Contraceptive Use and Its Associations With Social Determinants of Health Among Young Adults.

BACKGROUND: Nonuse and inconsistent use of contraception in young adults can result in undesired pregnancies. Prior research on contraceptive use has primarily focused on individual influences such as attitudes, beliefs, and skills related to contraceptive use, with little consideration of the social and economic determinants. OBJECTIVE: This study explored domains from the Healthy People 2030 Social Determinants of Health (SDH) framework and examined their cross-sectional associations with young adults' self-reported contraceptive use (ie, any use in the past year and consistent use of contraception). METHODS: Eleven measures related to 5 SDH domains were extracted from the Add Health dataset collected from 2001 to 2002 (Wave III). The final sample included 11,172 youth with a mean age of 21.88 years (SD: 1.84) and was 53.8% female. RESULTS: Measures associated with the past year's use of contraceptives included non-poverty status, employment, housing instability, high school graduation, enrollment in higher education, English language spoken at home, experience of civic participation, and access to primary care. For consistent use of contraception, associated measures were participants' non-poverty status, employment, high school graduation, enrollment in higher education, English language spoken at home, experience of civic participation, incarceration, and access to health care. CONCLUSIONS: Interventions that address social determinants of health can potentially promote contraceptive use.

E-cigarette Marketing Expenditures in the United States From 2016 to 2021: Targeted Media Outlets Geared Toward People Who Are at Increased Risk for Tobacco Use.

INTRODUCTION: E-cigarette advertising exposure is linked to e-cigarette initiation and use. Thus, monitoring trends in e-cigarette advertising practices is important to understand e-cigarette use patterns observed over recent years. AIMS AND METHODS: E-cigarette advertising expenditures (January 2016-July 2021; Numerator Ad Intel) for 154 U.S. market areas were harmonized with U.S. Census sociodemographic data through Nielsen zip code designations by market area. Descriptive statistics and multivariable linear regressions were used to examine trends in e-cigarette advertising expenditures across media outlets and associations between sociodemographic characteristics and e-cigarette advertising over time. RESULTS: E-cigarette advertising expenditures peaked in 2018/2019, followed by a sharp decline in 2020. Expenditures were concentrated primarily on print (58.9%), TV (20.6%), and radio (14.4%). Major print outlets were Sports Illustrated, Rolling Stone, and Star magazines. Top TV channels were AMC, Investigation Discovery, and TBS. TV advertisements were purchased commonly during popular movies and TV series (eg King of Queens, Everybody Loves Raymond, The Walking Dead). Higher expenditures were associated with U.S. market areas that had (1) a larger percentage of non-rural zip codes (radio), (2) smaller male populations (radio), and (3) larger White or Caucasian, Black or African American, American Indian or Alaska Native, Asian, and Other or Multiracial populations (radio, print, online display, and online video). CONCLUSIONS: E-cigarette companies advertised in print magazines geared toward males and youth and young adults, radio commercials focused in urban areas with smaller male populations, and nationwide TV commercials. Declines in e-cigarette advertising expenditures in 2020 demonstrate the potential impact that federal policies may have on protecting populations who are at higher risk for tobacco use from predatory advertising practices. IMPLICATIONS: E-cigarette advertising exposure is associated with the initiation and use of e-cigarettes. This study shows how e-cigarette marketing expenditures in the United States may have targeted specific consumers (eg youth and young adults) between 2016 and 2021. The precipitous drop in advertising expenditures across all outlets during early 2020 corresponds with the implementation of the Tobacco 21 federal policy, the federal enforcement policy to remove most unauthorized flavored e-cigarette cartridges from the U.S. market, preparations for FDA's premarket review of e-cigarette products, and the decision by several TV broadcast companies to stop showing e-cigarette ads. The potential impact of federal policies may have far-reaching implications for protecting populations who are at high risk for tobacco use and its health consequences.

Gestational Women's Perceptions About the Harms of Cigarette and E-Cigarette Use During Pregnancy.

OBJECTIVES: The purpose of this study was to examine differences between perceived harm of cigarette and electronic cigarette (e-cigarette) use while pregnant and differences between healthcare providers' communication about these products during pregnancy. METHODS: A convenience sample of gestational women (n = 218; ages 18-45) living in the US completed an online survey between May and December 2017. Participants reported perceived likelihood of adverse health outcomes (e.g., low birth weight, sudden infant death syndrome) among infants/children born to mothers who used cigarettes/e-cigarettes. T-tests and two-way ANOVAs examined differences between risk perceptions of using cigarettes/e-cigarettes while pregnant based on pregnancy status (previously pregnant, currently pregnant, future pregnant). Chi-square analyses examined differences between healthcare provider communication about cigarette/e-cigarette use during pregnancy. RESULTS: Overall, participants believed adverse health outcomes were significantly more likely to be caused by maternal use of cigarettes than e-cigarettes. Participants who planned to be pregnant reported higher endorsement that smoking combustible cigarettes would cause a miscarriage (p < .05) or increased blood pressure (p < .05) for a child than currently pregnant participants. Participants reported healthcare providers asked about (p < .05), advised them not to use (p < .001), and talked to them about health effects of smoking combustible cigarettes while pregnant (p < .001) significantly more than e-cigarettes. CONCLUSIONS FOR PRACTICE: Healthcare providers working with pregnant women should perform the 5As behavioral intervention method to provide pregnant women with tobacco cessation care. They should also discuss the absolute harm nicotine exposure (via cigarettes or e-cigarettes) can have on fetal health and development.

Pastors' Perceptions of the Black Church's Role in Teen Pregnancy Prevention.

Objective. To identify pastors' perceptions of the Black Church's role in promoting adolescent sexual health and preventing teen pregnancy. The Black Church and pastor are important partners in addressing health disparities in the Black community, especially those addressing sensitive issues as teen pregnancy. Methods. Semistructured interviews (n = 31) were conducted with Black Church pastors in two southwestern U.S. cities from September 2014 to July 2015. The question path was developed based on interviews with local leaders, literature searches, and key informant pastor interviews. Questions included knowledge/beliefs about sexuality education, church's role in preventing teen pregnancy, and implementation obstacles. Interviews were transcribed and thematically analyzed. Results. (1) All pastors believed that the Black Church should address teen pregnancy with parents and congregants. (2) Two major obstacles emerged: (a) all pastors perceived social consequences, including resistant parents and (b) discomfort discussing contraceptives/condoms. (3) All pastors were willing to partner with organizations, but most had reservations based on conflicting missions/values. Conclusions. Black Church pastors support teen pregnancy prevention programs in the church; however, public health partners must be willing to address the church's unique needs and mission.

Prospective Associations Among Youth Religiosity and Religious Denomination and Youth Contraception Use.

This study prospectively investigates associations among youth religiosity, religious denomination, and contraception use. Associations between youth religiosity and religious denomination, and type of contraceptive used and consistent contraceptive use among sexually active youth (N = 757) were analyzed using multinomial and binomial logistic regression. Identifying with a religious denomination was a predictor of dual contraceptive use relative to using no method of contraception (AOR = 2.17). There was no association between youth religiosity and type of contraceptive use or contraceptive consistency. Religious leaders and public health practitioners should collaborate to develop strategies to engage in conversations with sexually active youth about contraceptive use.

Experiences of women with cervical dysplasia and associated diagnoses using electronic cigarettes for smoking substitution.

INTRODUCTION: The aim of this qualitative study was to describe the motivation and experiences of women with cervical dysplasia and associated diagnoses who used electronic cigarettes (ECs) to reduce the number of cigarettes they smoked. METHODS: Qualitative interviews were conducted with 26 women aged 18-65 years with cervical dysplasia and associated diagnoses who smoked at least three cigarettes daily for the past year or more and who enrolled in an intervention designed to substitute regular cigarettes with ECs. At the 12-week follow-up, patients were contacted by telephone. Semi-structured interviews were recorded, then transcribed, coded and analysed for themes. RESULTS: When confronted with a new diagnosis associated with smoking, women in this study were eager to try ECs to help them reduce their intake of cigarettes. Women reported that physical cues similar to smoking, delivery of nicotine sufficient to assist with smoking reduction and the security of having the device available to use in instances where temptations to smoke may occur were all positive experiences in trying the device. Other women in the study reported negative experiences, such as a lack of sufficient nicotine to eliminate cravings, heaviness of the device and the need to keep it charged. Depression, nicotine addiction and habit were factors that made it difficult to decrease cigarette consumption. CONCLUSIONS: Findings suggest that ECs may help with smoking substitution in patients who must reduce smoking due to medical conditions or diagnoses.

Parents' beliefs of the Black Church's role in teen pregnancy prevention.

INTRODUCTION: Parents are important decision makers in black churches. The objective of this qualitative study was to identify African American parents' beliefs of the Black Church's role in preventing teen pregnancy and promoting healthy teen relationships. METHODS: Parent members (n = 36) of 27 predominately Black churches in two southwestern US cities participated in semi-structured interviews from February-June 2017. A question path was developed based on literature searches, key informant interviews, and a previous study with local pastors, and questions focused on parents' knowledge/beliefs about 1) sexuality education, 2) the church's role in preventing teen pregnancy, and 3) implementation obstacles. Interviews were transcribed verbatim, coded using NVivo, and open-coded for themes to investigate patterns across codes and participants. Transcripts were then reviewed for quotes to represent each theme. RESULTS: Five themes were identified, with multiple subthemes. Most parents said there should be no boundaries on the type of sexuality information shared by their church, but later changed their minds after reviewing a list of potential topics. Parents listed 'parent-child communication', 'goals and dreams', and 'relationships' as the most important topics for teen pregnancy prevention intervention. Parents said information shared during workshops should be judgement-free and realistic. Parents most often said pastors and/or youth pastors/directors should deliver sexual health information. Parents believed older adults and other parents may oppose sexual education. CONCLUSIONS: By understanding parents' beliefs of teen pregnancy prevention programs, public health practitioners can understand concerns, modify implementation strategies, and utilize parental support to gain buy-in before planning and implementing programs.

Cigarettes vs. E-Cigarettes: Policy Implications from a Focus Group Study.

Background: Rates of electronic cigarettes (e-cigarette) use (vaping) have increased among college students over the past decade. Objectives: The current study sought to provide an in-depth examination of college students' beliefs about and attitudes toward cigarettes and e-cigarettes that may influence support/non-support of tobacco-free policies on college campuses and within their communities. Methods: Between August and December 2015, five focus groups (n = 22) were conducted at a large Southern University. Focus group discussions addressed social acceptance and areas where students commonly smoked/vaped on campus. Sessions were transcribed verbatim. Two researchers independently coded the transcripts and identified themes. A third researcher independently reviewed the coding and thematic analysis process (triangulation of researchers). Results: Participants expressed positive attitudes toward smoke-free policies that did not target college students, especially those that protected vulnerable populations (e.g., children). However, some were skeptical of tobacco-free policies that included e-cigarettes. Participants believed the campus tobacco-free policy had moved smokers' behavior off campus, but many reported seeing people vape in locations where smoking was not allowed (i.e., library, dorm rooms). Most perceived smoking to be less acceptable than vaping; smoking was described as 'dirty', while vaping was glamorized as a cultural trend. Conclusions/Importance: Findings from our qualitative study suggest that college students are supportive of smoke-free policies, but they are less supportive of comprehensive tobacco-free policies that include e-cigarettes. College campuses and surrounding communities should plan for education about policy protection via communication channels viewed frequently by students when including vaping devices in their comprehensive tobacco-free policies/ordinances.

Living Outside the Gender Box in Mexico: Testimony of Transgender Mexican Asylum Seekers.

OBJECTIVES: To explore preimmigration experiences of violence and postimmigration health status in male-to-female transgender individuals (n = 45) from Mexico applying for asylum in the United States. METHODS: We used a document review process to examine asylum declarations and psychological evaluations of transgender Mexican asylum seekers in the United States from 2012. We coded documents in 2013 and 2014 using NVivo, a multidisciplinary team reviewed them, and then we analyzed them for themes. RESULTS: Mexican transgender asylum applicants experienced pervasive verbal, physical, and sexual abuse from multiple sources, including family, school, community, and police. Applicants also experienced discrimination in school and in the workplace. Applicants immigrated to the United States to escape persistent assaults and threats to their life. Applicants suffered health and psychological effects from their experiences in Mexico that affected opportunities in the United States for employment, education, and social inclusion. CONCLUSIONS: Additional social protections for transgender individuals and antidiscrimination measures in Mexican schools and workplaces are warranted as are increased mental health assessment and treatment, job training, and education services for asylum seekers in the United States.

Knowledge and Beliefs About E-Cigarettes in Straight-to-Work Young Adults.

INTRODUCTION: Young adults are a growing segment of electronic cigarette (e-cigarette) users. Young adults who go straight to work (STW) from high school make up a large portion of the young adult population, yet research to date has focused on college-educated young adults. This study explored STW young adult beliefs and knowledge about e-cigarettes. METHODS: Semistructured individual interviews were used to elicit in-depth information from STW young adults ages 19-31 from a state in the southwest United States. Thirty interviews were conducted focusing on beliefs about e-cigarettes, current knowledge, and information-seeking practices. Interviews were recorded, transcribed, and analyzed using NVivo. RESULTS: Nine themes were identified falling into three categories: (1) beliefs about e-cigarettes, (2) knowledge about e-cigarettes, and (3) personal rules about e-cigarettes. STW young adults held positive beliefs about the health and safety of e-cigarettes for themselves, others, and the environment. They reported their social networks and the Internet as reliable sources of information about e-cigarettes, but they reported parents as the best source for advice. Participants had rules about e-cigarettes that contradicted some of their beliefs such as using e-cigarettes around children indicating that their beliefs were not as strongly held as they initially reported. CONCLUSIONS: Industry marketing and contradictory information may contribute to STW young adult knowledge and beliefs about e-cigarettes. Lack of credible public health information may also contribute to this issue. Ensuring that what is known about the benefits and harms of e-cigarettes is conveyed through multichannel communication and continued monitoring of marketing practices of the e-cigarette industry in light of the soon to be implemented regulations should be top priorities for public health. IMPLICATIONS: Beliefs and knowledge of STW young adults have not been explored even though they are heavily targeted by the e-cigarette industry. This group holds strong positive beliefs about the health and safety of e-cigarettes, despite having little credible knowledge about them. This study indicates a need for efforts focused on educating STW young adults on the potential risks and benefits of e-cigarettes and the communication of credible information or at minimum the acknowledgment of the uncertainty regarding the long-term health effects of e-cigarettes. It also indicates a need for continued monitoring and advocacy related to marketing practices of the e-cigarette industry.

Mothers' self-reported grocery shopping behaviours with their 2- to 7-year-old children: relationship between feeding practices and mothers' willingness to purchase child-requested nutrient-poor, marketed foods, and fruits and vegetables.

OBJECTIVE: To assess relationships between mothers' feeding practices (food as a reward, food for emotion regulation, modelling of healthy eating) and mothers' willingness to purchase child-marketed foods and fruits/vegetables (F&V) requested by their children during grocery co-shopping. DESIGN: Cross-sectional. Mothers completed an online survey that included questions about feeding practices and willingness (i.e. intentions) to purchase child-requested foods during grocery co-shopping. Feeding practices scores were dichotomized at the median. Foods were grouped as nutrient-poor or nutrient-dense (F&V) based on national nutrition guidelines. Regression models compared mothers with above-the-median v. at-or-below-the-median feeding practices scores on their willingness to purchase child-requested food groupings, adjusting for demographic covariates. SETTING: Participants completed an online survey generated at a public university in the USA. SUBJECTS: Mothers (n 318) of 2- to 7-year-old children. RESULTS: Mothers who scored above-the-median on using food as a reward were more willing to purchase nutrient-poor foods (ß=0·60, P<0·0001), mothers who scored above-the-median on use of food for emotion regulation were more willing to purchase nutrient-poor foods (ß=0·29, P<0·0031) and mothers who scored above-the-median on modelling of healthy eating were more willing to purchase nutrient-dense foods (ß=0·22, P<0·001) than were mothers with at-or-below-the-median scores, adjusting for demographic covariates. CONCLUSIONS: Mothers who reported using food to control children's behaviour were more willing to purchase child-requested, nutrient-poor foods. Parental feeding practices may facilitate or limit children's foods requested in grocery stores. Parent-child food consumer behaviours should be investigated as a route that may contribute to children's eating patterns.

Needs of a Silent Minority: Mexican Transgender Asylum Seekers.

Mexican male to female transgender asylum seekers in the United States suffer from serious health issues that can be attributed to stressors related to their transgender, ethnic minority, and socioeconomic status. This study explored these stressors, the resulting health issues, and the needs of this particularly vulnerable population. Asylum seekers' (n = 45) sworn declarations and psychological evaluations were examined by a multidisciplinary research team using a systematic document review process. The review identified stressors that occurred both in Mexico and the United States: verbal, physical, and sexual assaults; unstable environments; fear for safety/security; hiding undocumented status; and economic insecurity. The health issues that resulted in part from these stressors include posttraumatic stress disorder, depression, anxiety, sleep issues, isolation, avoidance, drug/alcohol use, and suicidal tendencies. Despite suffering from multiple health issues, asylum seekers rarely sought health or social services. Health promotion practitioners can play an important role in serving this silent minority by (1) expanding community-based research focused on the intersection of transgender, ethnic minority, and socioeconomic status; (2) using trusted community members to connect this population to necessary resources; (3) providing communication training/resource development for health care providers; and (4) creating a network of service organizations that understand the needs of transgender asylum seekers.

Vapor Store Owner Beliefs and Messages to Customers.

INTRODUCTION: Electronic cigarette (e-cigarette) use is becoming increasingly popular but little is known about the role of the local vapor store in promoting use and influencing customer attitudes and beliefs about vaping. METHODS: Thirty-three vapor store owners were interviewed about their personal beliefs and attitudes about e-cigarettes and what they told customers about the health impact of using e-cigarettes. Interviews were recorded then transcribed, coded, and analyzed for themes. RESULTS: Vapor store owners used the internet to obtain information about vaping, most often from YouTube and industry sources. Owners often did not have the training to critically evaluate research studies posted on the internet. Owners promoted vaping as a healthier alternative to smoking and often compared it to a medical treatment. Owners considered ingredients in the e-liquid as safe to use if it was safe to eat and discussed other foods vapor ingredients were found in. Owners also discussed the safety of secondhand vapor. Owners described the health impact of nicotine in e-liquid by comparing nicotine to caffeine and promoted the nicotine in e-liquid as coming from vegetables rather than tobacco. Finally, owners talked about vaping as a habit rather than a continued addiction to nicotine. CONCLUSIONS: Local store owners are an important source of health information for current and potential e-cigarette users but their messages to customers may be based on incomplete or misinterpreted information. Understanding local store owner messages to customers in addition to internet-based messages is an important area for future public health research.

Prospective association between negative life events and initiation of sexual intercourse: the influence of family structure and family income.

OBJECTIVES: We examined the prospective association between negative life events and time to initiation of sexual intercourse and the influence of family structure and family income on this association. METHODS: We followed up a randomly selected sample (n=649) of ethnically diverse parents and their children aged 12 to 17 years over a 5-year period. We conducted Cox proportional hazards regression analysis to examine the relation between negative life events and time to initiation of sexual intercourse. Family structure and family income were assessed as confounders. RESULTS: Negative life events were significant predictors of time to initiation of sexual intercourse in adolescents. After controlling for demographic variables, youths reporting 1 negative life event had a hazard of initiation of sexual intercourse 1.40 times greater and youths reporting 2 or more negative life events had a hazard of initiation of sexual intercourse 1.61 times greater compared with youths reporting no negative life events. Family structure and family income were not significant confounders of the relation between initiation of sexual intercourse and negative life events. CONCLUSIONS: Interventions to prevent initiation of sexual intercourse should focus on youths with recent negative life events, regardless of family income and structure.

The association between chronic disease and smoking beliefs and behaviors in African American young adult smokers.

PURPOSE: African American young adults have higher rates of smoking and chronic disease than Whites. Understanding the association between chronic disease and smoking beliefs and behaviors could improve cessation strategies for young adult smokers. METHODS: African American young adult smokers aged 18-29 years (n = 243) were administered surveys assessing smoking beliefs and behaviors. Participants indicated if they had physician-diagnosed asthma, diabetes, and/or hypertension. Responses were analyzed using logistic regression, comparing responses of those diagnosed with a chronic disease to those without that disease. RESULTS: Smokers with asthma were 2.20 times more likely to acknowledge smoking negatively affected their health yet were no more likely to make a quit attempt than those without asthma. Diabetic smokers were 4.10 times more likely than those without to have made a quit attempt, yet were 3.24 times more likely to disagree that they were in control of their smoking. Hypertensive smokers were more likely to be heavier smokers and were 3.12 times more likely to disagree that they would stop smoking if they knew it affected the health of others than those without hypertension. Smokers with chronic disease were less likely to be influenced to quit by their physician than smokers without. CONCLUSIONS: African American young adult smokers with a chronic disease often diverge from smokers without that chronic disease in smoking beliefs and behaviors. These may influence how young adults respond to cessation messages and programs.

How old do I look? Aging appearance and experiences of aging among U.S. adults ages 50-80.

Appearance is an indicator of age and life stage, which are linked to socially salient stereotypes and prejudices. Older adults' appearance-related perceptions and behaviors may affect their experiences of aging within broader society, which may in turn influence health. This study examined associations between two measures related to aging appearance-assessment of one's aging appearance relative to same-age peers and investing time or effort to look younger-positive and negative experiences of aging, and health using multivariable regression. Cross-sectional data were from a nationally representative sample of 2006 U.S. adults ages 50-80 (Mage = 63, 52% women, 71% White) who completed Wave 6 of the National Poll on Healthy Aging in 2019. The majority (59%) reported appearing relatively younger than peers, while fewer reported appearing the same age (35%) or older (6%). About a third (35%) reported investing in looking younger. Appearing relatively younger was associated with more positive (p < .001) and less negative experiences of aging (p = .019). Appearing relatively older showed the opposite relationships (p values < .001). Investing in looking younger was associated with more positive and more negative experiences of aging (p values < .001). Few sociodemographic variations were detected. More positive and less negative experiences of aging were associated with better physical and mental health (p values < .001). While aging appearance is often the basis for jokes, it may affect the quality of older adults' experiences of aging and associated health outcomes. Nuanced findings caution against framing youthful biases in aging appearance and investments in looking younger as solely negative (or positive). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Situations and roles of cannabis versus cigarette use: Integrating ecological momentary assessment with qualitative mapping interviews.

Use of both cannabis and tobacco has surpassed use of tobacco alone among young adults in California. To better understand why, we collected data with 32 young adults ages 18-30 in Northern California who regularly used cigarettes and cannabis and had diverse sexual, gender, racial, and ethnic identities. Geographically-explicit ecological momentary assessment (EMA; 30 days) was integrated with qualitative mapping interviews. We found contrasting situations of use for cannabis (e.g., around other people) versus cigarettes (e.g., recent discrimination) and different reasons for why participants chose one substance over the other (e.g., enhancing experiences vs. stepping away). Understanding when and why diverse young adults choose cannabis versus cigarettes as they navigate everyday environments helps explain how cannabis and tobacco retail markets shape substance use disparities over time.

An Integrated mHealth App for Smoking Cessation in Black Smokers With HIV: Protocol for a Randomized Controlled Trial.

BACKGROUND: Black adults who smoke and have HIV experience immense stressors (eg, racial discrimination and HIV stigma) that impede smoking cessation success and perpetuate smoking-related health disparities. These stressors also place Black adults who smoke and have HIV at an increased risk of elevated interoceptive stress (eg, anxiety and uncomfortable bodily sensations) and smoking to manage symptoms. In turn, this population is more likely to smoke to manage interoceptive stress, which contributes to worse HIV-related outcomes in this group. However, no specialized treatment exists to address smoking cessation, interoceptive stress, and HIV management for Black smokers with HIV. OBJECTIVE: This study aims to test a culturally adapted and novel mobile intervention that targets combustible cigarette smoking, HIV treatment engagement and adherence, and anxiety sensitivity (a proxy for difficulty and responsivity to interoceptive stress) among Black smokers with HIV (ie, Mobile Anxiety Sensitivity Program for Smoking and HIV [MASP+]). Various culturally tailored components of the app are being evaluated for their ability to help users quit smoking, manage physiological stress, and improve health care management. METHODS: This study is a pilot randomized controlled trial in which Black combustible cigarette smokers with HIV (N=72) are being recruited and randomly assigned to use either (1) the National Cancer Institute's QuitGuide app or (2) MASP+. Study procedures include a web-based prescreener; active intervention period for 6 weeks; smartphone-based assessments, including daily app-based ecological momentary assessments for 6 weeks (4 ecological momentary assessments each day); a video-based qualitative interview using Zoom Video Communications software at week 6 for participants in all study conditions; and smartphone-based follow-up assessments at 0, 1, 2 (quit date), 3, 4, 5, 6, and 28 weeks postbaseline (26 weeks postquitting date). RESULTS: Primary outcomes include biochemically verified 7-day point prevalence of abstinence, HIV-related quality of life, use of antiretroviral therapy, and HIV care appointment adherence at 26 weeks postquitting date. Qualitative data are also being collected and assessed to obtain feedback that will guide further tailoring of app content and evaluation of efficacy. CONCLUSIONS: The results of this study will determine whether the MASP+ app serves as a successful aid for combustible cigarette smoking cessation, HIV treatment engagement, and physiological stress outcomes among Black people with HIV infection. If successful, this study will provide evidence for the efficacy of a new means of addressing major mental and physical health difficulties for this high-risk population. If the results are promising, the data from this study will be used to update and tailor the MASP+ app for testing in a fully powered randomized controlled trial that will evaluate its efficacy in real-world behavioral health and social service settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT05709002; https://clinicaltrials.gov/study/NCT05709002. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/52090.

Efficacy and implementation of exercise-based smoking cessation treatment for adults with high anxiety sensitivity (STEP): Study protocol for a randomized controlled trial.

Anxiety sensitivity (AS), reflecting the fear of bodily sensations, is a transdiagnostic vulnerability factor that underpins both affective psychopathology and smoking. Phase II research supports the efficacy of a 15-week community-based intervention (STEP) that combines high-intensity exercise offered by the YMCA with standard smoking cessation treatment (tobacco quitline and nicotine replacement therapy) for sedentary smokers with elevated AS. This Phase III study aims to enroll 360 adults to evaluate whether STEP efficacy for achieving smoking abstinence generalizes to Black and Hispanic smokers with elevated AS.

Chronic disease as a risk factor for cigarette and e-cigarette use from young adulthood to adulthood.

Chronic disease prevalence in young adults is increasing with 15-20 % reporting 1 or more chronic diseases. This study examined cross-sectional and prospective relationships between chronic disease and e-cigarette/cigarette use from young adulthood to adulthood utilizing the U.S.- based National Longitudinal Study of Adolescent to Adult Health (Add Health). Add Health Study wave 3 (2001-2002; ages 18-26), wave 4 (2008; ages 24-34), and wave 5 (2016-2018; ages 33-44) were used. Past 30-day cigarette use at waves 3-5 and past 30-day e-cigarette use at wave 5 were assessed. Two measures of chronic disease were used: asthma (yes/no) and non-asthmatic chronic disease (yes/no) composed of 7 additional chronic diseases (diabetes, migraine, heart problem, hepatitis B/C, high blood pressure, epilepsy, and cancer). Weighted multilevel logistic regression (controlling for age, race/ethnicity, gender, and education) was used to assess cross-sectional associations at wave 3, and then prospective associations of wave 3 chronic disease (asthma and non-asthmatic) with waves 4 and 5 cigarette and wave 5 e-cigarette use. Logistic regressions showed no significant cross-sectional or prospective relationships between asthma and cigarette and e-cigarette use. However, wave 3 non-asthmatic chronic disease was significantly associated with wave 4 cigarette use (aOR 1.38, p <.001, 95 % CI: 1.15, 1.65) and with wave 5 cigarette use (aOR 1.49, p <.001, 95 % CI: 1.21, 1.84) but not e-cigarette use. The association between chronic disease in young adulthood and tobacco use in adulthood differed by type of chronic disease and tobacco product, indicating the need for targeted interventions.