Tobacco Prevention Research Articles

Minority stressors and tobacco use among a US sample of sexual and gender minority young adults

IntroductionYoung adults who are sexual and gender minorities (SGM) are at the highest risk for tobacco initiation in young adulthood. Minority stress theory suggests that sexual orientation and gender identity (SOGI)-based discrimination may contribute to nicotine and tobacco use disparities. Our study aimed to quantify the association between SOGI-based distal minority stressors and current tobacco use among SGM young adults living in the United States (US). MethodsEligible participants—including young adults (aged 18–35 years old), who identified as SGM, and were currently residing in the US (N=1116) —were recruited via Prolific into an online survey. We applied stepwise binary regressions with backward selection to model the association between average past 30-day distal minority stress and current tobacco use (i.e., combustible cigarettes or e-cigarettes), controlling for perceived stress and sociodemographic covariates. We also tested interactions between minority stress and SGM status. Exploratory analyses assessed associations between minority stress and current tobacco use among YA, stratified by SGM subgroup. ResultsA 1-unit increase in experiencing minority stress in the past 30-days was associated with 1.02 greater odds of current tobacco use among SGM young adults. No difference between SGM subgroups in this association was found. Examining stratified SGM subgroups, a 1-unit increase in minority stress was associated with 1.11 greater odds of current tobacco among transgender adults only. ConclusionDistal minority stress is differentially associated with current tobacco use for transgender young adults, which suggests that tobacco prevention and cessation interventions may need tailoring for subgroups. ImplicationsThis study details the influence of minority stress on current tobacco use among sexual and gender minority (SGM) young adults. Findings underscore the need for targeted and tailored approaches to tobacco control, wherein SGM young adults most at-risk are engaged in cessation interventions that address minority stress as a contributing factor to tobacco use and which support their resilience. To promote health equity, tobacco control must address the contexts that engender minority stress. Assessment of policy impacts on SGM tobacco use and the effectiveness of interventions disseminated within SGM-supportive and discriminatory policy environments are important next steps.

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.

Smoking cessation among sexual minority women: Differences in cigarette quit ratios across age, race/ethnicity, and sexual orientation

ObjectiveSexual minority (SM) women experience tobacco-related disparities and report a higher prevalence of cigarette use, as well as subgroup differences in use, but little is known about their quitting behavior. This study used data from a national sample of United States SM women to examine cigarette quit ratios overall and by age, race/ethnicity, and sexual orientation. MethodsUsing baseline survey data from the Generations Study (2016–2017, N = 812), we calculated quit ratios among SM women reporting lifetime smoking (100+ cigarettes) who reported currently smoking “not at all” relative to those reporting smoking “every day or some days.” Quitting was compared across cohort, race/ethnicity, and sexual orientation, controlling for household income. ResultsSM women reporting lifetime smoking in the older cohort were significantly more likely to report quitting than those in the younger cohort. Bisexual women also reported a greater likelihood of quitting than gay/lesbian women. There was no association between race/ethnicity and the probability of quitting smoking. ConclusionsSM women remain a priority for tobacco prevention and cessation efforts. There is evidence that the probability of quitting cigarettes differs across sexual orientation and age cohorts, which has implications for tailoring of interventions and tobacco communications.

Interventions for Tobacco Prevention and Control in Humanitarian Settings: A Scoping Review.

Tobacco usage is an epidemic as statistics point towards smoking as the second leading cause of death. Populations experiencing humanitarian emergencies may experience a higher propensity for tobacco, alcohol, and other substance abuse disorders. This review aimed to map tobacco prevention and control interventions in humanitarian settings. The search for this scoping review was conducted in six databases and supplemented with a gray literature search. Articles were screened at title-abstract and full-text by two pairs of authors, and data was abstracted by three individuals independently. An adapted diffusion of governance framework is used to discuss the findings. A total of 26 articles were included from the searches conducted in the databases and grey literature. The interventions targeted all age groups. The documents retrieved from the grey literature search were classified as population-based interventions, as they were not restricted to a particular group of individuals. Interventions were delivered at various locations, using different methods and engaging multiple stakeholders. Interventions assessed were grouped into packaging, labeling, and other policy interventions (pricing and taxes). There are few tobacco prevention and control interventions in the humanitarian context. The diffusion of governance perspective in implementing these interventions in humanitarian settings provides a cue for inter-sectoral cooperation among different stakeholders and disciplines beyond the health sector. Our review recommends exploring complementarity between the demand and supply side interventions for tobacco control. The scoping review has highlighted various tobacco prevention and control efforts in humanitarian settings. The interventions were delivered using various modes, and yet the burden of smoking is higher among the humanitarian population. Further research may use impact evaluation techniques to assess the impact of these interventions to facilitate the re-design of the implementation approach and policy priorities.

Facilitators and Barriers to Passing Local Policies That Prohibit the Sale of Flavored Tobacco Products: Qualitative Analysis of Strategies Implemented by 36 Communities in California, 2017-2021.

To reduce youth access to tobacco products, the California Tobacco Prevention Program funded local tobacco prevention programs from July 2017 through December 2021 to address its Communities of Excellence Indicator 3.2.9: "the number of jurisdictions with a policy eliminating or restricting the sale and/or distribution of any mentholated cigarettes and other flavored tobacco products, and paraphernalia." We examined the strategies by which community coalitions attempted to limit the number of stores selling flavored tobacco across California. Thirty-six final evaluation reports (FERs) were used for our analysis. We examined certain elements or factors as primary areas of interest because of their apparent link to successful outcomes in analyses of FERs in the past. Over half (19 of 36) of FERs reported successfully passing at least 1 policy to regulate the sale of flavored tobacco products. Urban communities passed more policies (16 of 18) compared with rural communities (3 of 18). Successful campaigns tended to involve youth, demonstrate illegal sales to minors and public support for a ban, and identify a champion. Barriers included the COVID-19 pandemic, California wildfires, staffing shortages, and conservative political climates. This evaluation offers insights into the successes and challenges faced by local coalitions seeking policy changes for tobacco use prevention, which can be different for urban and rural communities. The evaluation also indicates the necessity of adopting flexible tactical plans for overcoming environmental factors that affected intervention and evaluation activities.

Reducing Commercial Tobacco Sales to Youth On and Around California Tribal Reservations With a Reward and Reminder Retail Intervention.

High prevalence of commercial tobacco product (CTP) use among American Indian and Alaska Native (AI/AN) youth is a public health crisis. A multi-level Tribal-community-based participatory research project under Tribal public health authority implemented a retailer-focused intervention to reduce AI/AN youth CTP use. We sought resolutions in support of a retailer-focused CTP intervention from Tribal Nations organized by a Tribally directed research program. We identified tobacco retail outlets operating on and within five miles of nine Tribal reservations, and CTP products sold at these outlets. We conducted a four-wave Reward and Reminder intervention with apparent minor buyers. Clerks who complied with the law received a modest reward and commendation in social media posts to the local Tribal communities, while clerks who sold without age verification were reminded of the laws. Of 18 retail outlets selling CTP, eight sold e-cigarettes, and all sold combustible cigarettes. The Reward and Reminder intervention showed an approximate 25% reduction in sales of CTP to apparent minors, with a 33% baseline CTP sales rate without age verification and an 8% intervention CTP sales rate without age verification. The intervention increased awareness of laws prohibiting CTP sales to minors and mandating age verification for young adults seeking to buy CTP. The intervention, which had support from all governing Tribal Nations, builds the evidence base of effective practices which Tribal public health authorities may utilize to reduce youth access to CTP on and around Tribal reservations. Sovereign Tribes have authority over commercial businesses operating on their lands. Tobacco 21 laws aiming to restrict commercial tobacco availability to youth are supported by Tribes. A retailer intervention in which apparent minors attempt commercial tobacco purchases can offer accountability feedback to retailers both on and near Tribal reservations. Obtaining Tribal support and publicizing the interventions helps mobilize Tribal communities to support commercial tobacco prevention and promote healthy youth.

PREVALENCE OF RISK FACTORS AND TARGET ORGAN DAMAGE CAUSED BY HYPERTENSION IN RESIDENTS OF THE ARAL SEA REGION OF UZBEKISTAN

Objective: Analysis of the results of screening the population over 40 years of age for early detection of risk factors and target organ damage caused by hypertension in real clinical practice of family clinics in the Aral Sea region. Design and method: The results of screening of 2430 respondents were analyzed according to the modified PEN WHO protocol, which 1020 people with blood pressure (BP) 140/90 mm Hg or more included in the study. The average age was 57.68±8.06 years, women 61.4%, men 38.6%. Additionally, we determined echocardiography, ultrasound examination of the brachiocephalic arteries, microalbuminuria, creatinine and uric acid in blood serum. Statistical data are presented as M±SD. Results: Among the patients with high BP, 24 (2.4%) were under 40 years old, 847 (81%) were aged 40-65 years, 169 (16.6%) were over 65 years old. Obesity was detected in 46.2% of patients, left ventricular hypertrophy in 96%, microalbuminuria in 76%, proteinuria in 21%, thickening of the intima-media of the common carotid artery >0.9 mm in 92% of the examined. It was revealed that low cardiovascular risk was 2 times more common among women compared to men: 11.3% versus 5.6% (χ2=8.990; p=0.003); almost 4 times fewer patients with coronary artery disease: 7.4% versus 28.9% (χ2=14.939; p=0.0001); there are no tobacco users or regular alcohol drinkers, whereas among men these risk factors were identified in 59.4% (χ2=178.848; p=0.0001) and 35% (χ2=82.238; p=0.0001), respectively. Hyperuricemia prevailed in men compared to women: 23.3% versus 6.4% (χ2=60.243; p=0.0001) but the incidence of type 2 diabetes is 2 times higher in women compared to men: 13.7% versus 7.4% (χ2=9.205; p=0.002) Conclusions: The study showed a wide distribution of CVD risk factors among the hypertensive population of the Aral Sea region and significant target organ damage caused by hypertension. Among hypertensive men, there was a significant prevalence of tobacco and alcohol use, a significantly frequent detection of coronary artery disease, and hyperuricemia compared to women; type 2 diabetes mellitus is significantly more frequently detected in the female population.

School-based Novel Tobacco Control Model for Encouraging Tobacco Prevention and Cessation

School-based Novel Tobacco Control Model for Encouraging Tobacco Prevention and Cessation

Smoking, mortality, access to diagnosis, and treatment of lung cancer in Brazil.

Lung cancer (LC) is a relevant public health problem in Brazil and worldwide, given its high incidence and mortality. Thus, the objective of this study is to analyze the distribution of smoking and smoking status according to sociodemographic characteristics and disparities in access, treatment, and mortality due to LC in Brazil in 2013 and 2019. Retrospective study of triangulation of national data sources: a) analysis of the distribution of smoking, based on the National Survey of Health (PNS); b) investigation of LC records via Hospital-based Cancer Registry (HCR); and c) distribution of mortality due to LC in the Mortality Information System (SIM). There was a decrease in the percentage of people who had never smoked from 2013 (68.5%) to 2019 (60.2%) and in smoking history (pack-years). This was observed to be greater in men, people of older age groups, and those with less education. Concerning patients registered in the HCR, entry into the healthcare service occurs at the age of 50, and only 19% have never smoked. While smokers in the population are mainly Mixed-race, patients in the HCR are primarily White. As for the initial stage (I and II), it is more common in White people and people who have never smoked. The mortality rate varied from 1.00 for people with higher education to 3.36 for people without education. Furthermore, White people have a mortality rate three times higher than that of Black and mixed-race people. This article highlighted relevant sociodemographic disparities in access to LC diagnosis, treatment, and mortality. Therefore, the recommendation is to strengthen the Population-Based Cancer Registry and develop and implement a nationwide LC screening strategy in Brazil since combined prevention and early diagnosis strategies work better in controlling mortality from the disease and continued investment in tobacco prevention and control policies.

Frequency and risk factors of cigarette smoking among male medical students of Bacha Khan Medical College, Mardan

Tobacco consumption is a major global health issue that contributes significantly to morbidity and mortality rates. The World Health Organization (WHO) estimates that over five million deaths occur each year due to tobacco use, projected to rise to 8 million by 2030. Furthermore, current research reveals that 47% of males and 12% of females worldwide smoke. Of particular concern is cigarette and tobacco use among medical students, given their role in crafting public health policy and guiding society's tobacco prevention measures. Studies show that smoking rates among medical students in developing countries are between 16-21%, with multi-country surveys in countries like Malaysia, India, Pakistan, Nepal and Bangladesh indicating rates between 6.7% and 17.8%. For example, a study conducted on medical students in Damascus University Faculty of Medicine revealed a 10.9% prevalence of cigarette smoking, 23.5% for water pipe, and 7.3% for both, with higher rates reported among final-year students. Likewise, a study of Rawalpindi Medical College students found that 24% had smoked at least once, with greater prevalence among hostellites rather than day scholar students.

Even worse for Black girls: the longitudinal association of racial bullying with the initiation of alcohol and tobacco use.

We used Poisson's linear regression to examine the association between racial bullying (RB) and the initiation of alcohol and tobacco uses after 9 months. Two cluster-randomized controlled trials were conducted in 2019 with children in grades five (girls: 50.0%; 10 years old: 82.0%; White: 36.8%; Black: 58.7%; others: 4.5%) and seven (girls: 49.5%; 12 years old: 78.1%; White: 33.2%; Black: 60.4%; others: 6.4%) from 30 public schools in the municipality of São Paulo, Brazil. We restricted our analyses to 2 subsets of students in each grade: those who reported no lifetime alcohol use at baseline and those who reported no lifetime baseline tobacco use. At baseline, 16.2% of fifth and 10.7% of seventh graders reported suffering from RB in the 30 days before data collection. After 9 months, 14.9% of fifth graders started using alcohol and 2.5%, tobacco. Among seventh graders, the figures were 31.2% and 7.7%, respectively. RB predicted the initiation of use of alcohol (risk ratio [RR]= 1.36; 95% CI, 1.07-1.70) and tobacco (RR= 1.81; 95% CI, 1.14-2.76) among seventh graders, with race-gender differences, particularly in Black girls (alcohol: RR= 1.45; 95% CI, 1.07-1.93; tobacco: RR= 2.34; 95% CI, 1.31-3.99). School-based programs and policies must explicitly address issues related to racism and gender in alcohol and tobacco prevention strategies.

Prevalence of tobacco smoking and the knowledge and attitudes on prevention of tobacco smoking among schooling adolescents in the age group of 13 – 15 years in the Kandy district in 2018

Introduction: The early age of tobacco smoking initiation among adolescents reported in Sri Lanka highlights the need to initiate tobacco prevention at a very young age.Objectives: To determine the prevalence of tobacco smoking, the knowledge, and attitudes on prevention of tobacco smoking among schooling adolescents in government schools in the age group of 13-15 years in the Kandy district in 2018.Methodology: A cross-sectional study was conducted among 1395 students in selected government schools in the Kandy district. The subjects were selected using a stratified multi-stage cluster sampling method. A pretested self-administered questionnaire was used.Results: The response rate was 97.1%. The Prevalence of ever tobacco smoking in the age group of 13 to 15 years, was 6.02% (95% CI, 4.83% - 7.40%). The prevalence of current smokers was 4.16% (3.23% - 5.24%). Satisfactory knowledge of the harmful effects of tobacco smoking was shown by 49.6% (n=692) of ever smokers. The majority (71.5%, n=997) showed favourable attitudes towards the prevention of smoking. There was a higher likelihood of smoking among students who had unsatisfactory knowledge (OR = 8.203; 95% CI = 4.142 – 16.247) and attitudes (OR=1.172; 95% CI=1.112 – 1.225) compared to students who had satisfactory knowledge and attitudes.Conclusions: The prevalence of tobacco smoking in the selected age group was high in the Kandy district compared to the national rates. School interventions should target more students who already smoke to improve their knowledge and attitudes.

Correlation between tobacco control policies and tobacco prevention in Mexico: a sub-national analysis.

This study aims to determinate the correlation between tobacco control policies (TCP) and the prevalence of tobacco use in the 32 Mexican states during the 2016-2017 period. This is an ecological study that measured TCP by the Tobacco Control Scale (TCS) which assigns a score (0-100) based on the level of these component's implementation: price, prohibition in public spaces, expenditures of public information campaigns, publicity prohibitions, health warnings, and treatments. We analyzed the associations between the TCS scores and prevalence of tobacco use extracted from the National Survey of Drug, Alcohol and Tobacco Consumption using Spearman correlations. Prevalence of daily smokers is negatively correlated with global TCS scores for adolescents (p = 0.026). Price showed similar negative correlations with daily prevalence in adolescents (p = 0.003), adults (p = 0.040), men (p < 0.006), and women (p = 0.040). Many Mexican states need to improve on tobacco control policies, especially targeting a key population: adolescents.

Perceptions of African American Youth and Adults Regarding Tobacco Use-Related Factors in Their Community: A Mixed-Methods Approach in Richmond, Virginia.

The US Food and Drug Administration is poised to restrict the availability of menthol cigarettes and flavored cigars, products disproportionately used by Black/African American (B/AA) individuals. We examined B/AA youth and adult perceptions regarding factors contributing to tobacco use, as well as prevention/cessation resources. In 2 mixed-methods studies in Richmond, Virginia, we conducted cross-sectional surveys among youth (n = 201) and adult (n = 212) individuals who were primarily B/AA and reported past 30-day cigar smoking or nontobacco use, followed by focus groups with a subset (youth: n = 30; adults: n = 24). Focus groups were analyzed using a thematic analysis framework, and descriptive survey data provided context to themes. Among focus group participants, 20% of youth and 75% of adults reported current cigar smoking. Six themes emerged across the groups: advertising/brands, sensory experiences, costs, social factors, youth-related factors, and dependence/cessation. Youth and adults perceived cigars as popular; cigar use was attributed to targeted advertising, flavors, affordability, and accessibility. While adults expressed concern regarding youth tobacco use, youth did not perceive tobacco prevention programs as helpful. Adults and youth reported limited access to community tobacco prevention/cessation programs. Expanded tobacco prevention and cessation resources for B/AA people who smoke could leverage federal regulatory actions to ban tobacco products targeted toward this group and decrease disparities in tobacco-related morbidity and mortality.

Network analysis of smoking-related sleep characteristics in Chinese adults

The associations between multiple sleep characteristics and smoking behavior are inconsistent, and it is unclear which sleep characteristics are most crucial for tobacco prevention. This study aimed to explore the associations between smoking status/intensity and multiple sleep characteristics and to identify the potential core domain of smoking-related sleep using network analysis. Data were obtained from a survey of cancer-related risk factors among Chinese adults. Logistic regression models were used to quantify the associations between sleep characteristics and smoking status/intensity. Network analyses were employed to identify the core sleep characteristics. A total of 5,228 participants with a median age of 44 years old were included in the study. Current smoking was significantly positively associated with long nap time, difficulty falling asleep, late bedtime, getting up after 7 am, and waking up earlier than expected. There was significant positive association between current smoking and short sleep duration in young adults under 45 years old. Late bedtime and getting up after 7 am were only associated with current heavy smoking, but not current light smoking. Network analyses showed that multiple smoking-related sleep characteristics were interconnected, with difficulty falling asleep and late bedtime as central characteristics in the network. The study found that the associations between sleep characteristics and smoking varied by age and smoking intensity and highlights the potential benefits of sleep health promotion in smoking cessation, with a particular focus on difficulty falling asleep and late bedtime.

Abstract 3945: The development of a culturally adapted tobacco prevention curriculum for LGBTQ+ youth across California: Formative research

Abstract Purpose: LGBTQ+ youth exhibit some of the highest rates of tobacco use and tobacco-related morbidity and mortality, making access to cancer prevention at an early age particularly critical. The purpose of this study is to develop an LGBTQ+ culturally tailored tobacco prevention curriculum within the Stanford Tobacco Prevention Toolkit, to help prevent LGBTQ+ students from starting or escalating the use of any tobacco product. Methods: A community-based participatory research (CBPR) was established between the Cedars-Sinai Cancer Research Center for Health Equity, facilitated by Community Outreach and Engagement, in collaboration with The Wall Las Memorias and the Stanford REACH Lab to conduct basic formative focus groups in the LGBTQ+ community. Seventy-six participants were recruited, and 9 focus groups were conducted (33 participants among LGBTQ+ youth; 19 community advocates and educators; and 24 parents/caregivers/guardians). A thematic analysis was conducted to identify lesson topics and subject matter content to be included in the curriculum and the best strategies to deliver the lesson to LGBTQ+ youth. Results: Several themes emerged from the focus groups, including an overall theme noting a desire for more safe spaces and peer support to discuss tobacco, vaping, and marijuana use among LGBTQ+ youth. LGBTQ+ youth noted tobacco, vaping, and marijuana were very accessible through friends and social groups in the school setting. They also expressed that tobacco, vaping, and marijuana use were associated with pressures to fit in, an increasing ‘normalization’ of marijuana use, and social media channels that glorify vaping and tobacco use. LGBTQ+ youth also expressed that they do not see tobacco prevention messaging relevant to themselves or their peers nor through their preferred information channels. Parents, educators, and community advocates expressed that they would like to be offered opportunities for education and direct involvement in LGBTQ+ research. With this information, the REACH Lab is developing the LGBTQ+ curriculum. Conclusions This CBPR approach builds upon the existing validated set of curricula contained in the Stanford Tobacco Prevention Toolkit, which is theory-driven and has reached over 3 million middle and high school students. Once completed, the LGBTQ+ Focused Tobacco Prevention Curriculum will be added to the Tobacco Prevention Toolkit and will be the first informed/validated tobacco prevention program for LGBTQ+ youth. Citation Format: Michael Fine, Zulfikarali Surani, Laurel J. Finster, Juanita T. Greene, Carly L. Kajiwara, Richard Zaldivar, Bonnie Halpern-Felsher, Robert W. Haile. The development of a culturally adapted tobacco prevention curriculum for LGBTQ+ youth across California: Formative research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3945.

Abstract 2196: Susceptibility to tobacco use among rural adolescents: Examining the role of tobacco marketing exposure and media use intensity

Abstract Background: Rural youth have higher rates of electronic nicotine delivery systems (ENDS) and tobacco product use compared to their urban counterparts. Prior literature confirms that marketing exposure increases pro-tobacco attitudes and susceptibilities, yet the extent to which tobacco product marketing and advertising messages relate to tobacco use susceptibility among rural adolescents is understudied. Objectives: To examine the association between tobacco marketing exposure and susceptibility to tobacco use and ever tobacco use among a population of rural youth. Methods: Youth (aged 14-18 years), enrolled in grades 9-11, able to speak and write in English, and residing in rural counties in Virginia (n = 697) were recruited to participate in the Southern Virginia - Adolescents, Place, and Behavior study. At baseline, eligible participants were asked to answer survey questions, including demographics (e.g., age, race/ethnicity, and gender), tobacco product (e.g., e-cigarettes/vapes, cigarettes, and cigars), tobacco use susceptibility (e.g., “do you think you will try any type of tobacco product in the next year?”), digital media use (e.g., “how many hours do you spend visiting social networking sites on both a typical weekday and a typical weekend day?"), and interaction and exposure to tobacco advertisements. Results: The majority of participants were female (51.9%), White (62.4%) and non-Hispanic (86.6%), with an average age of 15.1 years old (SD = .96). Less than a quarter (20.7%) of participants reported ever using any tobacco products. Heavy social media users and text users were more likely to be tobacco ever-users than those who were light social media users, X2(1) = 12.00, p &amp;lt; .001. Multivariate logistic regression models report that exposure to online ads promoting tobacco products (OR: 2.03, 95% CI [1.37 - 3.03]) and higher grade level (OR: 1.77, 95% CI [1.29 - 2.43]) were significantly associated with the likelihood of ever using tobacco products, while controlling for mother’s education, gender, and ethnicity. Among adolescents who never used tobacco products, higher grade levels (OR: 1.40, 95% CI [1.05 - 1.86]) were associated with greater susceptibility to initiating tobacco product use while controlling for the covariates. Conclusions: Greater social media use and exposure to ads promoting tobacco products were significantly associated with tobacco ever use. For never tobacco users, social media use or tobacco ad exposure was not associated with greater susceptibility to tobacco use. Higher grade levels were associated with both tobacco ever use and greater susceptibility to tobacco product use. Identification of these risk factors may help inform potential targets for future tobacco prevention campaigns. Citation Format: Sunny Jung Kim, Kendall Fugate-Laus, Jeremy Barsell, Elizabeth K. Do, Rashelle Hayes, David Wheeler, Bernard Fuemmeler. Susceptibility to tobacco use among rural adolescents: Examining the role of tobacco marketing exposure and media use intensity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2196.

Achieving Public Health Impact: Health Communication Research to Inform Tobacco Regulatory Science

ABSTRACT Health communication research applies communication science to develop generalizable knowledge capable of improving the health and well-being of individuals and communities. But to what extent does the knowledge generated by the health communication field actually achieve public health impact? To answer this question, we discuss the application of health communication science and research within a tobacco regulatory science framework. We describe three areas in which health communication research funded by the Food and Drug Administration (FDA) Center for Tobacco Products (CTP) contributed to 1) youth tobacco prevention campaigns, 2) cigarette health warnings, and 3) regulation of labeling, advertising, and marketing claims. These examples demonstrate how communication regulatory science achieves public health impact in the real world by informing national policies, regulatory actions, and public health practice.

The prevalence and sociodemographic determinants of tobacco and nicotine use among students in healthcare disciplines in Saudi Arabian universities: a cross-sectional survey.

Tobacco smoking is one of the most significant health-related problems worldwide. However, the prevalence and sociodemographic determinants of tobacco and nicotine use among students on healthcare courses in Saudi Arabia are limited. This cross-sectional study used a questionnaire that was distributed via SurveyMonkey between November 2022 and June 2023 to all student universities offering healthcare courses. Data are presented as frequency and percentages. The associated sociodemographic factors with current tobacco and nicotine use were subjected to logistic regression. Overall, 5,012, of whom 3,872 (77.25%) were males, responded to the online survey. The prevalence of current tobacco and nicotine use was 3,553 (71%). The majority of users used electronic nicotine delivery systems (1,622: 32.36%). The current use of cigarettes (AOR: 1.75 (1.42 to 2.15)), e-cigarettes (AOR: 1.17 (1.01 to 1.37)), and smokeless tobacco substances (AOR: 1.35 (1.02 to 1.90)) were more pronounced among males compared to female students. However, the current use of a hookah was less among males (AOR: 0.74 (95% CI: 61 to 0.91)). Smoking cigarettes was practiced less among students living in other regions compared to the Central Region. However, smokeless tobacco substances seem to be more prevalent in the Western, Southern, and Northern Regions, (AOR: 1.57 (95% CI: 1.09 to 2.26)), (AOR: 1.43 (95% CI: 1.04 to 1.95)), and (AOR: 1.57 (95% CI: 1.09 to 2.26)), respectively. Smoking is prevalent among students in the healthcare disciplines, with electronic nicotine delivery systems being the most used product. Several sociodemographic factors were associated with higher tobacco or nicotine use.

Tobacco use and its associated factors among middle and old-aged women in India using LASI wave-1 data.

Despite a global decline in tobacco use reported by the Global Adult Tobacco Survey (GATS), India stands out for its high number of tobacco users. While research in India often focuses on tobacco use among young adults, there's a notable lack of studies addressing tobacco use among middle and old-aged women. However, the national prevalence of tobacco use among middle and old-aged (45 years and above) women in India is 18.2%. Thus, this study seeks to identify the factors influencing tobacco consumption among middle and old-aged women in the country. The study has utilized secondary data from Longitudinal Aging Study in India (LASI) conducted in 2017-18. This study exclusively included a total of 38,180 middle and old-aged women who reported tobacco use. The analysis encompassed the utilization of Chi-square tests and Binary logistic regression to pinpoint the risk factors linked to tobacco use among middle and old-aged women. Our study reveals a heightened likelihood of tobacco use among middle and old-aged women residing in the northeastern region of India. The study underscores the imperative to direct targeted efforts toward middle and old-aged women who fall into specific categories, including those who are widowed, separated, or unmarried, individuals who consume alcohol, those with lower socioeconomic and educational standings, residents of rural areas, those living in solitude, individuals experiencing depressive symptoms, and those who self-report poor health. Given the heightened susceptibility of these demographic groups to tobacco use, it is crucial to prioritize tobacco prevention and cessation initiatives specifically tailored to their needs and circumstances.