CPH Alumni and Faculty Publish on Tobacco Use in Middle School Students
Dr. Daniel Owusu, alumnus of the Doctor of Public Health program in East Tennessee State University College of Public Health, has authored an article in Substance Use and Misuse. The article, “Intention to Try Tobacco Among Middle School Students in a Predominantly Rural Environment of Central Appalachia” discusses tobacco use rates and associated factors among rural youth.
Drs. Hadii Mamudu, Liang Wang, and Mary Ann Littleton are faculty co-authors. College of Public Health alumni Crystal Robertson Besse and Candice Collins along with undergraduate research assistant Holdon Guy and Nashville State Community College faculty member Rafie Boghozian are additional co-authors.
Tobacco smoking remains the leading preventable cause of morbidity and mortality in the United States. Over 36.5 million people in the U.S. continue to smoke and tobacco use accounts for over 480,000 annual deaths and about $300 billion in economic costs. Tobacco control has become complicated due to the invention and popularity of new tobacco products, including hookah/waterpipe, little cigar and cigarillos (LCCs), and electronic cigarettes (e-cigarettes). In particular, research reports show that e-cigarettes have become the most commonly used tobacco product among youth.
Disparities in tobacco use exist across regions in the United States. The Central Appalachian region carries very high rates of tobacco use prevalence but research on tobacco use initiation is sparse. The objective of this study was to investigate the intention to try tobacco and its associated factors among nonsmoking youth.
Data were obtained from 539 school-based tobacco surveys conducted in 11 middle schools (6th–8th grades; aged 10–15 years) in Northeast Tennessee in 2015–2016. Nonsmoking participants without firm commitment to abstain from trying tobacco in the next year were considered to have an intention to try tobacco. The Full Information Maximum Likelihood estimation (FIML) method in Mplus was employed to conduct a multivariable logistic regression analysis to delineate correlates of intention to try tobacco.
Overall, 20.0% of participants intended to try tobacco. Among participants with the intention to try tobacco, 53.7% owned tobacco-branded item(s), 86.1% believed that tobacco users have more friends, and 88.9% lived with tobacco users. The researchers suggest that individual, interpersonal, and community level factors influence intention to try tobacco in this environment where tobacco pre-emption laws impede development of local tobacco control policies and regulations.
A concerning proportion of the participants intend to try tobacco in the next year. Tobacco promotions and interpersonal factors are significantly associated with the intention to try tobacco. This study provides a baseline for monitoring intention to use tobacco in this high-risk population, and the results suggest the need to implement strong school-based anti-tobacco programs in the midst of tobacco preemption laws that prevent local tobacco policies and regulations.