{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T01:42:45Z","timestamp":1768009365581,"version":"3.49.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T00:00:00Z","timestamp":1650067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute of Minority Health and Health Disparities","doi-asserted-by":"crossref","award":["1R01MD013338-01"],"award-info":[{"award-number":["1R01MD013338-01"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]},{"name":"United States Government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The present study examines the contributions of individual-level health determinants on young adult tobacco use initiation to improve understanding of racial and ethnic distinctions and to inform effective tobacco prevention strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using time-to-event analyses, the 10\u2013wave (2011\u20132016) Truth Initiative Young Adult Cohort, a probability-based, nationally representative sample of the US young adults aged 18\u201334 years (N = 7 665), provides data to examine differences in variables that influence tobacco uptake, by race and ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among Non\u2013Hispanic White young adults, having fewer peers who smoke cigarettes is protective against any tobacco initiation, whereas hazard of tobacco initiation increases for males, having low confidence to resist smoking, and having higher proclivity for sensation seeking. Depressive and anxiety symptoms increase uptake hazard most in the Non\u2013Hispanic All Other Races group and least among Non\u2013Hispanic Black individuals. Among Hispanic young adults, being female and perceiving tobacco as harmful are notably protective while being male is a notable uptake hazard. Unlike other groups, higher income levels do not lower hazards among Hispanic individuals. Cannabis use and overestimating the smoking rate among peers increase hazard least among Hispanic individuals. In the Non\u2013Hispanic All Other Races group, aging is least protective; hazard increases notably if individuals engage in regular alcohol or cannabis use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Tobacco prevention efforts are critical during young adulthood. Specific tobacco uptake hazard and protective factors exist by race and ethnicity and should be considered when developing selective young adult prevention, particularly among groups with the highest risk for tobacco initiation during this life stage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications<\/jats:title><jats:p>Rising rates of tobacco initiation among the US young adults necessitate expanded efforts to prevent tobacco use initiation and progression beyond youth. Results highlight nuanced and differential tobacco uptake hazards by race and ethnicity for late initiation and sustained non\u2013tobacco use among young adults. The study confirms existing evidence on tobacco use patterns and contributes to new knowledge on risk and protective factors. Tobacco prevention and control interventions, including policies, tailored in more meaningful ways could reduce tobacco use disparities among those most disproportionately affected.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ntr\/ntac106","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T11:14:40Z","timestamp":1649934880000},"page":"1487-1497","source":"Crossref","is-referenced-by-count":4,"title":["Individual Health Determinants That Predict Low Risk of Transitioning to Tobacco Use During Young Adulthood: An In-Depth Examination of Race and Ethnicity"],"prefix":"10.1093","volume":"24","author":[{"given":"Kimberly","family":"Horn","sequence":"first","affiliation":[{"name":"Virginia Tech-Carilion Fralin Biomedical Research Institute , Virginia Tech, Roanoke, VA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Crandell","sequence":"additional","affiliation":[{"name":"Center for Biostatistics and Health Data Science , Virginia Tech, Roanoke, VA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minal","family":"Patel","sequence":"additional","affiliation":[{"name":"Schroeder Institute, Truth Initiative , Washington DC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4200-1197","authenticated-orcid":false,"given":"Shyanika W","family":"Rose","sequence":"additional","affiliation":[{"name":"Department of Behavioral Science and Center for Health Equity Transformation, College of Medicine, University of Kentucky , Lexington, KY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Schillo","sequence":"additional","affiliation":[{"name":"Schroeder Institute, Truth Initiative , Washington DC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanell","family":"Folger","sequence":"additional","affiliation":[{"name":"Schroeder Institute, Truth Initiative , Washington DC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra","family":"Bernat","sequence":"additional","affiliation":[{"name":"The George Washington University, Department of Epidemiology, Milken Institute School of Public Health , Washington DC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4642-9606","authenticated-orcid":false,"given":"Steve","family":"Branstetter","sequence":"additional","affiliation":[{"name":"The Pennsylvania State University, Department of Bio-behavioral Science, College of Health , State College, PA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,4,16]]},"reference":[{"issue":"10","key":"2022080616595063600_CIT0001","doi-asserted-by":"crossref","first-page":"e2019022","DOI":"10.1001\/jamanetworkopen.2020.19022","article-title":"Trends in the age of cigarette smoking initiation among young adults in the US from 2002 to 2018.","volume":"3","author":"Barrington-Trimis","year":"2020","journal-title":"JAMA Netw."},{"key":"2022080616595063600_CIT0002","volume-title":"Investing in the Health and Well-Being of Young Adults","author":"Bonnie","year":"2014"},{"issue":"8","key":"2022080616595063600_CIT0003","doi-asserted-by":"crossref","first-page":"e0200827","DOI":"10.1371\/journal.pone.0200827","article-title":"Patterns in first and daily cigarette initiation among youth and young adults from 2002 to 2015.","volume":"13","author":"Cantrell","year":"2018","journal-title":"PLoS One."},{"issue":"46","key":"2022080616595063600_CIT0004","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.15585\/mmwr.mm6946a4","article-title":"Tobacco product use among adults \u2014 United States, 2019.","volume":"69","author":"Cornelius","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"39","key":"2022080616595063600_CIT0005","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.15585\/mmwr.mm7039a4","article-title":"Notes from the field: E-cigarette use among middle and high school students \u2014 National Youth Tobacco Survey, United States, 2021.","volume":"70","author":"Park-Lee","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"10","key":"2022080616595063600_CIT0006","doi-asserted-by":"crossref","first-page":"e1913804","DOI":"10.1001\/jamanetworkopen.2019.13804","article-title":"Association of flavored tobacco use with tobacco initiation and subsequent use among US youth and adults, 2013-2015.","volume":"2","author":"Villanti","year":"2019","journal-title":"JAMA Netw."},{"key":"2022080616595063600_CIT0007","volume-title":"Investing in the Health and Well-Being of Young Adults","author":"Committee on Improving the Health, Safety, and Well-Being of Young Adults; 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