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Brain Injury Is Prevalent and Precedes Tobacco Use among Youth and Young Adults Experiencing Homelessness

Author

Listed:
  • Julianna M. Nemeth

    (Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA)

  • Allison M. Glasser

    (Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA)

  • Alice Hinton

    (Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA)

  • Joseph M. Macisco

    (Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA)

  • Amy Wermert

    (Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA)

  • Raya Smith

    (College of Arts and Sciences, The Ohio State University, Columbus, OH 43210, USA)

  • Hannah Kemble

    (Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
    Division of Health Services, Management, and Policy, College of Public Health, The Ohio State University, Columbus, OH 43210, USA)

  • Georgia Sasser

    (Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA)

Abstract

70%+ of youth and young adults experiencing homelessness (YYEH; 14–24 years old) smoke combustible tobacco. Little is known about the prevalence of acquired brain injury (ABI) among youth and young adult smokers experiencing homelessness (YYSEH) and its impact on tobacco use progression—the aim of our study. Through an interviewer-administered survey, YYSEH were asked about timing of tobacco use; exposure to causes of ABI; including brain oxygen deprivation (BOD; strangulation; accidental; choking games) and blunt force head trauma (BFHT; intentional; shaken violently; accidental); and perpetrators of intentional assault. Participants ( n = 96) were on average 22 years old and from populations who experience structural disparities; including those minoritized by race (84.4%) and gender/sexual orientation (26.0%). In total, 87% of participants reported at least one exposure to BFHT and 65% to BOD. Intentional injury was more common than accidental. Furthermore, 60.4% of participants ( n = 59) were classified as having ABI using the Brain Injury Severity Assessment. A significant proportion of YYSEH living with ABI were exposed to both BFHT and BOD prior to trying (68.5%, p = 0.002) and to first regular use (82.8%, p < 0.001) of tobacco. Among YYSEH with ABI; injury exposure occurred a median of 1 and 5 years before age of first regular tobacco use, dependent on injury mechanism. ABI from intentional violence is prevalent and precedes tobacco use among YYSEH.

Suggested Citation

  • Julianna M. Nemeth & Allison M. Glasser & Alice Hinton & Joseph M. Macisco & Amy Wermert & Raya Smith & Hannah Kemble & Georgia Sasser, 2023. "Brain Injury Is Prevalent and Precedes Tobacco Use among Youth and Young Adults Experiencing Homelessness," IJERPH, MDPI, vol. 20(6), pages 1-15, March.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:6:p:5169-:d:1097921
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    References listed on IDEAS

    as
    1. Hwang, S.W. & Chambers, C. & Chiu, S. & Katic, M. & Kiss, A. & Redelmeier, D.A. & Levinson, W., 2013. "A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance," American Journal of Public Health, American Public Health Association, vol. 103(S2), pages 294-301.
    2. Mackelprang, J.L. & Harpin, S.B. & Grubenhoff, J.A. & Rivara, F.P., 2014. "Adverse outcomes among Homeless Adolescents and young adults who report a history of traumatic brain injury," American Journal of Public Health, American Public Health Association, vol. 104(10), pages 1986-1992.
    3. Song, A.V. & Morrell, H.E.R. & Cornell, J.L. & Ramos, M.E. & Biehl, M. & Kropp, R.Y. & Halpern-Felsher, B.L., 2009. "Perceptions of smoking-related risks and benefits as predictors of adolescent smoking initiation," American Journal of Public Health, American Public Health Association, vol. 99(3), pages 487-492.
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