Pathways and Processes to Co-occurring Obesity and Tobacco Use in Emerging Adults - Abstract
Obesity and tobacco use among adolescents and young adults remain two of the most pressing public health
concerns in the U.S.; both are linked to pervasive declines across health domains. The transition from
adolescence to young adulthood – emerging adulthood - presents a critical period for examining these health-
risks; problematic substance use often emerges during this developmental stage and obesity status during this
period is predictive of chronic obesity. Research on co-occurring obesity and substance use points to a strong
link between obesity and tobacco use; however, the pathways and processes underlying this co-occurrence
are unclear. Furthermore, it is unknown whether links between obesity and tobacco use extend to e-
cigarette/vaping use, which has surged in popularity in the past decade. The current study seeks to identify
developmental pathways and risk processes to co-occurring obesity and tobacco use (cigarette smoking, e-
cigarette/vaping use) during emerging adulthood. The study aims to collect longitudinal health-risk survey data
(five timepoints over two years) from a probability sample of N = 1,450 young adults (18-24 years) enrolled as
undergraduates at California State University, Long Beach (CSULB). Participants will be recruited from
randomly sampled classes and asked to complete five online surveys over a two-year period. The survey
includes questions on weight status, nutrition, physical activity, self-regulation, social relationships,
psychosocial adjustment, and substance use. Given that the transition from adolescence to young adulthood is
characterized by significant life changes, along with neurocognitive and socio-emotional challenges, key
aspects of Steinberg’s Dual-Systems Model, Rimal and Real’s Theory of Normative Social Behavior, and
Lazarus and Folkman’s Transactional Model of Stress and Coping frame the study’s conceptual model. Key
study aims include: (1) determine the extent to which obesity and tobacco use co-occur during emerging
adulthood and identify the pathways (obesity → tobacco use; tobacco use → obesity) to co-occurrence; (2)
identify processes underlying co-occurring obesity and tobacco use, including biobehavioral (impulsivity,
sensation-seeking), socio-contextual (social acceptance, weight stigma, deviant peer affiliation), and
psychosocial (depression, social anxiety, perceived stress) components; and (3) evaluate whether obese
emerging adults from specific ethnic/gender groups are at higher or lower risk of engaging in cigarette smoking
and/or e-cigarette/vaping use. As both obesity and tobacco use place severe burdens on the health care
system, identifying pathways and processes by which obesity is related to tobacco use in emerging adulthood
is likely to have significant implications for prevention and intervention efforts aimed at mitigating co-occurring
health-risks earlier in the lifespan.