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Community and Family Context of Teen Smoking

Institution: University of California, Los Angeles
Investigator(s): Ritesh Mistry, Ph.D. M.P.A.
Award Cycle: 2008 (Cycle 17) Grant #: 17KT-0030 Award: $270,000
Subject Area: Public Health, Public Policy, and Economics
Award Type: New Investigator Awards
Abstracts

Initial Award Abstract
Teen smoking remains among the top public health challenges facing California with a recent upturn in teen smoking rates that had been declining for over a decade, and with existing wide inequities across California regions, race/ethnicity and socioeconomic status. Programs and policies to reduce teen smoking and its related disparities in California will require efforts at multiple levels designed to affect teen smoking directly as well as indirectly, by targeting the social, economic and political influences affecting them where they live and go to school.

This proposed research will examine how economic and social context of where teens live and go to school could influence teen smoking, while simultaneously analyzing the influence of family context. Detailed information about community socioeconomic status will be used. We will also examine the level of community social cohesion, which refers to strong social networks and trust between community members, the civic nature of the community and a community-focused perspective. Since the family as well as community contexts of teens powerfully influence their developmental trajectories, studies that analyze the effects of these contexts jointly are needed to gain a deeper understanding of what influences teen smoking. Family influences can represent powerful forces that strongly change the way the socioeconomic context influences teens’ establishment of a healthful lifestyle and maintenance. We will, therefore, assess community influences on teen smoking in conjunction with family influences such that we will be able to identify the types of families and parenting practices that are important to understanding how and under what conditions the community context influences teen smoking. We hypothesize that: a) positive family influences will buffer while negative family influences will exacerbate the effect of negative area-level social and economic influences; b) area-level effects on teen smoking will differ based on whether the family context includes dual parenting and parent non-smoking; c) communities that have low socioeconomic status will tend to be less socially cohesive which will in turn increase the risk of teen smoking; d) areas characterized by low socioeconomic status and social cohesion will have a greater density and closer proximity of tobacco retailers to schools and homes, which will increasing teen smoking risk; and e) adolescents living in low socioeconomic and less socially cohesive areas will be more likely to use tobacco because they would be at a greater risk of having depressive symptoms.

We will capitalize on the wealth of existing data relevant to teen smoking in California and link this information with existing data from governmental sources about community social, economic and tobacco market factors. We will produce a rich dataset to characterize California communities in terms of not only income distribution by including a variety of measures of community socioeconomic status, the level of social cohesion, as well as the density and proximity of tobacco retailers to places where teenagers live and go to school. We will analyze these data using complex statistical techniques in order to gain a better understanding of the determinants of teen smoking. The analysis will also provide valuable information about influential community social and economic factors, possible mechanisms by which these factors influence teen smoking, and will include an often ignored layer of analysis in community effects studies by incorporating the role of family context.

The lack of information about mechanisms by which contextual factors impact health and health behaviors is an important barrier to translation of finding into public health action. The information gained from this research should help guide programs and policies about where to focus efforts regionally, and identify aspects of family and communities as well as teen mental health that may be critical areas for intervention to mitigate the risk of teen smoking.
Publications

Resliience and patterns of health risk behaviors in California adolescents
Periodical: Preventive Medicine Index Medicus:
Authors: Mistry, R; McCarthy, WJ; Yancey, AK; Lu, Y; Patel, M ART
Yr: 2009 Vol: 48 Nbr: 3 Abs: Pg: 291-297

Adolescent smoking risk increases with wider income gaps between rich and poor.
Periodical: Health and Place Index Medicus:
Authors: Mistry, R; McCarthy, WJ; De Vogil, R; Crespi, CM, Wu, Q; Patek, M; ART
Yr: 2011 Vol: 17 Nbr: 1 Abs: Pg: 222-229