Joseph G L Lee
Biographic Data
| ID | 194430 |
|---|---|
| NAME | Joseph G L Lee |
| GIVEN NAMES | Joseph G L |
| FAMILY NAME | Lee |
| SIGNATURE | LEE J G L |
| AFFILIATIONS | East Carolina University |
| ORCID | 0000-0001-9698-649X |
| VERIFIED | Yes |
| TOTAL WORKS | 47 |
| TOTAL CITATIONS | 34 |
| AUTHOR COUNT | 47 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2010 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Use of digital distress metrics to assess digital exclusion can obscure vulnerable groups: The case of migrant and seasonal farmworkers in North Carolina, U.S.A.
Paneugenesis: A regenerative systems hypothesis for advancing health promotion
Despite major advances in health promotion science, dominant approaches remain largely prevention-and risk-reduction-oriented. The prevailing orientation creates a substantial opportunity to advance generative, system-design strategies that intentionally produce well-being rather than merely prevent disease. This article proposes paneugenesis as a regenerative systems framework and a testable theoretical model for the intentional creation of net-…
“You’re Not a Cop, Right?” How Tobacco Retailers Navigate Underage Tobacco Purchases at the Point of Sale: A Qualitative Analysis of Underage Buyers’ Comments from Three U.S. states
PURPOSE: Despite the passage of federal Tobacco 21 (T21) policies, underage tobacco use remains a problem. Retailers play a critical role in enforcing T21 policies as they control access to tobacco products at the point of sale. Given the importance of retailer compliance in the success of T21 policies, this study aimed to investigate how clerks navigate situations when underage buyers attempt to purchase tobacco products by using comments captur…
Modelling how age-restricted location policies would impact tobacco retailer density in four US states: California, Connecticut, North Carolina and Ohio
The degree of TRD reduction estimated by these simulation models for an ARL policy is more powerful than what has been found for other retailer-focused strategies (eg, prohibiting tobacco retailers close to schools). ARL policies could be a promising and potentially powerful strategy for reducing TRD in the USA
Pushing the US nicotine pouch market: Insights from Zyn’s free can campaign in September 2025
Tobacco retailer density and rurality across four US states: California, Connecticut, North Carolina, and Ohio
PURPOSE: Research has demonstrated many types of disparities in tobacco retailer density (TRD), but these analyses often fail to explore rural disparities. Given the substantial burden of rural tobacco use in the USA, this is a critical gap. The purpose of the present study was to estimate rural disparities in TRD across four US states. METHODS: For the states of California, Connecticut, North Carolina, and Ohio, we used spatial statistical metho…
Telehealth, Telebehavioral Health, and Patient Portal Willingness, Use, and Access Challenges among Migrant Farmworkers on H-2A Visas, North Carolina, USA, 2024
Digital health services can facilitate patients' access to healthcare. However, access to reliable internet and utilization of digital healthcare are patterned by race, ethnicity, and class in the United States. We assessed willingness, use, and challenges accessing digital healthcare platforms among farmworkers arriving in North Carolina on temporary H-2A work visas (n = 327). We fielded a survey on digital healthcare access in English and Spani…
Patient-Provider Communication and Health Disparities: An Experiment Exploring Language Proficiency and Communication Accommodation
Effective communication is critical for equitable healthcare delivery. In situations where there is language discordance between patients and providers, with one person speaking a shared language more proficiently, communication challenges may exacerbate disparities, particularly for racially or ethnically minoritized patients. Even when patients and providers are both fluent enough in English to not need interpretation, communication challenges …
Age Restricted Location Policies: A Potential Strategy for Advancing the Tobacco Endgame
Community health worker outreach to farmworkers in rural North Carolina: Learning from adaptations to the Sars‐CoV‐2 pandemic
BACKGROUND: Community health workers represent a critical part of the health outreach and services for migrant and seasonal farmworkers ('farmworkers') in rural areas of the United States. PURPOSE: We sought to identify adaptations to farmworker patient engagement and health outreach made by community health workers during the first 18 months of the COVID-19 pandemic. METHODS: In this qualitative study, we used semi-structured interviews with com…
Reactions to a Hypothetical Menthol Cigarette Ban among Sexual- and Gender-Minoritized Communities: A Concept Mapping Study
Menthol cigarette use is disproportionately higher among sexual- and gender-minoritized (SGM; 36%) individuals compared to cisgender, heterosexual (29%), individuals. The FDA has announced intentions to ban menthol in cigarettes, citing these use and health disparities as partial motivation. This study identified potential outcomes of a menthol cigarette ban among SGM individuals who smoke menthol cigarettes (N = 72). Potential outcomes were iden…
Tobacco and Alcohol Retailer Availability and Neighborhood Racialized, Economic, and Racialized Economic Segregation in North Carolina
Connecting Environmental Injustice for Lesbian, Gay, Bisexual, and Transgender Populations With Neighborhood Health Equity Research
Digital Inclusion for Farmworkers in a Pandemic: The North Carolina Farmworker Health Program Internet Connectivity Project, 2020‒2021
The North Carolina Farmworker Health Program (NCFHP) implemented an emergency program in response to North Carolina migrant and seasonal farmworkers’ urgent need for Internet access for health information, family connections, and telehealth services during COVID-19 isolation and quarantine. This article describes the NCFHP Internet Connectivity Project implementation and evaluation from June 2020 to December 2021. The project placed 448 devices a…
Sexual Minority Status and Marijuana Initiation during Adulthood: A Longitudinal Study Using Nationally Representative Data
Introduction Sexual minorities (i.e. individuals who identify as lesbian, gay, and bisexual) are at increased risk for marijuana use. However, little is known about initiation during adulthood. This study examines: (1) sexual minority status as a risk factor for marijuana initiation, and (2) the modifying effect of sex (labeled at birth) on this relationship. Methods: We analyzed Wave 1 (2013–2014) and Wave 2 (2014–2015) of the Population Assessm…
Underutilisation of no-tobacco-sale orders against retailers that repeatedly sell to minors, 2015–2019, USA
The FDA's failure to fully leverage its powers to address retailers' underage sales of tobacco products has weakened efforts to curb the youth e-cigarette epidemic
Evidence of potential tobacco industry influence in Tobacco Regulatory Science
A May 2021 special issue1 of the American Journal of Health Behavior ( AJHB ) on JUUL consisted of 13 articles with 12 including authors who were employees of JUUL Labs; all articles reported at least one author with funding from the tobacco industry. JUUL is an electronic cigarette device that holds the greatest market share2 and is the most popular device among youth.3 The research reported in the issue was “designed to provide the US Food and …
Risk, Resilience, and Smoking in a National, Probability Sample of Sexual and Gender Minority Adults, 2017, USA
Background. There are well-documented inequities in smoking between sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, and transgender [LGBT]) and straight and cisgender people. However, there is less information about risk for and resilience against smoking among SGM people. Such information is critical for understanding etiology and developing interventions. Aims. To conduct a within-group assessment of risks and resiliencies relati…
Sexual Orientation, Tobacco Use, and Tobacco Cessation Treatment-Seeking: Results From a National U.S. Survey
Despite higher rates of tobacco use and smoking-related diseases among sexual minorities, tobacco cessation treatment-seeking behaviors (e.g., medication, nicotine replacement products) remain poorly understood across sexual orientation subgroups. This study examines tobacco cessation treatment-seeking behaviors associated with Diagnostic and Statistical Manual of Mental Disorders, 5th Edition tobacco use disorder (TUD) across the three major sex…
Assurances of Voluntary Compliance: A Regulatory Mechanism to Reduce Youth Access to E-Cigarettes and Limit Retail Tobacco Marketing
Objectives. To evaluate assurances of voluntary compliance (AVCs) between state attorneys general and retail chains by assessing e-cigarette sales to underage decoys and tobacco marketing violations in corporate-owned stores (that sign AVCs) and franchise stores (that do not sign AVCs). Methods. Decoys 18 to 19 years of age attempted to purchase e-cigarettes without presenting ID in California convenience stores (n = 540). Auditors characterized …
Major online retailers selling electronic cigarettes as smoking cessation products in the USA
No electronic cigarettes (e-cigarettes) available in the USA have been approved by the US Food and Drug Administration (FDA) to be marketed for smoking cessation, and any such approvals would only apply to a specific product rather than e-cigarettes as a class of products. Accordingly, any marketing of e-cigarettes that explicitly or implicitly states that they are for cessation assistance (or any other medical purpose) would violate the Federal …
Evolving Iqos packaging designs change perceptions of product appeal, uniqueness, quality and safety: A randomised experiment, 2018, USA
Linking or separating IQOS products with a well-established cigarette brand changes how adult smokers respond to the product. Regulators should consider the visual design of packaging
Tobacco Policies and Alcohol Sponsorship at Lesbian, Gay, Bisexual, and Transgender Pride Festivals: Time for Intervention
"Tobacco Policies and Alcohol Sponsorship at Lesbian, Gay, Bisexual, and Transgender Pride Festivals: Time for Intervention." , 108(2), pp. 187–188
Residential Segregation and Racial Cancer Disparities: A Systematic Review
An Experiment Assessing Punitive versus Wellness Framing of a Tobacco-Free Campus Policy on Students’ Perceived Level of University Support
The objective of this study was to examine how different ways of describing a hypothetical tobacco-free campus policy would impact college students' perceived level of support from the college. In the spring of 2016, we randomized 1885 undergraduate students in a required course to three message conditions in an online survey: control (no message), wellness (emphasizing promoting health and quitting support), and punitive (emphasizing consequence…
Real Men Don't”: Constructions of Masculinity and Inadvertent Harm in Public Health Interventions
Research shows that constraining aspects of male gender norms negatively influence both women’s and men’s health. Messaging that draws on norms of masculinity in health programming has been shown to improve both women’s and men’s health, but some types of public health messaging (e.g., Man Up Monday, a media campaign to prevent the spread of sexually transmitted infections) can reify harmful aspects of hegemonic masculinity that programs are work…
Inequalities in tobacco outlet density by race, ethnicity and socioeconomic status, 2012, USA: Results from the ASPiRE Study
BACKGROUND: Evidence of racial/ethnic inequalities in tobacco outlet density is limited by: (1) reliance on studies from single counties or states, (2) limited attention to spatial dependence, and (3) an unclear theory-based relationship between neighbourhood composition and tobacco outlet density. METHODS: In 97 counties from the contiguous USA, we calculated the 2012 density of likely tobacco outlets (N=90 407), defined as tobacco outlets per 1…
Asthma Disparities and Within-Group Differences in a National, Probability Sample of Same-Sex Partnered Adults
Objectives. We examined the prevalence and correlates of self-reported lifetime diagnosis of asthma and current asthma among same-sex and opposite-sex partnered adults. Methods. Data were from the 2004 Behavioral Risk Factor Surveillance System, in which same-sex partnership was a response option to a family planning item in the core questionnaire. Self-reported lifetime diagnosis of asthma and current asthma were examined in logistic regression …
Adding Sexual Orientation Questions to Statewide Public Health Surveillance: New Mexico's Experience
We examined refusal rates for sensitive demographic questions to determine whether questions on sexual orientation are too sensitive for routine use on public health surveys. We compared the percentage of active refusals in New Mexico for a sexual orientation question and 6 other sensitive demographic questions. In 2007 and 2008, refusal rates for sexual orientation questions were similar to rates for questions on race/ethnicity and weight and si…
Reasons for Caution When Emphasizing Health Disparities for Sexual and Gender Minority Adults in Public Health Campaigns
Reasons for Caution When Emphasizing Health Disparities for Sexual and Gender Minority Adults in Public Health Campaigns Affiliation Joseph G. L. Lee PhD, MPH, Hope Landrine PhD, Ryan J. Martin PhD, Derrick D. Matthews PhD, MPH, Paige E. Averett PhD, MSW, and Jeff Niederdeppe PhDJoseph G. L. Lee and Ryan J. Martin are with the Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenvil…
Tobacco Policies and Alcohol Sponsorship at Lesbian, Gay, Bisexual, and Transgender Pride Festivals: Time for Intervention
"Tobacco Policies and Alcohol Sponsorship at Lesbian, Gay, Bisexual, and Transgender Pride Festivals: Time for Intervention." , 108(2), pp. 187–188
A Profile of North Carolina Lesbian, Gay, and Bisexual Health Disparities, 2011
Objectives. We investigated the health profile of lesbian, gay, and bisexual (LGB) adults in North Carolina, the first state in the South to include a measure of sexual orientation identity in a probability-based statewide health survey. Methods. Using data from 9876 respondents in the 2011 North Carolina Behavioral Risk Factor Surveillance Survey, we compared sexual minorities to heterosexuals on a variety of health indicators. Results. LGB resp…
Statewide diffusion of 100% tobacco-free college and university policies
Tobacco-free policy adoption on college campuses can be accelerated with a multilevel statewide intervention
Adding Sexual Orientation Questions to Statewide Public Health Surveillance: New Mexico's Experience
We examined refusal rates for sensitive demographic questions to determine whether questions on sexual orientation are too sensitive for routine use on public health surveys. We compared the percentage of active refusals in New Mexico for a sexual orientation question and 6 other sensitive demographic questions. In 2007 and 2008, refusal rates for sexual orientation questions were similar to rates for questions on race/ethnicity and weight and si…
High Tobacco Use among Lesbian, Gay, and Bisexual Populations in West Virginian Bars and Community Festivals
With no information on tobacco use for lesbian, gay, or bisexual (LGB) populations in West Virginia (WV), it is unclear if nationally-identified LGB tobacco disparities also exist in this State. To address this data gap, we conducted a community tobacco survey in bars and events associated with the WV Pride Parade and Festival. Trained community surveyors used electronic and paper survey instruments in bars (n = 6) in three WV cities and communit…
Successful implementation of a wellness and tobacco cessation curriculum in psychosocial rehabilitation clubhouses
Mental health settings are important locations for implementing programs to address tobacco use. In this real-world implementation of a model curriculum in psychosocial rehabilitation clubhouses, the curriculum tested well, was feasible and well-received, and suggests potential impact on tobacco use outcomes. Revision, dissemination, and a randomized controlled trial evaluation of the model curriculum should now occur
Cigarette butts near building entrances: What is the impact of smoke-free college campus policies
This study provides some of the first evidence on the impact of 100% tobacco-free outdoor policies on college campuses using an objective and reproducible measure. Such policies likely provide a more healthful environment for students, staff, faculty and visitors
Up in Smoke: Vanishing Evidence of Tobacco Disparities in the Institute of Medicine’s Report on Sexual and Gender Minority Health
The Institute of Medicine (IOM) released a groundbreaking report on lesbian, gay, bisexual, and transgender (LGBT) health in 2011, finding limited evidence of tobacco disparities. We examined IOM search terms and used 2 systematic reviews to identify 71 articles on LGBT tobacco use. The IOM omitted standard tobacco-related search terms. The report also omitted references to studies on LGBT tobacco use (n = 56), some with rigorous designs. The IOM…
A systematic review of the aetiology of tobacco disparities for sexual minorities
Asthma Disparities and Within-Group Differences in a National, Probability Sample of Same-Sex Partnered Adults
Objectives. We examined the prevalence and correlates of self-reported lifetime diagnosis of asthma and current asthma among same-sex and opposite-sex partnered adults. Methods. Data were from the 2004 Behavioral Risk Factor Surveillance System, in which same-sex partnership was a response option to a family planning item in the core questionnaire. Self-reported lifetime diagnosis of asthma and current asthma were examined in logistic regression …
Out smoking on the big screen: Tobacco use in LGBT movies, 2000–2011: Table 1
Viewers of movies with LGBT themes or characters are exposed, on average, to one depiction of tobacco use for every 15 min of movie run-time. As a major component of the entertainment media environment, movies may contribute to smoking among LGBT people
Health Inequalities Among Sexual Minority Adults
Real Men Don't”: Constructions of Masculinity and Inadvertent Harm in Public Health Interventions
Research shows that constraining aspects of male gender norms negatively influence both women’s and men’s health. Messaging that draws on norms of masculinity in health programming has been shown to improve both women’s and men’s health, but some types of public health messaging (e.g., Man Up Monday, a media campaign to prevent the spread of sexually transmitted infections) can reify harmful aspects of hegemonic masculinity that programs are work…
A Profile of North Carolina Lesbian, Gay, and Bisexual Health Disparities, 2011
Objectives. We investigated the health profile of lesbian, gay, and bisexual (LGB) adults in North Carolina, the first state in the South to include a measure of sexual orientation identity in a probability-based statewide health survey. Methods. Using data from 9876 respondents in the 2011 North Carolina Behavioral Risk Factor Surveillance Survey, we compared sexual minorities to heterosexuals on a variety of health indicators. Results. LGB resp…
Fleming et al. Respond
AffiliationsPaul J. Fleming is with the Department of Health Behavior and the Carolina Population Center, University of North Carolina at Chapel Hill. Joseph G. L. Lee is with the Department of Health Behavior, University of North Carolina at Chapel Hill. Shari L. Dworkin is with the Department of Social and Behavioral Sciences and the Center for AIDS Prevention Studies, University of California, San Francisco
Testing warning messages on smokers’ cigarette packages: A standardised protocol
NCT02247908
A Systematic Review of Neighborhood Disparities in Point-of-Sale Tobacco Marketing
We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbani…
Discrepancy in Self-Report “Loosie” Use and Federal Compliance Checks
Discrepancy in Self-Report “Loosie” Use and Federal Compliance Checks Affiliation Hannah M. Baker MPH, Joseph G. L. Lee PhD, MPH, Leah M. Ranney PhD, and Adam O. Goldstein MD, MPHHannah M. Baker, Joseph G. L. Lee, and Leah M. Ranney are with the Tobacco Prevention and Evaluation Program, University of North Carolina, Chapel Hill. Adam O. Goldstein is with the Tobacco Intervention Programs at the University of North Carolina.CopyRightCorrespondenc…
Identification of Vape Shops in Two North Carolina Counties: An Approach for States without Retailer Licensing
Stores that sell electronic nicotine delivery systems (ENDS) as their primary product are a new phenomenon and often termed "vape shops". While vape shops are now regulated by state and federal agencies, not all states maintain lists of vape shops in operation. Standard ways of identifying tobacco retailers through off-premise alcohol permits and business listing services may not identify vape shops. We used four online business listing services …
Inequities in tobacco retailer sales to minors by neighbourhood racial/ethnic composition, poverty and segregation, USA, 2015
Regulatory agencies should consider oversampling retailers in areas with higher likelihood of sales to minors for inspection. Interventions with tobacco retailers to reduce inequities in youth access should be implemented
Residential Segregation and Racial Cancer Disparities: A Systematic Review
An Experiment Assessing Punitive versus Wellness Framing of a Tobacco-Free Campus Policy on Students’ Perceived Level of University Support
The objective of this study was to examine how different ways of describing a hypothetical tobacco-free campus policy would impact college students' perceived level of support from the college. In the spring of 2016, we randomized 1885 undergraduate students in a required course to three message conditions in an online survey: control (no message), wellness (emphasizing promoting health and quitting support), and punitive (emphasizing consequence…
Their Packaging Has Always Been Like a Power”: A Qualitative Study of U.S. Smokers’ Perceptions of Cigarette Pack Visual Design Features to Inform Product Regulation
Cigarette packaging matters to consumer behavior. However, it is less clear which changes to packaging design would be salient for adult smokers. Such information is critically important to regulators in the United States who are charged with reviewing new tobacco products for their impact on population health. In this qualitative study, U.S. adult smokers ( n = 33) participated in six telephone-based focus groups in March 2017. Separate groups w…
Health Inequities among Lesbian, Gay, and Bisexual Adults in North Carolina, 2011–2014
Inequalities in health have been identified for lesbian, gay, and bisexual (LGB) populations nationally. Policies in the U.S. South offer fewer protections for LGB people than in other regions, yet, limited data exist for this region. North Carolina (NC) BRFSS data from 2011 to 2014 were combined (LGB n = 604; heterosexual n = 33,170) and analyzed using SAS survey procedures to estimate health characteristics by sexual orientation within gender. …
Inequalities in tobacco outlet density by race, ethnicity and socioeconomic status, 2012, USA: Results from the ASPiRE Study
BACKGROUND: Evidence of racial/ethnic inequalities in tobacco outlet density is limited by: (1) reliance on studies from single counties or states, (2) limited attention to spatial dependence, and (3) an unclear theory-based relationship between neighbourhood composition and tobacco outlet density. METHODS: In 97 counties from the contiguous USA, we calculated the 2012 density of likely tobacco outlets (N=90 407), defined as tobacco outlets per 1…
Reasons for Caution When Emphasizing Health Disparities for Sexual and Gender Minority Adults in Public Health Campaigns
Reasons for Caution When Emphasizing Health Disparities for Sexual and Gender Minority Adults in Public Health Campaigns Affiliation Joseph G. L. Lee PhD, MPH, Hope Landrine PhD, Ryan J. Martin PhD, Derrick D. Matthews PhD, MPH, Paige E. Averett PhD, MSW, and Jeff Niederdeppe PhDJoseph G. L. Lee and Ryan J. Martin are with the Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenvil…
Tobacco Policies and Alcohol Sponsorship at Lesbian, Gay, Bisexual, and Transgender Pride Festivals: Time for Intervention
"Tobacco Policies and Alcohol Sponsorship at Lesbian, Gay, Bisexual, and Transgender Pride Festivals: Time for Intervention." , 108(2), pp. 187–188
Medicine (33 works) · Environmental health (25 works) · Psychology (19 works) · Smoking Behavior and Cessation (19 works) · Public health (18 works) · Political science (15 works) · Population (14 works) · Sociology (14 works) · Demography (13 works) · Social Psychology (13 works)