title: Demographic, psychosocial, and genetic risk associated with smokeless tobacco use among Mexican heritage youth.
abstract: BACKGROUND
  Despite well-established negative health consequences of smokeless tobacco use (STU), the number and variety of alternative non-combustible tobacco products on the market have increased tremendously over the last 10 years, as has the market share of these products relative to cigarettes. While STU among non-Hispanic white youth has decreased over the last 10 years, the prevalence has remained constant among Hispanic youth. Here we examine demographic, psychosocial, and genetic risk associated with STU among Mexican heritage youth.
  
  
  METHODS
  Participants (50.5 % girls) reported on psychosocial risk factors in 2008-09 (n = 1,087, mean age = 14.3 years), and smokeless tobacco use in 2010-11 (mean age = 16.7 years). Participants provided a saliva sample that was genotyped for genes in the dopamine, serotonin and opioid pathways.
  
  
  RESULTS
  Overall 62 (5.7 %) participants reported lifetime STU. We identified five single nucleotide polymorphisms that increased the risk for lifetime use. Specifically, rs2023902 on SERGEF (OR = 1.93; 95 % CI: 1.05-3.53), rs16941667 on ALDH2 (OR = 3.14; 95 % CI: 1.65-5.94), and rs17721739 on TPH1 (OR = 1.71; 95 % CI: 1.00-2.91) in the dopamine pathway, rs514912 on TRH-DE (OR = 1.84; 95 % CI: 1.25-2.71) in the serotonin pathway, and rs42451417 on the serotonin transporter gene, SLC6A4 (OR = 3.53; 95 % CI: 1.56-7.97). After controlling for genetic risk, being male (OR = 1.86; 95 % CI: 1.02-3.41), obesity status (OR = 2.22; 95 % CI: 1.21-4.09), and both higher levels of anxiety (OR = 1.04; 95 % CI: 1.01-1.08) and social disinhibition (OR = 1.26; 95 % CI: 1.07-1.48) were associated with increased use. High subjective social status (OR = 0.78; 95 % CI: 0.64-0.93) was protective against use, while higher parental education (OR = 2.01; 95 % CI: 1.03-3.93) was associated with increased use.
  
  
  CONCLUSIONS
  These data suggest that use of genetic risk, along with psychosocial, demographic, and behavioral risk factors may increase our ability to identify youth at increased risk for STU, which in turn may improve our ability to effectively target prevention messages to Mexican heritage youth.
authors.affiliation: Michael & Susan Dell Center for Healthy Living & The University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX, 78701, USA. anna.v.wilkinson@uth.tmc.edu.
authors.forename: Anna V
authors.initials: AV
authors.lastname: Wilkinson
authors.affiliation: Social and Behavioral Division, National Human Genome Research Institute, Bethesda, MD, USA. koehlylm@nih.gov.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Koehly
authors.affiliation: Michael & Susan Dell Center for Healthy Living & The University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX, 78701, USA. Elizabeth.a.vandewater@uth.tmc.edu.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Vandewater
authors.affiliation: Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. rkyu@mdanderson.org.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Yu
authors.affiliation: The University of Texas School of Public Health Brownsville Regional Campus, Brownsville, TX, USA. susan.p.fisher-hoch@uth.tmc.edu.
authors.forename: Susan P
authors.initials: SP
authors.lastname: Fisher-Hoch
authors.affiliation: Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. aprokhor@mdanderson.org.
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Prokhorov
authors.affiliation: Michael & Susan Dell Center for Healthy Living & The University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX, 78701, USA. harold.w.kohl@uth.tmc.edu.|Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA. harold.w.kohl@uth.tmc.edu.
authors.forename: Harold W
authors.initials: HW
authors.lastname: Kohl
authors.affiliation: Baylor College of Medicine, Houston, TX, USA. spitz@bcm.edu.
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Spitz
authors.affiliation: Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. sshete@mdanderson.org.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Shete
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology / Q000235:genetics; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000235:genetics / Q000523:psychology / Q000706:statistics & numerical data; D020641:Polymorphism, Single Nucleotide; D015995:Prevalence; D011584:Psychology; D012307:Risk Factors; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data