class were eligible to join the survey. This current study only selected those who smoked at the time of survey. The univariate, bivariate (Chi-square and t-test), and multivariate (ordinal logistic regression) has been tested in this study. The prevalence of tobacco uses among adolescent in Indonesia in 2019 was 19.2%. The determinants of tobacco use mostly related to pocket money, having products with cigarettes logo, and can purchase near the school. The role of sociodemographic, factors related to current tobacco use is very important to arrange the policy. The policy is very important to prevent and control tobacco use, especially among adolescence.

Mobile Health Tobacco Cessation Interventions to Promote Health Equity: Current Perspectives.

Although US tobacco use trends show overall improvement, social disadvantage continues to drive significant disparities. Traditional tobacco cessation interventions and public policy initiatives have failed to equitably benefit socially-disadvantaged populations. Advancements in mobile digital technologies have created new opportunities to develop resource-efficient mobile health (mHealth) interventions that, relative to traditional approaches, have greater reach while still maintaining comparable or greater efficacy. Their potential for affordability, scalability, and efficiency gives mHealth tobacco cessation interventions potential as tools to help redress tobacco use disparities. We discuss our perspectives on the state of the science surrounding mHealth tobacco cessation interventions for use by socially-disadvantaged populations. In doing so, we outline existing models of health disparities and social determinants of health (SDOH) and discuss potential ways that mHealth interventions might be optimized to offset or address the impact of social determinants of tobacco use. Because smokers from socially-disadvantaged backgrounds face multi-level barriers that can dynamically heighten the risks of tobacco use, we discuss cutting-edge mHealth interventions that adapt dynamically based on context. We also consider complications and pitfalls that could emerge when designing, evaluating, and implementing mHealth tobacco cessation interventions for socially-disadvantaged populations. Altogether, this perspective article provides a conceptual foundation for optimizing mHealth tobacco cessation interventions for the socially-disadvantaged populations in greatest need.

NIH Tobacco Research and the Emergence of Tobacco Regulatory Science.

This study explores how the emergence of FDA-funded Tobacco Regulatory Science (TRS) research complements and perhaps influenced the direction of tobacco research supported by NIH. New NIH- and FDA-funded tobacco projects awarded in fiscal years (FY) 2011-2020 were identified using internal NIH databases of awarded grants. Project abstracts and research aims were coded by the authors to characterize research domains and tobacco products studied. Between FY 2011 and 2020, NIH funded 1032 and FDA funded 322 new tobacco projects. For the years and grant activity codes studied, the number of new NIH tobacco projects declined while FDA's increased; combined the number of new projects held steady. Much of NIH research included smoking combustibles (43.7%). The most common products in FDA research were cigarettes (74.8%) and e-cigarettes/ENDS (48.1%). Most NIH (58.6%) and FDA (67.7%) projects included research on the determinants of tobacco use. Another area of apparent overlap was health effects (29.5% NIH and 30.1% FDA). Projects unique to NIH included treatment interventions (33.3%), disease pathology/progression (17.8%) and neurobiology (18.9%). A minority of both NIH and FDA projects included populations particularly vulnerable to tobacco product use. In total, support for new tobacco research supported by NIH and FDA combined remained steady for the time period covered, though there was a concomitant decline in NIH tobacco projects with the increase in FDA-funded TRS projects for the activity codes studied. Despite the apparent overlap in some areas, both NIH and FDA support research that is unique to their respective missions. NIH continues to support tobacco research that falls within and outside of FDA's regulatory authorities. This research still is needed not only to bolster the evidence base for regulatory decisions at the national and state levels, but also to advance a comprehensive scientific agenda that can inform multiple levels of influence on tobacco control, use and addiction. It will be important to continue monitoring FDA-funded TRS and NIH-funded tobacco research portfolios to ensure that the level of support for and focus of the research is sufficient to address the burden of tobacco-related morbidity and mortality.

Correlates of tobacco use among Asian and Pacific Islander youth and young adults in the U.S.: A systematic review of the literature.

Rates of tobacco product use, including the use of combustible and electronic cigarettes, remain high in youth and young adults within the U.S. Though a substantial body of work has examined risk factors associated with initiation and ongoing use of tobacco products, research on tobacco use and associated correlates among Asian and Pacific Islanders (APIs) has been more limited despite high rates in select API subgroups. This systematic review outlines recent research (2010-2020) on the correlates of tobacco use in APIs aged 9-29. To better understand determinants of tobacco use and identify gaps in the literature, we framed correlates based on the National Institute on Minority Health and Health Disparities (NIMHD) multidimensional research framework. Database and author-focused searches were conducted, followed by article abstract and full-text reviews, much of which were guided by a discrete set of inclusionary and exclusionary criteria related to tobacco use and youth/young adults. A total of 24 articles were included in this review. The majority of articles focused on individual-level correlates, with a high number of studies demonstrating association between behavioral and sociocultural factors and tobacco product use behavior. Interpersonal factors also made up a substantial portion of the literature, commonly focusing on peer, family, and social norms. Gaps related to the NIMHD model are addressed. Future research should examine biological and community/societal factors associated with API smoking to better understand unique correlates in this population and to inform tobacco prevention and intervention approaches. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Determinants of Tobacco Use and Nicotine Dependence Among Healthcare Students and Their Undergraduate Peers

Background: Global estimates suggest that tobacco will account for 8 million deaths per year by 2030. The Global Adult Tobacco Survey (2016-17) reported that more than half of men and one in ten women aged 15 years and above smoke in India. Introduction: Health science courses students (HCS), being the future of our health care system, are expected to be more knowledgeable regarding the hazards of tobacco and are considered less likely to use it compared to their peers (non-HCS) from other fields. The aim of the study is to determine the prevalence and determinants of tobacco use and levels of nicotine dependence amongst HCS and non-HCS students. Methods: Web-based survey (response rate of 72%) employing Global Youth Tobacco Survey (GYTS) and Fagerström standardized questionnaires (n = 4770 [21.5 (SD: ± 1.61) years: 62% male] was filled by HCS (43.5%) and non-HCS (56.3%) students from three universities. A descriptive, comparative and multivariate analysis was performed. Results: Half of non-HCS and a third of HCS used tobacco, with a higher proportion of male users in both groups. 70% of overall participants showed ‘low nicotine dependence’ with a higher proportion of ‘high dependence’ within the non-HCS group (13.89% vs. 9.2%). There were crucial differences in specific determinants and ages of initiation of tobacco use between the two groups. Conclusion: Tobacco use in HCS, apart from personal health risks, may potentially affect their future commitment to support patients in tobacco cessation programs. There is a need for further research into tobacco prevention and cessation programs tailored to the needs of student groups based on the determinants affecting them.