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Zhao H, Pan Y, Wang C, Guo Y, Yao N, Wang H, Li B. The Effects of Metal Exposures on Charlson Comorbidity Index Using Zero-Inflated Negative Binomial Regression Model: NHANES 2011-2016. Biol Trace Elem Res 2021; 199:2104-2111. [PMID: 32816137 DOI: 10.1007/s12011-020-02331-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/05/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND With the rising incidence of chronic diseases, and the increase of aging population has led to multimorbidity a serious public health problem. The aim of this study was to explore the association between metal exposures and Charlson comorbidity index (CCI), which will provide valuable information for improving quality of life and reducing mortality. METHODS The study sample consists of three continuous cycles (2011-2016) of the National Health and Nutrition Examination Survey (NHANES), and 4901 eligible subjects were included in the study. Zero-inflated negative binomial (ZINB) model was utilized to investigate the effects in metal exposures on CCI, which includes spot urine (arsenic, mercury, and cadmium), whole blood (manganese, selenium, and lead), and serum (copper and zinc). RESULTS In count part (CCI ≥ 0), holding other variables constant, the expected change in CCI for a one-unit increase in blood selenium is 0.997 (RR = 0.997, p = 0.017). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.659, 1.073, and 0.963 for every additional urinary cadmium (OR = 0.659, p = 0.007), blood lead (OR = 1.073, p = 0.023), blood manganese (OR = 0.963, p = 0.025), respectively. CONCLUSIONS Our findings indicated that cadmium and manganese were likely to increase mortality. Inversely, selenium and lead might be positive on people's health. The findings may be extremely essential for preventing diseases and improving life quality.
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Affiliation(s)
- Hantong Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Yingan Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Changcong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Yinpei Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Nan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Han Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China.
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Raitasalo K, Karjalainen K, Ollila H, Ruokolainen O, Hakkarainen P. Smoke in the air - Associations between experimentation with cannabis and the use of tobacco and nicotine products among 15-16-year-old school students. Addict Behav 2021; 114:106714. [PMID: 33139144 DOI: 10.1016/j.addbeh.2020.106714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cannabis is the most popular illicit drug among adolescents in developed countries, including Finland. The aim of this study was to estimate 1) how cannabis experimentation among Finnish adolescents changed between 2003 and 2019, and 2) whether the associations between cannabis experiments and factors related to it, especially the use of tobacco and nicotine products, changed during the same time period. METHODS The analyses are based on the European School Survey Project on Alcohol and Other Drugs data, collected from Finnish adolescents aged 15 to 16 in 2003, 2007, 2011, 2015, and 2019 (N = 20,630). RESULTS Experimentation with cannabis among Finnish adolescents has increased since the beginning of our follow-up. At the same time, alcohol use and smoking have decreased markedly, and attitudes toward cannabis use have become more relaxed. The association between smoking and cannabis experimentation has become weaker over time. However, the use of tobacco and nicotine products, especially polytobacco, is still a strong risk factor for experimentation with cannabis. The higher the number of tobacco or nicotine products used, the higher the probability for cannabis experimentation. CONCLUSIONS Experimentation with cannabis has previously been concentrated predominantly on adolescents who smoke, but recently non-smokers are increasingly trying cannabis. It is possible that alternative ways of using cannabis may have increased its use. Despite the strict cannabis policy in Finland, its use has increased, which may be an indication that youth cultures and images of different substances play a significant role in adolescents experimenting with cannabis.
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Affiliation(s)
| | | | - Hanna Ollila
- Finnish Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland.
| | - Otto Ruokolainen
- Finnish Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland.
| | - Pekka Hakkarainen
- Finnish Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland.
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Zhao H, Wang C, Pan Y, Guo Y, Yao N, Wang H, Jin L, Li B. Niacin, lutein and zeaxanthin and physical activity have an impact on Charlson comorbidity index using zero-inflated negative binomial regression model: National Health and Nutrition Examination Survey 2013-2014. BMC Public Health 2019; 19:1589. [PMID: 31779602 PMCID: PMC6883694 DOI: 10.1186/s12889-019-7906-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/06/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Combined with the increasing life expectancy, chronic medical conditions have gradually become the dominant cause of death and disability, and multimorbidity became an increasingly serious public health challenge. However, most existing studies have focused on the coexistence of specific diseases or relatively few diseases. Given one person may have multiple diseases at the same time, we applied Charlson Comorbidity Index (CCI) to systematically evaluate one's 10-year mortality. In this study, we explored the effects of nutrients and physical activity on CCI using National Health and Nutrition Examination Survey (NHANES) 2013-2014 data. METHODS The study sample consists of one continuous cycle (2013-2014) of NHANES, and 4386 subjects were included in the study. Nutrients intake was measured by dietary recall, and physical activity was evaluated by the Global Physical Activity Questionnaire respectively. Besides, CCI was the sum of the scores assigned for each medical condition. We utilized zero-inflated negative binomial (ZINB) model to investigate the effects in nutrients intake and physical activity on CCI by adjusting for seven sociodemographic characteristics, smoking and drinking. RESULTS Among the 4386 participants, 2018 (68.7%) are Non-Hispanic White, over half participants (78.6%) drink. In count part (CCI ≥ 0), holding other variables constant, the expected change in CCI for a one-unit increase in niacin is 1.621(RR = 1.621, p = 0.016), in lutein + zeaxanthin is 0.974 (RR = 0.974, p = 0.031), and in sedentary time is 1.035 (RR = 1.035, p = 0.005). Moreover, those who do not have vigorous work activity would be more likely to have higher CCI than those who have (RR = 1.275, P = 0.045). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.541 and 0.708 for every additional vigorous recreational activity (OR = 0.541, p = 0.004) and moderate recreational activity (OR = 0.708, p = 0.017) respectively. CONCLUSIONS Lutein and zeaxanthin intake, vigorous work activity, vigorous recreational activity and moderate recreational activity may be good for one's health. Rather, increasing niacin intake and sedentary activity may be likely to raise 10-year mortality. Our findings may be significant for preventing diseases and improving health, furthermore, reducing people's financial burden on healthcare.
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Affiliation(s)
- Hantong Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Changcong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Yingan Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Yinpei Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Nan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Han Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China.
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, People's Republic of China.
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Marandure BN, Graham HL. Self-reported reasons for voluntary abstinences by adolescent cannabis users. DRUGS AND ALCOHOL TODAY 2017. [DOI: 10.1108/dat-01-2016-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Factors influencing cannabis use have been previously identified mainly using multivariate approaches. However, there is a dearth of information collected from the perspective of the adolescent cannabis user, in particular for voluntary abstinences. The paper aims to discuss these issues.
Design/methodology/approach
In total, 38 cannabis users were identified from a sample of 261 adolescents recruited from schools. They completed open-ended questions identifying reasons for voluntary abstinences. Thematic analysis was used to assess their responses.
Findings
Voluntary abstinences by cannabis users were influenced by both internal and external factors. These were the user’s state of mind, an attempt to quit, negative effects of cannabis, prior to important events, prior to family interactions and peers.
Research limitations/implications
The results show that adolescent cannabis users are flexible in their approach to using cannabis, being able to briefly stop when the situation warrants it. However, the study is limited by a lack of in depth and rich data, limiting the scope of the analysis.
Originality/value
This is the first study to identify reasons for voluntary abstinences from the user’s perspective in adolescent cannabis users.
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Miovský M, Vonkova H, Čablová L, Gabrhelík R. Cannabis use in children with individualized risk profiles: Predicting the effect of universal prevention intervention. Addict Behav 2015; 50:110-6. [PMID: 26126178 DOI: 10.1016/j.addbeh.2015.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 05/11/2015] [Accepted: 06/04/2015] [Indexed: 01/19/2023]
Abstract
AIM To study the effect of a universal prevention intervention targeting cannabis use in individual children with different risk profiles. METHODS A school-based randomized controlled prevention trial was conducted over a period of 33 months (n=1874 sixth-graders, baseline mean age 11.82). We used a two-level random intercept logistic model for panel data to predict the probabilities of cannabis use for each child. Specifically, we used eight risk/protective factors to characterize each child and then predicted two probabilities of cannabis use for each child if the child had the intervention or not. Using the two probabilities, we calculated the absolute and relative effect of the intervention for each child. According to the two probabilities, we also divided the sample into a low-risk group (the quarter of the children with the lowest probabilities), a moderate-risk group, and a high-risk group (the quarter of the children with the highest probabilities) and showed the average effect of the intervention on these groups. RESULTS The differences between the intervention group and the control group were statistically significant in each risk group. The average predicted probabilities of cannabis use for a child from the low-risk group were 4.3% if the child had the intervention and 6.53% if no intervention was provided. The corresponding probabilities for a child from the moderate-risk group were 10.91% and 15.34% and for a child from the high-risk group 25.51% and 32.61%. School grades, thoughts of hurting oneself, and breaking the rules were the three most important factors distinguishing high-risk and low-risk children. CONCLUSIONS We predicted the effect of the intervention on individual children, characterized by their risk/protective factors. The predicted absolute effect and relative effect of any intervention for any selected risk/protective profile of a given child may be utilized in both prevention practice and research.
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Hakkarainen P, Karjalainen K, Raitasalo K, Sorvala VM. School’s in! Predicting teen cannabis use by conventionality, cultural disposition and social context. DRUGS: EDUCATION, PREVENTION AND POLICY 2015. [DOI: 10.3109/09687637.2015.1024611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Pekka Hakkarainen
- National Institute for Health and Welfare (THL), Alcohol and Drugs Unit, Helsinki, Finland
| | - Karoliina Karjalainen
- National Institute for Health and Welfare (THL), Alcohol and Drugs Unit, Helsinki, Finland
| | - Kirsimarja Raitasalo
- National Institute for Health and Welfare (THL), Alcohol and Drugs Unit, Helsinki, Finland
| | - Veli-Matti Sorvala
- National Institute for Health and Welfare (THL), Alcohol and Drugs Unit, Helsinki, Finland
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Chauchard E, Goutaudier N, Valls M, Melioli T, van Leeuwen N, Chabrol H. Consommation de cannabis et comportements antisociaux dans un échantillon d’adolescents scolarisés. Encephale 2014; 40:387-91. [DOI: 10.1016/j.encep.2013.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 11/27/2013] [Indexed: 11/29/2022]
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Piontek D, Kraus L, Bjarnason T, Demetrovics Z, Ramstedt M. Individual and country-level effects of cannabis-related perceptions on cannabis use. A multilevel study among adolescents in 32 European countries. J Adolesc Health 2013; 52:473-9. [PMID: 23299007 DOI: 10.1016/j.jadohealth.2012.07.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 07/16/2012] [Accepted: 07/17/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE The present article investigated individual and aggregated effects of cannabis-related perceptions and other cannabis-related indicators on 12-month cannabis use prevalence and frequency among 15-16 year olds using multilevel analysis across 32 European countries. METHODS Data on cannabis use, perceptions of availability, risks and friends' use as well as socio-demographic characteristics were taken from the 2007 European School Survey Project on Alcohol and Other Drugs. At the country level, aggregated measures of the perceptions were used. Data on cannabis price and 12-month cannabis use prevalence in the total population were taken from the World Drug Report. The analytical sample comprised 86,107 students (82.5% of the overall 2007 international database). RESULTS Strong and persistent individual-level effects were identified for perceived availability, perceived harm, and the number of cannabis using friends. The effects on cannabis use prevalence and frequency were more pronounced than country-level effects. At the country level, aggregated perceived peer consumption and population prevalence were significant predictors, whereas price was not found to be related to both outcome variables. The association between perceived friends' use and cannabis use was moderated by aggregated perceived availability. CONCLUSIONS Proximal influences related to the immediate social situation seem to be more strongly associated with cannabis use than do distal influences related to social contexts, emphasizing the importance of personal attitudes and perceptions in substance use behavior. Prevention programs may focus on informing adolescents about the potential risks of cannabis and on correcting misperceptions of social norms. Policy measures may target on reducing visibility of drug use.
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Affiliation(s)
- Daniela Piontek
- Epidemiological Research Department, IFT Institut für Therapieforschung, Munich, Germany.
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