Assaf Oshri1, Steven Kogan2, Sihong Liu2, Lawrence Sweet3, James Mackillop4. 1. Department of Human Development and Family Science, The Youth Development Institute, The University of Georgia, Athens, GA, 30602, USA. oshri@uga.edu. 2. Department of Human Development and Family Science, The Youth Development Institute, The University of Georgia, Athens, GA, 30602, USA. 3. Department of Psychology, Behavioral and Brain Sciences Program, The University of Georgia, Athens, GA, 30602, USA. 4. McMaster University, Hamilton, ON, L8S 4L8, Canada.
Abstract
BACKGROUND: African American men experience increases in smoking during the young adult transition. Exposure to childhood adversity, a risk factor which disproportionately affects African American men, has been identified as a robust precursor to health risk behavior in general and cigarette smoking in particular. The intermediate mechanisms that transmit the influence of early adversity to smoking behavior are not well understood. PURPOSE: We tested a model of the escalation of smoking behaviors among young adult African American men, investigating sleep disturbance and delayed reward discounting as intermediate factors linking adverse childhood experiences with smoking. METHODS: Hypotheses were tested with three waves of data (M age-T1 = 20.34, M age-T2 = 21.92, M age-T3 = 23.02) from 505 African American men living in rural counties in South Georgia. Men provided self-report data on their adverse childhood experiences, sleep problems, and smoking behavior using audio-assisted computer self-interviews. Men also completed a computer-based delayed reward discounting task. RESULTS: Structural equation modeling analyses supported our hypotheses: Adverse childhood experiences predicted poor sleep adequacy, which forecast increases in delayed reward discounting; discounting, in turn, predicted increased smoking. Significant indirect pathways were detected linking adversity to discounting via sleep adequacy and linking sleep adequacy to smoking via discounting. CONCLUSIONS: Prevention and intervention researchers can draw on these findings to develop programs that focus on sleep adequacy to reduce smoking in African American men exposed to childhood adversity.
BACKGROUND: African American men experience increases in smoking during the young adult transition. Exposure to childhood adversity, a risk factor which disproportionately affects African American men, has been identified as a robust precursor to health risk behavior in general and cigarette smoking in particular. The intermediate mechanisms that transmit the influence of early adversity to smoking behavior are not well understood. PURPOSE: We tested a model of the escalation of smoking behaviors among young adult African American men, investigating sleep disturbance and delayed reward discounting as intermediate factors linking adverse childhood experiences with smoking. METHODS: Hypotheses were tested with three waves of data (M age-T1 = 20.34, M age-T2 = 21.92, M age-T3 = 23.02) from 505 African American men living in rural counties in South Georgia. Men provided self-report data on their adverse childhood experiences, sleep problems, and smoking behavior using audio-assisted computer self-interviews. Men also completed a computer-based delayed reward discounting task. RESULTS: Structural equation modeling analyses supported our hypotheses: Adverse childhood experiences predicted poor sleep adequacy, which forecast increases in delayed reward discounting; discounting, in turn, predicted increased smoking. Significant indirect pathways were detected linking adversity to discounting via sleep adequacy and linking sleep adequacy to smoking via discounting. CONCLUSIONS: Prevention and intervention researchers can draw on these findings to develop programs that focus on sleep adequacy to reduce smoking in African American men exposed to childhood adversity.
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