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Demetriades SZ, Walter N, Horvát EÁ, Abhari R. Dying to Fit In: How Interpersonal Networks Shape COVID-19 Health Outcomes Through Discussion and Social Norms. HEALTH COMMUNICATION 2024:1-10. [PMID: 38373894 DOI: 10.1080/10410236.2024.2321405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Research has repeatedly demonstrated the ability of social networks, interpersonal discussion, and perceived social norms to shape health-related outcomes. There are still substantial gaps, however, in understanding the theoretical mechanism that holds these components together, as well as the boundary conditions of their effects. Employing ego-network analysis with a representative sample of Illinois residents (N = 711) and focusing on the context of COVID-19 vaccine adherence, this study constructs a comprehensive framework to examine the direct, indirect, and conditional relationships linking social capital within networks, factual knowledge, and vaccination. Overall, the results point to the ability of tight-knit networks to influence knowledge and behavior for better or worse, depending on the composition of the network and its conversational valence. Theoretical and practical implications are discussed.
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Affiliation(s)
| | - Nathan Walter
- Department of Communication Studies, Northwestern University
| | | | - Rod Abhari
- Department of Communication Studies, Northwestern University
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2
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Gupta A, Grover S, Sakrawal K, Kumar A, Meena S, Rathore M, Kumawat P. Prevalence, Patterns, and Predictors of Tobacco Consumption among Adolescents: An Observational Study from a Rural area of Rajasthan. Indian J Community Med 2023; 48:748-754. [PMID: 37970174 PMCID: PMC10637613 DOI: 10.4103/ijcm.ijcm_382_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/27/2023] [Indexed: 11/17/2023] Open
Abstract
Background The prevalence of smoking cigarettes among adolescents in India is nearly one in 10, and almost half of them initiate tobacco use before turning 10 years old. Our study objective was to assess the prevalence of tobacco consumption and the sociodemographic factors associated with tobacco consumption among adolescents in a rural area of Rajasthan. Materials and Methods This community-based, cross-sectional study was conducted for a period of 1 year from April 2021 to March 2022 in village Naila, Jaipur. All 1083 adolescents of village Naila were contacted; however, 1049 were included in the study. Multivariate logistic regression (forward likelihood model) was used to assess the strength of the association of risk factors for the consumption of tobacco. Results A considerable proportion, that is, 22.4% (235/1049), of adolescents were tobacco consumers. Out of 235 consumers, 104 were smokers, 65 were consuming smokeless tobacco, and 66 were consuming both forms of tobacco. In multivariate analysis, age, sex, grade of participants, pocket money, family history of tobacco and alcohol consumption, maternal education, and per capita income were found to be significant predictors of tobacco consumption (P < 0.05). Conclusion Tobacco consumption is highly common in Rajasthan's rural adolescent population, and it begins at a very young age. Hence, corrective measures need to be initiated in an early stage of life. To reduce the impact of social norms, peer pressure, and family members who consume tobacco, the behavioral change communication activities must be strengthened.
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Affiliation(s)
- Ajay Gupta
- Community Medicine and Family Medicine Department, All India Institute of Medical Sciences Jodhpur, Rajasthan, India
| | - Somya Grover
- Department of Community Medicine, SMS Medical College, Jaipur, Rajasthan, India
| | - Komal Sakrawal
- Department of Community Medicine, SMS Medical College, Jaipur, Rajasthan, India
| | - Abhishek Kumar
- Community Medicine and Family Medicine Department, All India Institute of Medical Sciences Rishikesh, Uttarakhand, India
| | | | - Monika Rathore
- Department of Community Medicine, SMS Medical College, Jaipur, Rajasthan, India
| | - Pragya Kumawat
- Department of Community Medicine, JNU Medical College, Jaipur, Rajasthan, India
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Singer JM, Keller-Hamilton B, Roberts ME, Klein EG, Ferketich AK. Geographic Differences in JUUL Use and Risk Perceptions. Subst Use Misuse 2022; 57:1918-1922. [PMID: 36103627 PMCID: PMC9661056 DOI: 10.1080/10826084.2022.2120360] [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] [Indexed: 10/14/2022]
Abstract
PURPOSE The aim of this study was to compare prevalence of JUUL use and JUUL risk perceptions between adolescents living in an urban area versus Appalachian areas of the U.S. METHODS Data were drawn from a prospective cohort study of adolescent males (the Buckeye Teen Health Study, or BTHS); our cross-sectional analysis used data from one timepoint, collected between January and December 2019 (N = 873). Chi-square tests and multivariable logistic regression compared JUUL use prevalence and risk perceptions between participants in an urban Ohio county and nine predominantly rural Appalachian Ohio counties. RESULTS Over a quarter of the sample (29.2%) had ever used JUUL. In the unadjusted model, prevalence of JUUL use was similar between regions but Appalachian participants perceived JUUL as more harmful (p < .001) and more addictive (p = .04) than urban participants. In the adjusted model, region was not significantly related to current JUUL use (OR: 1.20, 95% CI: 0.77, 1.87) or ever JUUL use (OR: 1.15, 95% CI: 0.83, 1.60). CONCLUSIONS JUUL use was similar between urban and Appalachian participants despite regional differences in risk perceptions. Interventions that only target risk perceptions may not be sufficient to prevent adolescent e-cigarette use, particularly in rural communities.
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Affiliation(s)
- Jill M. Singer
- College of Public Health, The Ohio State University, Columbus, United States
| | | | - Megan E. Roberts
- College of Public Health, The Ohio State University, Columbus, United States
| | - Elizabeth G. Klein
- College of Public Health, The Ohio State University, Columbus, United States
| | - Amy K. Ferketich
- College of Public Health, The Ohio State University, Columbus, United States
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Mantey DS, Clendennen SL, Sumbe A, Wilkinson AV, Harrell MB. Positive Affect and Multiple-tobacco Product Use among Youth: A 3-year Longitudinal Study. Am J Health Behav 2021; 45:849-855. [PMID: 34702432 DOI: 10.5993/ajhb.45.5.5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Multiple-tobacco product (MTP) use is common among adolescent tobacco users. Low positive affect is a risk factor for e-cigarette use and combustible tobacco smoking. In this study, we examine the longitudinal relationship between positive affect and MTP use in a diverse cohort of adolescents in Texas. Methods: We analyzed 6 waves of biennial data (fall 2014-spring 2017) from the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system. Participants were 3868 sixth-, eighth-, and tenth-grade students in urban Texas, at enrollment. Multinomial logistic regression models examined the longitudinal relationship between positive affect and categories of MTP use, controlling for sex, race/ethnicity, past 30-day alcohol use, cohort, survey wave, and peer tobacco use. Results: The sample was comprised of 4.6% single-product users, 1.7% dual-users, and 0.7% poly-users. Each unit decrease in positive affect was associated with increased risk for single- (RRR: 1.29; 95% CI: 1.16-1.44), dual- (RRR: 1.35; 95% CI: 1.11-1.64), and poly- (RRR: 1.98; 95% CI: 1.54-2.54) use, relative to non-use. Similarly, each unit decrease in positive affect was also associated with increased risk for poly-tobacco use relative to single- (RRR: 1.53; 95% CI: 1.19-1.97) and dual- (RRR: 1.47; 95% CI: 1.11-1.95) use. Positive affect did not differentiate between single- and dual-use. Conclusion: We observed a gradient relationship between low positive affect and greater number of tobacco products used. Findings reinforce the association between poor mental health and tobacco use during adolescence. Prevention efforts may need to incorporate methods of addressing low positive affect.
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Affiliation(s)
- Dale S. Mantey
- Dale S. Mantey, NCI Postdoctoral Fellow, Department of Health Promotion and Behavioral Science, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth)
School of Public Health in Austin, TX, United States
| | - Stephanie L. Clendennen
- Stephanie L. Clendennen, Postdoctoral Fellow, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin,
TX, United States
| | - Aslesha Sumbe
- Aslesha Sumbe, Doctoral Candidate, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United States
| | - Anna V. Wilkinson
- Anna V. Wilkinson, Associate Professor, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United
States
| | - Melissa B. Harrell
- Melissa B. Harrell, Professor, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United States;,
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Mantey DS, Omega-Njemnobi O, Barroso CS. Secondhand Smoke Exposure at Home and/or in a Vehicle: Differences Between Urban and Non-Urban Adolescents in the United States, From 2015 to 2018. Nicotine Tob Res 2021; 23:1327-1333. [PMID: 33155051 PMCID: PMC8496497 DOI: 10.1093/ntr/ntaa222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 10/29/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Secondhand smoke exposure during adolescence is linked to increased risk for cigarette smoking susceptibility and initiation. Non-urban youth may encounter a disproportionate number social and environmental risk factors for secondhand smoke exposure. Research is needed to explore geographic disparities in secondhand smoke exposure. AIMS AND METHODS Four years of National Youth Tobacco Survey (2015-2018) data were pooled. Participants were 69 249 middle and high school students. Multivariable logistic regression examined the relationship between geographic region and secondhand smoke exposure (1) at home and (2) in a vehicle. A multivariable, multinomial logistic regression examined the relationship between geographic region and number of sources of secondhand smoke exposure (ie, 0, 1 source, 2 sources). Covariates included sex, race/ethnicity, grade level, past 30-day tobacco use, and living with a tobacco user. RESULTS From 2015 to 2018, ~28.4% of middle and high school students reported secondhand smoke exposure either at home, in a vehicle, or both. Non-urban youth had greater odds of reporting secondhand smoke exposure at home (Adj OR: 1.26; 95% CI: 1.15 to 1.38) and in a vehicle (Adj OR: 1.50; 95% CI: 1.35 to 1.65), compared with urban youth. Similarly, non-urban youth had greater odds of reporting secondhand smoke exposure via one source (RRR: 1.21; 95% CI: 1.11 to 1.31) and two sources (RRR: 1.61; 95% CI: 1.42 to 1.82), relative to no exposure, than urban youth. CONCLUSION Secondhand smoke exposure at home and/or in a vehicle varies across geographic region. Targeted interventions should be developed and implemented to reduce secondhand smoke exposure among at-risk youth. IMPLICATIONS Findings showcase the need to address secondhand smoke exposure in non-urban areas and how it impacts adolescents. Public health interventions and regulatory policies aimed at improving social norms and expanding health infrastructure in rural communities should be designed and implemented in order to prevent and reduce secondhand smoke exposure among non-urban youth.
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Affiliation(s)
- Dale S Mantey
- University of Texas School of Public Health,
Austin, TX, USA
| | | | - Cristina S Barroso
- University of Tennessee, College of Education, Health, and
Human Sciences, Knoxville, TN, USA
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Janssen E, Le Nézet O, Shah J, Chyderiotis S, Brissot A, Philippon A, Legleye S, Spilka S. Increasing socioeconomic disparities in tobacco smoking decline among French adolescents (2000-2017). J Public Health (Oxf) 2021; 42:e449-e457. [PMID: 31774505 DOI: 10.1093/pubmed/fdz135] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This paper studies the evolution of transitions from first cigarette use to daily use by socioeconomic status (SES) among French adolescents over the course of 17 years, in a context of decreasing prevalence of tobacco use. METHODS A total of 182 266 adolescents participated in the nationally representative ESCAPAD survey at nine different time points between 2000 and 2017. Discrete time-event analysis was used to model the transition to daily cigarette use as a function of SES, gender, age at onset and the use of other psychoactive substances. RESULTS Although lifetime cigarette smoking and daily cigarette smoking decreased significantly over the studied time span, suggesting a positive impact of prevention policies, disadvantaged adolescents were consistently more prone to engage in daily cigarette smoking, more so in 2017 than 15 years earlier. In the same time span, transitions from initiation to daily cigarette smoking have shortened, with an accelerated pace among underprivileged adolescents. CONCLUSIONS Accelerated transitions from initiation to daily cigarette use are a prevalent trend among disadvantaged adolescents in France. Efforts to mitigate the impact of marketing strategies and to promote health literacy should be pursued to reduce social inequalities in health.
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Affiliation(s)
- Eric Janssen
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France
| | - Olivier Le Nézet
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France
| | - Jalpa Shah
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France
| | - Sandra Chyderiotis
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France.,Research Centre on Population Epidemiology and Health (CESP), Faculty of Medicine-University of Paris-Sud, Faculty of Medicine-University of Versailles Saint-Quentin, Unit 1018, INSERM, University Paris-Saclay, 94800 Villejuif, France
| | - Alex Brissot
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France
| | - Antoine Philippon
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France
| | - Stéphane Legleye
- Research Centre on Population Epidemiology and Health (CESP), Faculty of Medicine-University of Paris-Sud, Faculty of Medicine-University of Versailles Saint-Quentin, Unit 1018, INSERM, University Paris-Saclay, 94800 Villejuif, France.,National Institute of Statistics and Economic Studies (INSEE), 92120 Montrouge, France
| | - Stanislas Spilka
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France.,Research Centre on Population Epidemiology and Health (CESP), Faculty of Medicine-University of Paris-Sud, Faculty of Medicine-University of Versailles Saint-Quentin, Unit 1018, INSERM, University Paris-Saclay, 94800 Villejuif, France
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Burgess ER, Walter N, Ball-Rokeach SJ, Murphy ST. Communication Hotspots: How Infrastructure Shapes People's Health. HEALTH COMMUNICATION 2021; 36:361-371. [PMID: 31760807 DOI: 10.1080/10410236.2019.1692490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Informed by communication infrastructure theory (CIT) and the social capital approach to health, this study focused on the role played by communication hotspots: physical places in a community (e.g., parks, churches, or restaurants) where health information is shared between network actors. By analyzing survey data that included information about communication infrastructure, frequency of health conversations, as well as the size and diversity of respondents' social networks, this study illustrates how communication hotspots may reduce perceived barriers to healthcare among Latinas in the greater Los Angeles area (N = 780). The results suggest that communication hotspots can influence people's health by facilitating information-sharing activities. In addition, communication hotspots may reduce perceived barriers to healthcare by bringing together diverse network actors. We conclude by considering future health interventions and policy planning to leverage and enhance community members' interactions at communication hotspots.
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Affiliation(s)
| | | | - Sandra J Ball-Rokeach
- Annenberg School for Communication and Journalism, University of Southern California
| | - Sheila T Murphy
- Annenberg School for Communication and Journalism, University of Southern California
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8
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Heris C, Thurber KA, Wright D, Thomas D, Chamberlain C, Gubhaju L, Sherriff S, McNamara B, Banks E, Smith N, Eades S. Staying smoke-free: Factors associated with nonsmoking among urban Aboriginal adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Health Promot J Austr 2020; 32 Suppl 2:185-196. [PMID: 33034057 DOI: 10.1002/hpja.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 10/04/2020] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED To examine the factors associated with preventing regular smoking among Aboriginal adolescents. METHODS Cross-sectional analysis of data from 106 Aboriginal adolescents aged 12-17 years, and their caregivers, from four Aboriginal Community Controlled Health Services in urban New South Wales, 2008-2012. The relation of individual, social, environmental and cultural factors to having 'never' smoked tobacco regularly was examined using Poisson regression. RESULTS Overall, 83% of adolescents had never smoked regularly; 13 reported current and five past smoking. Most lived in smoke-free homes (60%) despite 75% reporting at least one current smoker caregiver. Participants were significantly more likely to have never smoked regularly if they had good mental health (PR = 1.4, 95% CI: 1.1-1.9), their mother as their primary caregiver (1.3, 1.0-1.6), good family relationships (1.2, 1.0-1.5), stable housing (1.3, 1.1-1.7), had never used alcohol (1.8, 1.3-2.4), were not sexually active (3.1, 1.3- 7.2) and had no criminal justice interactions (1.8, 1.2-2.8). CONCLUSIONS Most participants lived in smoke-free homes and the vast majority had never smoked regularly. Promoting good mental health and strengthening social connections may be protective against smoking as those experiencing less social disruption were more likely to have never smoked regularly. Smoking may be an indicator of psychosocial conditions and a prompt for screening and simultaneous treatment. SO WHAT?: Organisations should be resourced to deliver holistic adolescent health promotion programs. Programs and policies should support positive family relationships and stable housing as this may protect against the uptake of regular smoking.
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Affiliation(s)
| | | | - Darryl Wright
- Tharawal Aboriginal Corporation, Campbelltown, NSW, Australia
| | - David Thomas
- Menzies School of Health Research, Darwin, NT, Australia
| | | | - Lina Gubhaju
- University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Emily Banks
- Australian National University, Canberra, ACT, Australia
| | - Natalie Smith
- Sax Institute, Sydney, NSW, Australia.,Riverina Medical and Dental Aboriginal Corporation, Wagga Wagga, NSW, Australia
| | - Sandra Eades
- University of Melbourne, Melbourne, VIC, Australia
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Buja A, Mortali C, Mastrobattista L, Minutillo A, Pichini S, Genetti B, Vian P, Andreotti A, Grotto G, Baldo V, Pacifici R. Pathways connecting socioeconomic variables, substance abuse and gambling behaviour: a cross-sectional study on a sample of Italian high-school students. BMJ Open 2019; 9:e031737. [PMID: 31719086 PMCID: PMC6858210 DOI: 10.1136/bmjopen-2019-031737] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The aim of this study was to elucidate the pathway of associations linking gambling, alcohol intake, smoking habit, cannabis consumption between each other and with demographic and socioeconomic variables. SETTING AND PARTICIPANTS A survey was conducted in 2017 on a representative sample of 15 602 Italian 14-year-olds to 17-year-olds attending 201 secondary schools. OUTCOME MEASURES Structural Equation Models analysis was used to assess the pathway between gambling, alcohol intake, smoking, cannabis consumption, demographics and socioeconomic factors. RESULTS Irrespective of socioeconomic or demographic variables, gambling is positively associated with alcohol and cannabis consumption, while cannabis consumption is predicted by smoking and by alcohol intake, smoking is predicted by alcohol intake. Adolescents with a higher weekly income are more at risk of gambling, drinking alcohol and smoking, while the degree of economic dissatisfaction was positively associated with alcohol intake, cannabis consumption and smoking. Maternal employment appeared to be positively associated with adolescents' smoking, alcohol intake and cannabis consumption. CONCLUSIONS This is one of the first studies to shed light on the pathways of associations connecting various health-risk behaviours among adolescents with demographic and socioeconomic factors.
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Affiliation(s)
- Alessandra Buja
- Department of Cardiological, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova, Italy
| | - Claudia Mortali
- Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Roma, Italy
| | | | - Adele Minutillo
- Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Roma, Italy
| | - Simona Pichini
- Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Roma, Italy
| | - Bruno Genetti
- Explora Center for Research and Statistical Analysis, Vigodarzere, Italy
| | - Paolo Vian
- Explora Center for Research and Statistical Analysis, Vigodarzere, Italy
| | | | - Giulia Grotto
- Department of Cardiological, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova, Italy
| | - Vincenzo Baldo
- Department of Cardiological, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova, Italy
| | - Roberta Pacifici
- Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Roma, Italy
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10
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Ozbas S, Onur R, Alkan MA. Behavior and attitudes towards smoking among teachers in Turkey. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-0961-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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11
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Kim EM, Park E, Kim H. Sex Differences in Multilevel Factors of Smoking Experimentation and Age of Initiation in Korean Adolescents. J Sch Nurs 2019; 36:348-359. [PMID: 30966858 DOI: 10.1177/1059840519840805] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
This study purpose was to investigate sex differences in multilevel factors associated with smoking experimentation and age of initiation among Korean adolescents. Based on the ecological model, this cross-sectional study used data from the 2016 Korea Youth Risk Behavior Web-Based Survey (N = 65,528). Among 33,803 males (51.6%) and 31,725 females (48.4%), a greater proportion of males (21.9%) than females (7.1%) engaged in smoking experimentation. Males started smoking earlier than females (males: 12.7 years, females: 12.9 years, respectively, p < .05). In both sex groups, common factors associated with smoking were age, depression, suicidal ideation, academic achievement, household economic status, and having friends smoking and a specific person to talk with about their personal concern (all p values <.05). There were significant sex differences in psychological, family, and school factors of smoking initiation and experimentation. It is necessary to develop smoking interventions considering both individual and environmental factors with sex-specific strategies.
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Affiliation(s)
- Eun-Mi Kim
- 26721Yonsei University College of Nursing, Seoul, Republic of Korea.,Department of Nursing, Sunlin University, Pohang-si, Gyeongsangbuk-do, Republic of Korea
| | - Eunhee Park
- School of Nursing, 12292University at Buffalo, Buffalo, NY, USA
| | - Heejung Kim
- 26721Yonsei University College of Nursing, Seoul, Republic of Korea.,Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
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Aho H, Koivisto AM, Paavilainen E, Joronen K. Parental involvement and adolescent smoking in vocational setting in Finland. Health Promot Int 2019; 33:846-857. [PMID: 28549167 DOI: 10.1093/heapro/dax027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The present study examined whether parental involvement in their adolescents' lives is associated with adolescent smoking in a vocational school setting when controlling for socioeconomic background and parental smoking. The study was conducted in spring 2013 and involved 34 776 Finnish vocational school students (mean age 17.6 years). The data were analyzed using multinomial regression. The results showed that lower parental involvement was significantly associated with adolescent daily smoking in both genders and with occasional smoking in girls. Parental daily smoking predicted adolescent daily smoking, and this association was also seen for those adolescents whose mother and father had quitted smoking. Furthermore, our results indicate that mothers' smoking may be more influential on adolescents' smoking than fathers' smoking. Multivariate analysis showed that living in a nuclear family or alternately with both parents in two homes decreased daily smoking in both genders compared to living in other family arrangements.
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Affiliation(s)
- Hanna Aho
- Faculty of Social Science, Health Sciences, University of Tampere, Tampere, Finland.,Department of Musclosceletal Diseases, Tampere University Hospital, Tampere, Finland.,Tampere Univesity of Applyed Sciences, Tampere, Finland
| | - Anna-Maija Koivisto
- Faculty of Social Science, Health Sciences, University of Tampere, Tampere, Finland
| | - Eija Paavilainen
- Faculty of Social Science, Health Sciences, University of Tampere, Tampere, Finland
| | - Katja Joronen
- Faculty of Social Science, Health Sciences, University of Tampere, Tampere, Finland
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13
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Ahmad MH, Ibrahim MI, Ab Rahman A, Musa KI, Mohd Zin F, Mohd Zain R, Hasan R, Hassan N, Ahmad I, Idris NS. Development and Validation of Positive Smoker Identity Questionnaire (PSmoQi): A New Instrument for Smoking Cessation Correlates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030351. [PMID: 30691181 PMCID: PMC6388284 DOI: 10.3390/ijerph16030351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/17/2019] [Accepted: 01/19/2019] [Indexed: 02/05/2023]
Abstract
Background: The positive smoker identity construct, which was based on West's PRIME Theory, affected the smoking prevalence, quit attempts and cessation success. A validated questionnaire which could measure this rich and complex construct may facilitate prediction models of successful cessation. We aimed to develop and validate a questionnaire that assesses positive smoker identity based on West's PRIME Theory. Method: The initial item pool was developed based on a theoretical framework, empirical literature, existing scales and expert review. The questionnaire was conveniently distributed to 100 smokers. Exploratory factor analysis was utilized to explore domains in the questionnaire. Construct and criterion validity, internal consistency and reliability of the domains were analyzed. Results: The final positive smoker identity questionnaire (PSmoQi) has 26 items under four internally-consistent and reliable domains: Contributory factors, contextual and temporal patterning, identity related to smoking, and behaviour in relation to smoking. The full scale demonstrated good internal consistency (∝ = 0.78), acceptable convergent and divergent validity, and good concurrent validity with the smoker self-concept scale. Conclusion: The current study provides fundamental evidence for the PSmoQi as a valid instrument in research related to smoking cessation and interventional strategy. The PSmoQi contained validated domains which could measure almost a full spectrum of smoking cessation components.
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Affiliation(s)
- Mohd Hanief Ahmad
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
| | - Azriani Ab Rahman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
| | - Faridah Mohd Zin
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
- Hospital Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
| | - Rehanah Mohd Zain
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
| | - Ruhaya Hasan
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
| | - Noraryana Hassan
- FCTC and Tobacco Control Unit, Disease Control Division (NCD), Ministry of Health Malaysia, 62590 Putrajaya, Malaysia.
| | - Imran Ahmad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
- Hospital Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
| | - Nur Suhaila Idris
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
- Hospital Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
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14
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Badr HE, Francis K. Psychosocial perspective and suicidal behaviors correlated with adolescent male smoking and illicit drug use. Asian J Psychiatr 2018; 37:51-57. [PMID: 30118993 DOI: 10.1016/j.ajp.2018.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 07/22/2018] [Accepted: 08/04/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the prevalence of smoking and drug use among adolescent boys, and to examine adolescents' psychosocial factors, and suicidal behaviors associated with adolescents' substance use. METHODS The Kuwait Global School-Based Student Health Survey employed a two-stage cluster sample design targeting a representative sample of adolescents. This study focused on the participated 1310 boys. Statistical analysis included Chi-square test, student t-test, and multivariate analysis. RESULTS The mean age was 14.5 ± 0.03 years. The reported prevalence of: smoking, ever drug use, and both smoking and drug use were 26.6% (95% CI:24.2-29.1%) and 7.4% (95% CI:6.1-9.0%) and 5.5% (95% CI:4.4-6.9%) respectively. Logistic regression model analysis revealed that adolescents whose parents smoke, suffered from insomnia, were victims of bullying, and had negative social school environment, were more likely than others to be smokers, drug users or both. Addendum, suicidal ideation, and its combination with suicidal planning and/or suicidal attempt were significantly associated with smoking. The odds of these life-threatening behaviors increased when drug use was reported and augmented when both smoking and drug use were experienced. CONCLUSIONS Prevalence of smoking and illicit drug use were high among adolescent boys. This study confirmed the association between adolescents' smoking and substance use with psychosocial context, and suicidal behaviors. Addressing these predictors would be crucial in the development of effective strategies targeting the prevention of smoking and substance use, which might consequently reduce suicidal behaviors among adolescents.
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Affiliation(s)
- Hanan E Badr
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait.
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15
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Brown JM, Anderson Goodell EM, Williams J, Bray RM. Socioecological Risk and Protective Factors for Smoking Among Active Duty U.S. Military Personnel. Mil Med 2018; 183:e231-e239. [PMID: 29697835 PMCID: PMC6027073 DOI: 10.1093/milmed/usx021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 06/12/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction Cigarette smoking can have negative consequences in military populations including injury, reduced physical endurance, higher frequency of sick days, and reduced combat readiness. This study used the socioecological model to understand individual, interpersonal, and organizational influences on cigarette smoking among military members. Materials and Methods The sample for this secondary analysis was drawn from personnel at 24 large U.S. military installations, six from each service branch. Analyses included 4,728 personnel who were classified as current cigarette smokers. Generalized linear mixed models were used to estimate the associations among risk and protective factors from multiple ecological levels for smoking intensity and nicotine dependence. Results Smoking to fit in with one's unit, being in the Army, smoking as a reaction to stress, and work-related stressors were all related to increased intensity of smoking and nicotine dependence. More active coping was associated with lower nicotine dependence and reduced smoking intensity. Conclusion Results based on the socioecological model identify influencing factors and suggest possible interventions for smoking cessation. Reducing tobacco use in the military will require coordinated interventions that address multilevel determinants of use and improve military health. This is important to the strategic alignment of policy and services across the continuum of health care needs.
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Affiliation(s)
| | | | | | - Robert M Bray
- RTI International, Research Triangle Park, Durham NC
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16
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Horn K, Ali M, Gray T, Anesetti-Rothermel A, Branstetter S. School-level disadvantage and failed cessation treatment among adolescent smokers. Tob Prev Cessat 2018; 4:11. [PMID: 32411839 PMCID: PMC7205073 DOI: 10.18332/tpc/87074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION While understanding factors that lead to successful adolescent smoking cessation outcomes is necessary, it is also prudent to determine factors and conditions that contribute to failure to quit smoking. The present study posits that adolescents' proximal environments, such as schools, may influence cessation treatment outcomes. METHODS Using aggregated and geographically-referenced data from multi-year school-based cessation trials with 14-19 year olds seeking cessation in 5 States of the USA, the present study developed and applied a tobacco-specific socio-spatial model inclusive of Hierarchical Linear Modeling. Specifically, this novel approach spatially joined individual data files (n=8855) with measures of school (n=807) and county socio-economic factors. Once linked multi-level analyses explored the extent to which cessation treatment failure was explained by the interplay of individual, school and county-level factors. Treatment was deemed as failing to meet its primary goals if participants continued to smoke cigarettes, measured 3-months post baseline. RESULTS Ten per cent of the variation in cessation treatment failure was attributable to school-level variables. Adolescent smokers were more likely to experience failure to quit in: a) school districts with large percentages of the population having less than high-school education, and b) schools with a higher ratio of students to teachers. The strength of the relationship between cessation self-efficacy and treatment success was further weakened among adolescents attending schools with higher percentages of students eligible for free or reduced lunch programs. CONCLUSIONS Findings implicate school-level socio-economic disadvantage as a significant factor inhibiting cessation, regardless of adolescent self-efficacy to quit smoking. Understanding the interplay of proximal school environments and individual-level factors may provide insights to educators, policy makers and practitioners into the complexities that inhibit or strengthen an adolescent's smoking cessation treatment experience.
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Affiliation(s)
- Kimberly Horn
- Department of Population Health Sciences, Virginia Tech Carilion Research Institute, Virginia, United States
| | - Maliha Ali
- Milken Institute School of Public Health, Department of Prevention and Community and Health, George Washington University, Washington, United States
| | - Tiffany Gray
- Milken Institute School of Public Health, Department of Prevention and Community and Health, George Washington University, Washington, United States
| | | | - Steve Branstetter
- Department of Biobehavioral, Health Pennsylvania State University, United States
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Lastunen A, Laatikainen T, Isoaho H, Lazutkina G, Tossavainen K. Family members’ and best friend’s smoking influence on adolescent smoking differs between Eastern Finland and Russian Karelia. Scand J Public Health 2017; 45:789-798. [DOI: 10.1177/1403494817723550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: The aim of this study was to find out whether family members’ (mother, father, siblings) and best friend’s smoking is related to 9th grade pupils’ daily smoking in Eastern Finland and in the Pitkäranta district, in the Republic of Karelia, Russia, and whether these relations have changed in these two culturally very different neighbourhood countries from 1995 to 2013. Methods: Data comprised four cross-sectional studies in all schools of the Pitkäranta region and selected schools in Eastern Finland. In data analyses, structural equation modelling techniques were used. Results: Our findings showed that best friend’s smoking had the strongest influence on adolescents’ smoking in both countries and study years (p < .01). The relations among family members were highly different between Pitkäranta and Eastern Finland, particularly in 2013. Conclusions: Results suggest that health promotion in schools should take into account cultural impacts and pay special attention to pupils who have family members and friends who smoke.
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Affiliation(s)
- Annamari Lastunen
- Department of Nursing Science, University of Eastern Finland, Finland
| | - Tiina Laatikainen
- National Institute for Health and Welfare, Finland/ Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | | | - Galina Lazutkina
- State Budgetary Health Care Institution of the Republic of Karelia, Pitkäranta Central Hospital, Republic of Karelia, Russia
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18
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Wen M. Social Capital and Adolescent Substance Use: The Role of Family, School, and Neighborhood Contexts. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2017; 27:362-378. [PMID: 28876530 DOI: 10.1111/jora.12299] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study assesses the link between social capital factors of norm-setting social arenas including family, school, and neighborhood and adolescent substance use measured by cigarette smoking, alcohol consumption, and illicit drug use among a sample of adolescents in California. The key messages of this study are that socialization processes at different life domains, in varying degrees, are associated with adolescent substance use behavior. Compared with school and neighborhood contexts, family is the most influential setting that should be primarily targeted for youth substance use prevention. Among different aspects of within-family social resources, parental monitoring seems to be the most protective of adolescent substance use. Study implications on family-based interventions are discussed.
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Raymond-Flesch M, Auerswald C, McGlone L, Comfort M, Minnis A. Building social capital to promote adolescent wellbeing: a qualitative study with teens in a Latino agricultural community. BMC Public Health 2017; 17:177. [PMID: 28178971 PMCID: PMC5299737 DOI: 10.1186/s12889-017-4110-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/04/2017] [Indexed: 11/29/2022] Open
Abstract
Background Latino youth, particularly in rural settings, experience significant disparities in rates of teen pregnancy and violence. Few data are available regarding social and structural influences on Latino youth’s developmental trajectories, specifically on factors that promote wellbeing and protect them from engagement in high-risk sexual and violence-related behaviors. Methods Forty-two youth aged 13 to 19 years old were recruited from middle schools and youth leadership programs to participate in one of eight community-based focus groups in Salinas, a predominantly Latino, urban center in California’s rural central coast. Focus groups covered youths’ experiences with the risk and protective factors associated with exposure to violence and romantic relationships. Four researchers completed coding with a Grounded Theory approach, informed by the theoretical frameworks of the social ecological model and social capital. The study’s design and participant recruitment were informed by a community advisory board of local youth-serving organizations and health care providers. Results Participants described family lives rich in bonding social capital, with strong ties to parents and near-peer family members. They reported that while parents had a strong desire to promote healthful behaviors and social mobility, they often lacked the bridging or linking social capital required to help youth navigate structural systems, such as college applications and access to confidential health care. Youth also reported that some families link their children to negative social capital, such as exposure to gang affiliation. Conclusion Adolescents in this agricultural community identified robust sources of bonding social capital within their families. However, they identified limitations in their families’ capacities to link them to structural resources in education, employment, and health care that could support healthful behaviors and upward social mobility.
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Affiliation(s)
- Marissa Raymond-Flesch
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94118, USA.
| | - Colette Auerswald
- School of Public Health, Division of Community Health Sciences, University of California Berkeley, 570 University Hall, Berkeley, CA, 94702, USA
| | - Linda McGlone
- Monterey County Health Department, 1270 Natividad Road, Salinas, CA, 93906, USA
| | - Megan Comfort
- Division of Behavioral Health and Criminal Justice, Research Triangle Institute International, 351 California Street, Suite 500, San Francisco, CA, 94104, USA
| | - Alexandra Minnis
- Women's Global Health Imperative, Research Triangle Institute International, 351 California Street, Suite 500, San Francisco, CA, 94104, USA.,University of California Berkeley School of Public Health, 351 California Street, Suite 500, San Francisco, CA, 94104, USA
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20
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Li K, Wen M. Substance use, age at migration, and length of residence among adult immigrants in the United States. J Immigr Minor Health 2016; 17:156-64. [PMID: 23925520 DOI: 10.1007/s10903-013-9887-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In this study we scrutinize prevalence of current smoking and binge drinking among adult US immigrants, and examine whether age at migration predicts these two behaviors and moderates the effect of length of residence. Immigrant groups include those from Latin America/Caribbean, East and South Asia, Sub-Saharan Africa, Europe/Central Asia, and Middle East/North Africa. Multivariate logistic regressions are estimated using cross-sectional data from the New Immigrant Survey (N = 7,397). Results show that patterns of smoking and binge drinking vary by gender and by region of origins. In addition, arriving at age 0-9 are directly associated with higher odds of binge drinking among adult women. Among adult men, age at migration moderates the association between length of residence and substance use. Specifically, length of residence has more detrimental effects for adolescent immigrants (arriving at age 10-18) on smoking, while its detrimental effects are more pronounced for childhood immigrants (arriving at age 0-9) on binge drinking. We interpret our findings within the critical period model in epidemiological research, concluding that adolescence and childhood are critical life stages that are associated with differential effects of length of residence when looking at smoking and binge drinking among immigrant men.
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Affiliation(s)
- Kelin Li
- Department of Sociology, University of Utah, 380 S 1530 E, RM 301, Salt Lake City, UT, 84112, USA,
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21
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Gwon SH, DeGuzman PB, Kulbok PA, Jeong S. Density and Proximity of Licensed Tobacco Retailers and Adolescent Smoking. J Sch Nurs 2016; 33:18-29. [PMID: 27864341 DOI: 10.1177/1059840516679710] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Adolescent smoking prevention is an important issue in health care. This literature review describes the theoretical concept of ecological model for adolescent smoking and tobacco retailers and summarizes previous studies on the association between the density and proximity of tobacco retailers and adolescent smoking. We reviewed nine studies on tobacco retailer density and proximity in relation to adolescent smoking, published in peer-reviewed journals between 2004 and 2014. The tobacco retailer density and proximity were correlated with adolescent lifetime smoking, past 12-month smoking, past 30-day smoking, and susceptibility to smoking. School nurses or other school health professionals may need to include the density and proximity of tobacco retailer factors around schools in school-based tobacco-use prevention programs. Health policy makers may need to consider zoning or licensing restrictions of tobacco retailers around schools for adolescent smoking prevention.
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Affiliation(s)
- Seok Hyun Gwon
- 1 University of Wisconsin-Milwaukee College of Nursing, Milwaukee, WI, USA
| | - Pamela B DeGuzman
- 2 University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Pamela A Kulbok
- 2 University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Suyong Jeong
- 3 College of Nursing, Seoul National University, Seoul, Republic of Korea
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22
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Aura A, Sormunen M, Tossavainen K. The relation of socio-ecological factors to adolescents’ health-related behaviour. HEALTH EDUCATION 2016. [DOI: 10.1108/he-03-2014-0029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to identify and describe adolescents’ health-related behaviours from a socio-ecological perspective. Socio-ecological factors have been widely shown to be related to health behaviours (smoking, alcohol consumption, physical activity and diet) in adolescence and to affect health. The review integrates evidence with socio-ecological factors (social relationships, family, peers, schooling and environment).
Design/methodology/approach
– The data were collected from electronic databases and by manual search consisting of articles (n=90) published during 2002-2014. The selected articles were analysed using inductive content analysis and narrative synthesis.
Findings
– The findings suggest that there was a complex set of relations connected to adolescent health behaviours, also encompassing socio-ecological factors. The authors tentatively conclude that socio-ecological circumstances influence adolescents’ health-related behaviour, but that this review does not provide the full picture. There seemed to be certain key factors with a relation to behavioural outcomes that might increase health inequality among adolescents.
Practical implications
– School health education is an important pathway for interventions to reduce unhealthy behaviours among adolescents including those related to socio-ecological factors.
Originality/value
– Some socio-ecological factors were strongly related to health behaviours in adolescence, which may indicate an important pathway to current and future health. This paper may help schoolteachers, nurses and other school staff to understand the relationships between socio-ecological factors and health-related behaviours, which may be useful in developing health education to reduce health disparities during adolescence.
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Cantrell J, Ganz O, Anesetti-Rothermel A, Harrell P, Kreslake JM, Xiao H, Pearson JL, Vallone D, Kirchner TR. Cigarette price variation around high schools: evidence from Washington DC. Health Place 2015; 31:193-8. [PMID: 25560754 DOI: 10.1016/j.healthplace.2014.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 11/26/2014] [Accepted: 12/02/2014] [Indexed: 11/16/2022]
Abstract
This study examines lowest cigarette prices in all tobacco retail outlets in Washington D.C. (n=750) in relation to the type and number of high schools nearby, controlling for confounders. The lowest overall and Newport menthol prices were significantly lower at outlets near public non-charter and charter schools compared with outlets near private schools. Given higher smoking prevalence and more price-sensitive youth subgroups in U.S. public schools, exposure to low prices may contribute to tobacco-related health disparities in minority and low-income populations. Tobacco taxes combined with policies to minimize the increasing use of price as a marketing tool are critical.
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Affiliation(s)
- Jennifer Cantrell
- Department of Research and Evaluation, Legacy, Washington, DC, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Ollie Ganz
- Department of Research and Evaluation, Legacy, Washington, DC, USA
| | - Andrew Anesetti-Rothermel
- Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA; Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Paul Harrell
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL (current affiliation); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (affiliation at the time the article was written)
| | - Jennifer M Kreslake
- Department of Research and Evaluation, Legacy, Washington, DC, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Haijun Xiao
- Department of Research and Evaluation, Legacy, Washington, DC, USA
| | - Jennifer L Pearson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA
| | - Donna Vallone
- Department of Research and Evaluation, Legacy, Washington, DC, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas R Kirchner
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA
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Kaai SC, Brown KS, Leatherdale ST, Manske SR, Murnaghan D. We do not smoke but some of us are more susceptible than others: a multilevel analysis of a sample of Canadian youth in grades 9 to 12. Addict Behav 2014; 39:1329-36. [PMID: 24837756 DOI: 10.1016/j.addbeh.2014.04.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 04/04/2014] [Accepted: 04/10/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Smoking susceptibility has been found to be a strong predictor of experimental smoking. This paper examined which student- and school-level factors differentiated susceptible never smokers from non-susceptible never smokers among a nationally representative sample of Canadian students in grades 9 to 12. METHODS Student-level data from the 2008-2009 Canadian Youth Smoking Survey were linked with school-level data from the 2006 Census, and one built environment characteristic (the density of tobacco retailers surrounding schools). These data were examined using multilevel logistic regression analyses. RESULTS The likelihood of a never smoker being susceptible to smoking significantly varied across schools (p=0.0002). Students in this study were more likely to be susceptible never smokers if they reported low self-esteem, held positive attitudes towards smoking, used alcohol or marijuana, had close friends who smoked, and came from homes without a total ban on smoking. The school location (rural versus urban), the socioeconomic status of the neighbourhood surrounding a school, and the density of tobacco retailers that were located within 1-km radius of each school were not associated with students' smoking susceptibility. CONCLUSION These findings underscore the continued need to develop school-based tobacco use prevention policies and/or programs that enhance students' self-esteem, address tobacco use misinformation and substance use, and include strategies targeting friends who smoke, and students who come from homes without a total ban on smoking.
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Affiliation(s)
- Susan C Kaai
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada.
| | - K Stephen Brown
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada; Propel Centre for Population Health Impact, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada; Department of Statistics and Actuarial Science, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada.
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada.
| | - Stephen R Manske
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada; Propel Centre for Population Health Impact, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1 Canada.
| | - Donna Murnaghan
- School of Nursing, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, C1A 4P3 Canada.
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25
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McPherson KE, Kerr S, Morgan A, McGee E, Cheater FM, McLean J, Egan J. The association between family and community social capital and health risk behaviours in young people: an integrative review. BMC Public Health 2013; 13:971. [PMID: 24138680 PMCID: PMC4015354 DOI: 10.1186/1471-2458-13-971] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 10/11/2013] [Indexed: 11/10/2022] Open
Abstract
Background Health risk behaviours known to result in poorer outcomes in adulthood are generally established in late childhood and adolescence. These ‘risky’ behaviours include smoking, alcohol and illicit drug use and sexual risk taking. While the role of social capital in the establishment of health risk behaviours in young people has been explored, to date, no attempt has been made to consolidate the evidence in the form of a review. Thus, this integrative review was undertaken to identify and synthesise research findings on the role and impact of family and community social capital on health risk behaviours in young people and provide a consolidated evidence base to inform multi-sectorial policy and practice. Methods Key electronic databases were searched (i.e. ASSIA, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Embase, Medline, PsycINFO, Sociological Abstracts) for relevant studies and this was complemented by hand searching. Inclusion/exclusion criteria were applied and data was extracted from the included studies. Heterogeneity in study design and the outcomes assessed precluded meta-analysis/meta-synthesis; the results are therefore presented in narrative form. Results Thirty-four papers satisfied the review inclusion criteria; most were cross-sectional surveys. The majority of the studies were conducted in North America (n=25), with three being conducted in the UK. Sample sizes ranged from 61 to 98,340. The synthesised evidence demonstrates that social capital is an important construct for understanding the establishment of health risk behaviours in young people. The different elements of family and community social capital varied in terms of their saliency within each behavioural domain, with positive parent–child relations, parental monitoring, religiosity and school quality being particularly important in reducing risk. Conclusions This review is the first to systematically synthesise research findings about the association between social capital and health risk behaviours in young people. While providing evidence that may inform the development of interventions framed around social capital, the review also highlights key areas where further research is required to provide a fuller account of the nature and role of social capital in influencing the uptake of health risk behaviours.
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Affiliation(s)
- Kerri E McPherson
- Institute for Applied Health Research, School of Health & Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK.
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Randolph KA, Archuleta A, Smith T, Teasley M. Beliefs About Alcohol Use Among Youths During Early Adolescence. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2013. [DOI: 10.1080/1067828x.2012.747893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Kaai SC, Leatherdale ST, Manske SR, Brown KS. Using student and school factors to differentiate adolescent current smokers from experimental smokers in Canada: a multilevel analysis. Prev Med 2013; 57:113-9. [PMID: 23668990 DOI: 10.1016/j.ypmed.2013.04.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 03/20/2013] [Accepted: 04/29/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE In order to understand the factors that differentiate adolescents who have tried smoking from those who have become established smokers, this study examined which student- and school-level factors differentiated current smokers from experimental smokers among a nationally representative sample of Canadian secondary school students. METHOD Student-level secondary data from the 2008-2009 Canadian Youth Smoking Survey was linked with school-level data from the 2006 Census and one built environment characteristic, and examined using multilevel logistic regression analyses. RESULTS The current smoking rates varied (P<0.001) across schools. The number of tobacco retailers surrounding the schools was associated with current smoking when adjusting for student characteristics. Additionally, students were more likely to be current smokers if they were: male, in higher grades, believed that smoking can help when they are bored, reported low school connectedness, used marijuana, had a sibling or close friend who smoked, and had no smoking bans at home. CONCLUSIONS These study findings suggest that school anti-smoking strategies need to target males, increase students' attachment to their school, address tobacco-related beliefs, and include interventions targeting smoking siblings and friends. The government should consider zoning restrictions to limit sales of tobacco products near schools.
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Affiliation(s)
- Susan C Kaai
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
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28
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Baheiraei A, Hamzehgardeshi Z, Mohammadi MR, Nedjat S, Mohammadi E. Personal and Family Factors Affecting Life time Cigarette Smoking Among Adolescents in Tehran (Iran): A Community Based Study. Oman Med J 2013; 28:184-90. [PMID: 23772284 DOI: 10.5001/omj.2013.51] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 04/28/2013] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The prevalence of smoking among adolescents varies in different parts of the world. The current study aims to survey the socio-demographic and family characteristics related to adolescent lifetime cigarette smoking among 1201 Iranian adolescents aged 15-18 years old. METHODS This study is a population-based cross-sectional survey conducted using the multistage random cluster sampling method in Tehran, Iran in the summer of 2010. RESULTS The prevalence of lifetime cigarette use amongst boys (30.2%) was about 1.5 times that of girls (22.2%), (p=0.002). Older age, low parental control, very little parental supervision in the adolescent's selection of friends, and having a friend or family member who smokes were associated with lifetime cigarette use among male adolescents. Moreover, the use of verbal punishment by the parents was a protective factor for female lifetime cigarette use. Smoking has become one of the great health threats among Iranian adolescents. CONCLUSIONS As a result, health promotion programs should be gender based whilst educational and interventional programs for preventing tobacco use should begin before adolescence.
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Affiliation(s)
- Azam Baheiraei
- Department of Reproductive Health, Tehran University of Medical Sciences, Tehran, Iran
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Schultz ASH, Nowatzki J, Ronson G. Effects of household socialization on youth susceptibility to smoke: differences between youth age groups and trends over time. Am J Public Health 2013; 103:e39-42. [PMID: 23678907 DOI: 10.2105/ajph.2013.301344] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A Canadian biennial youth survey facilitated repeating investigation of susceptibility to smoke and household socialization. We operationalized susceptibility to smoke by 3 levels on the basis of intention and behavior. Variables consistently predicting greater susceptibility across time and age groups were sibling smoking, household restrictions, and vehicle smoke exposure. Gender was predictive among older youths. Household restrictions and emerging legislation to ban smoking in vehicles with youth passengers provide protection against secondhand smoke exposure and sustained resolve to remain smoke-free.
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Affiliation(s)
- Annette S H Schultz
- Faculty of Nursing, University of Manitoba and Psychosocial Oncology & Cancer Nursing Research Group, St. Boniface Research Centre, Winnipeg, Canada.
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Huisman C, Bruggeman J. The social network, socioeconomic background, and school type of adolescent smokers. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2012. [DOI: 10.1177/0165025412444078] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study is to examine the role of Dutch second grade (age 13–14) high school peer networks in mediating socioeconomic background and school type effects on smoking behavior. This study is based on a longitudinal design with two measurement waves at five different high schools, of the complete networks of second grader friendships, as well as their smoking behavior, school type, and parents’ educational level. The analysis is done by simulation investigation for empirical network analysis (SIENA) modeling that can control for friendship selection on the basis of smoking similarity when assessing friends’ influence on smoking. The findings show that, when controlling for friendship selection, the influence of friends still plays a significant role in adolescent smoking behavior, and suggests that socioeconomic background and school type effects on smoking are mediated by the friendship networks at school.
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WILSON KATHLEENS, SPINK KEVINS. Child's Physical Activity Lapses: Parents' Intended Use of Social Control1. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2011. [DOI: 10.1111/j.1559-1816.2011.00850.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fettes DL, Aarons GA. Smoking behavior of US youths: a comparison between child welfare system and community populations. Am J Public Health 2011; 101:2342-8. [PMID: 22021304 DOI: 10.2105/ajph.2011.300266] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared rates of smoking for 2 groups of youths aged 12 to 14 years: those involved in the child welfare system (CW) and their counterparts in the community population. We then investigated factors associated with smoking for each group. METHODS We drew data from 2 national-level US sources: the National Survey of Child and Adolescent Well-Being and the National Longitudinal Study of Adolescent Health. We estimated logistic regression models for 3 binary outcome measures of smoking behavior: lifetime, current, and regular smoking. RESULTS CW-involved youths had significantly higher rates of lifetime smoking (43% vs 32%) and current smoking (23% vs 18%) than did youths in the community population. For CW-involved youths, delinquency and smoking were strongly linked. Among youths in the community population, multiple factors, including youth demographics and emotional and behavioral health, affected smoking behavior. CONCLUSIONS Smoking prevalence was notably higher among CW-involved youths than among the community population. In light of the persistent public health impact of smoking, more attention should be focused on identification of risk factors for prevention and early intervention efforts among the CW-involved population.
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Affiliation(s)
- Danielle L Fettes
- Department of Psychiatry, University of California, San Diego, 92093-0812, USA.
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Kelly AB, O'Flaherty M, Connor JP, Homel R, Toumbourou JW, Patton GC, Williams J. The influence of parents, siblings and peers on pre- and early-teen smoking: a multilevel model. Drug Alcohol Rev 2011; 30:381-7. [PMID: 21355905 DOI: 10.1111/j.1465-3362.2010.00231.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND AIMS Despite considerable success in tobacco control, many teenagers in Australia and other industrialised countries still smoke tobacco. There is mixed evidence on the relative influence of proximal social networks (parents/siblings/peers) on pre- and early-teen smoking, and no research has examined how these influences compare after accounting for school- and community-level effects.The aim of this study was to compare the relative influences of parents, siblings and peers, after accounting for school- and community-level variation in smoking. DESIGN AND METHODS A cross-sectional fixed and random effects model of smoking prevalence was used, with individuals (n = 7314) nested within schools (n = 231) nested within communities (n = 30). Grade 6 and 8 students (modal ages 11 and 13 years) completed an on-line survey. Key variables included parent/sibling/peer use. Controls included alcohol involvement, sensation seeking, pro-social beliefs, laws/norms about substance use and school commitment. RESULTS There was significant variation in smoking at both the school and community levels, supporting the need for a multilevel model. Individual-level predictors accounted for much of the variance at higher levels. The strongest effects were for number of friends who smoke, sibling smoking and alcohol involvement. Smaller significant effects were found for parent smoking. At the community level, socioeconomic disadvantage was significant, but community-level variance in pro-social and drug-related laws/norms was not related to smoking. DISCUSSION AND CONCLUSIONS Cross-level interactions were generally non-significant. Early teenage smoking was best explained by sibling and peer smoking, and individual risks largely accounted for the substantial variation observed across schools and communities. In terms of future tobacco control, findings point to the utility of targeting families in disadvantaged communities.
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Affiliation(s)
- Adrian B Kelly
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia.
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Henry DB, Kobus K, Schoeny ME. Accuracy and bias in adolescents' perceptions of friends' substance use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2011; 25:80-9. [PMID: 21244119 PMCID: PMC3749771 DOI: 10.1037/a0021874] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study tested competing hypotheses related to the false consensus effect and pluralistic ignorance by examining the accuracy and bias of adolescents' perceptions of peer substance use and the effects of their own substance use, gender, and age on perceptions of peer behavior. Two samples (ns = 163 and 2,194) that collected data on peer nominations, perceptions of peer substance use, and self-reports of substance use were used in analyses. Results from both samples provided evidence supporting the false consensus effect, that is, adolescents' reports of their friends' substance use were biased in the direction of their own use. Users and nonusers did not differ in accuracy of perceptions; however, across all substances and samples, they differed significantly in bias. Substance users displayed nearly perfect liberal bias, assuming their friends also used substances. Nonusers displayed an opposite, conservative bias, assuming their friends did not use substances. Gender and age differences in bias also were observed, with older adolescents and girls having more liberal biases than younger adolescents and boys. Results suggest the importance of differentiating the effects of actual and perceived peer substance use.
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Affiliation(s)
- David B Henry
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608, USA.
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Ennett ST, Foshee VA, Bauman KE, Hussong A, Faris R, Hipp JR, Cai L. A social contextual analysis of youth cigarette smoking development. Nicotine Tob Res 2010; 12:950-62. [PMID: 20688870 DOI: 10.1093/ntr/ntq122] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION We apply a social contextual perspective based on Bronfenbrenner's ecology of human development theory to understanding development of youth cigarette smoking. We examine the contributions of family, peer, school, and neighborhood contexts. Context attributes examined were derived from social learning and social control theories. METHODS Data are from 6,544 youth who participated in at least one of five waves of data collection between Spring 2002 and Spring 2004, 1,663 randomly selected parents who participated in one or more of three waves of data collection in the same time period; and the U.S. Census. Three-level hierarchical growth models were used to examine the contributions of time-varying measures of the four social contexts to development of smoking from age 11-17 years. Interactions between variables were examined within and between social contexts. RESULTS Attributes of each social context made independent contributions to adolescent smoking development; there also were significant interactions between variables from different contexts indicating joint contextual effects. Attributes of the social bond moderated exposure to models of smoking within and between the family and peer contexts. DISCUSSION Results suggest the value of a social contextual perspective in research on the etiology of youth smoking development as well as the utility of guidance by social learning and social control theories. While all contexts were implicated in adolescent smoking, the family and peer contexts were primarily implicated, with findings suggesting the need for consideration of interactive effects between social learning and social control variables within and between these contexts.
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Affiliation(s)
- Susan T Ennett
- Department of Health Behavior and Health Education, University of North Carolina at Chapel Hill, Campus Box 7440, Chapel Hill, NC 27599, USA.
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Cynthia Logsdon M, Davis DW. Social Justice as a Wider Lens of Support for Childbearing Women. J Obstet Gynecol Neonatal Nurs 2010; 39:339-46; quiz 346-8. [DOI: 10.1111/j.1552-6909.2010.01145.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Wilkinson AV, Spitz MR, Prokhorov AV, Bondy ML, Shete S, Sargent JD. Exposure to smoking imagery in the movies and experimenting with cigarettes among Mexican heritage youth. Cancer Epidemiol Biomarkers Prev 2010; 18:3435-43. [PMID: 19959693 DOI: 10.1158/1055-9965.epi-09-0766] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There is growing evidence that an adolescent's decision to try cigarettes is influenced by level of exposure to movies in which smoking is portrayed. Less is known about how ethnicity affects this process. We examined whether acculturation and/or country of birth influence the relationship between exposure to smoking imagery in the movies and experimenting with cigarettes among Mexican origin youth. We prospectively followed 1,328 Mexican origin adolescents ages 11 to 13 years at baseline. We assessed which of 50 movies (randomly selected from a pool of 250 popular contemporary movies released from 1999 to 2004 and content analyzed for smoking) adolescents had seen. Smoking behavior was assessed at baseline and at 6-month intervals over 24 months. Ten percent of the adolescents had experimented at baseline; 17% tried subsequently. Multivariate analyses revealed, as exposure to smoking imagery in the movies increased, the chances of having ever experimented [adjusted odds ratio (AOR) = 1.27; 95% confidence interval (CI), 1.10-1.48] and of being a new experimenter (AOR = 1.19; 95% CI, 1.01-1.40) increased, equivalent to a 4.2% increased risk of ever and a 3.0% increased risk of new experimenting for each additional quartile of movie exposure. This effect was moderated by country of birth. For Mexican-born youth, exposure to smoking imagery in the movies was the strongest independent predictor of new experimentation (AOR = 1.52; 95% CI, 1.14-2.05). For U.S.-born youth, we observed a ceiling effect: the percent of experimenters increased with increasing exposure, and then flattened. Among Mexican-born youth, exposure to smoking imagery in the movies may be an important part of the acculturation process associated with smoking initiation.
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Affiliation(s)
- Anna V Wilkinson
- Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, 77030, USA.
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