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The purpose of this proposal is to investigate the influence of stressful life events and social-cognitive variables on low income, at-risk women’s ability to reduce their children’s exposure to secondhand smoke (SHS). Data will be collected as part of an ongoing SHS reduction intervention in San Diego county with 120 low income mothers who have been randomized to a tobacco counseling or a usual care control condition. Primary Specific Aims: (1) to examine the influence of stressful life events, group assignment (usual care vs. counseling condition), social cognitive variables, and demographic variables on: children’s exposure to SHS, home smoking policies, and level of mother’s smoking; (2) to develop reliable and valid measures of stressful life events and home smoking policies that capture key experiences and perceptions of at-risk, low income women; (3) to formulate a tobacco policy agenda, based on the study’s findings, to guide future policy efforts in California to prevent tobacco use in at-risk, low income populations; (4) to formulate a clinical research agenda, based on the study’s findings, to guide future clinical research studies aimed at preventing and treating tobacco use in at-risk, low income women.
Participants will complete measures of stressful life events, social support, self-efficacy, home smoking policies, urine cotinine assessments, children’s exposure to SHS, tobacco use, general health behaviors (diet and physical activity) and demographics. Data will be analyzed using descriptive statistics and hierarchical multiple regression analyses. We will test the hypothesis that group condition (social cognitive theory-based tobacco counseling vs. usual care) will predict mothers’ ability to reduce their children’s exposure to SHS. We will also test the hypothesis that the effect of group condition on mothers’ abilities to reduce their children’s exposure to SHS will be enhanced when stressful life events are controlled. Results of this study will increase our understanding of the relative contribution of stressful life events and social cognitive determinants on low-income women’s ability to control their children’s exposure to SHS. Furthermore, the study will lead to a more systematic understanding of the types of life events that impact these women’s lives, which can help guide future policy and intervention efforts to help low income, at risk women who smoke. An understanding of life events that impact disenfranchised women’s smoking behavior is critical, given that smoking levels remain elevated among this group relative to the rest of the population, and that this medically underserved group is ill-equipped to cope with the significant morbidity imposed by tobacco use.
This proposal responds to several key TRDRP research priorities; namely, it focuses on tobacco control in an understudied, at-risk, low income population, it focuses on environmental factors (life events and poverty) that influence tobacco use, it will consider the impact of the findings on future California tobacco control policies, it will examine the effectiveness of an intervention to reduce children’s SHS exposure, and it will provide recommendations for future clinical research studies aimed at preventing SHS exposure. Moreover, the study will inform policy development for low income women smokers, by outlining effective clinical services that can help these women alleviate distress that occurs in the context of stressful life events. |
