Understanding and reducing health disparities through social and behavioral research

National Institute On Minority Health And Health Disparities

Investigators

Linked publications, trials & patents

Abstract

Understanding inter-relationships between social determinants and tobacco use We leveraged nationally representative survey data to examine how the use of different tobacco products vary by social determinants of health. For example, using the Tobacco Use Supplement to the Current Population Survey, we examined how cigarette smoking and e-cigarettes varied by demographics. We found that non-Hispanic Black and American Indians/Alaskan Natives were less like to report using e-cigarettes to quit cigarette smoking, while prevalence of cigarette smoking in these population remains high, suggesting that e-cigarettes may not reduce commercial tobacco use disparities. We also assessed cigar-smoking patterns among US adults using the Population Assessment of Tobacco and Health (PATH) Study. We found that non-Hispanic Black adults are more likely to use cigarillos and little cigars, and also at higher intensity, than non-Hispanic White adults. Following on this study, we conducted a qualitative study to examine Black young adult cigar smokers cessation interest and experiences. Finally, we reported the variations in substance use and disorders by the intersection of sexuality and race/ethnicity. Investigate mediating and moderating factors associated with tobacco use disparities Through an online discrete choice experiment, we tested how point-of-sale cigarette pricing strategies affect young adult smokers intention to purchase cigarettes. We found that price discounting at the point of sale increased young adult smokers intention to purchase cigarettes, only among those with less than college education. This suggests point-of-sale cigarette pricing strategies disproportionately affect lower socioeconomic young adult smokers. In a separate study, we examined the relationships between receiving price promotions for different products and tobacco product use among US youth. We found that receiving these promotions increased likelihood of US youth to use tobacco products, and the relationship was specific to the type of product they promoted. In terms of factors that reduce commercial tobacco use, we found that e-cigarette-inclusive smoke-free policies and raising legal tobacco purchasing age to 21 years were associated with no/slower increase in US youth e-cigarette use despite the increase of their use in the US as a whole. Additionally, through analyzing data from a longitudinal study, we found that parental anti-smoking encouragement during adolescence predicted cigarette smoking during young adulthood. This provides a testable avenue of intervention to reduce commercial tobacco use disparities. Investigate the impact of tobacco use patterns and health outcomes We continued to document the health effects of e-cigarettes. Using data from a national survey, we found that independent of cigarette smoking and cannabis use, youth who used e-cigarettes were more likely than those who did not use e-cigarettes to have asthma. This adds to our previous studies showing that e-cigarettes use is associated with asthma attack. In a second analysis, we examined how e-cigarette use among youth is associated with sleep deprivation. We found that youth who reported e-cigarette use were more likely than those who did not report e-cigarette use to suffer from sleep deprivation, even after accounting for cigarette smoking and other risk factors. Together with extramural investigators, we also conducted a review of the effect of e-cigarette use on respiratory disorders. COVID-19 and Tobacco Use We conducted a qualitative study with Black young adult cigar smokers during the COVID-19 pandemic to explode changes in cigar smoking because of the pandemic. We found that these Black participants increased cigarillo and blunt smoking during the pandemic to cope with stress. This is likely to increase their risks of cigarillo- and cannabis-related health consequences. We completed the data collection of an online survey focusing on COVID-19 pandemic, racism, and tobacco use. We are currently analyzing the data.