Poster #85 - Preventing Tobacco Use of Indigenous Children in Child Welfare

• In Event: Poster Session 05

Abstract

Children in child welfare are at elevated risk for tobacco use. Children in foster care are estimated to smoke cigarettes at higher rates than children in the general population (Braciszewski & Colby, 2015; Siegel et al., 2016). Few studies of tobacco use of children in child welfare include Indigenous children, yet Indigenous children in the general population are at increased risk for tobacco use (Hoffman et al., 2019; Yu et al., 2005). Indigenous children have the highest prevalence of cigarette use of any ethnic group in the United States (Agaku et al., 2014). Cardiovascular disease and lung cancer are highly correlated with tobacco use and are the leading causes of death among Indigenous individuals. The mortality rate for Indigenous individuals that use tobacco is double that of the general population (Centers for Disease Control, 2021; U.S. Department of Health and Human Services, 2021). Studies of tobacco use of Indigenous children in child welfare are needed given their increased risk outside of child welfare. Utilizing data from the National Survey of Child and Adolescent Well-being II, a nationally representative study of the U.S. child welfare system (Dowd et al., 2002), this secondary data analysis was performed using baseline and 36-month follow-up data on a subsample of 87 Indigenous children. Child age ranged from 11-17 at baseline (M = 13.97; SD = 1.69) (55.17% male). Approximately 22% were living below poverty, 25% had caregivers with less than a high school education, and 34% had caregivers with substance abuse. One-third of these children experienced neglect as opposed to other forms of child maltreatment (34.18%). Missing data was addressed via multiple imputation. Logistic regression was used to explore the factors that contribute to tobacco use at 36-month follow-up, including child age, poverty, caregiver substance abuse and out-of-home placement. The logistic regression model was statistically significant ( = -9.29, SE = 3.0, p < 0.01). Child age ( = 0.52, SE = 0.20, p < .01, OR = 1.69) and caregiver substance abuse ( = 1.42, SE = 0.65, p < .05, OR = 4.15) were statistically significant factors associated with tobacco use at 36-month follow-up. Older children and those with a caregiver with substance abuse problems were more likely to report tobacco use. However, poverty and out-of-home placement were not significantly associated with tobacco use. Our findings suggest that caregiver substance use is significantly related to child tobacco use (Yu et al., 2005). Due to numerous health disparities, Indigenous individuals, especially those in child welfare, are particularly at risk for negative tobacco-related health consequences. Early intervention addressing the intergenerational impact of caregiver substance use may be an appropriate strategy for preventing cigarette and further substance use for child welfare involved Indigenous children. Findings should be interpreted carefully due to the small sample. Other factors not included in our model may play a significant role in tobacco use. Future research is needed to identify additional factors that may account for differences in Indigenous children’s tobacco use, particularly closeness with caregivers and access to cultural resources.

Authors

• Jessica E. Simpson, University of Minnesota - Twin Cities
  Presenting Author

• Ashley Lace Landers, The Ohio State University

• Armeda Wojciak

• Noah Gagner, University of St. Thomas