Socioeconomic status and smoking exposure in Appalachia

阿巴拉契亚地区的社会经济状况和吸烟暴露

• 批准号: 8662214
• 负责人: JOSHUA E MUSCAT
• 金额: $ 32.06万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8662214
• 关键词: Accounting; Address; Affect; Air; Appalachian Region; Behavior; Biological; Biological Markers; Breathing; Cancer Control; Carbon Monoxide; Carcinogens; Cigarette; Cigarette Smoker; Cohort Studies; Communities; Cotinine; Diet; Disease; Dose; Early Diagnosis; Early treatment; Educational Background; Environment; Exposure to; Goals; Habits; Incidence; Intake; Laboratory Study; Length; Life Style; Lung; Mainstreaming; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Medically Underserved Area; Nicotine; Occupational Status; Occupations; Patient Self-Report; Pattern; Pennsylvania; Persons; Population; Population Heterogeneity; Prevention strategy; Prostate; Psychological Stress; Recording of previous events; Reporting; Research Personnel; Risk; Risk Factors; Salivary; Smoke; Smoker; Smoking; Smoking Behavior; Socioeconomic Status; Stress; Study Section; Testing; Tobacco; Tobacco smoke; Toxin; United States National Institutes of Health; Variant; base; cancer prevention; cancer risk; cigarette smoking; instrumentation; interdisciplinary approach; low socioeconomic status; malignant breast neoplasm; malignant mouth neoplasm; medically underserved; mortality; prospective; psychologic; research study; screening; smoke inhalation; smoking prevalence; social inequality; socioeconomics

DESCRIPTION (provided by applicant): Social inequalities are an important predictor of disease incidence, including cancer. Persons with low socioeconomic status (SES) have increased rates of lung and other tobacco-related cancers. Although smoking prevalence is higher in persons with lower levels of education and occupational status, smoking prevalence does not explain this excess risk. In prospective cohort studies, the associations between low SES and elevated lung cancer risk persist after adjustment for smoking amount and duration. The investigators' overall hypothesis is that the unaccounted increased risk in populations with lower SES is due to higher smoke exposure that cannot be accounted for by self-reported smoking habits. Their previous laboratory studies demonstrate that there is a wide degree of variation in biological exposure to tobacco smoke toxins and carcinogens per cigarette smoked. The investigators propose to conduct a community-based participatory study in the medically underserved area of Appalachian Pennsylvania to determine the relationship between SES and the dose of inhaled mainstream smoke and the dose of biological markers of tobacco smoke exposure. Specific aims are: Specific Aim 1. Determine whether SES is associated with smoking puffing behaviors including puff volume, duration, interval, and length of cigarette smoked. Specific Aim 2. Determine whether SES is associated with biomarkers of smoking exposure including salivary cotinine and expired carbon monoxide. This addresses the SES hypothesis using biological measures of dose in addition to environmental measures such as puffing dose. Specific Aim 3. Correlate environmental and biological measures of smoke exposure. This aim will determine whether levels of mainstream smoke exposure, as estimated by puffing profiles are determinants of the biological levels of cigarette smoke exposure, and whether this relationship differs by SES. This brings together aims 1 and 2 to comprehensively address the SES hypothesis. Specific Aim 4. Determine the effects of psychological stress, as assessed by psychological scales and salivary stress biomarkers, on smoking puffing parameters and salivary cotinine levels. The proposed research study will be conducted in Appalachia, Pennsylvania (PA), a NIH-designated medically underserved but socioeconomically diverse population. The investigators predict that lower SES is associated with higher smoke intake as determined by topography and smoke biomarkers, and that this finding will help to explain the long-observed patterns of lung cancer incidence disparities.

描述（由申请人提供）：社会不平等是包括癌症在内的疾病发病率的重要预测指标。社会经济地位低的人（SES）的肺部和其他与烟草有关的癌症的发生率提高。尽管在教育水平和职业地位较低的人中吸烟流行率较高，但吸烟的患病率并不能解释这种过多的风险。在前瞻性队列研究中，在调整吸烟量和持续时间后，低SES与肺癌升高风险之间的关联持续存在。调查人员的总体假设是，SES较低的人群中未指定的风险增加是由于烟雾较高，这是由于自我报告的吸烟习惯无法解释的。他们以前的实验室研究表明，每烟的烟草毒素和致癌物的生物暴露有很大变化。研究人员建议在阿巴拉契亚宾夕法尼亚州的医学贫乏地区进行基于社区的参与性研究，以确定SES与吸入主流烟雾的剂量与烟草烟雾暴露的生物标记剂量之间的关系。具体目的是：特定目标1。确定SES是否与吸烟行为相关，包括泡芙体积，持续时间，间隔和吸烟长度。具体目标2。确定SES是否与吸烟暴露的生物标志物有关，包括唾液可替宁和过期的一氧化碳。除环境措施（例如膨化剂量）外，这还使用剂量的生物学测量来解决SES假设。特定目的3。将烟雾暴露的环境和生物学量相关。该目标将确定主流烟雾暴露的水平是否通过膨胀的概况估计是香烟烟雾暴露的生物学水平的决定因素，以及这种关系是否因SES而异。这将旨在1和2的目标汇集在一起​​，以全面解决SES假设。具体目的4。确定心理压力的影响，通过心理量表和唾液应激生物标志物，对吸烟膨胀参数和唾液可替宁水平的影响。拟议的研究将在宾夕法尼亚州阿巴拉契亚（PA）进行，这是NIH指定的医学服务不足但在社会经济上多样化的人群。研究人员预测，较低的SES与较高的烟雾摄入量有关，这是由地形和烟雾生物标志物确定的，这一发现将有助于解释肺癌发病率差异的长期观察模式。