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BackgroundTwo psychosocial constructs that have shown consistent associations with negative health outcomes are discrimination and perceived unfairness. ObjectiveThe current analyses report the effects of discrimination and unfairness on medical, psychological, and behavioral outcomes from a recent cross-sectional survey conducted in a multiethnic sample of adults in Michigan. MethodsA cross-section survey was collected using multiple approaches: community settings, telephone-listed sample, and online panel. Unfairness was assessed with a single-item previously used in the Whitehall study, and everyday discrimination was assessed with the Williams 9-item scale. Outcomes included mental health symptoms, past-month cigarette use, past-month alcohol use, past-month marijuana use, lifetime pain medication use, and self-reported medical history. ResultsA total of 2238 usable surveys were collected. In bivariate analyses, higher unfairness values were significantly associated with lower educational attainment, lower age, lower household income, and being unmarried. The highest unfairness values were observed for African American and multiracial respondents followed by Middle Eastern or North African participants. Unfairness was significantly related to worse mental health functioning, net adjustment for sociodemographic variables, and everyday discrimination. Unfairness was also related to self-reported history of depression and high blood pressure although, after including everyday discrimination in the model, only the association with depression remained significant. Unfairness was significantly related to 30-day marijuana use, 30-day cigarette use, and lifetime opiate use. ConclusionsOur findings of a generally harmful effect of perceived unfairness on health are consistent with prior studies. Perceived unfairness may be one of the psychological pathways through which discrimination negatively impacts health. Future studies examining the relationships we observed using longitudinal data and including more objective measures of behavior and health status are needed to confirm and extend our findings.

Context: Adults who live in rural areas of the United States have among the highest smoking rates in the country. Rural populations, including Appalachian adults, have been historically underserved by tobacco control programs and policies and little is known about their effectiveness. Purpose: To examine the end-of-class quit success of participants in A Tobacco Cessation Project for Disadvantaged West Virginia Communities by place of residence (rural West Virginia and the urban area of Greater Charleston). Methods: This collaborative program was implemented in 5 underserved rural counties in West Virginia and consisted of 4 intervention approaches: (1) a medical examination; (2) an 8-session educational and behavioral modification program; (3) an 8-week supply of pharmacotherapy; and (4) follow-up support group meetings. Findings: Of the 725 program participants, 385 (53.1%) had successfully quit using tobacco at the last group cessation class they attended. Participants who lived in rural West Virginia counties had a lower end-of-class quit success rate than those who lived in the urban area of Greater Charleston (unadjusted odds ratio [OR] = 0.69, 95% confidence interval [CI] = 0.48, 0.99), even after taking into account other characteristics known to influence quit success (adjusted OR = 0.58, 95% CI = 0.35, 0.94). Conclusions: Tobacco control programs in rural West Virginia would do well to build upon the positive aspects of rural life while addressing the infrastructure and economic needs of the region. End-of-class quit success may usefully be viewed as a stage on the continuum of change toward long-term quit success.

Objectives. We sought to fill gaps in knowledge of smoking behaviors among college-educated and non-college-educated young adults. Methods. We used data from the 2003 Tobacco Use Supplement of the Current Population Survey to analyze smoking behaviors among young adults aged 18-24 years and older young adults aged 25-34 years by college status (enrolled, or with a degree, but not enrolled) and other measures of socioeconomic position. Results. Current smoking prevalence among US young adults aged 18-24 years who are not enrolled in college or who do not have a college degree was 30%. This was more than twice the current smoking prevalence among college-educated young adults (14%). Non-college-educated young adults were more likely than were college-educated young adults to start smoking at a younger age and were less likely to have made a quit attempt, although no differences were found in their intentions to quit. Higher rates of smoking in the non-college-educated population were also evident in the slightly older age group. Conclusions. Non-college-educated young adults smoke at more than twice the rate of their college-educated counterparts. Targeted prevention and cessation efforts are needed for non-college-educated young adults to prevent excess morbidity and mortality in later years. (Am J Public Health. 2007;97:1427-1433. doi:10.2105/ AJPH.2006.103945)

Online data collection has become an extremely popular survey mode given its reduced cost, ease of administration, and timeliness. Although extensive research exists on the influence of e-mail invitation design characteristics to prompt survey participation, less is known about the effectiveness of e-mail reminders in prompting survey completion among nonresponders. The purpose of this study was to determine whether incorporating humor into e-mail reminders improved survey completion rates. Respondents from the Truth Initiative Young Adult Cohort (n = 2,963) who did not respond to the first standard e-mail invitation to complete their follow-up survey were randomly assigned to one of the three e-mail reminder groups: control (standard), humor only, or humor plus statistics. Those who received an initial humor plus statistics reminder e-mail received the humor only e-mail as their second reminder and vice versa. Logistic regression was used to generate the odds ratios (OR) for the probability of completing the survey after the first reminder. Results of multivariable models showed that, when collapsed together, the humor only and humor plus statistics e-mails were more effective than the control [adjusted OR (AOR) = 1.23, 95% confidence interval (CI) [1.01, 1.49], p = .05]. Receiving the humorous e-mail as the first reminder increased the odds of response to the survey by 24% (AOR = 1.24, 95% CI [1.00, 1.54], p = .04). Those entering the study at an earlier wave, nonsmokers and those living in smaller households were more likely to respond after the first reminder. A humorous reminder tailored to the voice of the audience is an easy, efficient, and effective way to increase response rates among young adults. [ABSTRACT FROM AUTHOR]