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Ruokolainen O, Ollila H, Raitasalo K. Have there been changes in daily smoking and cigarette consumption among adolescents? Investigation between 1999 and 2019 among Finnish adolescents. Addiction 2024; 119:478-487. [PMID: 37984823 DOI: 10.1111/add.16385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/11/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND AND AIMS It is postulated that due to decreased smoking rates and increased denormalisation of smoking, those who start and maintain smoking have more socially disadvantaged characteristics and are more dependent on nicotine than those who do not (the so-called 'hardening' hypothesis). The aim of this study was to measure changes in daily smoking and cigarette consumption among Finnish adolescents according to background factors. DESIGN AND SETTING A repeated cross-sectional study using data from European School Survey Project on Alcohol and other Drugs (ESPAD) on six representative cross-sections of 15- to 16-year-old students between 1999 and 2019 in Finland. PARTICIPANTS A total of 11 377 males and 12 247 females. MEASUREMENTS The outcome measures included the proportion of daily smokers among current smokers, daily smoking and the estimated mean number of smoked cigarettes per day (CPD). Substance use, parental monitoring and school performance were used as independent variables. All measures were self-reported. FINDINGS Daily smoking decreased over time and daily smokers constituted a smaller part of current smokers in 2019 compared with 1999 (the ratio among boys 0.68 and 0.43, respectively; among girls 0.59 and 0.43). Boys using cannabis (interaction between cannabis*survey year: P = 0.020; in 2019 odds ratio [OR]: 3.68, 95% confidence interval [CI] 2.23-6.08) and girls with heavy episodic drinking (interaction between heavy episodic drinking*survey year: P = 0.006, in 2019 OR: 9.00, 95% CI 5.61-14.42) had elevated adjusted odds for daily smoking over time. The estimated mean number of CPD decreased among daily smokers from 9.0 in 1999 to 7.2 in 2019 (P = 0.0002) and the differences diminished between groups based on gender, snus/alcohol use and parental monitoring. The between-group differences remained with regard to cannabis use (P = 0.0233 in 2019) and school performance (P = 0.0111 in 2019). CONCLUSIONS Among currently smoking Finnish adolescents, the proportion of daily smokers decreased between 1999 and 2019, as did the number of cigarettes smoked per day (CPD) among daily smokers, suggesting an absence of 'hardening' in this group. However, differences were observed related to the odds of daily smoking and the mean number of CPD, indicating the change has been less favorable among some adolescent groups than others.
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Affiliation(s)
- Otto Ruokolainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kirsimarja Raitasalo
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Adinkrah E, Najand B, Young-Brinn A. Parental Education and Adolescents' Asthma: The Role of Ethnicity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020267. [PMID: 36832395 PMCID: PMC9955909 DOI: 10.3390/children10020267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/20/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023]
Abstract
While high parental education is associated with better health, this association may be weaker for ethnic minority than for ethnic majority families. It is unknown whether the association between parental education and adolescents' asthma also varies by ethnicity. AIM To study the association between parental education and adolescents' asthma overall and by ethnicity. METHODS The current study used data from the Population Assessment of Tobacco and Health (PATH)-Adolescents study. All participants were 12 to 17-year-old non-smokers (n = 8652). The outcome of interest was adolescents' asthma. The predictor of interest was baseline parental education, the covariates were age, sex, and number of parents present at baseline, and the moderator was ethnicity. RESULTS According to logistic regression analyses, higher parental education was predictive of adolescents' asthma; however, this association was weaker for Latino than non-Latino adolescents (OR 1.771; CI 1.282-2.446). We did not find a significant difference in the effect of parental education on asthma of White and African American adolescents. Our stratified models also showed that higher parental education was associated with lower asthma for non-Latino but not for Latino adolescents. CONCLUSION The effect of high parental education on adolescents' asthma prevalence differs between Latino and non-Latino families, with Latino families showing weaker protective effects of parental education on adolescents' asthma. Future research should test the role of exposure to environmental pollutants, neighborhood quality, and prevalence of smoking in social network members as well as other contextual factors at home, in school, and in the neighborhood that may increase prevalence of asthma in Latino adolescents regardless of their parental education. Given that these potential causes are multi-level, potential causes of such disparities should be tested in future multi-level research.
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Affiliation(s)
- Edward Adinkrah
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Marginalization-Related Diminished Returns Center, Los Angeles, CA 90059, USA
- Correspondence:
| | - Babak Najand
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
| | - Angela Young-Brinn
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
- Marginalization-Related Diminished Returns Center, Los Angeles, CA 90059, USA
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Osuafor GN, Okoli CE, Phateng R. Risk and protective factors associated with health risk behaviours among school learners in Western Cape, South Africa. BMC Public Health 2023; 23:16. [PMID: 36597075 PMCID: PMC9811777 DOI: 10.1186/s12889-022-14845-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/09/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Health risk behaviour is rife among school learners in the Western Cape province. This paper assesses risk and protective factors related to health risk behaviours among high school learners. METHOD Longitudinal data were sourced from 2950, 2675 and 2230 at Time 0, Time 1 and Time 2 among grade 8 learners aged 13-18 years between 2012 and 2013. Health risk behaviours were assessed on alcohol consumption, smoking cannabis in the past six months, and ever having sexual intercourse. The sociodemographic variables examined were age, sex, residence, socioeconomic status (SES), family structure and population group. Contextual variables studied were the feeling of learners about the intervention program, participation in religious activities, paid casual work and school sports. Descriptive statistics, bivariate associations and binary logistic analyses predicting health risk behaviours were carried out using generalized linear mixed models after restructuring the data collected at different time points. RESULT Health risk behaviours increased consistently for alcohol consumption (25.7-42.7%), smoking cannabis (10.4-22.1%) and (22.3-36.0%) engaging in sexual intercourse. Increasing age emerged as a risk factor for all the health risk behaviours: alcohol consumption [OR:1.3 (1.2-1.4), p < 0.001]; smoking cannabis [OR:1.3 (1.2-1.4), p < 0.001] and had sex [OR:1.5 (1.4-1.7), p < 0.001]. Participation in paid casual work also predicted health risk behaviour: alcohol use [OR:1.5 (1.2-1.8), p < 0.001]; smoking cannabis [OR:1.3 (1.0-1.7), p < 0.05] and sex [OR:1.4 (1.1-1.7), p < 0.01]. High SES and feelings about the EPEP programme enhanced alcohol consumption and smoking cannabis. Smoking cannabis was augmented by residing in an urban area. Participation in school sports was associated with increased alcohol consumption and engaging in sexual intercourse. Participation in religious activities was protected against alcohol consumption [OR:0.7 (0.53-0.83), p < 0.001]; and sex [OR: 0.5 (0.4-0.7), p < 0.001]. Being a female and belonging to a coloured population group diminished engaging in sexual intercourse, and the family structure of both parents attenuated involvement in smoking cannabis. CONCLUSION The findings of the study on risks and protective factors on health risk behaviours mirror those of school-based programmes in developing countries. Learners who participated in paid work and school sports are at risk of adverse health outcomes. Furthermore, participation in religious practices and family structure roles in attenuating health risk behaviours should be integrated and considered in the school-based intervention programme.
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Affiliation(s)
- Godswill N. Osuafor
- grid.25881.360000 0000 9769 2525Department of Population Studies and Demography, North West University, Mafikeng Campus, Mahikeng, South Africa
| | | | - Reamogetse Phateng
- grid.25881.360000 0000 9769 2525Department of Population Studies and Demography, North West University, Mafikeng Campus, Mahikeng, South Africa
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de Looze ME, Henking C, Torsheim T, Currie DB, Weber MW, Alemán-Díaz AY. The association between MPOWER tobacco control policies and adolescent smoking across 36 countries: An ecological study over time (2006–2014). THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 109:103871. [DOI: 10.1016/j.drugpo.2022.103871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/16/2022] [Accepted: 09/18/2022] [Indexed: 10/31/2022]
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Dierckens M, Richter M, Moor I, Elgar FJ, Clays E, Deforche B, De Clercq B. Trends in material and non-material inequalities in adolescent health and health behaviours: A 12-year study in 23 European countries. Prev Med 2022; 157:107018. [PMID: 35283161 DOI: 10.1016/j.ypmed.2022.107018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/29/2021] [Accepted: 03/06/2022] [Indexed: 11/18/2022]
Abstract
Information on trends in adolescent health inequalities is scarce but the available evidence suggests that inequalities are increasing. Prior studies describe associations between material resources of socioeconomic status (SES) and health, while information on non-material SES resources and inequalities in health behaviours is lacking. To improve current understandings of evolutions in adolescent health inequalities, we examined how material and non-material SES resources were associated with changes in selected health outcomes (life satisfaction, physical and psychological symptoms) and health behaviours (physical activity, screen time, breakfast, fruit, vegetables, sweets and soft drinks consumption and alcohol and tobacco use) over a 12-year period. Repeated cross-sectional data came from the 2002, 2006, 2010 and 2014 waves of the Health Behaviour in School-aged Children (HBSC) survey from 23 European countries (n = 480,386). Measures of family affluence and occupational social class were used as indicators of material and non-material SES resources respectively. Regression-based slope indices of inequality indicated that absolute material and non-material inequalities remained stable from 2002 to 2014 in all health outcomes, except for life satisfaction for which a decrease in material inequalities was found between the highest and lowest affluence group (0.81 to 0.68 difference; p < 0.001). In terms of health behaviours, material inequalities decreased in screen time between highest and lowest affluence groups (0.53 to 0.34 h/day difference; p < 0.001), fruit (odds ratio [OR] 1.89 to 1.72 lower odds; p = 0.0088) and soft drinks consumption (OR 1.36 to 1.13 lower odds; p < 0.001) and remained stable in all others. Non-material inequalities increased in all health behaviours (except for sweets consumption) between highest and lowest occupational social class groups: physical activity (0.16 to 0.24 h/day difference; p = 0.0071), screen time (-0.41 to -0.58 h/day difference; p < 0.001), breakfast (0.21 to 0.51 day/week difference; p < 0.001), fruit (OR 1.23 to 1.48 higher odds; p < 0.001), vegetables (OR 1.39 to 1.74 higher odds; p < 0.001) and soft drinks consumption (OR 0.59 to 0.43 lower odds; p < 0.001) and alcohol (OR 0.99 to 0.85 lower odds; p = 0.0420) and tobacco use (OR 0.71 to 0.59 lower odds; p = 0.0183). In summary, non-material inequalities in most health behaviours increased, whereas material inequalities in adolescent health and health behaviours remain stable or decreased. Policies and interventions may consider non-material SES components as these can help in reducing future health inequalities.
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Affiliation(s)
- Maxim Dierckens
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
| | - Matthias Richter
- Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
| | - Irene Moor
- Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, 2001 McGill College Avenue, Suite 1200, Montreal, Quebec, Canada
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium; Movement and Nutrition for Health and Performance Research Group, Department of Movement and Sports Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - Bart De Clercq
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
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Kunst AE. Commentary on Titus et al.: Understanding how smoke-free policies can contribute to smoke-free generations. Addiction 2022; 117:739-740. [PMID: 34825429 PMCID: PMC9298895 DOI: 10.1111/add.15748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/10/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Anton E. Kunst
- Department of Public and Occupational Health, Amsterdam UMCUniversity of AmsterdamAmsterdamNetherlands
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Strizek J, Uhl A, Schaub M, Malischnig D. Alcohol and Cigarette Use among Adolescents and Young Adults in Austria from 2004-2020: Patterns of Change and Associations with Socioeconomic Variables. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413080. [PMID: 34948689 PMCID: PMC8701464 DOI: 10.3390/ijerph182413080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/18/2022]
Abstract
Background: Adolescents and young adults are a crucial target group for preventing harm related to substance use. Recently, declining alcohol and tobacco consumption in young people has been observed in many countries. Based on survey data from 2004 to 2020, we describe time trends for several subgroups of adolescents and young adults (based on consumption levels and socioeconomic variables) and analyze associations between the level of alcohol per capita consumption or daily smoking and socioeconomic variables. Methods: Time trends for males and females are analyzed by a two-way ANOVA and predictors of use by using multivariate regression and logistic regression. Results: Alcohol per capita consumption decreased significantly for both sexes in the 16-year period, with male and female consumption levels converging. Daily smoking was equally prevalent for young males and females and decreased to a similar degree for both sexes. Being male and living in rural areas are associated with a higher level of alcohol consumption. Daily smoking is associated with a low level of education and is more prevalent among young adults who have already started to work. Conclusions: The decline in alcohol use and daily smoking among adolescents and young adults is taking place simultaneously. However, higher levels of alcohol consumption and daily smoking occur in different groups of adolescents and young adults, which should be considered in prevention strategies.
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Affiliation(s)
- Julian Strizek
- Gesundheit Österreich GmbH (Austrian Public Health Institute), 1010 Vienna, Austria;
- Correspondence: (J.S.); (D.M.); Tel.: +43-1-51561-148 (J.S.); +43-1-4000-87321 (D.M.)
| | - Alfred Uhl
- Gesundheit Österreich GmbH (Austrian Public Health Institute), 1010 Vienna, Austria;
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, 1020 Vienna, Austria
| | - Michael Schaub
- Swiss Research Institute of Public Health and Addiction (ISGF), University of Zürich, 8006 Zurich, Switzerland;
| | - Doris Malischnig
- Institute for Addiction Prevention, Office of Addiction and Drug Policy of Vienna, 1030 Vienna, Austria
- Correspondence: (J.S.); (D.M.); Tel.: +43-1-51561-148 (J.S.); +43-1-4000-87321 (D.M.)
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Feliu A, Fernández E, Baena A, Joossens L, Peruga A, Fu M, Martínez C. The Tobacco Control Scale as a research tool to measure country-level tobacco control policy implementation. Tob Induc Dis 2020; 18:91. [PMID: 33192223 PMCID: PMC7656742 DOI: 10.18332/tid/128318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/30/2020] [Accepted: 10/09/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The Tobacco Control Scale (TCS) was designed for advocacy purposes but has also been used as a research tool. In the present study, we characterized TCS use, its limitations and strengths, and critically assessed its use as a research instrument. METHODS We conducted an extensive search of the biomedical databases PubMed and Web of Science for the keyword ‘tobacco control scale’ in all fields. The search was limited to studies published in the period March 2006 to December 2019. Out of 69 hits, 32 studies met the inclusion criteria. Two reviewers independently extracted information from each publication regarding their general characteristics, publication and research aspects, and the characteristics of the use of the TCS. RESULTS We found that researchers have used the TCS as a tool to monitor tobacco control policies mainly in cross-sectional observational studies with ecological and multilevel designs directed to advocacy and the promotion of further research. Different outcomes, such as smoking prevalence and quit ratios, have been associated with tobacco control policy scores. The main reported limitations of the TCS were a low variance across countries and a failure to express enforcement and to incorporate the most recent legislation. CONCLUSIONS The TCS has been commonly used to assess differences in outcomes according to tobacco control policies. However, there are still areas for improvement in its use in research regarding the lack of comparability of TCS scores across time. The lessons that have been learned should be used to adapt and expand the TCS overseas.
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Affiliation(s)
- Ariadna Feliu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Antoni Baena
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,eHealth Center, Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | | | - Armando Peruga
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain.,Center for Epidemiology and Health Policies, Clínica Alemana, School of Medicine, Universidad del Desarrollo, Santiago de Chile, Chile
| | - Marcela Fu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Cristina Martínez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, United States
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Li J, Yuan B, Zeng G. Campus Policy on Tobacco Prohibition and Tobacco Use among Youth in Sub-Saharan Africa: An Investigation Based on the Perspectives of School Personnel. Risk Manag Healthc Policy 2020; 13:1939-1950. [PMID: 33116975 PMCID: PMC7548855 DOI: 10.2147/rmhp.s257834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 08/13/2020] [Indexed: 11/30/2022] Open
Abstract
Background Schools in sub-Saharan Africa respond to the widespread use of tobacco among youth with the tobacco-prohibition policies. This study empirically examined the impact of the strength of campus tobacco-prohibition policies on tobacco use among youth across 20 sub-Saharancountries. Methods This study used data from the Global School Personnel Survey across 20 sub-Saharan countries during 2005–2011. Respondents comprised 7,365 school personnel (valid sample size) from Cameroon, Central African Republic, Congo, Eritrea, Ghana, Guinea-Bissau, Lesotho, Malawi, Mauritania, Mauritius, Namibia, Niger, Rwanda, Senegal, Seychelles, Sierra Leone, South Africa, Swaziland, Togo, and Uganda. Considering the potential endogeneity-estimation bias occurring in the normal ordinary least square estimation, instrumental variable estimation was used to ensure the regression results were reliable. Results The interaction term “tobacco-prohibition policy × policy-enforcement strength” was found to negatively predict perceived seriousness of tobacco use among youth (−0.0053, 95% CI [-0.0101, -0.0005]; p<0.05), which indicated that when campus tobacco-prohibition policy and enforcement were both sufficiently strict, the extent to which school personnel felt concerned or anxious about tobacco use among youth in the 20 countries was lowest. A series of identification tests using instrumental variable estimation demonstrated that these regression results were reliable and without endogeneity-estimation bias. Conclusion This study confirms the effectiveness of the interaction of tobacco-prohibition policy and policy-enforcement strength for alleviating the seriousness of tobacco use among youth in underdeveloped areas. A series of important policy implications are discussed to prevent fast development of tobacco use in this area.
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Affiliation(s)
- Jiannan Li
- International School of Business and Finance, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Bocong Yuan
- School of Tourism Management, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Guojun Zeng
- School of Tourism Management, Sun Yat-Sen University, Guangzhou, People's Republic of China
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Kim SY, Jang M, Yoo S, JeKarl J, Chung JY, Cho SI. School-Based Tobacco Control and Smoking in Adolescents: Evidence from Multilevel Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3422. [PMID: 32423028 PMCID: PMC7277168 DOI: 10.3390/ijerph17103422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 11/16/2022]
Abstract
Since 2015, universal comprehensive school-based tobacco control programs have been provided in all primary and secondary schools in Korea. This study explored the association of school-level tobacco control with adolescent smoking, and the interactions to investigate whether gender moderates the impact of school tobacco control programs and school-level norms. Both school- and individual-level data were drawn from the 2015 School-Based Tobacco Prevention Program Survey. Multilevel logistic regression analyses were performed using data from 4631 students (ages 10-18 years) who were nested in 62 secondary schools in Seoul, Korea. Students who participated in more prevention programs were less likely to smoke (OR = 0.47, 95% CI 0.30-0.74). The effect of the programs was significantly moderated by gender. For boys, exposure to a greater number of programs decreased the risk of smoking (OR = 0.32, 95% CI 0.18-0.57) but not for girls. At the school level, the school norm regarding tobacco control regulations was negatively associated with smoking (OR = 0.28, 95% CI 0.11-0.76), and its effect was significant for girls only (OR = 0.35, 95% CI 0.17-0.76). This study highlights how the school environment is associated with adolescent smoking behavior, and the effects of programs and norms are different by gender. The findings suggest the need to develop strategies to enhance school-based tobacco control programs and the school norm considering gender differences.
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Affiliation(s)
- Seong Yeon Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; (S.Y.K.); (S.Y.)
| | - Myungwha Jang
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea;
| | - Seunghyun Yoo
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; (S.Y.K.); (S.Y.)
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea;
| | - Jung JeKarl
- Department of Health Convergence, College of Science and Industry Convergence, Ewha Womans University, Seoul 03760, Korea;
| | | | - Sung-il Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; (S.Y.K.); (S.Y.)
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea;
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Holstein BE, Andersen A, Damsgaard MT, Due P, Bast LS, Rasmussen M. Trends in socioeconomic differences in daily smoking among 15-year-old Danes 1991–2014. Scand J Public Health 2019; 48:667-673. [DOI: 10.1177/1403494819848284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: To examine trends in socioeconomic differences in daily smoking among 15-year-old Danes between 1991–2014, using occupational social class as indicator of socioeconomic status. Methods: The study included 15-year-olds participating in seven Danish Health Behaviour in School-aged Children studies between 1991–2014, n = 8,641. The analyses focused on absolute socioeconomic differences (prevalence difference between low and high occupational social class) and relative socioeconomic differences communicated by odds ratio for daily smoking. Results: The prevalence of daily smoking declined from 18.6% in 1991 to 4.5% in 2014. Across all surveys, the prevalence was 8.9% in high, 12.8% in middle and 16.5% in low occupational social classes ( p < 0.0001). The absolute socioeconomic differences increased from 1991 to 2006 and declined thereafter. Across all survey years, the odds ratio (95% confidence interval) for daily smoking was 1.40 (1.19–1.65) in middle and 1.90 (1.56-2.32) in low versus high occupational social classes. The statistical interaction between occupational social class and survey year was significant ( p = 0.0404), suggesting increasing relative socioeconomic differences from 1991 to 2014. Conclusions: There was a substantial decline in daily smoking among 15-year-olds between 1991–2014 in all occupational social class groups. The prevalence of daily smoking was highest in the low occupational social class during the entire period. The absolute socioeconomic differences in daily smoking increased between 1991–2006 and declined thereafter. The relative socioeconomic differences increased over 1991–2014. Studies of change in socioeconomic differences over time should address both absolute and relative socioeconomic differences as they may result in different conclusions and because important improvement in prevalence patterns may be disguised by exclusive focus on changes in relative socioeconomic differences.
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Affiliation(s)
- Bjørn E. Holstein
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Anette Andersen
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Mogens Trab Damsgaard
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Pernille Due
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Lotus Sofie Bast
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Mette Rasmussen
- University of Southern Denmark, National Institute of Public Health, Studiestræde 6, 1455 Copenhagen K, Denmark
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McCarthy S, Thomas SL, Bellringer ME, Cassidy R. Women and gambling-related harm: a narrative literature review and implications for research, policy, and practice. Harm Reduct J 2019; 16:18. [PMID: 30832672 PMCID: PMC6399932 DOI: 10.1186/s12954-019-0284-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/30/2019] [Indexed: 12/20/2022] Open
Abstract
Background While the prevalence of women’s participation in gambling is steadily increasing, there is a well-recognised male bias in gambling research and policy. Few papers have sought to synthesise the literature relating to women and gambling-related harm and provide practical suggestions to guide future research, policy, and practice which take into account the specific nuances associated with women’s gambling. Methods A narrative literature review was conducted to review the evidence base on women’s gambling behaviours and experiences of harm. Drawing from strategies used effectively in other areas of public health, key elements for a gendered approach to harm prevention were identified and adapted into practical public health research, policy and practice strategies. Results Results indicated a lack of research that explores women’s gambling. Few studies have examined the impact of gambling on the lives of women, with limited understanding of the factors that influence women’s engagement with gambling products, and the impact of industry tactics. A gendered approach was identified as a strategy used successfully in other areas of public health to shift the focus onto women and to ensure they are considered in research. In tobacco control, increasing trends in women’s smoking behaviour were combatted with targeted research, policy and practical initiatives. These key elements were adapted to create a conceptual framework for reducing and preventing gambling harm in women. The framework provides regulatory direction and a research agenda to minimise gambling-related harm for women both in Australia and internationally. Evidence-based policies should be implemented to focus on the influence of gender and associated factors to address gambling-related harm. Practical interventions must take into account how women conceptualise and respond to gambling risk in order to develop specific harm prevention programs which respond to their needs. Conclusion A gendered approach to gambling harm prevention shifts the focus onto the unique factors associated with women’s gambling and specific ways to prevent harm. As seen in other areas of public health, such a framework enables harm measures, policies, and interventions to be developed that are salient to girls and women’s lives, experiences and circumstances. Electronic supplementary material The online version of this article (10.1186/s12954-019-0284-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Simone McCarthy
- Centre for Population Health Research, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia.
| | - Samantha L Thomas
- Centre for Population Health Research, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Maria E Bellringer
- Gambling and Addictions Research Centre, School of Public Health and Psychosocial Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Rebecca Cassidy
- Department of Anthropology, Goldsmiths, University of London, London, UK
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Reinaldo AMDS, Pereira MO. Fatores associados ao tabagismo entre adolescentes do sexo feminino. SAÚDE EM DEBATE 2018. [DOI: 10.1590/0103-11042018s412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo foi conhecer os fatores associados ao tabagismo entre adolescentes do sexo feminino. Pesquisa descritiva, qualitativa, em duas escolas de Belo Horizonte, Minas Gerais, Brasil. Participaram do estudo 75 adolescentes do sexo feminino. A análise de conteúdo foi utilizada com o suporte do software de apoio à análise qualitativa. O uso de tabaco foi associado ao controle do peso corporal, socialização no ambiente escolar, redução da ansiedade e estresse e pouca percepção de risco para a saúde. Ações de prevenção ao uso de tabaco no ambiente escolar devem ser planejadas considerando gênero, faixa etária, linguagem e modos de vida.
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Chang Y, Cho S, Kim I, Bahk J, Khang YH. Trends in Inequality in Cigarette Smoking Prevalence by Income According to Recent Anti-smoking Policies in Korea: Use of Three National Surveys. J Prev Med Public Health 2018; 51:310-319. [PMID: 30514061 PMCID: PMC6283740 DOI: 10.3961/jpmph.18.225] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 10/22/2018] [Indexed: 11/23/2022] Open
Abstract
Objectives This study examined trends in inequality in cigarette smoking prevalence by income according to recent anti-smoking policies in Korea. Methods The data used in this study were drawn from three nationally representative surveys, the Korea National Health and Nutrition Examination Survey, the Korea Community Health Survey, and the Social Survey of Statistics Korea. We calculated the age-standardized smoking prevalence, the slope index of inequality, and the relative index of inequality by income level as a socioeconomic position indicator. Results Smoking prevalence among men decreased during the study period, but the downward trend became especially pronounced in 2015, when the tobacco price was substantially increased. Inequalities in cigarette smoking by income were evident in both genders over the study period in all three national surveys examined. Absolute inequality tended to decrease between 2014 and 2015 among men. Absolute and relative inequality by income decreased between 2008 and 2016 in women aged 30-59, except between 2014 and 2015. Conclusions The recent anti-smoking policies in Korea resulted in a downward trend in smoking prevalence among men, but not in relative inequality, throughout the study period. Absolute inequality decreased over the study period among men aged 30-59. A more aggressive tax policy is warranted to further reduce socioeconomic inequalities in smoking in young adults in Korea.
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Affiliation(s)
- Youngs Chang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Sanghyun Cho
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Ikhan Kim
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Jinwook Bahk
- Department of Public Health, Keimyung University, Daegu, Korea
| | - Young-Ho Khang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea.,Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
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Tinner L, Caldwell D, Hickman M, MacArthur GJ, Gottfredson D, Lana Perez A, Moberg DP, Wolfe D, Campbell R. Examining subgroup effects by socioeconomic status of public health interventions targeting multiple risk behaviour in adolescence. BMC Public Health 2018; 18:1180. [PMID: 30326897 PMCID: PMC6192072 DOI: 10.1186/s12889-018-6042-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/17/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Multiple risk behaviour (MRB) refers to two or more risk behaviours such as smoking, drinking alcohol, poor diet and unsafe sex. Such behaviours are known to co-occur in adolescence. It is unknown whether MRB interventions are equally effective for young people of low and high socioeconomic status (SES). There is a need to examine these effects to determine whether MRB interventions have the potential to narrow or widen inequalities. METHODS Two Cochrane systematic reviews that examined interventions to reduce adolescent MRB were screened to identify universal interventions that reported SES. Study authors were contacted, and outcome data stratified by SES and intervention status were requested. Risk behaviour outcomes alcohol use, smoking, drug use, unsafe sex, overweight/obesity, sedentarism, peer violence and dating violence were examined in random effects meta-analyses and subgroup analyses conducted to explore differences between high SES and low SES adolescents. RESULTS Of 49 studies reporting universal interventions, only 16 also reported having measured SES. Of these 16 studies, four study authors provided data sufficient for subgroup analysis. There was no evidence of subgroup differences for any of the outcomes. For alcohol use, the direction of effect was the same for both the high SES group (RR 1.26, 95% CI: 0.96, 1.65, p = 0.09) and low SES group (RR 1.14, 95% CI: 0.98, 1.32, p = 0.08). The direction of effect was different for smoking behaviour in favour of the low SES group (RR 0.83, 95% CI: 0.66, 1.03, p = 0.09) versus the high SES group (RR 1.16, 95% CI: 0.82, 1.63, p = 0.39). For drug use, the direction of effect was the same for both the high SES group (RR 1.29, 95% CI: 0.97, 1.73, p = 0.08) and the low SES group (RR 1.28, 95% CI: 0.84, 1.96, p = 0.25). CONCLUSIONS The majority of studies identified did not report having measured SES. There was no evidence of subgroup difference for all outcomes analysed among the four included studies. There is a need for routine reporting of demographic information within studies so that stronger evidence of effect by SES can be demonstrated and that interventions can be evaluated for their impact on health inequalities.
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Affiliation(s)
- Laura Tinner
- Population Health Sciences, Bristol Medical School, University of Bristol, Canygne Hall, Bristol, BS8 2BN UK
| | - Deborah Caldwell
- Population Health Sciences, Bristol Medical School, University of Bristol, Canygne Hall, Bristol, BS8 2BN UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Canygne Hall, Bristol, BS8 2BN UK
| | - Georgina J MacArthur
- Population Health Sciences, Bristol Medical School, University of Bristol, Canygne Hall, Bristol, BS8 2BN UK
| | - Denise Gottfredson
- Department of Criminology and Criminal Justice, University of Maryland, College Park, Prince George’s, MD USA
| | - Alberto Lana Perez
- Department of Preventive Medicine and Public Health, School of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain
| | - D Paul Moberg
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI USA
| | - David Wolfe
- Faculty of Education, Western University, Ontario, Canada
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, Canygne Hall, Bristol, BS8 2BN UK
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Lo CC, Yang F, Ash-Houchen W, Cheng TC. Racial/Ethnic Differences in Cigarette Use: The Roles of Mental Illness and Health-Care Access/Utilization. Subst Use Misuse 2018; 53:1184-1193. [PMID: 29172859 DOI: 10.1080/10826084.2017.1400062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Empirical evidence supports a hypothesis that cigarettes may be used to cope with mental illness. Little research, however, addresses how race/ethnicity is linked to mental health and cigarette use. OBJECTIVES This study applied the self-medication hypothesis. It asked whether mental status was associated, via health-care access/utilization, with the cigarette use outcomes of four racial/ethnic groups. It also tested whether race/ethnicity moderated any such associations. METHODS We used nationally representative data from the 2009-2010 and 2011-2012 National Health and Nutrition Examination Surveys to link cigarette use to mental status and health-care access/utilization. The final sample included 3827 White respondents, 1635 African-American respondents, 1144 Mexican-American respondents, and 781 Hispanic American (other than Mexican-American) respondents. RESULTS Consistent with earlier research and the self-medication hypothesis, we observed a positive relationship between cigarette use and mental status. Associations of cigarette use and health-care access/utilization sometimes failed to take expected directions. CONCLUSIONS We concluded from the findings that race/ethnicity's moderating role in associations between cigarette use and health-care access was generally more advantageous to Whites than other groups examined. Where treatment is delayed by lack of access to, or lack of trust in, care providers, mental health may worsen-and it is often minority Americans who lack access and trust. If minority Americans' health is to improve, shrinking racial health disparities, then access to adequate health care must be available to them, facilitating prompt treatment of mental and other illness.
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Affiliation(s)
- Celia C Lo
- a Department of Sociology and Social Work , Texas Woman's University , Denton , Texas , USA
| | - Fan Yang
- b Doctoral Student, School of Social Work , University of Alabama , Tuscaloosa , Alabama , USA
| | - William Ash-Houchen
- c Doctoral Student, Department of Sociology and Social Work , Texas Woman's University , Denton , Texas , USA
| | - Tyrone C Cheng
- d Department of Social Work and Child Advocacy , Montclair State University , Montclair , New Jersey , USA
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Perelman J, Alves J, Pfoertner T, Moor I, Federico B, Kuipers MAG, Richter M, Rimpela A, Kunst AE, Lorant V. The association between personal income and smoking among adolescents: a study in six European cities. Addiction 2017; 112:2248-2256. [PMID: 28667824 PMCID: PMC5698771 DOI: 10.1111/add.13930] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/06/2017] [Accepted: 06/23/2017] [Indexed: 11/30/2022]
Abstract
AIMS This study investigates the link between personal income and smoking among adolescents, and aims to answer the following questions: (i) to what extent is personal income related to smoking, independent of family socio-economic status (SES) and (ii) does the association between personal income and smoking apply to different subpopulations? DESIGN Cross-sectional study. SETTING Six cities from European countries (Amersfoort, the Netherlands; Coimbra, Portugal; Hannover, Germany; Latina, Italy; Namur, Belgium; Tampere, Finland) in 2013. PARTICIPANTS A school-based sample of 10 794 adolescents aged 14-17 years. MEASUREMENTS We modelled smoking experimentation, weekly smoking, daily smoking and (among daily smokers) smoking intensity as function of personal income, adjusting for age, sex, family SES, parental smoking and country. We tested interactions between personal income and covariates. Stratification analyses were performed for the variables for which interactions were significant. FINDINGS Adolescents in the highest income quintile were more likely to be smoking experimenters [odds ratio (OR) = 1.87; P < 0.01], weekly smokers (OR = 3.51; P < 0.01) and daily smokers (OR = 4.55; P < 0.01) than those in the lowest quintile. They also consumed more cigarettes per month (β = 0.79; P < 0.01). Adjusting for family SES did not modify the significance of relationships, and increased the magnitude of the association for daily smoking. None of the interactions between covariates and personal income was significant for smoking measures. For the intensity of smoking, the interaction was significant for SES. The stratified analysis showed a non-significant association between smoking intensity and personal income among the oldest adolescents and those with the lowest SES background, while significant among younger and higher SES backgrounds. CONCLUSION In the Netherlands, Portugal, Germany, Italy, Belgium and Finland, adolescents' personal income is related positively to smoking behaviours independent of family socio-economic status (SES). However, among low socio-economic status adolescent daily smokers, the association between the intensity of smoking and personal income is weaker.
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Affiliation(s)
- Julian Perelman
- Escola Nacional de Saúde PúblicaUniversidade NOVA de Lisboa, and Centro de Investigação em Saúde PúblicaPortugal
| | - Joana Alves
- Escola Nacional de Saúde PúblicaUniversidade NOVA de Lisboa, and Centro de Investigação em Saúde PúblicaPortugal
| | - Timo‐Kolja Pfoertner
- Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of MedicineUniversity of CologneCologneGermany
| | - Irene Moor
- Institute of Medical Sociology, Martin Luther University Halle‐WittenbergGermany
| | - Bruno Federico
- Department of Human Sciences, Society and HealthUniversity of Cassino and Southern LazioItaly
| | - Mirte A. G. Kuipers
- Department of Public Health, Academic Medical CenterUniversity of Amsterdamthe Netherlands
| | - Matthias Richter
- Institute of Medical Sociology, Martin Luther University Halle‐WittenbergGermany
| | - Arja Rimpela
- Department of Adolescent PsychiatryTampere University HospitalFinland
| | - Anton E. Kunst
- Department of Public Health, Academic Medical CenterUniversity of Amsterdamthe Netherlands
| | - Vincent Lorant
- Institute of Health and Society, Université catholique de LouvainBelgium
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18
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Filippidis FT, Laverty AA, Hone T, Been JV, Millett C. Association of Cigarette Price Differentials With Infant Mortality in 23 European Union Countries. JAMA Pediatr 2017; 171:1100-1106. [PMID: 28975220 PMCID: PMC5710372 DOI: 10.1001/jamapediatrics.2017.2536] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Raising the price of cigarettes by increasing taxation has been associated with improved perinatal and child health outcomes. Transnational tobacco companies have sought to undermine tobacco tax policy by adopting pricing strategies that maintain the availability of budget cigarettes. OBJECTIVE To assess associations between median cigarette prices, cigarette price differentials, and infant mortality across the European Union. DESIGN, SETTING, AND PARTICIPANTS A longitudinal, ecological study was conducted from January 1, 2004, to December 31, 2014, of infant populations in 23 countries (comprising 276 subnational regions) within the European Union. INTERVENTIONS Median cigarette prices and the differential between these and minimum cigarette prices were obtained from Euromonitor International. Pricing differentials were calculated as the proportions (%) obtained by dividing the difference between median and minimum cigarette price by median price. Prices were adjusted for inflation. MAIN OUTCOMES AND MEASURES Annual infant mortality rates. Associations were assessed using linear fixed-effect panel regression models adjusted for smoke-free policies, gross domestic product, unemployment rate, education, maternal age, and underlining temporal trends. RESULTS Among the 53 704 641 live births during the study period, an increase of €1 (US $1.18) per pack in the median cigarette price was associated with a decline of 0.23 deaths per 1000 live births in the same year (95% CI, -0.37 to -0.09) and a decline of 0.16 deaths per 1000 live births the following year (95% CI, -0.30 to -0.03). An increase of 10% in the price differential between median-priced and minimum-priced cigarettes was associated with an increase of 0.07 deaths per 1000 live births (95% CI, 0.01-0.13) the following year. Cigarette price increases across 23 European countries between 2004 and 2014 were associated with 9208 (95% CI, 8601-9814) fewer infant deaths; 3195 (95% CI, 3017-3372) infant deaths could have been avoided had there been no cost differential between the median-priced and minimum-priced cigarettes during this period. CONCLUSIONS AND RELEVANCE Higher cigarette prices were associated with reduced infant mortality, while increased cigarette price differentials were associated with higher infant mortality in the European Union. Combined with other evidence, this research suggests that legislators should implement tobacco tax and price control measures that eliminate budget cigarettes.
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Affiliation(s)
- Filippos T. Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, England
| | - Anthony A. Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, England
| | - Thomas Hone
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, England
| | - Jasper V. Been
- Division of Neonatology, Department of Paediatrics, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, the Netherlands,Department of Obstetrics and Gynaecology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, the Netherlands,Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Scotland
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, England
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Intarut N, Pukdeesamai P. Socioeconomic Inequality in Concurrent Tobacco and Alcohol Consumption. Asian Pac J Cancer Prev 2017; 18:1913-1917. [PMID: 28749620 PMCID: PMC5648398 DOI: 10.22034/apjcp.2017.18.7.1913] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Whilst several studies have examined inequity of tobacco use and inequity of alcohol drinking individually, comparatively little is known about concurrent tobacco and alcohol consumption. The present study therefore investigated inequity of concurrent tobacco and alcohol consumption in Thailand. Methods: The 2015 Health and Welfare Survey was obtained from Thailand’s National Statistical Office and used as a source of national representative data. Concurrent tobacco and alcohol consumption was defined as current and concurrent use of both tobacco and alcohol. The wealth assets index was used as an indicator of socioeconomic inequity. Socioeconomic status included 5 groups ranging from poorest (Q1) to richest (Q5). A total of 55,920 households and 113,705 participants aged 15 years or over were included and analyzed. A weighted multiple logistic regression was performed. Results: The prevalence of concurrent tobacco and alcohol consumption, tobacco consumption only, and alcohol consumption only were 15.2% (95% CI: 14.9, 15.4), 4.7% (95% CI: 4.5, 4.8), and 18.9% (95% CI: 18.7, 19.1), respectively. Weighted multiple logistic regression showed that concurrent tobacco and alcohol consumption was high in the poorest socioeconomic group (P for trend <0.001), and tobacco consumption only was also high in the poorest group (P for trend <0.001). A high prevalence of alcohol consumption was observed in the richest group (P for trend <0.001). Conclusions: These findings suggest that tobacco and alcohol consumption prevention programs would be more effective if they considered socioeconomic inequities in concurrent tobacco and alcohol consumption rather than focusing on single drug use.
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Affiliation(s)
- Nirun Intarut
- Clinical Epidemiology Unit, Mahasarakham University, Muang, Mahasarakham, Thailand.,Graduate Division, Faculty of Medicine, Mahasarakham University, Muang, Mahasarakham, Thailand.
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Castro-Calvo J, Ballester-Arnal R, Gil-Llario MD, Giménez-García C. Common etiological pathways between toxic substance use, Internet and cybersex addiction: The role of expectancies and antisocial deviance proneness. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.05.066] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Tobacco control policy and socio-economic inequalities in smoking in 27 European countries. Drug Alcohol Depend 2016; 165:79-86. [PMID: 27262899 DOI: 10.1016/j.drugalcdep.2016.05.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 05/13/2016] [Accepted: 05/20/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Higher Tobacco Control Scale (TCS) scores, in the early 2000s were associated with higher smoking cessation rates across Europe, both among lower and higher educated people. We aimed to assess if this association held in recent years. METHODS Repeated cross-sectional Eurobarometer surveys were used, in 27 European countries from 2006 to 2012 (study sample=73,617 adults). We used multilevel regression to model associations between the TCS (ranging from 0 to 100, quantifying: tobacco price, smoke-free laws, mass-media campaigns, advertising bans, warning labels, and cessation support) and both smoking cessation and cigarettes smoked per day. We modelled associations according to respondents' education and occupation, with adjustment for age, sex, and survey-wave. RESULTS We found no association between the TCS and smoking cessation for lower or middle educated respondents, but we did find an association for higher educated respondents (OR: 1.13, 95%CI: 1.08 to 1.19). For smoking intensity, we observed no associations with the TCS for lower educated respondents (beta: 0.04, 95%CI: -0.33 to 0.41) but we did observe significant associations for middle (beta: -0.25, 95%CI: -0.47 to -0.03) and higher educated respondents (beta: -0.27, 95%CI: -0.55 to -0.01). Associations were observed for both manual and non-manual classes, but not for those not working for pay. Of the TCS domains, none were associated with smoking cessation for lower educated respondents, but five were for higher educated respondents. CONCLUSIONS Associations between tobacco control policies and smoking cessation were found mostly among higher socioeconomic groups. This underlines the need for specific tobacco control policies that explicitly focus on reaching low socio-economic groups.
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Pförtner TK, Rathmann K, Moor I, Kunst AE, Richter M. [Social inequalities in adolescent smoking: A cross-national perspective of the role of individual and macro-structural factors]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 59:206-16. [PMID: 26631012 DOI: 10.1007/s00103-015-2280-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In an EU-funded project, we examined on the basis of international comparative analyses which factors were associated with and contributed to socioeconomic inequalities in adolescent smoking. This paper presents the results obtained and discusses their implications for policy and research. METHODS Analyses were based on the "Health Behaviour in School-aged Children (HBSC)" study in 2006 and included more than 50,000 adolescents from 37 countries. The focus was on the association between family affluence and weekly smoking (regularly, at least once a week) among adolescents. Explanatory variables at the individual level refer to psychosocial resources and burdens of school, family, and peers. At the country level, national income, various tobacco control policies, and an index of external differentiation of the educational system were used. RESULTS The psychosocial factors of school and family explained many of the inequalities in the smoking behavior of adolescents. In an international comparison, socioeconomic inequalities in smoking were stronger in richer countries. Absolute smoking rates were lower and inequalities in smoking smaller for boys in countries with higher tobacco prices. On the other hand, educational systems with higher degrees of external differentiation showed lower inequalities in smoking beahviour by girls, and relatively higher rates of smoking (for boys and girls). Stronger inequalities in smoking behaviour were demonstrated in countries with a greater range of preventative measures for tobacco dependence (for boys) and with higher levels of government spending on tobacco control (for girls). CONCLUSION Experiences in richer countries revealed that tobacco control needs to be strengthened for socially disadvantaged adolescents. The reduction of smoking prevalence and socioeconomic inequalities in smoking behavior should be based not only on a strengthening of psychosocial resources in the family and at school, but also on an increase in tobacco prices.
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Affiliation(s)
- Timo-Kolja Pförtner
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Universität zu Köln, Eupener Straße 129, 50933, Köln, Deutschland.
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland.
| | - Katharina Rathmann
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Irene Moor
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Anton E Kunst
- Department of Public Health, AMC, University of Amsterdam, Amsterdam, Niederlande
| | - Matthias Richter
- Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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