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IntroductionLesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals use tobacco at disproportionately high rates but are as likely as straight tobacco users to want to quit and to use quitlines. Little is known about the demographics and geographic distribution of LGBTQ quitline participants, their engagement with services, or their long-term outcomes.Aims and methodsCalifornians (N = 333 429) who enrolled in a statewide quitline 2010-2022 were asked about their sexual and gender minority (SGM) status and other baseline characteristics. All were offered telephone counseling. A subset (n = 19 431) was followed up at seven months. Data were analyzed in 2023 by SGM status (LGBTQ vs. straight) and county type (rural vs. urban).ResultsOverall, 7.0% of participants were LGBTQ, including 7.4% and 5.4% of urban and rural participants, respectively. LGBTQ participants were younger than straight participants but had similar cigarette consumption. Fewer LGBTQ participants reported a physical health condition (42.1% vs. 48.4%) but more reported a behavioral health condition (71.1% vs. 54.5%; both p's < .001). Among both LGBTQ and straight participants, nearly 9 in 10 chose counseling and both groups completed nearly three sessions on average. The groups had equivalent 30-day abstinence rates (24.5% vs. 23.2%; p = .263). Similar patterns were seen in urban and rural subgroups.ConclusionsLGBTQ tobacco users engaged with and appeared to benefit from a statewide quitline even though it was not LGBTQ community-based. A quitline with staff trained in LGBTQ cultural competence can help address the high prevalence of tobacco use in the LGBTQ community and reach members wherever they live.ImplicationsThis study describes how participants of a statewide tobacco quitline broke down by sexual orientation and gender. It compares participants both by SGM status and by type of county to provide a more complete picture of quitline participation both in urban areas where LGBTQ community-based cessation programs may exist and in rural areas where they generally do not. To our knowledge, it is the first study to compare LGBTQ and straight participants on their use of quitline services and quitting aids, satisfaction with services received, and rates of attempting quitting and achieving prolonged abstinence from smoking.

Youth vaping is a concern and schools may use many approaches to discipline students caught vaping at school. This study identified the prevalence of school staff seeing vaping in schools and the measures used to discipline students. A state-wide sample of 7,938 staff from 255 middle and high schools reported whether they saw any students vaping at school in the last 30 days, whether they have caught any students vaping during class in the last semester, and what happened after catching a student vaping in class. Open-text responses were coded and themes were identified related to disciplinary approaches. 31.9% of staff reported seeing students vaping at school, and 11.9% of teachers reported catching a student vaping during class. Teachers described four categories of disciplinary approaches after catching students vaping in class: no consequences, punitive approaches, restorative approaches, and mixed approaches. Additional support is necessary to help schools address student vaping.

IntroductionThe objective of this study was to examine access, engagement, and quitting behaviors of American Indian/Alaska Native (AIAN) callers to the California Smokers' Helpline. Telephone counseling is the primary function of the quitline. The overarching theoretical framework for California's quitline is social cognitive theory, although it also utilizes motivational interviewing and cognitive-behavioral strategies.Aims and methodsAIAN (n = 16 089) and White (n = 173 425) California quitline callers from 2009 to 2018 were compared on their characteristics, engagement, and quitting behaviors. Quitline callers responded to a telephone survey at intake. A random selection was called for evaluation 7 months later (White n = 8194, AIAN n = 764). Data from the 2009 to 2017 California Health Interview Survey (CHIS) were used as a reference point for AIANs (AIAN n = 1373).ResultsThe quitline and CHIS had similar proportions of AIANs (4.6% vs. 4.3%, respectively). AIAN smokers were more likely than White smokers to report physical (53.6% vs. 44.9%) and mental (65.7% vs. 57.8%) health conditions at intake. AIANs were more likely to participate in counseling than White callers (67.1% vs. 65.7%). Among those who received counseling, AIANs had greater odds than White smokers of making a quit attempt (adjusted odds ratio = 1.39 [1.06, 1.81]) and similar odds of quitting for 180 days (adjusted odds ratio = 0.95 [0.69, 1.31]).ConclusionsRates of access, engagement, and quitting suggest that individualized quitline counseling was as effective with AIANs as it was with White smokers. Increasing efforts to refer AIANs to existing state quitlines can help more smokers quit.ImplicationsThis study showed that AIAN smokers were well represented among California quitline callers, even without a targeted campaign. It also found that AIAN smokers engaged in quitline services and were as able to quit as their White counterparts were, even after adjusting for other baseline characteristics. One implication is that public health programs can promote quitlines using broad-based campaigns knowing that they will still motivate AIAN smokers to seek help. Another implication is that a standard, individualized counseling protocol delivered by culturally competent quitline staff can effectively help AIAN smokers to quit.

BackgroundUrban trails are a useful resource to promote physical activity. This study identified features of urban trails that correlated with trail use.MethodsMultiuse urban trails were selected in Chicago, Dallas, and Los Angeles. An audit of each trail was completed using the Systematic Pedestrian and Cyclist Environmental Scan for Trails instrument, identifying built environmental features. A self-report of trail use was obtained from trailside residents (N = 331) living within 1 mile of each trail. Univariate and multivariate Poisson regressions controlled for trail time from home and motivation for physical activity.ResultsPositive associations with the past month's hours on the trail were observed for the presence of distance signs, vegetation height, vegetation maintenance, and trail crowding, and a negative association was observed for the presence of crossings on the trail. Positive associations with dichotomous trail use were observed for the presence of distance signs, vegetation height, and vegetation maintenance, and a negative association was observed for the presence of crossings on the trail.ConclusionsThese correlates should be confirmed in other studies and, if supported, should be considered in the promotion and design of urban trails.

INTRODUCTION:We reviewed research literature on pro-tobacco marketing and anti-tobacco campaigns targeting eight vulnerable populations to determine key findings and research gaps. Results can inform tobacco policy and control efforts and the design of public education campaigns for these groups. METHODS:Five journal databases in medicine, communication, and science, were used to identify 8875 peer-reviewed, original articles in English, published in the period 2004-2018. There were 144 articles that met inclusion criteria on pro-tobacco marketing or anti-tobacco campaigns aimed at eight US groups: women of reproductive age, racial/ethnic minority groups (African American, Hispanic/Latino, Asian/Pacific Islander and American Indian/Alaska Native), Lesbian/Gay/Bisexual/Transgender (LGBT) populations, groups with low socioeconomic status, rural/inner city residents, military/veterans, and people with mental health or medical co-morbidities. We summarized the number of articles for each population, type of tobacco, and pro-tobacco or anti-tobacco focus. Narrative summaries were organized by population and by pro-tobacco or anti-tobacco focus, with key strategies and gaps by group. RESULTS:There were more studies on pro-tobacco marketing rather than anti-tobacco campaigns, and on cigarettes rather than other tobacco products. Major gaps included studies on Asian Americans, American Indian/Alaska Natives, pregnant women, LGBT populations, and those with mental health or medical co-morbidities. Gaps related to tobacco products were found for hookah, snus, and pipe/roll-your-own tobacco in the pro-tobacco studies, and for all products except cigarettes in anti-tobacco studies. Common tobacco industry methods used were tailoring of product and package design and messages that were used to reach and appeal to different sociodemographic groups. Studies varied by research design making it difficult to compare results. CONCLUSIONS:We found major research gaps for specific groups and tobacco products. Public education campaigns need a stronger foundation in empirical studies focused on these populations. Research and practice would benefit from studies that permit comparisons across studies.

IntroductionThe California Stop Tobacco Access to Kids Enforcement (STAKE) Act requires licensed tobacco retailers to post minimum age-of-sale signage at the point of sale. This study investigated STAKE Act compliance in licensed tobacco retailers across four racial/ethnic communities in Southern California.MethodsThe sample consisted of 675 licensed tobacco retailers (excluding chain store supermarkets and pharmacies) randomly selected based on zip codes from predominantly non-Hispanic White (n=196), African American (n=193), Hispanic/Latino (n=186), and Korean American (n=100) communities. A protocol for assessing signage was completed at each store by community health workers (promotoras de salud). The law changed from a minimum age of 18 to 21 years (Tobacco 21) during data collection, as of 9 June 2016. Differences in signage compliance were evaluated before and after changes in the State law.ResultsOverall, 45% of the stores were compliant with posting the required age-of-sale signage (which varied in minimum age by date of collection); 14% of stores did not have any store interior age-of-sale signs, and 41% of stores had some type of age-of-sale sign but were not compliant with the STAKE Act (e.g. 29.5% of the stores had non-compliant tobacco industry We Card signs but not STAKE Act signs). Stores observed after the 2016 implementation of Tobacco 21 had significantly lower STAKE Act signage compliance rates (38.6%) compared to stores observed before the change in the State law (70.9%) (z=6.8623, p

IntroductionThe California Stop Tobacco Access to Kids Enforcement (STAKE) Act requires licensed tobacco retailers to post minimum age-of-sale signage at the point of sale. This study investigated STAKE Act compliance in licensed tobacco retailers across four racial/ethnic communities in Southern California.MethodsThe sample consisted of 675 licensed tobacco retailers (excluding chain store supermarkets and pharmacies) randomly selected based on zip codes from predominantly non-Hispanic White (n=196), African American (n=193), Hispanic/Latino (n=186), and Korean American (n=100) communities. A protocol for assessing signage was completed at each store by community health workers (promotoras de salud). The law changed from a minimum age of 18 to 21 years (Tobacco 21) during data collection, as of 9 June 2016. Differences in signage compliance were evaluated before and after changes in the State law.ResultsOverall, 45% of the stores were compliant with posting the required age-of-sale signage (which varied in minimum age by date of collection); 14% of stores did not have any store interior age-of-sale signs, and 41% of stores had some type of age-of-sale sign but were not compliant with the STAKE Act (e.g. 29.5% of the stores had non-compliant tobacco industry We Card signs but not STAKE Act signs). Stores observed after the 2016 implementation of Tobacco 21 had significantly lower STAKE Act signage compliance rates (38.6%) compared to stores observed before the change in the State law (70.9%) (z=6.8623, p

Youth vaping is a concern and schools may use many approaches to discipline students caught vaping at school. This study identified the prevalence of school staff seeing vaping in schools and the measures used to discipline students. A state-wide sample of 7,938 staff from 255 middle and high schools reported whether they saw any students vaping at school in the last 30 days, whether they have caught any students vaping during class in the last semester, and what happened after catching a student vaping in class. Open-text responses were coded and themes were identified related to disciplinary approaches. 31.9% of staff reported seeing students vaping at school, and 11.9% of teachers reported catching a student vaping during class. Teachers described four categories of disciplinary approaches after catching students vaping in class: no consequences, punitive approaches, restorative approaches, and mixed approaches. Additional support is necessary to help schools address student vaping. [ABSTRACT FROM AUTHOR]

Background: Non-Hispanic American Indians and Alaska Natives (NH AI/AN) have the highest commercial tobacco use (CTU) among U.S. racial/ethnic groups. Tobacco marketing is a risk factor, however few studies examine it among NH AI/AN. Objective: We identified prevalence of tobacco industry marketing exposure and correlates of CTU among NH AI/AN compared to other racial/ethnic groups. Methods: Data were from wave 1 (2013–2014; N = 32,320) of the Population Assessment of Tobacco and Health Study, analyzing self-reported exposure to tobacco ads from stores, tobacco package displays, direct mail and email marketing. Correlates of CTU were identified and interactions between racial/ethnic groups and tobacco marketing were assessed. Results: NH AI/AN (n = 955) had a higher prevalence of exposure to retail tobacco ads (64.5% vs 59.3%; p < 0.05), mail (20.2% vs.14.3%; p < 0.001) and email (17.0% vs.10.6%; p < 0.001) marketing than NH Whites (n = 19,297). Adjusting for tobacco use and related risk factors, exposure to email marketing remained higher among NH AI/AN than NH Whites. Interactions between racial/ethnic groups and marketing exposures on CTU were nonsignificant. CTU was higher among NH AI/AN than NH Whites and among adults who reported exposure to tobacco ads, mail, and email marketing. Conclusions/importance: There is higher tobacco marketing exposure in stores and via mail for NH AI/AN. Email marketing exposure was higher, even after controlling for tobacco-related risk factors. The tobacco industry may be targeting NH AI/AN through emails, which include coupons and other marketing promotions. Culturally relevant strategies that counter-act tobacco industry direct marketing tactics are needed to reduce disparities in this population. [ABSTRACT FROM AUTHOR]

The current experimental study assessed the utility, and potential harm, of depression public service announcements (D-PSAs) that were matched, moderately matched, or mismatched based on attitude function (i.e., social-adjustive or object-appraisal) and either one-sided or refutational two-sided. US adults (N = 567) with mild to severe depressive symptomatology were randomly assigned to view control messages or one set of D-PSAs. Results indicate that functionally matched D-PSAs, regardless of message sidedness, caused more favorable help-seeking outcome expectations, attitudes, and intentions compared to the control messages. Exposure to the mismatched D-PSAs, particularly refutational, led to less-favorable help-seeking outcome expectations, attitudes, and intentions compared with the control condition. Help-seeking outcomes among those exposed to the moderately matched messages were not significantly different from those exposed to the control messages, with the exception of those exposed to the one-sided moderately matched messages. The one-sided moderately matched messages resulted in lower help-seeking intentions than the control messages. Overall, results indicate that if messages can be tailored to match the recipients' attitude functions, help-seeking outcomes among people with heightened depressive symptomatology can be increased. However, the results also indicate that some D-PSAs can have negative effects. [ABSTRACT FROM AUTHOR]

Campaigns seeking to help people with depression can be effective, but they can also backfire. Psychological reactance is proposed as a partial explanation. Two experimental studies examined the effect of two depression messages (i.e., autonomy-supportive language, controlling language) for participants (n = 2027,n = 777) with varying levels of depressive symptomatology. For Study 1, two versions of a print public service announcement about seeking help for depression served as the experimental stimulus. Study 2 used an existing video public service announcement about seeking help for depression, but the text was altered to create the two conditions. In both studies, increased depressive symptomatology was associated with reduced help-seeking attitudes and intentions, as well as greater state reactance to a public service announcement about depression. Increased state reactance mediated the relationship between increased depressive symptomology and unfavorable help-seeking outcomes. Further, across the two studies, participants with high levels of depressive symptomatology who were exposed to the autonomy-supportive language ad reported either as much, or more, state reactance than participants with high levels of depressive symptomatology who were in the control condition. These results warn that language perceived as autonomy-supportive by people without depression might be perceived as controlling among people with depression. [ABSTRACT FROM PUBLISHER]

Differences on expectancies and self-efficacy between college females who engage in heavy episodic drinking (HED) and non-HED were examined. Students ( N = 95) from Southern California filled out the Comprehensive Effects of Alcohol, Cognitive Appraisal of Risky Events, and Drinking Context Convivial Drinking scales as well as self-efficacy, alcohol use, and demographic items in the fall semester of 2008. Logistic and linear regression showed that greater positive expectancies and lower self-efficacy were predictive of categorization as HED and greater convivial drinking. Implications, limitations, and directions for future research are discussed. [ABSTRACT FROM AUTHOR]