Tobacco use among 10th grade students in Istanbul and related variables

Prevalence, Knowledge, Attitude, and Predictors of Waterpipe Smoking among School Adolescents in Saudi Arabia

This cross-sectional study was designed to investigate the prevalence, knowledge, attitude, and predictors of waterpipe (WP) smoking among intermediate and secondary school adolescents in the Kingdom of Saudi Arabia (KSA). A self-administered anonymous questionnaire was used to collect data on demography, WP smoking status and patterns, the Arabic version of the Global Youth Tobacco Survey tool, and instruments to assess knowledge and attitude towards WP smoking. The Patient Health Questionnaire (PHQ-9) was also used. Descriptive and inferential statistical techniques were used. Modeling of WP smoking behavior was conducted using logistic regression. A total of 639 male students participated in this study. The prevalence of current WP and cigarette smokers were 17.7% and 14.6%, respectively. Out of the total population, 47.8% of students have the misconception that WP smoking is less harmful than cigarettes. A significant association (P < 0.05) of some demographic factors (age, school stage, residence, and parents' educational level) on WP smoking status was observed. Pleasure, socializing, and happiness represented the primary motives for initiating WP smoking. The majority of students had misconceptions about WP's health effects. More than 50% believed that smoking WP could ease anxiety, cause less harm, and has less addictive properties compared to cigarettes. Modeling suggested that the most significant predictors of WP smoking were cigarette smoking, depression, and the attitude index. Current findings warrant further research and official health programs to promote educational initiatives regarding WP smoking.

Waterpipe tobacco smoking prevalence among young people in Great Britain, 2013-2016

Background

One percent of adults in Great Britain use waterpipe tobacco at least monthly, however national epidemiological evidence among young people is absent. This study aims to assess waterpipe tobacco prevalence and correlates among young people in Great Britain.

Methods

Data were analyzed from online surveys conducted annually from 2013 to 2016 with weighted national samples of 11 to 18-year olds in Great Britain (annual n = 1936-2059). Primary outcome measures were at least monthly waterpipe tobacco use and lifetime waterpipe tobacco use. Binary logistic regression models tested the association between these outcomes and age, sex, country of residence and other tobacco consumption.

Results

Between 2013 and 2016, 1.7% (95% CI 1.5-2.1%) used waterpipe tobacco at least monthly and 9.9% (95% CI 9.2-10.7%) used waterpipe in their lifetime. There were no changes in prevalence over time. At least monthly use was associated with older age groups [16-18 years vs. 11-15 years, adjusted odds ratio (AOR) 2.63, 95% CI 1.55-4.46], male sex (AOR 1.82, 95% CI 1.23-2.71) and other tobacco consumption (e.g. lifetime cigarette use AOR 10.30, 95% CI 5.22-20.29). Lifetime use had similar correlates, but was not associated with male sex (AOR 0.97, 95% CI 0.80-1.17).

Conclusions

One in 10 young people in Great Britain have tried waterpipe tobacco, though more frequent use appears low. We found no evidence of increasing or decreasing prevalence of waterpipe use between 2013 and 2016. Being male, older and a concurrent user of other tobacco products were correlated with waterpipe tobacco use.

Substance use and suicidal ideation and behaviour in low- and middle-income countries: a systematic review

Background

Understanding relationships between substance use and suicidal ideation and behaviour (SIB) has important public health implications for suicide prevention in low- and middle-income countries (LMICs), where 75% of suicides occur. This systematic review explored the associations between substance use and SIB in LMICs.

Methods

We searched five databases using a combination of keywords for substance use, SIB and LMICs to identify English-written quantitative studies published between January 2006 and February 2016. Data were extracted to provide an overview of what is known about the topic, highlight gaps in the literature, and explore the implications of current knowledge for suicide prevention. Studies included in the review were assessed for methodological quality using the Scottish Intercollegiate Guidelines Network checklist.

Results

Analysis of included studies (N = 108) demonstrated a consistent positive association between substance use and SIB across all substances (i.e. alcohol, tobacco, cannabis, illicit drugs, non-medical use of prescription drugs), all substance use dimensions (i.e. intoxication, use, and pathological use) and all SIB dimensions (i.e. suicidal ideation, non-fatal suicidal behaviour, and suicide). Most of the available research evidence comes from upper-middle-income countries, only 22% comes from lower-middle-income and low-income countries. Most studies focused on alcohol and tobacco, while neglecting substances such as cannabis, opioids, sedatives, stimulants, misuse of prescription medication, inhalants, and hallucinogens. Most of the studies employed a cross-sectional design, were conducted within a risk-factor paradigm, and provided little information about the potential interaction between variables.

Conclusions

Public health suicide prevention policy and research in LMICs should take account of the fact that: substance use is a potentially modifiable risk factor; assessment and management of substance use is integral to the care of at-risk patients; reducing consumption and hazardous use of substances in LMICs is important for suicide prevention; and research needs to be expanded to include more theory driven research that focuses on all substance use dimensions and SIB dimensions, while employing more sophisticated statistical methods.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5425-6) contains supplementary material, which is available to authorized users.

The prevalence and trends of waterpipe tobacco smoking: A systematic review

INTRODUCTION

Waterpipe tobacco smoking is harmful to health however its prevalence estimates remain uncertain. We aimed to systematically review the medical literature on waterpipe tobacco prevalence and trends.

METHODS

We searched Medline, Embase and ISI Web of Science for 'waterpipe' and its synonyms, without using language or date restrictions. We included any measure of waterpipe tobacco smoking prevalence in jurisdictionally representative populations. We stratified findings by prevalence measure (past 30 day, ever, regular or occasional, daily, other or unspecified) and age (adults or youth).

RESULTS

We included 129 studies reporting 355 estimates for 68 countries. In general, prevalence estimates among adults were highest in the Eastern Mediterranean, and among youth were about equal between Eastern Mediterranean and European regions. Past 30 day use was highest among Lebanese youth (37.2% in 2008), ever use was highest among Lebanese youth in 2002 and Lebanese university students in 2005 (both 65.3%), regular or occasional use was highest in among Iranian university students (16.3% in 2005), and daily use was highest among Egyptian youth (10.4% in 2005). Trend data were limited but most studies reported increased use over time, ranging from 0.3-1.0% per year among youth in the US to 2.9% per year among youth in Jordan (both for past 30 day use). Results were similar for ever use trends. Turkey (2.3% in 2008 to 0.8% in 2010) and Iraq (6.3% in 2008 and 4.8% in 2012) both witnessed decreased waterpipe use.

CONCLUSION

Waterpipe tobacco smoking is most prevalent in Eastern Mediterranean and European countries, and appears higher among youth than adults. Continued surveillance will be important to assess and inform policy measures to control waterpipe tobacco use.

Health behaviors in high school students in İzmir, Turkey

AIM

The aim of this cross-sectional study was to determine the prevalence of the self reported health behaviors and differences in these behaviors by gender and grades in high school adolescents in İzmir, Turkey.

MATERIAL AND METHODS

A stratified cluster sampling procedure was used for this cross-sectional study. The study sample included 2 296 students attending 22 high schools in Izmir. As a data collection instrument, some questions from the Health Behavior in School-aged Children Study 2009/2010 questionnnaire and questions which were developed by the researchers to understand behaviors of internet use in adolescents were used. Chi-square tests and Cramer's V statistics were used for statistical analyses.

RESULTS

Among the high school students, 33.8% experimented smoking, 26.3% smoked cigarette during the 30 days before the survey, 14.9% smoked cigarette regularly during the 30 days before the survey, 54.1% experimented drinking alcohol, 38.4% drunk alcohol during the 30 days before the survey, 31.6% got drunk, 10.9% were adequately physically active, 59.9% watched TV for a long period of time, 72.8% used internet for a long period of time, 48.1% ate breakfast regularly, 36.2% ate adequate amount of fruit, 14.1% ate adequate amount of vegetable, 31.3% ate candies and chocolate very often, 18% drunk soft drink very often, 30.3% were bullied, 29.9% bullied others and 41% involved in a physical fight.

CONCLUSIONS

These results showed that "Adolescent friendly health services" should be generalized all over Turkey, physicians should evaluate each adolescent for his/her health behaviors in each visit and implementation of prevention programs which adopt a health promotion perspective is necessary begining from the elementary school.

Suicidal behaviors among Moroccan school students: prevalence and association with socio-demographic characteristics and psychoactive substances use: a cross-sectional study

BACKGROUND

Suicidal behavior is a major cause of injury and death worldwide, especially among adolescents and young adults. Few studies have tackled this issue in the Arab world. The present study investigated the prevalence and the risk factors of suicidal behaviors among Moroccan school students.

METHODS

From April 2012 to November 2013, a cross-sectional study was conducted in the North-Centre region of Morocco among students in public secondary schools selected using stratified cluster random sampling. The data were collected via anonymous self-administered questionnaires. The Mini International Neuropsychiatric Interview was used in its Moroccan Colloquial Arabic version to assess suicidality according to the DSM-IV criteria.

RESULTS

A total of 3020 students (53 % boys) aged 11-23 years (average age = 16 ± 2.1 years) were included in the study. The prevalence of suicide ideation, suicide planning and suicide attempts during the last month were 15.7, 6.3, and 6.5 % respectively. Univariate analyses demonstrated that suicidal behaviors followed different epidemiological patterns. According to the multivariate analyses, the risk factors for all suicidal behaviors among Moroccan school students were the female gender, middle school level, urban locations, low family income, parents' divorce, tobacco consumption and psychoactive substances (alcohol and cannabis) use.

CONCLUSIONS

The intervention of preventive programs has become an emergency to overcome the issue of suicidality in Morocco. Further researches on adolescents' suicidal behaviors are suggested to update temporal data and assess the effectiveness of potential interventions.

Increased risk of suicide attempt in bipolar patients with severe tobacco dependence

BACKGROUND

The aim of our study was to investigate, in bipolar patients, the association between tobacco status (use and dependence) and history of suicide attempt, and to assess the possible role of inflammation as a missing link in the association between smoking status and history of suicide attempt.

METHODS

A total of 453 adult bipolar out-patients recruited in the French FondaMental Advanced Centres of Expertise for Bipolar Disorder were divided into two subgroups: 274 patients without past history of suicide attempt (non-SA), and 179 patients with a past history of suicide attempt (SA). Tobacco use and dependence, psychiatric and somatic comorbidities, history of childhood abuse, family history of suicide were assessed. Fasting blood tests yielded samples collected for the measurement of high sensitivity (hs-)CRP.

RESULTS

The risk of suicide attempt increased with smoking dependence. Notably, bipolar patients with a history of suicide attempt were three times more likely to have severe tobacco dependence, independently of confounding factors. However, we failed to find arguments promoting the hypothesis of inflammatory markers (through hs-CRP measure) in the link between tobacco dependence and suicidal behavior.

CONCLUSIONS

We found a significant association between severe tobacco dependence and history of suicide attempt, but not with level of CRP, independently of confusing factors. Longitudinal studies taken into account all these potential confusing factors are needed to confirm our results.

Energy-drink consumption and its relationship with substance use and sensation seeking among 10th grade students in Istanbul

Aim of this study was to determine the prevalence and correlates of energy-drink (ED) consumption among 10th grade students in Istanbul/Turkey. Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul. The questionnaire included sections about demographic data, self-destructive behavior and use of substances including tobacco, alcohol and drugs. Also Psychological Screening Test for Adolescents (PSTA) was used. The analyses were conducted based on the 4957 subjects. Rate of those reported a ED consumption once within last year was 62.0% (n=3072), whereas rate of those reported ED consumption at least once in a month was 31.1%. There were consistent, statistically significant associations between genders, lifetime substance use (tobacco, alcohol and drug use), measures of sensation seeking, psychological problems (depression, anxiety, anger, impulsivity) and self-destructive behavior (self-harming behavior and suicidal thoughts) with ED consumption. In logistic regression models male gender, sensation seeking, life-time tobacco, alcohol and drug use predicted all frequencies of ED consumption. In addition to these predictors, anger and self-harming behavior also predicted ED consumption at least once in a month. There were no interactions between the associations of lifetime tobacco, alcohol and drug use with ED consumption. The findings suggest that the ED consumption of male students is related with three clusters of substances (tobacco, alcohol and drug) through sensation seeking and these relationships do not interact with each other.