VCU news

By Blake Belden
VCU Massey Cancer Center

VCU Massey Cancer Center researchers have received three grants totaling more than $1 million from the Virginia Foundation for Healthy Youth to study the factors that increase the risk of youth tobacco use. Study findings will be utilized to inform youth tobacco use prevention strategies and policies.

Tobacco use is the leading cause of cancer in Virginia and the U.S., according to the Centers for Disease Control and Prevention. It is linked to the development of a wide range of disease types including lung, larynx, mouth, esophagus, throat, bladder, kidney, liver, stomach, pancreas, colorectal and cervical cancer, as well as acute myeloid leukemia, according to the National Cancer Institute.

More than 80 percent of adult smokers started smoking before age 18 — in many cases as early as 13 or 14 — with nicotine addiction often developing in a matter of a few weeks, according to the VFHY.

“Massey Cancer Center is committed to discovering novel ways of eliminating cancer in our community,” said Bernard Fuemmeler, Ph.D., associate director for cancer prevention and control at Massey and one of the researchers who received a VFHY grant.

The research funded by the grants will focus on identifying the social, cultural and institutional factors that motivate youth to start smoking.

“By better understanding these multi-level factors, the data will inform local solutions and policy approaches that might be leveraged to prevent youth from using tobacco,” Fuemmeler said. “Reducing initiation of tobacco use during adolescence has the potential to improve the lives of our residents and ultimately reduce the cancer burden in our state.”

The VFHY empowers Virginia’s youth to make healthy choices by reducing and preventing youth tobacco use, substance use and childhood obesity.

“We are pleased to have several projects being conducted at VCU that focus on relevant issues such as e-cigarette and cigar use by youth in Virginia,” said Marty Kilgore, VFHY executive director. “This research will help inform future efforts to reduce and prevent youth tobacco use, not just here in the commonwealth, but across the nation.”

Fuemmeler, a professor in the Department of Health Behavior and Policy at the VCU School of Medicine, will work with Elizabeth Do, Ph.D., also from the Department of Health Behavior and Policy, on a $450,000 VFHY grant to study the geographic impact of tobacco retail and vape shop outlets on the rate of tobacco use among Virginia’s youth. The researchers will examine how federal and state policies can be enacted to potentially reduce risks.

Previous research has demonstrated a positive correlation between tobacco retail outlet locations and increased rates of cigarette smoking among adolescents living in proximity to the retail outlets, including a study in the Journal of Biometrics and Biostatistics. Fuemmeler and Do’s study will uncover more about potential links between vape shop density and tobacco use among the surrounding youth population.

The researchers hope their findings will influence legislators on regulations related to where tobacco retail and vape shop outlets should be positioned, with the ultimate goal of decreasing the risk of young people starting tobacco use.

Another grant from the VFHY provides $450,000 to support a study that uses interactive simulation models to guide policy development, implementation and evaluation for the prevention and control of tobacco use among Virginia’s youth. The study uses systems science, the study of how simple and complex systems impact nature, society and human decision-making. The project is led by Hong Xue, Ph.D., an assistant professor in the VCU Department of Health Behavior and Policy, along with co-investigators and Massey Cancer Prevention and Control research members Andrew Barnes, Ph.D., associate professor in the VCU Department of Health Behavior and Policy, and J. Randy Koch, Ph.D., research associate professor in the Department of Psychology in the College of Humanities and Sciences.

The study will create systems-based simulation models to learn more about the potential benefits of three regulatory approaches to minimize the burden of tobacco products:

• Increasing the minimum age of legal access to e-cigarettes and conventional cigarettes
• Imposing new taxes on e-cigarettes and increasing the taxes on conventional tobacco products
• Creating a mandatory distance for e-cigarette retail outlets from K-12 schools

“We are thrilled to receive funding from the VFHY,” Xue said. “We expect our project to generate significant evidence to support efforts to advance legislative issues in Virginia. We hope to prevent and reduce e-cigarette use as a means to improve the health of young people.”

Barnes and Caroline Cobb, Ph.D., a member of the Cancer Prevention and Control research program at Massey and an assistant professor in the Department of Psychology, are leading a $150,000 study that will examine cigar use among Virginia youth living in lower socioeconomic communities.

Nearly 8 percent of high school students are reported to use cigars, and cigars are the most commonly used tobacco product among African-American high school students, according to the Centers for Disease Control and Prevention. Flavored cigars are deliberately marketed toward youth and African Americans, with heavier instances of advertising and distribution in lower-income and African-American communities.

“Despite the clear role that cigars, particularly flavored cigars, play in promoting youth tobacco use and amplifying health disparities, they have not been a primary focus of federal or state tobacco control and prevention efforts,” Barnes said.

The mixed-methods cigar use study will recruit cigar-smoking and non-tobacco-using youth residing in lower socioeconomic communities to participate in surveys and focus groups that will inform investigators about the attitudes, perceptions and knowledge of cigars, as well as the social and behavioral factors that influence cigar use. An advisory board will be involved to translate the research findings to the community and state legislators.

“A well-designed and concise study timeline paired with a team experienced in community-engaged research will ensure the availability of results that can make an impact within local communities and Virginia at large to improve outcomes related to youth tobacco use,” Barnes said.

The three grants went into effect in July and will fund research for three years.

Other collaborators on the projects include the University of Virginia, the College of William & Mary, Georgetown University, Georgia State University and the Tobacco Free Alliance of Virginia.