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Introduction Of youth experiencing homelessness (YEH; 14–24 years old), 70%+ smoke combustible, commercial tobacco. Though many have tried to quit, most use ineffective methods. Drop-in centers for YEH are opportune places to link YEH to evidence-based treatment. Using the Phase-Based Model (PBM) for Cessation Research, the aim of this study was to identify "Motivation" phase-specific challenges impacting YEH's willingness to make a quit attempt—the goal of this cessation phase. Aims and Methods Surveys were interview administered with 96 past-week combusted tobacco users accessing drop-in services. Regression models were fit to confirm hypothesized challenges impacting YEH's willingness to quit. Results Moderate nicotine dependence was noted—a key Motivation phase cessation mechanism targeted—and was associated with population challenges including, but not limited to, replacing food with tobacco, accidental oxygen-deprivation events, and smoking to socialize. While 67.1% of participants made a past-year quit attempt, 45.8% expressed 30-day quit interest. Dimensions of coping with housing were associated with quit attempts and quit interest. Quit attempts were also associated with nicotine dependence, working, and smoking to socialize. Whereas, quit interest was associated with less endorsement of smoking to regulate affect and more endorsement to avoid danger. Conclusions Though common challenges targeted in Motivation phase cessation exist among YEH, other challenges may also need to be addressed to promote quitting. Implications Future research in optimizing evidence-based cessation access for YEH through drop-in centers may consider addressing the challenges of housing, food security, social context, violence, and neurotrauma sequela to bolster YEH willingness to make a quit attempt. [ABSTRACT FROM AUTHOR]

INTRODUCTION E-cigarette use is disparately high among sexual minoritized populations. As e-cigarette advertising may influence product appeal, this study tested sexual orientation- and gender-based differences in response to e-cigarette advertisement exposure on advertisement perceptions and product appeal. METHODS We recruited 497 adults (mean age=31.9 years, 45.1% women, 54.3% heterosexual, 71.2% Non-Hispanic White) living in the United States via the crowdsourcing platform Prolific. Participants viewed two randomly selected e-cigarette advertisements (from n=173 advertisements). Post-exposure, participants rated the perceived advertisement effectiveness, relevance, and product use intention. Associations between sexual orientation and outcomes were estimated using multivariable linear mixed-effects models. We tested interaction effects between sexual orientation, gender, and advertisement feature (e.g. presence of humans, flavors, and product packaging), and ran Tukey post hoc tests for pairwise comparisons. RESULTS Post-exposure, heterosexual women, sexual minoritized men, and sexual minoritized women (reference group: heterosexual men) rated perceived advertisement effectiveness and relevance lower after viewing advertisements featuring flavors (vs no flavors; all p<0.001). Sexual minoritized men and sexual minoritized women rated perceived advertisement relevance lower after viewing advertisements featuring humans (all p<0.001) or fruit (all p<0.001). Heterosexual women, sexual minoritized men, and sexual minoritized women reported lower product use intention after viewing advertisements featuring an e-liquid bottle (vs no e-liquid bottle; all p<0.05). CONCLUSIONS Sexual minoritized women and men reported lower e-cigarette advertisement appeal and product use intentions than heterosexual men. More evidence is needed to understand advertisement perceptions and product appeal in this group to inform e-cigarette advertising regulations and anti-tobacco messaging campaigns that aim to reduce tobacco-related health inequities. [ABSTRACT FROM AUTHOR]

Background: The prevalence of e-cigarette use among young people remains high. Young people are susceptible to e-cigarette advertising, although potential heterogeneity in perceptions of e-cigarette ads with respect to age and e-cigarette use history remains unexplored. We aimed to assess differences in perceptions of e-cigarette ads and product use intention, by age and e-cigarette use status. Methods: Participants from an online convenience sample (N = 497, Mage=31.9) viewed two randomly selected e-cigarette ads and reported their perceptions of the ads and product use intention. We used mixed effects linear regression models to estimate associations between age group (18–20 years, 21–25 years, 26+ years), e-cigarette use status (never, former, and current use), and their interaction effects, on outcomes related to perceptions of ads and use intention. Models controlled for demographics and other tobacco use. Results: Current e-cigarette users (vs. never users) and participants who were 26+ years old (vs. 18–20 years old) had greater liking of the ads, perceived ad relevance, and perceived ad effectiveness. Among current e-cigarette users, participants who were 26+ years old (vs. 18–20 years old) had lower use intention. Conclusion: The effect of e-cigarette ad exposures on perceptions of the ad and use intention is heterogeneous with respect to age group and e-cigarette use history. While ads appealed more to adults who were 26+ years old across e-cigarette use groups, current e-cigarette users who were 18–20 years old demonstrated high use intention following ad exposure, suggesting a need for marketing interventions to mitigate continued e-cigarette use among young people. [ABSTRACT FROM AUTHOR]

Introduction: Approximately 70% of youth experiencing homelessness smoke cigarettes; many try to quit and are interested in formal smoking cessation programs. The purpose of this study was to describe the intrapersonal, social, and environmental contexts associated with the most recent smoking experience among youth experiencing homelessness and (2) identify differences in contextual factors by age and willingness to quit.Methods: Thirty-six youth experiencing homelessness aged 14-24 years and who reported current smoking were recruited from a drop-in center in a Midwestern city. Semi-structured in-person interviews were analyzed to understand smoking behaviors.Results: Two-thirds of participants reported stress and nicotine dependence as primary reasons for smoking, and older youth (aged 18-24 years) reported smoking to de-escalate negative emotions associated with stressful events. For 25% of participants, and especially older youth, smoking was described as part of a routine. Over 80% of participants smoked outside at the homeless drop-in center or the places they lived. Social prompts from drop-in center peers regularly preempted smoking. Younger youth (aged 14-17 years) reported smoking socially while older youth were more likely to smoke alone.Conclusions: For youth experiencing homelessness, smoking is integrated into daily life and is often used to manage stress associated with homelessness and engage socially with homeless peers. Multicomponent interventions to reduce structural stressors specific to homelessness, change social smoking norms (environmental and social context), and address stress management and nicotine dependence (intrapersonal context) are needed to support smoking cessation among youth experiencing homelessness.Implications: Youth experiencing homelessness overwhelmingly described how daily stressors associated with homelessness and nicotine dependence preceded recent smoking. Older youth (aged 18-24 years) also reported smoking as "routine", which likely underscores nicotine dependence in this group. Younger youth (aged 14-17 years) described social smoking. Researchers must develop optimized multilevel interventions to support youth experiencing homelessness who want to quit smoking. Interventions directly targeting social determinants of stress (e.g., poverty, housing instability, food insecurity) and linkages to supportive services are needed. Complementary strategies to address stress coping and nicotine dependence (intrapersonal context) and social smoking norms (social and environmental context) are also necessitated. [ABSTRACT FROM AUTHOR]

Objectives Most evidence concerning aging ignores women's sexual orientation, yet sexual orientation-related discrimination across the life course may influence older lesbian and bisexual women's risk for poorer health. Understanding aging-well in this group is vital to development, testing, and implementation of evidence-based health promotion programming and services for aging sexual minority women. Method Data were from the Women's Health Initiative (N = 15,691; heterosexual n = 15,002, lesbian n = 440, bisexual n = 249) extension study. Multivariable linear and logistic regression tested associations between sexual orientation and indicators of successful, effective, and optimal aging-well in age-stratified groups of women (60–74 and 75+). Results Lesbians aged 60–74 were more likely (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.16, 2.18) to report good self-mastery, more social support (b = 2.92, 95% CI, 1.99, 3.85), and greater likelihood of enjoying life (OR 1.46, 95% CI 1.06, 2.01) compared with heterosexual women. Bisexual women aged 75+ reported increased personal growth (b = 1.09, 95% CI 0.23, 1.95) compared to heterosexuals. While lesbians aged 75+ had greater likelihood of living in a nursing home (OR 1.96; 95% CI 1.01, 3.82) and were less likely to be happy at least most of the time (OR 0.68, 95% CI 0.49, 0.99), they reported greater self-mastery (OR 1.55; 95% CI 1.06, 2.26) than their heterosexual peers. Discussion Aging-well is not the same for all women. Health promotion programs may consider maximizing sexual minority women's internal and external resources—including social supports, self-mastery, and personal growth—to promote wellness in older age. [ABSTRACT FROM AUTHOR]

Purpose: We examined how perceived stress and social support were associated with changes in health behaviors during the COVID-19 pandemic among sexual minoritized women (SMW)., Methods: In an online convenience sample of SMW ( N  = 501, M age  = 23.6), we used multinomial logistic regression models to estimate associations of perceived stress and social support (emotional, material, virtual, in-person) with self-reported changes (increased or decreased vs. no change) in fruit and vegetable intake, physical activity, sleep, tobacco, alcohol, and substance use during the pandemic. We also tested whether social support modified associations between perceived stress and changes in health behaviors. Models controlled for sexual orientation, age, race and ethnicity, and income., Results: Perceived stress and social support were associated with changes in health and risk behaviors. Specifically, increased perceived stress was associated with decrease (odds ratio [OR] = 1.20, p  = 0.01) and increase (OR = 1.12, p  = 0.04) in fruit and vegetable intake, and increase in substance use (OR = 1.19, p  = 0.04). Receiving in-person social support was associated with changes in decrease (OR = 10.10, p  < 0.001) and increase (OR = 7.35, p  < 0.01) in combustible tobacco use and increase in alcohol use (OR = 2.63, p  = 0.01). Among SMW who never received material social support during the pandemic, increased perceived stress was associated with increased alcohol use (OR = 1.25, p  < 0.01)., Conclusions: Perceived stress and social support were associated with SMW's health behavior changes during the pandemic. Future research may explore interventions to mitigate the effects of perceived stress and appropriately increase social support to promote health equity among SMW., Competing Interests: The authors report no conflict of interest., (© Donghee N. Lee et al., 2022; Published by Mary Ann Liebert, Inc.)

Competing Interests: Disclosures: The authors have no relevant financial disclosures or conflicts of interest.