Smoking Among Hispanic/Latino Nationality Groups and Whites, Comparisons Between California and the United States.

Introduction: Although California is home to the largest Hispanic/Latino population, few studies have compared smoking behavior trends of Hispanic/Latino nationality groups in California to the remaining United States, which may identify the impact of the states antitobacco efforts on these groups. This study compared smoking status, frequency, and intensity among Mexican Americans, Central/South Americans, and non-Hispanic Whites in California to the remaining United States in the 1990s and 2000s. Methods: Data were analyzed using the 1992-2011 Current Population Survey Tobacco Use Supplement to report the estimated prevalence of smoking status, frequency, and intensity by decade, race/ethnicity, and state residence. Weighted logistic regression explored sociodemographic factors associated with never and heavy smoking (≥20 cigarettes per day). Results: There were absolute overall increases from 6.8% to 9.6% in never smoking across all groups. Compared to the remaining United States, there was a greater decrease in heavy smoking among Mexican American current smokers in California (5.1%) and a greater increase in light and intermittent smokers among Central/South American current smokers in California (9.3%) between decades. Compared to those living in the remaining United States, smokers living in California had lower odds of heavy smoking (1990s: odds ratio [OR] = 0.64, 95% confidence interval [CI] = 0.62, 0.66; 2000s: 0.54, 95% CI = 0.52, 0.55). Conclusions: California state residence significantly impacted smoking behaviors as indicated by significant differences in smoking intensity between California and the remaining United States among Hispanic/Latino nationality groups. Understanding smoking behaviors across Hispanic/Latino nationality groups in California and the United States can inform tobacco control and smoking prevention strategies for these groups. Implications: The present study explored the differences in smoking behaviors between Whites, Mexican Americans, and Central South/Americans living in California versus the rest of the United States in the 1990s and the 2000s. The results contribute to our current knowledge as there have been minimal efforts to provide disaggregated cigarette consumption information among Hispanic/Latino nationality groups. Additionally, by comparing cigarette consumption between those in California and the remaining United States, our data may provide insight into the impact of California's antitobacco efforts in reaching Hispanic/Latino subpopulations relative to the remaining US states, many of which have had less tobacco control policy implementation.

Tobacco use disparities by racial/ethnic groups: California compared to the United States.

Racial/ethnic disparities in cigarette use and cessation persist. This study compared cigarette consumption and former smoking trends in California (CA) with the rest of the United States (US) by racial/ethnic categories of non-Hispanic White, Black, Hispanic/Latino, and Asian/Pacific Islander groups. Data were analyzed from the 1992 to 2011 Tobacco Use Supplement to the Current Population Survey. Consumption levels across decades were examined and adjusted logistic regression models were fit to compare across CA and US. Results indicated steady declines in ever smoking prevalence for all groups with much lower magnitudes of change among US Blacks and Whites compared to their CA counterparts. After controlling for age, gender, and education, CA had significantly fewer heavy smokers (OR=0.45, 95% CI:0.38-0.54), more light and intermittent smokers (LITS; OR=1.68, 95%CI: 1.45-1.93), and a greater proportion of former smokers (OR=1.35, 95%CI: 1.24-1.48) than the rest of US. Data were stratified by race/ethnicity and the patterns shown were mostly consistent with CA performing statistically better than their US counterparts with the exception of Black LITS and Asian/Pacific Islander former smokers. California's success in reducing tobacco use disparities may serve as a prime example of tobacco control policy for the country. CA and the US will need to continue to address tobacco use and cessation in the context of the growing diversity of the population.

Light and intermittent smoking among California Black, Hispanic/Latino, and non-Hispanic White men and women.

INTRODUCTION: The prevalence of light and intermittent smoking (LITS) is increasing as the prevalence of heavier smoking continues to fall. The purpose of this study was to examine changes in LITS over time among Blacks, Hispanic/Latinos (Latinos) and non-Hispanic Whites (Whites). METHODS: Data from the California Tobacco Surveys from 1990, 1992, and 1996 (Time 1 [T1]) were combined and compared to combined data from 1999, 2002, 2005, and 2008 (Time 2 [T2]). T1 participants (N = 50,424) included Blacks (n = 3,029), Latinos (n = 7,910), and Whites (n = 39,485). T2 participants (N = 53,005) included Blacks (n = 5,460), Latinos (n = 14,273), and Whites (n = 33,246). RESULTS: LITS increased by a factor of 12.9% to a rate of 79.6% (76.0-83.2) among Latinos, by 19.4% to a rate of 74.4% (70.9-77.9) among Blacks, and by 51.7% to a rate of 48.9% (47.5-50.3) among Whites. In unadjusted analyses at T1, females were more likely to be LITS than males across ethnic groups. At T2, this sex difference was maintained among Whites, but not Blacks and Latinos. Females were significantly more likely to be LITS than males when controlling for demographic variables. CONCLUSIONS: The present study found that LITS rates increased over time for male and female Black, Latino and White adults. There is a need for increased tobacco control attention to LITS across all ethnic groups, but with additional focus on Blacks, Latinos, and women who have the highest rates of LITS.

Smoking Trends and Disparities Among Black and Non-Hispanic Whites in California.

OBJECTIVES: The current study examined disparities in smoking trends across Blacks and non-Hispanic Whites in California. METHODS: Data from the 1996 to 2008 California Tobacco Survey were analyzed to examine trends in smoking behaviors and cessation across Blacks and non-Hispanic Whites. RESULTS: A decrease in overall ever and current smoking was observed for both Black and non-Hispanic Whites across the 12-year time period. A striking decrease in proportions of heavy daily smokers for both Black and non-Hispanic Whites were observed. Proportions of light and intermittent smokers and moderate daily smokers displayed modest increases for Blacks, but large increases for non-Hispanic Whites. Increases in successful cessation were also observed for Blacks and, to a lesser extent, for non-Hispanic Whites. DISCUSSION: Smoking behavior and cessation trends across Blacks and non-Hispanic Whites were revealing. The decline in heavy daily and former smokers may demonstrate the success and effectiveness of tobacco control efforts in California. However, the increase in proportions of light and intermittent smokers and moderate daily smokers for both Blacks and non-Hispanic Whites demonstrates a need for tobacco cessation efforts focused on lighter smokers.

National trends in smoking behaviors among Mexican, Puerto Rican, and Cuban men and women in the United States.

OBJECTIVES: We examined trends in smoking behaviors across 2 periods among Mexicans, Puerto Ricans, and Cubans in the United States. METHODS: We analyzed data from the 1992-2007 Tobacco Use Supplements to the Current Population Survey. We constructed 2 data sets (1990s vs 2000s) to compare smoking behaviors between the 2 periods. RESULTS: Significant decreases in ever, current, and heavy smoking were accompanied by increases in light and intermittent smoking across periods for all Latino groups, although current smoking rates among Puerto Rican women did not decline. Adjusted logistic regression models revealed that in the 2000s, younger Mexicans and those interviewed in English were more likely to be light and intermittent smokers. Mexican and Cuban light and intermittent smokers were less likely to be advised by healthcare professionals to quit smoking. Mexicans and Puerto Ricans who were unemployed and Mexicans who worked outdoors were more likely to be heavy smokers. CONCLUSIONS: Increases in light and intermittent smoking among Mexican, Puerto Rican, and Cuban Americans suggest that targeted efforts to further reduce smoking among Latinos may benefit by focusing on such smokers.

Increases in light and intermittent smoking among Asian Americans and non-Hispanic Whites.

INTRODUCTION: Asian Americans are the fastest growing immigrant group in the United States and are more likely to be light and intermittent smokers (LITS) compared with non-Hispanic Whites (NHWs). LITS experience adverse health effects related to smoking. Previous research has aggregated Asian American ethnic groups, masking important differences between groups. We sought to compare LITS rates among Asian American subgroups before and after the 1998 Master Settlement Agreement (MSA) with NHWs in California utilizing data from the California Tobacco Surveys (CTS). METHODS: We combined 1990, 1992, and 1996 CTS (pre-MSA) and the 1999, 2002, 2005, and 2008 CTS (post-MSA) to examine changes in LITS (<10 cigarettes/day or not smoking daily). Chinese, Filipino, Japanese, and Korean ethnic groups were compared with NHWs. RESULTS: Pre-MSA logistic regression models adjusted for age, gender, education level, language spoken at home, and use of other tobacco products found that Chinese (odds ratio [OR] = 3.38, 95% confidence interval [CI] = 2.19, 5.21), Filipinos (OR = 3.55, 95% CI = 2.73, 4.63), Japanese (OR = 1.99, 95% CI = 1.22, 3.27), and Koreans (OR = 3.22, 95% CI = 2.06, 5.03) were significantly more likely to be LITS compared with NHWs. Post-MSA, all Asian American subgroups experienced an increase in LITS (11.7%-37.8%); however, only Chinese (OR = 2.19, 95% CI = 1.16, 4.13) and Filipinos (OR = 3.33, 95% CI = 2.26, 4.91) remained significantly more likely to be LITS compared with NHWs. CONCLUSIONS: Our results highlight the need for tobacco control efforts that address the growing group of LITS among Asian Americans and NHWs.

Moderation Effects of Gender on the Association between Intimate Partner Violence and Suicidal Ideation or Attempt among Adolescents: A Secondary Analysis of the 2017 YRBS.

OBJECTIVE: Physical and sexual intimate partner violence (IPV) among adolescents leads to adverse health behaviors, particularly suicidal ideation and attempts. Studies demonstrated the link between IPV and suicidal ideation and attempts among adolescents, yet there is conflicting evidence regarding differences between adolescent males and females; research evaluating the interaction of gender and the association between IPV and suicidal ideation and attempts is limited. The present study used a nationally representative sample from the Youth Behavioral Risk Surveillance questionnaire to determine whether there is an interaction of gender on the relationship between physical IPV, sexual IPV, and suicidal ideation and suicidal attempts. METHOD: Weighted logistic regressions were fit using Stata 15.1 and multiple imputations were used to account for missing data. RESULTS: There is a significant gender by sexual IPV interaction (AOR = 0.66, CI = 0.51-0.84, p = 0.002) such that at low levels of sexual IPV there were no differences between genders in reported suicide attempts (t[33] = 1.19, p = 0.242). However, at moderate and high instances of sexual IPV, adolescent females were significantly less likely than males to report attempting suicide in the past year (t[33] = -2.71, p = 0.011; t[33] = -3.17, p = 0.003, respectively). CONCLUSIONS: The present study demonstrates the vital need for IPV and suicidal ideation and attempt screening, tailored multi-level interventions, and advocacy for adolescents. Policies are essential to increase screening among medical providers, and increase school- and community-based interventions and IPV and suicide awareness to decrease rates among adolescents.HIGHLIGHTSFemale students were more likely than males to report suicidal ideation.Significant interaction between sex and sexual IPV on suicide attempts.Gender differences at medium and high levels of sexual IPV on suicide attempts.

Ethnic groups' perception of physicians' attentiveness: implications for health and obesity.

Variables from the Health Tracking Household Survey 2007 were mapped to fit the "integrative model" of patient-doctor communication proposed by Ashton et al. (2003) to describe how communication patterns between patients and doctors influence patients' health outcomes. Patients' perceptions of their physician's attentiveness were examined to determine if perceived attentiveness mediated the relationship between physicians' recommendations (to diet and exercise) and health. Ethnic group differences related to these variables were explored. Overall, patient perception of physician attentiveness did significantly mediate the relationship between recommendations and patients' general health status. Hispanics and African Americans perceived their physicians as significantly less attentive to them, compared to Caucasians' perception of attentiveness. Across all ethnic groups, there was no evidence that doctors' recommendations to diet and exercise had an effect on patients' body mass index. The findings support previous research regarding the importance of physicians' communication skills and cultural sensitivity in promoting patient adherence to health recommendations.

Evaluation of sexual minority identity as a moderator of the association between intimate partner violence and suicidal ideation and attempts among a national sample of youth.

Sexual minority (SM) youth are at high risk for intimate partner violence (IPV) and suicidal ideation/attempts compared to their heterosexual peers. We examined whether SM identity enhanced the relationship between experiences of IPV and suicidal ideation/attempts. Weighted logistic regression models were run using the 2017 Youth Risk Behavior Survey. All main effects were significant; each SM identity and both physical and sexual IPV were significantly associated with suicidal ideation and suicide attempts. The interaction between bisexual identity and physical IPV was significant for suicidal ideation; as physical IPV experiences increased, the difference between bisexual identity and heterosexual youth was non-significant. Findings suggest exploring trauma and suicidal ideation by aggregate groups and increasing support for SM youth in schools and communities.

Hookah and Electronic Inhalant Device Use and Perceptions Among African American Youth and Young Adults: Are We Asking the Right Questions?

Objectives. Survey items used in surveillance systems to assess the use of emerging products like hookah and electronic inhalant devices (EIDs) may not match definitions used by high-risk populations. This qualitative study explored how African American youth and young adults (YYAs) (1) use hookah and EIDs and (2) identify patterns in the ways they describe and organize these products. Design. Individual in-person interviews were conducted among a sample of continuation high school and vocational school students in southern California. Participation was limited to those who had ever tried at least one tobacco product, self-identified as African American, and were between the ages of 14 and 26 years (n = 28). We conducted a content analysis to identify patterns in perceptions and use of these products. Results. African American YYAs recognized and described traditional hookah based on physical attributes, but for EIDs, including e-cigarettes, e-hookah, and vape pens, YYAs focused on reasons for using the product. Three primary categories emerged for reasons YYA used specific products: nicotine content and quitting, social facilitation, and use with marijuana. E-cigarettes were identified as quitting aids and as having nicotine but were not considered addictive. The term hookah recalled both the traditional and electronic pen-type products for YYAs. The terms vapes, hookah, wax pens, and others are used in the context of describing product use with marijuana. Conclusions. A better understanding of why African American YYAs use these products is needed to develop better measures for accurate rates of use, uncover differences in use between product types, and to develop effective prevention messaging.

The Relationship Between Perceived Hookup Attitudes and Negative Hookup Consequences: Do Perceived Attitudes of Close Friends Matter?

Research suggests that the perceived hookup attitudes of close referents are generally a poor predictor of hookup behavior and likely a poor direct predictor of negative hookup consequences. The current study aimed to examine three intervening variables as mediators of the relationship between the perceived hookup attitudes of college students' close friends and negative hookup consequences (e.g., regret, embarrassment). Self-report data were collected from 589 heavy-drinking college students from three midsized universities. The results indicated that students' own attitudes toward hooking up, motivation to hook up, and self-reported number of hookup partners significantly mediated the relationship between the perceived hookup attitudes of close friends and negative hookup consequences. The perceived hookup attitudes of close friends were positively associated with participants' attitudes toward hooking up. Participants' attitudes toward hooking up were positively associated with social-sexual motivation to hook up. Elevated social-sexual motivation to hook up was positively associated with hooking up with multiple partners, with hooking up with multiple partners positively associated with negative hookup consequences. A better understanding of the predictors and mediators of negative hookup consequences has the potential to inform prevention and intervention efforts.

Associations Between Cigarette Print Advertising and Smoking Initiation Among African Americans.

OBJECTIVES: The objective of this study was to examine changes in the annual number of cigarette advertisements in magazines with a predominantly African-American audience following the broadcast ban on tobacco, and whether fluctuations in cigarette print advertising targeting African Americans during the late-1970s until the mid-1980s were associated with declines in smoking initiation. DESIGN: We tabulated the annual number of cigarette advertisements from magazines with large African-American readerships (Ebony, Essence, and Jet) from 1960 to 1990. Advertisements were coded depending on whether they featured African-American models. We calculated the incidence rate of regular smoking initiation from 1975 to 1990 for African-American 14-25 years old using data from the 1992-1993, 1995-1996, 1998-1999, and 2001-2002 Tobacco Use Supplements of the Current Population Survey. We examined whether trends in smoking initiation coincided with trends in cigarette advertising practices among African Americans. RESULTS: The annual aggregated number of printed cigarette advertisements in Ebony, Essence, and Jet magazines increased at least five-fold starting in 1971, following the broadcast ban on cigarette advertising. A decrease in the percentage of ads by Brown & Williamson that showed African-American models was positively correlated (r = 0.30) with declines in the incidence rate of smoking initiation among African Americans from the late-1970s to the mid-1980s. CONCLUSION: The tobacco industry adapted quickly following the broadcast ban on cigarettes by increasing print advertising in African-American magazines. However, changes in print advertising practices by were associated with declines in smoking initiation among African Americans from the late-1970s to mid-1980s.

Neurological changes in brain structure and functions among individuals with a history of childhood sexual abuse: A review.

OBJECTIVE: Review literature focused on neurological associations in brain structure among individuals with a history of childhood sexual abuse (CSA). METHODOLOGY: A review of literature examining physiological irregularities in brain structures of individuals with a history of CSA was conducted. RESULTS: Results revealed that a history of CSA was associated with irregularities in the cortical and subcortical regions of the brain. These irregularities have been recognized to contribute to various cognitive, behavioral, and psychological health outcomes later in life. Age of CSA onset was associated with differential neurological brain structures. CONCLUSION: Mental and behavioral health problems such as anxiety, depression, substance abuse, dissociative disorders, and sexual dysfunction are associated with CSA and may persist into adulthood. Research depicting the associations of CSA on neurological outcomes emphasizes the need to examine the biological and subsequent psychological outcomes associated with CSA. Early intervention is imperative for CSA survivors.

Disparities in the Population Distribution of African American and Non-Hispanic White Smokers Along the Quitting Continuum.

PURPOSE: To examine disparities and changes over time in the population-level distribution of smokers along a cigarette quitting continuum among African American smokers compared with non-Hispanic Whites. METHODS: Secondary data analyses of the 1999, 2002, 2005, and 2008 California Tobacco Surveys (CTS). The CTS are large, random-digit-dialed, population-based surveys designed to assess changes in tobacco use in California. The number of survey respondents ranged from n = 6,744 to n = 12,876 across CTS years. Current smoking behavior (daily or nondaily smoking), number of cigarettes smoked per day, intention to quit in the next 6 months, length of most recent quit attempt among current smokers, and total length of time quit among former smokers were assessed and used to recreate the quitting continuum model. RESULTS: While current smoking rates were significantly higher among African Americans compared with non-Hispanic Whites across all years, cigarette consumption rates were lower among African Americans in all years. There were significant increases in the proportion of former smokers who had been quit for at least 12 months from 1999 (African Americans, 26.8% ± 5.5%; non-Hispanic Whites, 36.8% ± 1.6%) to 2008 (African Americans, 43.6% ± 4.1%; non-Hispanic Whites, 57.4% ± 2.9%). The proportion of African American former smokers in each CTS year was significantly lower than that of non-Hispanic Whites. CONCLUSIONS: Despite positive progression along the quitting continuum for both African American and non-Hispanic White smokers, the overall distribution was less favorable for African Americans. The lower smoking consumption levels among African Americans, combined with the lower rates of successful smoking cessation, suggest that cigarette addiction and the quitting process may be different for African American smokers.

Recruitment results among families contacted for an obesity prevention intervention: the Obesity Prevention Tailored for Health Study.

BACKGROUND: Overweight and obesity are serious threats to health and increase healthcare utilization and costs. The Obesity Prevention Tailored for Health (OPT) study was designed to test the effectiveness of a family-based intervention targeting diet and physical activity. We describe the results of efforts to recruit parents and children enrolled in a large managed-care organization into the OPT study. METHODS: Parents with 10- to 12-year-old children were randomly selected from the membership of Kaiser Permanente Southern California, a large integrated health plan, and contacted between June 2010 and November 2011. We describe recruitment outcomes and compare characteristics of parents and children who did and did not participate. Information was collected from calls with parents and through the administrative and electronic medical records of the health plan. RESULTS: Of the 4,730 parents contacted, 16.1% expressed interest in participation (acceptors), 28.8% declined participation (refusers), 4.7% were ineligible, and, even after multiple attempts, we were unable to reach 50.4%. Slightly less than half of the acceptors (n = 361) were ultimately randomized to receive either the OPT program plus usual care or usual care alone (7.6% of all parents initially contacted). There were not any significant differences between acceptors who were or were not randomized. Overall, we found that acceptors were more likely to be female parents, have overweight/obese children, and higher utilization of outpatient visits by parents and children compared with refusers and those we were unable to reach. We found no differences in recruitment outcomes by body mass index or comorbidity score of the parents, level of physical activity of the parents and children, education of the parents, or household income. CONCLUSIONS: Recruiting parents and children into an obesity prevention program in a healthcare setting proved to be challenging and resource-intensive. Barriers and incentives for participation in obesity prevention programs need to be identified and addressed. Concern for the weight of their children may motivate parents to participate in family-based lifestyle interventions; however, the healthcare setting may be more relevant to weight-related treatment than to primary prevention. TRIAL REGISTRATION NUMBER: ISRCTN06248443, 30 January 2014.