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标题：Gender Differences in the Association Between Perceived Discrimination and Adolescent Smoking
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作者：Sarah E. Wiehe ; Matthew C. Aalsma ; Gilbert C. Liu 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2010
卷号：100
期号：3
页码：510-516
DOI：10.2105/AJPH.2009.169771
语种：English
出版社：American Public Health Association
摘要：Objectives. We examined associations between perceived racial/ethnic discrimination, gender, and cigarette smoking among adolescents. Methods. We examined data on Black and Latino adolescents aged 12 to 19 years who participated in the Moving to Opportunity study (N = 2561). Perceived discrimination was assessed using survey items asking about unfair treatment because of race/ethnicity in the prior 6 months. We used logistic regression to investigate associations between discrimination and smoking, stratified by gender and controlling for covariates. Results. One fourth of adolescents reported that discrimination had occurred in at least 1 location. Discrimination was associated with increased odds of smoking among boys (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.2, 3.0) and decreased odds among girls (OR = 0.6; 95% CI = 0.3, 1.1). Discrimination at school or work contributed to associations for girls (OR = 0.3; 95% CI = 0.1, 0.9), and discrimination at shops (OR = 2.0; 95% CI = 1.1, 3.8) and by police (OR = 2.0; 95% CI = 1.2, 3.4) contributed to associations for boys. Conclusions. Associations between discrimination and smoking differ by gender. Girls’ decreased smoking in higher-discrimination settings may be a result of protective factors associated with where they spend time. Boys’ increased smoking in higher-discrimination settings may reflect increased stress from gender-specific targeting by police and businesses. Several studies have found perceived racial/ethnic discrimination to be associated with adolescent and young adult smoking.^{1 – 7} Smoking as a response to the stress of discrimination is a possible reason for this association, but mediating factors are not well understood.¹ A mediating factor that merits attention is the intersection of gender with smoking and the context of discrimination. Gender is relevant, as boys are more likely to smoke cigarettes than girls, and gender differences in smoking prevalence are more pronounced among Blacks.⁸ In addition, adolescents may make different choices about where to spend time based on gender,⁹ and these “gendered” contexts may relate to smoking behavior. For example, the Moving to Opportunity study showed that gender plays a significant role in both smoking behavior and where adolescents spend time. Girls in the Moving to Opportunity intervention groups, whose families used a study voucher to relocate to a neighborhood of their own choice or to a low-poverty neighborhood, were less likely to smoke than girls in the control group (whose families were not offered the means to move from public housing). However, boys in the intervention groups were more likely to smoke than boys in the control group.¹⁰ A follow-up study found that girls and boys spent time in different locales.¹¹ Girls in intervention groups were more likely to spend time closer to home. Boys in intervention groups were more likely to return to their public housing community and congregate at street corners, parks, vacant lots, and other places without adult supervision. These gender differences in context may influence adolescents’ situational exposure to discrimination. In other words, the experience of discrimination may be caused by gender-specific use of place, which may then differentially relate to smoking behaviors. The primary purpose of this study was to examine the influence of gender on smoking's association with discrimination and with context of discrimination among adolescents. We hypothesized that this association would be stronger among boys and that gender differences would be mediated by the context of discrimination. Analyses were adjusted for mediating factors that may contribute to smoking among individuals who perceive higher levels of discrimination, such as stress, depression, and anxiety.^{3 , 4 , 6 , 12} Whether these factors differentially influence girls and boys in terms of the association between discrimination and smoking risk is unknown.