Tobacco Use Trajectories And Disparities Among Sexual Minorities In U.S Adolescents And Adults

美国青少年和成年人中性少数群体的烟草使用轨迹和差异

基本信息

批准号：
10220007
负责人：
Rebecca J. Evans-Polce
金额：
$ 19.5万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10220007
关键词：
14 year old 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol Address Adolescent Adult Age Area Biological Biological Markers Bisexual C-reactive protein Cardiovascular Diseases Cessation of life Data Data Reporting Data Set Discrimination Effectiveness Electronic cigarette Emerging Tobacco Products Ethnic Origin Exposure to Financial cost Frequencies Future Gays Health Health Care Costs Heterosexuals Individual Interleukin-6 Knowledge Lead Lesbian Link Longitudinal Studies Malignant Neoplasms Measures Minority Minority Groups Modeling Outcome Patient Self-Report Pattern Play Policies Population Assessment of Tobacco and Health Prevalence Psychological Stress Public Health Race Recording of previous events Regulation Research Research Priority Risk Role Sampling Sex Differences Sex Orientation Smoking History Stress Subgroup Surveys Symptoms Time Tobacco Tobacco Use Cessation Tobacco Use Disorder Tobacco use Tobacco-Related Carcinoma Vulnerable Populations Youth age difference cancer risk cigarette smoking clinical practice ethnic difference experience fluidity health data health disparity innovation interest intersectionality polytobacco use productivity loss prospective psychological distress racial difference respiratory response secondary analysis sex sexual identity sexual minority stressor theories time use tobacco advertising tobacco products tobacco regulatory science

项目摘要

Project Summary/Abstract Tobacco use is responsible for enormous health and financial costs in the U.S. including more than 480,000 deaths per year due to cigarette use and more than $193 billion annually in health care costs and loss of productivity. Sexual minority individuals are at substantially greater risk for tobacco use and tobacco use disorder (TUD) and tobacco-related health outcomes compared to heterosexual individuals in the U.S. Longitudinal data is needed to understand differences in tobacco use across time and resultant tobacco- related health disparities among sexual minorities. This information is necessary to inform tobacco regulatory policy strategies to reduce these health disparities. We draw on concepts of minority stress and intersectionality to understand these tobacco use trajectories and related health disparities by sexual orientation. This proposal is in direct response to RFA-OD-19-022 by using secondary data to examine tobacco use trajectories and its health effects over time in a vulnerable population, focusing on new tobacco products. The national and longitudinal Population Assessment of Tobacco and Health (PATH) study provides an unprecedented opportunity to identify differences in tobacco use trajectories, associated health disparities, and mechanisms behind these differences. Using PATH data we will be able to examine detailed tobacco use trajectories across four waves, sexual identity transitions across four waves, and prospective links to health outcomes. In addition we triangulate both self-report and biological data on stress and health. Using PATH’s large nationally representative dataset of youth and adults, this study aims to: (1) To examine tobacco product initiation and use trajectories by sexual orientation and their associations with regular tobacco use and TUD symptoms; (2) To identify tobacco use trajectories by sexual orientation and differential associations with self report and biological health outcomes among adults; (3) To examine the role of biological and psychological stress on tobacco use trajectories, tobacco cessation and tobacco-related health outcomes among adults and how this differs by sexual orientation and transitions in sexual identity. We will assess tobacco trajectories, with emphasis on specific changes of critical public health importance including: (1) tobacco use initiation, (2) progression in the number of tobacco products used (i.e., single product use to dual/polytobacco use) with a focus on trajectories including e-cigarettes and those without and (3) increases and decreases in tobacco frequency. Aims 2 and 3 will innovatively make use of the wealth of both survey self-report measures of stress (psychological distress) and health outcomes (respiratory illness, cancer, cardiovascular disease) alongside biological markers of stress (e.g., C-reactive protein, interleukin-6) and tobacco-specific markers linked to cancer risk (NNAL, NNN, TNE2). We will examine important moderators including age, sex, race, and ethnicity throughout all aims. This project will greatly inform and maximize effectiveness of tobacco regulatory policies particularly those aimed at reducing the health burden of tobacco use among sexual minorities.

项目概要/摘要在美国，烟草使用造成巨大的健康和财务成本，其中包括超过 480,000 每年因吸烟而死亡的人数以及每年超过 1,930 亿美元的医疗费用和生命损失性少数人群的烟草使用和吸烟风险要大得多。与美国异性恋者相比，精神障碍（TUD）和烟草相关的健康结果需要纵向数据来了解烟草使用随时间的差异以及由此产生的烟草使用情况。性少数群体之间的相关健康差异对于告知烟草监管是必要的。我们借鉴少数群体压力和减少这些健康差异的政策战略。交叉性来了解这些烟草使用轨迹和相关的性别健康差异该提案是对 RFA-OD-19-022 的直接回应，使用二手数据进行检查。弱势群体的烟草使用轨迹及其随时间对健康的影响，重点关注新型烟草国家纵向人口烟草与健康评估 (PATH) 研究提供了产品。这是一个前所未有的机会来确定烟草使用轨迹的差异、相关的健康差异、使用 PATH 数据，我们将能够检查详细的烟草使用情况。四波的轨迹、四波的性别认同转变以及与健康的预期联系此外，我们还使用 PATH 来对自我报告和生物数据进行三角测量。具有全国代表性的青少年和成人数据集，本研究旨在：(1) 检查烟草产品性取向的启动和使用轨迹及其与常规烟草使用和 TUD 的关联 (2) 通过性取向和与自我的差异关联来识别烟草使用轨迹 (3) 检验生理和心理的作用成人和青少年中烟草使用轨迹、戒烟和烟草相关健康结果的压力我们将评估烟草的轨迹，以及这与性取向和性认同的转变有何不同。强调对公共卫生具有重要意义的具体变化，包括：(1) 开始使用烟草，(2) 使用的烟草制品数量的进展（即从单一产品使用到双重/多种烟草使用）重点关注包括电子烟和不使用电子烟的轨迹以及 (3) 烟草的增加和减少目标 2 和 3 将创新性地利用这两项调查自我报告的压力测量方法。（心理困扰）和健康结果（呼吸系统疾病、癌症、心血管疾病）压力的生物标记（例如 C 反应蛋白、白细胞介素 6）和与烟草相关的特定标记我们将检查重要的调节因素，包括年龄、性别、种族和民族。该项目将为烟草监管政策提供极大的信息并最大限度地提高其有效性。特别是那些旨在减少性少数群体吸烟健康负担的措施。