Transdisciplinary Tobacco Use Research Center

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Preventing Tobacco Use Across Cultures
Principal Investigator: Dr. C. Anderson Johnson

This project investigates the cultural, social, psychological and environmental factors affecting tobacco use and prevention among youth in California, Hawaii and Wuhan, China with the goal of informing the development and testing of our culturally tailored smoking prevention curricula.

The California trial is an extension of a study funded by the Tobacco-Related Disease Research Program (University of California) already underway with 3,500 predominantly Hispanic/Latino and Asian-American immigrant middle school students.

We will deliver three years of a social normative, culturally tailored smoking prevention program and conduct annual surveys to track smoking beliefs, attitudes, uptake and progression, and relate uptake and program effectiveness to various dimensions of culture and acculturation in our student cohort from 6th through 10th grade.

The Hawaii study will build upon what we learn with our California cohort. We will modify the curriculum that we develop for California youth and tailor it to the unique characteristics of multicultural Hawaii youth. We will focus on youth in the more rural areas of Hawaii, particularly on the outer islands, where smoking prevalence is highest.

Our Wuhan, China study assesses the effect of a social normative program developed for Western youth in a relatively homogeneous, indigenous Chinese population (95% Han) of adolescents.

Because of the strong pro-smoking norms in China and relatively low but growing levels of Western influence in this central China city, this trial will provide a rigorous test of the cultural universality of a Western-based prevention program. The measures are the same, and mirror the experimental design of the California trial.

Role of Cultural Values in Adolescent Smoking
Principal Investigator: Dr. Jennifer B. Unger

Little is known about how cultural values influence adolescents’ decisions about smoking. A better understanding of the role of cultural values in adolescent smoking could lead to the development of smoking prevention interventions to teach adolescents ways to remain true to the values of their cultures without resorting to unhealthy behaviors such as smoking.

This cross-cultural study will investigate the role of cultural values in the smoking uptake process. The study will analyze longitudinal data from two ongoing studies: a multicultural sample of adolescents in California and a sample of Chinese adolescents in Wuhan, China. Both of these data sources will include longitudinal data from initial cohorts of 7th grade students, and both datasets will include assessments of cultural values and smoking behavior.

This study will determine which cultural values are associated with the risk of smoking initiation, occasional smoking and/or progression to established smoking among adolescents in these two specific countries, and it will determine whether these associations are consistent across cultures or culture-specific.

Specific goals of the study are to include a Multiethnic Cultural Values Scale, along with measures of smoking behavior, in ongoing longitudinal surveys of adolescents in California and Wuhan, China, and to conduct statistical analyses to determine how cultural values increase or decrease the risk of smoking in these two groups of adolescents.

Smoking Progression Among Culturally Diverse Youth
Principal Investigators: Dr. Xinguang Chen & Dr. Jennifer B. Unger

Despite nationwide antismoking efforts and a gradual decline in youth smoking nationally, cigarette smoking has actually increased among certain groups of ethnically diverse adolescents in the U.S.

Although numerous studies and tobacco control programs have focused on certain aspects of cigarette smoking among adolescents, the process by which adolescents progress from never smokers to susceptible nonsmokers, smoking experimenters and regular smokers has not been sufficiently investigated.

Vast differences between smoking rates in ethnically and culturally diverse populations suggest the importance of considering acculturation, media and social influences in smoking acquisition.

With longitudinal data from two cohorts of 7th graders -- 12,500 from California, a state with the most ethnically diverse population in the United States, and 5,000 from Wuhan, China, an industrial city in central China populated by 7 million ethnic Han -- this project seeks to understand the progression process of cigarette smoking in adolescents across culture and ethnicity.

With a cross-cultural and transdisciplinary approach, the progression from the never smokers to susceptible nonsmokers to smoking experimenters and, finally, to regular smokers including addicted and chipper smokers will be examined.

In addition to pro-tobacco media, social influences Parents and peers) and the role of acculturation in predicting smoking progression will be examined in detail. Cross-ethnicity, cross-country and cross-gender analyses will also be conducted. The findings from this project will facilitate the development of effective anti-smoking interventions geared toward our increasingly multicultural society.

Countering Tobacco Advertising in Diverse Populations

Principal Investigator: Dr. Tess Boley Cruz

Phase One of this study is designed to examine the independent and interactive effects of pro- and anti-tobacco media exposure on tobacco-related outcomes in diverse groups of adolescents and adults in California.

Data will be drawn from the California Independent Evaluation in-school surveys of approximately 40,000 adolescents and phone surveys of approximately 20,000 adults to explore the roles of ethnicity and acculturation in the exposure-outcome relationships and to determine whether there are stronger or weaker relationships among certain populations.

In this phase, we will identify specific ethnic, gender, acculturation level and age-specific groups that are more or less responsive to pro- and anti-tobacco media and potential moderators of outcomes in these groups.

In Phase Two, using the information obtained from Phase One, we will develop culturally grounded educational materials that can be used to inoculate youth and adult groups at highest risk to the effects of tobacco marketing.

Next, we will conduct an experimental trial to determine whether these culturally relevant media materials are more effective in influencing tobacco-related attitudes and behaviors among difficult-to-reach groups than the general-audience media materials.

Collaborative Intramural Project -
NIEHS Gene/Environment Interactions in Smoking Related Respiratory Symptoms
Principal Investigator: Dr. Stephanie London

Little is known about the respiratory health of children in China. At least 60% of Chinese men are smokers, nearly twice the rate of U.S. males. A recent survey of smoking habits among middle school students in Wuhan, China indicates an alarmingly high rate of exposure to environmental tobacco smoke in the home as well as personal smoking.

This project examines the relationship between exposure to tobacco and environmental smoke and childhood respiratory symptoms and illness. In particular, we will study the extent to which the risk of asthma, wheezing, and chronic cough are increased by in-utero exposure to tobacco smoke and exposure to environmental tobacco smoke in the first three years of life as well as during later childhood and adolescence.

We will also evaluate gene-environment interaction with respect to smoking and the risk of respiratory illness. Our study cohort will consist of 5,000 7th grade students in Wuhan, China.