A Multi-Method Exploration of the Genetic and Environmental Risks Contributing to Tobacco Use Behaviors in Young Adulthood

Tobacco use remains the leading preventable cause of morbidity and mortality in both the United States and worldwide. Twin and family studies have demonstrated that both genetic and environmental factors are important contributors to tobacco use behaviors. Understanding how genes, the environment, and their interactions is critical to the development of public health interventions that focus on the reduction of tobacco related morbidity and mortality. However, few studies have examined the transition from adolescent to young adulthood – the time when many individuals are experimenting with and developing patterns of tobacco use. This dissertation thesis seeks to provide a comprehensive set of studies looking at risk for tobacco use behaviors and nicotine dependence using samples of young adults. The first aim is to examine the joint contributions of genetic liability and environmental contexts on tobacco use in adolescence and young adulthood using classical twin study methodologies. The second goal is to identify genetic variants and quantifying genetic risk for tobacco use in young adulthood and examining their interaction with environmental context across development. Accordingly, the thesis is divided up into the following sections: i) reviews of existing literature on genes, environment, and tobacco use; ii) twin studies of genetic and environmental influences on tobacco use behavior phenotypes; iii) prevalence, correlates, and predictors of tobacco use behaviors; iv) genetic analyses of tobacco use behaviors; v) a commentary on the emergence of alternative nicotine delivery systems and its public health impacts; and vi) plans for an internet-based educational intervention seeking to reduce tobacco use (and nicotine dependence) by providing students attending university with information on genetic and environmental risk factors for nicotine dependence

Social Determinants of Smoke Exposure During Pregnancy: Findings From Waves 1 & 2 of the Population Assessment of Tobacco and Health (PATH) Study

Maternal smoking during pregnancy (MSDP) and secondhand smoke (SHS) exposure are associated with a myriad of negative health effects for both mother and child. However, less is known regarding social determinants for SHS exposure, which may differ from those of maternal smoking during pregnancy (MSDP). To identify social determinants for SHS exposure only, MSDP only, and MSDP and SHS exposure, data were obtained from all pregnant women (18–54 years; N = 726) in waves 1 and 2 of the Population Assessment of Tobacco and Health Study (2014–2015). Multiple logistic regressions were conducted using SAS 9.4. Smoke exposure during pregnancy was common; 23.0% reported SHS exposure only, 6.1% reported MSDP only, and 11.8% reported both SHS exposure and MSDP. Results demonstrate that relationships between smoke exposure during pregnancy and social determinants vary by type of exposure. Women at risk for any smoke exposure during pregnancy include those who are unmarried and allow the use of combustible tobacco products within the home. Those who are at higher risk for SHS exposure include those who are younger in age, and those who are earlier in their pregnancy. Those who are at higher risk for maternal smoking include those with fair/poor mental health status and those who believe that others\u27 view tobacco use more positively. These results suggest the need for implementing more comprehensive policies that promote smoke-free environments. Implementing these strategies have the potential to improve maternal and fetal health outcomes associated with tobacco smoke exposure

Healthcare Utilization Among Hispanic Immigrants with Diabetes: Investigating the Effect of US Documentation Status

Previous studies have not examined whether documentation status has an effect on healthcare utilization among US Hispanic immigrants with diabetes. A secondary analysis was conducted using data from the Pew Hispanic Center and Robert Johnson Wood Foundation’s 2007 Hispanic Healthcare Survey. Hispanic immigrants diagnosed with diabetes were included in analyses. The association between documentation status and healthcare utilization was assessed using logistic regressions. Of N = 577 Hispanic immigrants with diabetes, 80 % were documented immigrants and 81 % reported having visited a healthcare provider in the last 6 months. Adjusting for confounders, those who were undocumented faced higher odds of having seen a healthcare provider more than 6 months ago or never when compared to those who were documented (OR = 1.79; 95 % CI 1.01, 3.14). Unique opportunities in addressing healthcare disparities can be found in focusing on the Hispanic immigrant population living with diabetes

Socioeconomic and demographic factors modify the association between informal caregiving and health in the Sandwich Generation

BACKGROUND: Nearly 50 million Americans provide informal care to an older relative or friend. Many are members of the “sandwich generation”, providing care for elderly parents and children simultaneously. Although evidence suggests that the negative health consequences of caregiving are more severe for sandwiched caregivers, little is known about how these associations vary by sociodemographic factors. METHODS: We abstracted data from the Behavioral Risk Factor Surveillance System to determine how the association between caregiving and health varies by sociodemographic factors, using ordinal logistic regression with interaction terms and stratification by number of children, income, and race/ethnicity. RESULTS: The association between informal caregiving and health varied by membership in the “sandwich generation,” income, and race/ethnicity. This association was significant among subjects with one (OR = 1.13, 95% CI [1.04, 1.24]) and two or more children (OR = 1.17, 95% CI = 1.09, 1.26]), but not in those without children (OR = 1.01, 95% CI [0.97, 1.05]). Associations were strongest in those earning $50,000-$75,000 annually, but these income-dependent associations varied by race/ethnicity. In Whites with two or more children, the strongest associations between caregiving and health occurred in lower income individuals. These trends were not observed for Whites without children. CONCLUSIONS: Our findings suggest that the added burden of caregiving for both children and elderly relatives may be impacted by income and race/ethnicity. These differences should be considered when developing culturally appropriate interventions to improve caregiver health and maintain this vital component of the US health care system

Comparative and theoretical framework of Brazilian hospitality studies

The purpose of this article is to give a summary of the bibliographical production of the first publications made by the Master’s Programme in Hospitality at the Anhembi Morumbi University, São Paolo, the compilations edited by Célia Maria de Moraes Dias (2002) and Ada de Freitas Maneti Dencker and Marielys Siqueira Bueno (2003, 2004, 2008). It aims to introduce and discuss what could be called the first theoretical lines guiding the reflections of these researchers and their colleagues, which still guide the context in the present study of hospitality at the University. We outline the contributions of the various authors and discuss how they have built on the pioneering works of Conrad Lashley (2000) and Luiz Octávio de Lima Camargo (2002, 2004).Keywords: Hospitality, bibliographical production on hospitality, theoretical framework on hospitality, Universidade Anhembi Morumb

Prevalence of Nicotine Delivery Systems by Biological Sex in the Spit for Science Study

Nicotine intake usage trends have changed over recent decades given the wide variety of nicotine delivery systems including cigarettes, vaping, hookah, and snubs/chewables. These trends also vary by demographic factors, such as race/ethnicity, sex, and socioeconomic status (SES). For example, studies in rat populations, as well as humans, have found that females tend to be more dependent on nicotine products and have a more difficult time quitting than male rats and humans (Pogun et al., 2017). Also, race/ethnicity may impact the frequency of nicotine usage in different populations; in that non-white Hispanics were more susceptible to smoking through adolescence with a peak at ages 12 and 16; whereas non-Hispanic Asian Americans were less susceptible to smoking at ages 11 and 15 (El-Toukhy et al., 2016). Certain nicotine delivery methods may be more available or perhaps more socially accepted by certain groups of people. While lower SES is associated with more prevalent cigarette advertisements and usage, individuals with a higher SES were associated with an increased prevalence of e-cigarette advertisements, leading to an increased frequency of e-cigarette usage among adolescents (Simon et al., 2018). This project aims to document rates of nicotine use across different nicotine delivery systems in college students by demographic factors. We use the Spit for Science (S4S) database to investigate prevalence rates and study if they differ by sex, race/ethnicity, or SES. It is hypothesized that higher SES individuals will have an increased frequency of use with nicotine products that are non-cigarette based, non-white Hispanics will have greater frequency with nicotine usage, and females within the study sample will display a higher dependency on nicotine products than males. Preliminary analyses reveal that there are more female participants than males throughout the S4S cohorts collected between 2020 and 2022. Across cohorts, prevalence of all nicotine delivery systems differs in female and male participants across all products. Larger differences in prevalence between females and males are observed for cigarettes, smokeless tobacco, and cigars than for products that have been introduced more recently, such as hookah, vaping, and heat-not-burn products. Further analyses will focus on patterns of use in relation to race/ethnicity and SES. Understanding nicotine usage trends within our sample could pave the way for additional research (i.e., genetic studies) and allow for the development of prevention/intervention models tailored to our sample populations.https://scholarscompass.vcu.edu/uresposters/1436/thumbnail.jp

Genetic and Environmental Influences on Smoking Behavior across Adolescence and Young Adulthood in the Virginia Twin Study of Adolescent Behavioral Development and the Transitions to Substance Abuse Follow-Up

Little is known regarding the underlying relationship between smoking initiation and current quantity smoked during adolescence into young adulthood. It is possible that the influences of genetic and environmental factors on this relationship vary across sex and age. To investigate this further, the current study applied a common causal contingency model to data from a Virginia-based twin study to determine: (1) if the same genetic and environmental factors are contributing to smoking initiation and current quantity smoked; (2) whether the magnitude of genetic and environmental factor contributions are the same across adolescence and young adulthood; and (3) if qualitative and quantitative differences in the sources of variance between males and females exist. Study results found no qualitative or quantitative sex differences in the relationship between smoking initiation and current quantity smoked, though relative contributions of genetic and environmental factors changed across adolescence and young adulthood. More specifically, smoking initiation and current quantity smoked remain separate constructs until young adulthood, when liabilities are correlated. Smoking initiation is explained by genetic, shared, and unique environmental factors in early adolescence and by genetic and unique environmental factors in young adulthood; while current quantity smoked is explained by shared environmental and unique environmental factors until young adulthood, when genetic and unique environmental factors play a larger role

Web-Based Genome-Wide Association Study Identifies Two Novel Loci and a Substantial Genetic Component for Parkinson's Disease

Although the causes of Parkinson's disease (PD) are thought to be primarily environmental, recent studies suggest that a number of genes influence susceptibility. Using targeted case recruitment and online survey instruments, we conducted the largest case-control genome-wide association study (GWAS) of PD based on a single collection of individuals to date (3,426 cases and 29,624 controls). We discovered two novel, genome-wide significant associations with PD–rs6812193 near SCARB2 (, ) and rs11868035 near SREBF1/RAI1 (, )—both replicated in an independent cohort. We also replicated 20 previously discovered genetic associations (including LRRK2, GBA, SNCA, MAPT, GAK, and the HLA region), providing support for our novel study design. Relying on a recently proposed method based on genome-wide sharing estimates between distantly related individuals, we estimated the heritability of PD to be at least 0.27. Finally, using sparse regression techniques, we constructed predictive models that account for 6%–7% of the total variance in liability and that suggest the presence of true associations just beyond genome-wide significance, as confirmed through both internal and external cross-validation. These results indicate a substantial, but by no means total, contribution of genetics underlying susceptibility to both early-onset and late-onset PD, suggesting that, despite the novel associations discovered here and elsewhere, the majority of the genetic component for Parkinson's disease remains to be discovered