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Hunter S, Hilario C, Patte KA, Leatherdale ST, Pabayo R. Association Between Area-Level Income Inequality and Health-Related School Absenteeism: Evidence From the COMPASS Study. THE JOURNAL OF SCHOOL HEALTH 2024; 94:148-157. [PMID: 37675587 DOI: 10.1111/josh.13390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 07/20/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Income inequality is theorized to impact health. However, evidence among adolescents is limited. This study examined the association between income inequality and health-related school absenteeism (HRSA) in adolescents. METHODS Participants were adolescents (n = 74,501) attending secondary schools (n = 136) that participated in the 2018-2019 wave of the COMPASS study. Chronic (missing ≥3 days of school in the previous 4 weeks) and problematic (missing ≥11 days of school in the previous 4 weeks) HRSA was self-reported. Income inequality was assessed via the Gini coefficient at the census division (CD) level. Multilevel modeling was used. RESULTS Greater income inequality was associated with a higher likelihood of chronic and problematic HRSA (chronic: OR = 1.17, 95% CI: 1.06, 1.30; problematic: OR = 1.29, 95% CI 1.11 to 1.50). Increased predicted probabilities for Problematic HRSA were observed at greater degrees of income inequality among students who identified as either white, black, Latinx, or mixed, while protective associations were observed among students who identified as Asian or other. No associations were modified by gender. CONCLUSION Income inequality demonstrated unfavorable associations with HRSA, which was modified by racial identity.
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Affiliation(s)
- Stephen Hunter
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Carla Hilario
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan, 1147 Research Road ART, Kelowna, BC, V1V 1V7, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, TJB 2317, Waterloo, ON, N2L 3G1, Canada
| | - Roman Pabayo
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
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2
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Guo X, Cui J, Yuan X, Gao Z, Yu G, Wu H, Kou C. Long-term trends of nasopharyngeal carcinoma mortality in China from 2006 to 2020 by region and sex: an age-period-cohort analysis. BMC Public Health 2023; 23:2057. [PMID: 37864181 PMCID: PMC10588046 DOI: 10.1186/s12889-023-16892-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/04/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND China has a high mortality from nasopharyngeal carcinoma (NPC). The NPC mortality trends in China from 2006 to 2020 were described and analyzed to understand its epidemiological characteristics by region and sex and to explore age, period, and cohort effects. METHODS This study utilized NPC mortality data from the China Health Statistical Yearbook. A joinpoint regression model was used to fit the standardized NPC mortality and age-specific mortality. The age-period-cohort model was applied to investigate age, period, and cohort effects on NPC mortality risk. RESULTS The results showed that the NPC mortality rate in China has been declining steadily. From 2006 to 2020, the standardized NPC mortality rate in most age groups showed a significant downward trend. The annual percentage change was smaller in rural areas than in urban areas. The mortality risks of rural males and rural females from 2016 to 2020 were 1.139 times and 1.080 times those from 2011 to 2015, respectively. Both urban males born in 1984-1988 and rural males born in 1979-1983 exhibited an increasing trend in NPC mortality risk. CONCLUSIONS Our study confirmed the effectiveness of NPC prevention and treatment strategies in China from 2006 to 2020. However, it underscored the urgent need for targeted interventions in rural areas to further reduce NPC mortality rates.
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Affiliation(s)
- Xinru Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No. 1163 Xinmin Street, Changchun, 130021, China
| | - Jiameng Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No. 1163 Xinmin Street, Changchun, 130021, China
| | - Xin Yuan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, No. 1163 Xinmin Street, Changchun, 130021, China
| | - Zibo Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No. 1163 Xinmin Street, Changchun, 130021, China
| | - Ge Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No. 1163 Xinmin Street, Changchun, 130021, China
| | - Hao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No. 1163 Xinmin Street, Changchun, 130021, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, No. 1163 Xinmin Street, Changchun, 130021, China.
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Dong X, Chen L, Liu Y, Zhao L, Wang W. Effects of pocket money on weight status among junior high school students: A longitudinal study in China. Medicine (Baltimore) 2023; 102:e34513. [PMID: 37832134 PMCID: PMC10578662 DOI: 10.1097/md.0000000000034513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/05/2023] [Indexed: 10/15/2023] Open
Abstract
Overweight and obesity among adolescents has become a common public health problem, and both obesity rates and the amount of pocket money among adolescents in China are rising. We investigated to what extent the increase in pocket money could lead to weight gain of junior high school students and how this association may vary by school environment in China. Researchers utilized 3 waves of data from the China Education Panel Survey, a national longitudinal study, to investigate the likelihood of overweight and obesity. The Generalized Estimation Equation was employed to analyze the data. Three Generalized Estimation Equation models were constructed to explore the relationship between pocket money and overweight and obesity in 2 distinct food environments surrounding schools. A total of 8903 individuals (4604 boys and 4299 girls) from the China Education Panel Survey were analyzed. After adjusting for confounding factors, it was found that girls who received 20 to 49 yuan and ≥ 50 yuan per week had a higher risk of overweight and obesity compared to those who received 0 to 9 yuan per week (OR = 1.34, 95% CI: 1.07-1.69, OR = 1.53, 95% CI: 1.22-1.92). However, no significant association was observed between pocket money and overweight and obesity when food around the school was not easily accessible. The prevalence of overweight among Chinese teenagers has steadily increased from Wave1 to Wave3. Moreover, junior high school girls who receive more pocket money are at a greater risk of developing obesity and overweight issues.
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Affiliation(s)
- Xiaoyang Dong
- Emergency Office of West China Hospital, Sichuan University, Chengdu, China
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Libin Chen
- Department of Child Health Care, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China
| | - Yi Liu
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Weidong Wang
- National Survey Research Center National Survey Research Center at Renmin University of China, NSRC, Renmin University of China, Beijing, China
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Benny C, Steele BJ, Patte KA, Leatherdale ST, Pabayo R. Income inequality and daily use of cannabis, cigarettes, and e-cigarettes among Canadian secondary school students: Results from COMPASS 2018-19. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104014. [PMID: 37003193 DOI: 10.1016/j.drugpo.2023.104014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 02/24/2023] [Accepted: 03/16/2023] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Cannabis, cigarette, and e-cigarette use among Canadian adolescents is a major public health concern. Income inequality has been associated with adverse mental health among youth and may contribute to the risk of frequent cannabis, cigarette, and e-cigarette use. We tested the association between income inequality and the risk of daily cannabis, cigarette, and e-cigarette use among Canadian secondary school students. METHODS We used individual-level survey data from Year 6 (2018/19) of Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary Behavior (COMPASS) and area-level data from the 2016 Canadian Census. Three-level logistic models were used to assess the relationship between income inequality and adolescent daily and current cannabis use, cigarette smoking, and e-cigarette use. RESULTS The analytic sample included 74,501 students aged 12-19. Students were most likely to report being male (50.4%), white (69.1%), and having weekly spending money over $100 (23.5%). We found that a standard deviation unit increase in Gini coefficient was significantly associated with increased likelihood of daily cannabis use (OR=1.25, 95% CI = 1.01-1.54) when adjusting for relevant covariates. We found no significant relationship between income inequality and daily smoking. While Gini was not significantly associated with daily e-cigarette use, we observed a significant interaction between Gini and gender (OR=0.87, 95% CI= 0.80-0.94), indicating that increased income inequality was associated with higher risk of reporting daily e-cigarette use among females only. DISCUSSION An association between income inequality and the likelihood of reporting daily cannabis use across all students and daily e-cigarette use in females were observed. Schools in higher income inequality areas may benefit from targeted prevention and harm reduction programs. Results emphasize the need for upstream discussion on policies that can mitigate the potential effects income inequality.
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Affiliation(s)
- Claire Benny
- 3-300 Edmonton Clinic Health Academy, University of Alberta School of Public Health, 11405-87 Ave, T6G 1C9 Edmonton, Alberta, Canada.
| | - Brian J Steele
- 3-300 Edmonton Clinic Health Academy, University of Alberta School of Public Health, 11405-87 Ave, T6G 1C9 Edmonton, Alberta, Canada
| | - Karen A Patte
- Brock University Department of Health Sciences, 1812 Sir Isaac Brock Way, L2S 3A1 St. Catharines, Ontario, Canada
| | - Scott T Leatherdale
- University of Waterloo School of Public Health Sciences, 200 University Ave West, TJB 2317, N2L 3G1 Waterloo, Ontario, Canada
| | - Roman Pabayo
- 3-300 Edmonton Clinic Health Academy, University of Alberta School of Public Health, 11405-87 Ave, T6G 1C9 Edmonton, Alberta, Canada
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Zhang M, Shi Y, Shi O, Zhao Z, Zhang X, Li C, Huang Z, Zhao L, Wang L, Li Y, Li X. Geographical variations in cardiovascular health in China: A nationwide population-based survey of 74,726 adults. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2020; 3:100033. [PMID: 34327384 PMCID: PMC8315622 DOI: 10.1016/j.lanwpc.2020.100033] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/26/2020] [Accepted: 09/09/2020] [Indexed: 12/18/2022]
Abstract
Background Cardiovascular disease is the leading cause of death in China. The aim of this study was to evaluate the levels of cardiovascular health among Chinese adults and to understand the geographic pattern of cardiovascular health. Methods In 2015, a total of 74,726 respondents aged ≥ 20 years with no history of cardiovascular disease were randomly sampled from 298 counties/districts of 31 provinces in mainland China and were interviewed. Seven metrics, including smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting glucose, were determined. Ideal cardiovascular health was defined as the simultaneous presence of all metrics at the ideal level. A score ranging from 0 to 14 was calculated as the sum of all seven metrics for each province. Scores for cardiovascular health behaviors (smoking, body mass index, physical activity and diet) and those for cardiovascular health factors (smoking, total cholesterol, blood pressure, and fasting glucose) were also calculated. Findings The mean age was 44.4 ± 15.9 years, and 49.3% were women. The age-sex-standardized prevalence of ideal cardiovascular health was universally poor, ranging from 0.02% [95% confidence interval (CI): 0%, 0.05%] in Tibet to 2.76% (95% CI: 0.45%, 5.07%) in Heilongjiang. Ideal diet (7.1%) was the least common factor of the seven metrics in each province and varied considerably across provinces. Other component metrics of ideal cardiovascular health were also spatially patterned. In all provinces, women had higher scores than men for cardiovascular health, health behaviors and health factors. Differences in cardiovascular health and health behavior scores between urban and rural areas were associated with levels of socio-economic development. Interpretation Strategies for addressing poor cardiovascular health require geographic targeting and localized consideration. Funding This research was supported by National Key R&D Program, the Shenzhen Strategic Emerging Industry Development Special Fund, and the Fund of "Sanming" Project of Medicine in Shenzhen.
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Affiliation(s)
- Mei Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Yu Shi
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, 12# Langshan Rd, Nanshan District, Shenzhen 518057, Guangdong Province, China.,Department of Clinical Research and Epidemiology, Shenzhen Institute for Cardiovascular Disease, Shenzhen 518057, Guangdong Province, China
| | - Oumin Shi
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, 12# Langshan Rd, Nanshan District, Shenzhen 518057, Guangdong Province, China
| | - Zhenping Zhao
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Xiao Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Chun Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Zhengjing Huang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Liyun Zhao
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Yichong Li
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, 12# Langshan Rd, Nanshan District, Shenzhen 518057, Guangdong Province, China.,Department of Clinical Research and Epidemiology, Shenzhen Institute for Cardiovascular Disease, Shenzhen 518057, Guangdong Province, China
| | - Xinhua Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
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Vyas P, Tsoh JY, Gildengorin G, Stewart SL, Yu E, Guan A, Pham A, Burke NJ, McPhee SJ. Disentangling individual and neighborhood differences in the intention to quit smoking in Asian American male smokers. Prev Med Rep 2020; 18:101064. [PMID: 32226728 PMCID: PMC7093831 DOI: 10.1016/j.pmedr.2020.101064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 01/29/2020] [Accepted: 02/08/2020] [Indexed: 11/22/2022] Open
Abstract
Numerous studies have assessed individual-level factors associated with intention to quit smoking. However, fewer studies have assessed how neighborhood and built environment also contribute towards individual-level behavior. We used baseline data of 340 Chinese and Vietnamese male daily smokers from August 2015 to November 2017 living in the San Francisco Bay Area, who enrolled in a lifestyle intervention trial. The outcome variable was intention to quit in 30 days. To understand the role of contextual factors participants' residential addresses were geocoded, and neighborhood median income, ethnic composition, and tobacco retail density were computed. Individual level analysis suggested that Vietnamese American men had greater intention to quit smoking (OR = 2.90 CI = 1.59, 5.26) in comparison to Chinese Americans. However, after adding neighborhood level factors to the model, no ethnic group difference was observed. Neighborhood household median income (OR = 0.74, CI = 0.64, 0.86) and tobacco retail counts (OR = 0.79, CI = 0.67, 0.94) were negatively associated with intention to quit. Years lived in the U.S. was the only individual level factor associated with intention to quit. By comparing two Asian American groups that live in heterogeneous neighborhoods, we identify key environmental and policy drivers that are associated with quit intention. Future studies aimed at influencing individual-level behavior should take into consideration the neighborhood context and built environment characteristics.
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Affiliation(s)
- Priyanka Vyas
- Center for Tobacco Control Research and Education, University of California, San Francisco, United States
| | - Janice Y. Tsoh
- Center for Tobacco Control Research and Education, University of California, San Francisco, United States
- Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Ginny Gildengorin
- Division of General Internal Medicine, University of California, San Francisco, United States
| | - Susan L. Stewart
- Department of Public Health Sciences, University of California, Davis, United States
| | - Edgar Yu
- Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Alice Guan
- Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Amber Pham
- DePaul University, Chicago, United States
| | | | - Steven J. McPhee
- Division of General Internal Medicine, University of California, San Francisco, United States
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Harrison A, Ramo D, Hall SM, Estrada-Gonzalez V, Tolou-Shams M. Cigarette Smoking, Mental Health, and Other Substance Use among Court-Involved Youth. Subst Use Misuse 2020; 55:572-581. [PMID: 31760909 PMCID: PMC7386841 DOI: 10.1080/10826084.2019.1691593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Justice-involved youth are at risk to become cigarette smokers as they age, leading to a variety of poor health outcomes. However, little is known about cigarette use among justice-involved youth, especially youth supervised in the community where there is ample opportunity to smoke. Objective: This study investigates the prevalence of cigarette smoking and the associations between cigarette smoking, emotional and behavioral functioning, and other substance use among a sample of first-time offending court-involved, non-incarcerated (FTO-CINI) youth. Methods: Youth were recruited from a family court in the Northeast (N = 423). Substance use was self-reported using the Adolescent Risk Behavior Assessment (ARBA). Emotional and behavioral functioning was measured using the Behavior Assessment Schedule for Children-Second Edition (BASC-2), the Affect Dysregulation Scale (ADS), National Stressful Events Survey PTSD Short Scale (NSESSS), and the National Survey of Self-Reported Delinquency (NYS-SRD). Results: About 9.9% of FTO-CINI youth had smoked cigarettes in the past 30 days. Compared with FTO-CINI youth who had not smoked recently, recent smokers endorsed more emotional and behavioral symptoms, such as school problems (p < .001), internalizing problems (p = .012), inattention/hyperactivity (p = .020), affect dysregulation (p = .044), PTSD symptoms (p = .006), and delinquent behavior (p < .001). Recent smokers were also more likely to use alcohol (OR = 5.61, p < .001), marijuana (OR = 11.27, p < .001), and other drugs (OR = 5.00, p < .001). Conclusions: Recent smoking was higher among FTO-CINI youth than youth in the general population. Findings underscore the need to incorporate nicotine into existing substance use prevention interventions for this population, who are at high risk to initiate cigarette use as they age.
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Affiliation(s)
- Anna Harrison
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA.,Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.,Mental Health Service, San Francisco VA Medical Center, San Francisco, California, USA
| | - Danielle Ramo
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA.,Hopelab, San Francisco, California, USA
| | - Sharon M Hall
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA
| | - Vanessa Estrada-Gonzalez
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA.,Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA.,Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
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Cai L, Wang XM, Fan LM, Cui WL, Golden AR. Socioeconomic disparities in prevalence and behaviors of smoking in rural Southwest China. BMC Public Health 2019; 19:1117. [PMID: 31412820 PMCID: PMC6694669 DOI: 10.1186/s12889-019-7455-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 08/07/2019] [Indexed: 11/23/2022] Open
Abstract
Background This study examines how prevalence and behaviors of smoking differ by socioeconomic status among rural southwest Chinese adults. Methods A cross-sectional survey was conducted including 7743 adults aged ≥35 years in rural regions of Yunnan Province, China from 2016 to 2018. Information on individual socioeconomic status (SES), ethnicity, and self-reported smoking behaviors was collected utilizing a standardized questionnaire. The individual socioeconomic position (SEP) index was constructed using principal component analysis. Multivariate logistic regression models were used to analyze the association between individual SES variables and the prevalence and behaviors of smoking. Results In the study population, the overall prevalence rate of current smokers was 33.5%. Males had a markedly higher prevalence of current smokers than females (62.6% vs. 4.8%, P < 0.01). Of these smokers, 74.5% began smoking during adolescence, 88.8% had never attempted to quit smoking, and 81.1% reported smoking in public places. Ethnic minority participants and those with low levels of education and/or low SEP were more likely to use tobacco as well as more likely to start smoking, and regularly smoke, during adolescence (P < 0.01). Participants with poor access to medical services had a higher prevalence of current smoking than their counterparts (P < 0.01). Among current smokers, Han ethnicity, good access to medical services, and high SEP were positively associated with the probability of having attempted to quit smoking at least once, while a high level of education and high SEP were negatively associated with the probability of smoking in public places. Conclusions Disparities in prevalence and behaviors of smoking exist across a diversity of indicators of individual SES in rural southwest China. Future tobacco cessation interventions should focus on men, ethnic minorities, and those with low education levels, poor access to medical services, and low SEP.
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Affiliation(s)
- Le Cai
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming, 650500, China.
| | - Xu-Ming Wang
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming, 650500, China.,The First Affiliated Hospital of Kunming Medical University, Western Renmin Road, Kunming, 650032, China
| | - Lu-Ming Fan
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming, 650500, China
| | - Wen-Long Cui
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming, 650500, China
| | - Allison Rabkin Golden
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming, 650500, China
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Shenassa ED, Rossen LM, Cohen J, Morello-Frosch R, Payne-Sturges DC. Income Inequality and US Children's Secondhand Smoke Exposure: Distinct Associations by Race-Ethnicity. Nicotine Tob Res 2018; 19:1292-1299. [PMID: 27811157 DOI: 10.1093/ntr/ntw293] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 10/28/2016] [Indexed: 11/13/2022]
Abstract
Introduction Prior studies have found considerable racial and ethnic disparities in secondhand smoke (SHS) exposure. Although a number of individual-level determinants of this disparity have been identified, contextual determinants of racial and ethnic disparities in SHS exposure remain unexamined. The objective of this study was to examine disparities in serum cotinine in relation to area-level income inequality among 14 649 children from the National Health and Nutrition Examination Survey. Methods We fit log-normal regression models to examine disparities in serum cotinine in relation to Metropolitan Statistical Areas level income inequality among 14 649 nonsmoking children aged 3-15 from the National Health and Nutrition Examination Survey (1999-2012). Result Non-Hispanic black children had significantly lower serum cotinine than non-Hispanic white children (-0.26; 95% CI: -0.38, -0.15) in low income inequality areas, but this difference was attenuated in areas with high income inequality (0.01; 95% CI: -0.16, 0.18). Serum cotinine declined for non-Hispanic white and Mexican American children with increasing income inequality. Serum cotinine did not change as a function of the level of income inequality among non-Hispanic black children. Conclusions We have found evidence of differential associations between SHS exposure and income inequality by race and ethnicity. Further examination of environments which engender SHS exposure among children across various racial/ethnic subgroups can foster a better understanding of how area-level income inequality relates to health outcomes such as levels of SHS exposure and how those associations differ by race/ethnicity. Implications In the United States, the association between children's risk of SHS exposure and income inequality is modified by race/ethnicity in a manner that is inconsistent with theories of income inequality. In overall analysis this association appears to be as predicted by theory. However, race-specific analyses reveal that higher levels of income inequality are associated with lower levels of SHS exposure among white children, while levels of SHS exposure among non-Hispanic black children are largely invariant to area-level income inequality. Future examination of the link between income inequality and smoking-related health outcomes should consider differential associations across racial and ethnic subpopulations.
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Affiliation(s)
- Edmond D Shenassa
- School of Public Health, Maternal and Child Health Program, Department of Family Science, University of Maryland, College Park, MD.,Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD.,School of Public Health, Department of Epidemiology and Biostatistics, Brown University, Providence, RI.,School of Medicine, Department of Epidemiology and Biostatistics, University of Maryland, Baltimore, MD
| | - Lauren M Rossen
- Centers for Disease Control and Prevention, Office of Analysis and Epidemiology, National Center for Health Statistics, Hyattsville, MD
| | | | - Rachel Morello-Frosch
- School of Public Health, Department of Environmental Science Policy and Management, University of California, Berkeley, CA
| | - Devon C Payne-Sturges
- School of Public Health, Maryland Institute for Applied Environmental Health, University of Maryland, College Park, MD
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10
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Yaya S, Bishwajit G, Shah V, Ekholuenetale M. Socioeconomic Disparities in Smoking Behavior and Early Smoking Initiation Among Men in Malawi. Tob Use Insights 2017; 10:1179173X17726297. [PMID: 28839446 PMCID: PMC5560509 DOI: 10.1177/1179173x17726297] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 06/15/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Tobacco smoking is a growing concern for health care systems as it is projected to become the leading cause of death in the developing world. Knowledge of how smoking behavior differs across socioeconomic groups is crucial for designing effective preventive policies and alleviating the disparities. The aim of this study was to report the prevalence of (1) smoking status, (2) early smoking initiation, and (3) association with socioeconomic status (SES) of the 2 among Malawian men. Methods: Cross-sectional data on 1693 men aged between 15 and 49 years were collected from the latest 2013-2014 Multiple Indicator Cluster Survey in Malawi. Educational qualification and wealth index quintile were used as the indicators of SES. Outcome variables were smoking status, first age of smoking being below 18 years, and ever using any form of smokeless tobacco products. Multiple logistic regression models were used to see the contribution of SES to smoking status and early smoking initiation. Results: Mean age of the sample population was 33.23 years (SD: 8.25). Prevalence of smoking, early initiation, and ever using any form of smokeless tobacco were, respectively, 46.6%, 33.7%, and 6%. Compared with men who had higher education, those who had no formal education, primary-level, and secondary-level qualification had, respectively, 21% (adjusted odds ratio [AOR] = 1.209; 95% confidence interval [CI] = 0.498-2.935), 40% (AOR = 1.4; 95% CI = 0.647-3.029), and 26% (AOR = 1.256; 95% CI = 0.593-2.661) higher odds of being a smoker. Those who had no formal education were 2.7 times (AOR = 2.734; 95% CI = 1.123-6.653) as likely to try smoking before reaching 18 years of age. Compared with the richest, those in the lowest wealth quintile had 32% lower odds (AOR = 0.676; 95% CI = 0.455-1.006) of early onset of smoking, 63% lower odds (AOR = 0.372; 95% CI = 0.201-0.690) of trying other tobacco products. Conclusions: Addressing the socioeconomic disparities could play a vital role in delaying early onset and limiting overall consumption of tobacco. Ongoing health policy talks to reduce the prevalence of smoking should take into consideration improving educational and material well-being among men.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
| | - Ghose Bishwajit
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Vaibhav Shah
- Interdisciplinary School Health Sciences, University of Ottawa, Ottawa, ON, Canada
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Scalici F, Schulz PJ. Parents' and peers' normative influence on adolescents' smoking: results from a Swiss-Italian sample of middle schools students. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2017; 12:5. [PMID: 28109189 PMCID: PMC5251233 DOI: 10.1186/s13011-017-0089-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 01/17/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND METHOD Adolescents observe and imitate people to whom they are associated in their social context, and the normative factors sent out by reference groups are crucial determinants of their decision to smoke. The aim of the study is to investigate how adolescents' smoking changes when they are exposed to factors of pro-smoking normative influence by parents and peers, and how age moderate this relation. A cross sectional survey collected data from 5657 students, aged between 11 and 14, from public and private middle schools in the Italian region of Switzerland (Ticino) on their smoking habits, perceived parents' and peers' approval and smoking. RESULTS Multinomial logistic regression show that, as adolescents get older, more of the pro-smoking factors come from peers and parents, the higher the risk gets of being a "heavy smoker" has compared against having no experience with smoking. Living in a context with no factor of normative influence toward smoking play a protective role against smoking, and this effect becomes more important than more harmful the smoking behavior in question is. Furthermore, peers' descriptive norms are more influential for adolescents to become "light" and "heavy smokers", while smoking being approved by peers is important for adolescents to become accustomed to smoking. CONCLUSIONS Findings support the different influence of parents' and peers' norms on adolescents' smoking, and highlight the importance of peers' model behavior as the most important factor influencing smoking during adolescence. Such results have implications for programs that aim to prevent or reduce smoking in early adolescence when friendship choice starts to become crucial.
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Affiliation(s)
- Francesca Scalici
- Institute of Communication and Health, Università della svizzera italiana, Via Giuseppe Buffi 13, CH-6904, Lugano, Switzerland.
| | - Peter J Schulz
- Institute of Communication and Health, Università della svizzera italiana, Via Giuseppe Buffi 13, CH-6904, Lugano, Switzerland
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Liu Y, Wang M, Tynjälä J, Villberg J, Lv Y, Kannas L. Socioeconomic differences in adolescents' smoking: a comparison between Finland and Beijing, China. BMC Public Health 2016; 16:805. [PMID: 27534849 PMCID: PMC4989516 DOI: 10.1186/s12889-016-3476-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 08/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Various studies have demonstrated the associations between socioeconomic status (SES) and health and health behaviour among adolescents. However, few studies have compared the socioeconomic difference in adolescent smoking between countries with different stage of smoking. The purpose of this study was to examine and compare the relationship between socioeconomic status (SES) and adolescent smoking in Beijing, China and Finland through the Health Behaviour in School-aged Children (HBSC) study. METHODS The data used in this study were derived from the Chinese HBSC linked project survey 2008 in Beijing and the Finnish HBSC survey 2006. The final sample included 2005 Chinese and 1685 Finnish 15-year-old schoolchildren. The associations between Family Affluence Scale (FAS), as the SES measure, and adolescents' smoking behaviour, including ever smoked, weekly smoking and the early onset of smoking were examined separately in two countries through binary logistic regression. RESULTS Compared to students from the high FAS group, Chinese boys from the low FAS group were more likely to report having ever smoked (OR = 2.12, 95 % CI = 1.49-3.01) and being early onset of smoking (OR = 2.17, 95 % CI = 1.44-3.26). Finnish girls from the low FAS group were more likely to report being weekly smokers (OR = 1.68, 95 % CI = 1.07-2.65). No significant difference was found for Chinese girls and Finnish boys. CONCLUSIONS This study indicated different patterns of socioeconomic difference in smoking between Chinese and Finnish adolescents by gender and by smoking behaviour, which suggests that socioeconomic inequalities in smoking are different among adolescents in countries with different stage of smoking. Country specific policies and interventions for different target groups should be encouraged and designed for reducing the prevalence of adolescents' smoking.
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Affiliation(s)
- Yang Liu
- School of Physical Education and Sport Training, Shanghai University of Sport, 200438, Shanghai, China. .,Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, 200438, Shanghai, China.
| | - Mei Wang
- Mass Sport Research Centre, China Institute of Sport Science, 100061, Beijing, China
| | - Jorma Tynjälä
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyvaskyla, 40014, Jyväskylä, Finland
| | - Jari Villberg
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyvaskyla, 40014, Jyväskylä, Finland
| | - Yan Lv
- Zhejiang Institute of Sport Science, 310004, Hangzhou, China
| | - Lasse Kannas
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyvaskyla, 40014, Jyväskylä, Finland
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13
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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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14
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Analysis of Income Inequality Based on Income Mobility for Poverty Alleviation in Rural China. SUSTAINABILITY 2015. [DOI: 10.3390/su71215821] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Ferreira HR, Rosa EF, Antunes JLF, Duarte DA, Imparato JCP, Pannuti CM, Mendes FM. Prolonged pacifier use during infancy and smoking initiation in adolescence: evidence from a historical cohort study. Eur Addict Res 2015; 21:33-8. [PMID: 25358513 DOI: 10.1159/000365351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 06/19/2014] [Indexed: 11/19/2022]
Abstract
AIM To investigate the association between prolonged pacifier use during childhood and smoking in adolescence and early adulthood. METHODS A historical cohort study including patients from a dental private office was designed. Dental records were used, which contained complete data about sucking habits from 314 children (2-10 years of age) who had attended a private dental office from 1988 to 1994 in Ibiá, Brazil. Then, we collected data about the smoking habits from 261 subjects who were successfully contacted again from 2004 to 2006. Our outcome variable was smoking, and subjects who had smoked more than 100 cigarettes during their lifetime were classified as smokers. Poisson regression analysis matched the association between oral habits and smoking. Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) were calculated. The level of significance was set at 5%. RESULTS We observed a statistically significant association between prolonged pacifier use (more than 24 months) and smoking (IRR = 4.48; 95% CI 2.32-8.65). Breastfeeding, in contrast, was a protective factor (IRR = 0.64; 95% CI 0.42-0.96). CONCLUSIONS Prolonged pacifier use during childhood is positively associated with smoking initiation in adolescence and early adulthood.
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Affiliation(s)
- Helenice R Ferreira
- Division of Pediatric Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
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16
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Levin KA, Dundas R, Miller M, McCartney G. Socioeconomic and geographic inequalities in adolescent smoking: a multilevel cross-sectional study of 15 year olds in Scotland. Soc Sci Med 2014; 107:162-70. [PMID: 24607678 PMCID: PMC3988930 DOI: 10.1016/j.socscimed.2014.02.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 11/19/2013] [Accepted: 02/06/2014] [Indexed: 11/26/2022]
Abstract
The objective of the study was to present socioeconomic and geographic inequalities in adolescent smoking in Scotland. The international literature suggests there is no obvious pattern in the geography of adolescent smoking, with rural areas having a higher prevalence than urban areas in some countries, and a lower prevalence in others. These differences are most likely due to substantive differences in rurality between countries in terms of their social, built and cultural geography. Previous studies in the UK have shown an association between lower socioeconomic status and smoking. The Scottish Health Behaviour in School-aged Children study surveyed 15 year olds in schools across Scotland between March and June of 2010. We ran multilevel logistic regressions using Markov chain Monte Carlo method and adjusting for age, school type, family affluence, area level deprivation and rurality. We imputed missing rurality and deprivation data using multivariate imputation by chained equations, and re-analysed the data (N = 3577), comparing findings. Among boys, smoking was associated only with area-level deprivation. This relationship appeared to have a quadratic S-shape, with those living in the second most deprived quintile having highest odds of smoking. Among girls, however, odds of smoking increased with deprivation at individual and area-level, with an approximate dose-response relationship for both. Odds of smoking were higher for girls living in remote and rural parts of Scotland than for those living in urban areas. Schools in rural areas were no more or less homogenous than schools in urban areas in terms of smoking prevalence. We discuss possible social and cultural explanations for the high prevalence of boys' and girls' smoking in low SES neighbourhoods and of girls' smoking in rural areas. We consider possible differences in the impact of recent tobacco policy changes, primary socialization, access and availability, retail outlet density and the home environment.
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Affiliation(s)
- K A Levin
- CAHRU, School of Medicine, University of St Andrews, Medical and Biological Sciences Building, North Haugh, St Andrews KY16 9TF, UK; Ludwig Boltzmann Institute for Health Promotion Research, Vienna, Austria.
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Abstract
OBJECTIVE It is widely known that cigarette use and depressive symptoms co-occur during adolescence and young adulthood and that there are gender differences in smoking initiation, progression, and co-occurrence with other drug use. Given that females have an earlier onset of depressive symptoms while males have an earlier onset of cigarette use, this study explored the possible bidirectional development of cigarette use and depressive symptoms by gender across the transition from adolescence to young adulthood. Gender differences in the stability and crossed effects of depressive symptoms and cigarette smoking during the transition to young adulthood, controlling for other known risk factors, were examined using a nationally representative longitudinal sample. METHODS A bivariate autoregressive multi-group structural equation model examined the longitudinal stability and crossed relationships between a latent construct of depressive symptoms and cigarette smoking over four waves of data. Data for this study came from four waves of participants (N = 6,501) from the National Longitudinal Survey of Adolescent Health. At each of four waves, participants completed a battery of measures including questions on depressive symptoms and an ordinal measure of number of cigarettes smoked per day. RESULTS The best-fitting bivariate autoregressive models were gender-specific, included both crossed and parallel associations between depressive symptoms and cigarette use during the transition to adulthood, and controlled for wave-specific parental smoking, alcohol use, and number of friends who smoke. For females, greater depressive symptoms at each wave, except the first one, were associated with greater subsequent cigarette use. There were bidirectional associations between depressive symptoms and cigarette use only for females during young adulthood, but not for males. CONCLUSIONS The development of depressive symptoms and cigarette use from adolescence and into young adulthood follows similar patterns for males and females. Controlling for the correlation and stability between initial levels of depressive symptoms and cigarette use from adolescence into young adulthood, there remains a crossed association between cigarette use and depressive symptoms specific to females during young adulthood. The findings suggest that prevention interventions focused on mental health should include warnings that cigarette use may exacerbate depressive symptoms.
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Affiliation(s)
- Cristina B Bares
- a School of Social Work , Virginia Commonwealth University , Richmond , Virginia , USA
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18
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Chen CY, Lin IF, Huang SL, Tsai TI, Chen YY. Disposable income with tobacco smoking among young adolescents: a multilevel analysis. J Adolesc Health 2013; 52:724-30. [PMID: 23523310 DOI: 10.1016/j.jadohealth.2012.12.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 12/07/2012] [Accepted: 12/13/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE Prior studies examining the connection between disposable income and adolescent smoking often yielded mixed results, partly due to the lack of consideration for contextual variables. In the present study, we sought to broaden understanding of disposable income on adolescent smoking behaviors via both absolute and relative perspectives in the school context. METHODS We obtained data from the 2010 Global Youth Tobacco Survey (GYTS) in Taiwan. Information concerning sociodemographics, disposable income, smoking history, and contextual smoking exposure (e.g., school) were assessed via self-report. Recent-onset smokers were defined as those who had their first cigarette within two years of the survey. Complex survey and multilevel analyses were carried out to estimate association. RESULTS Adolescents with higher monthly disposable income were 2∼5 times more likely to start smoking and become regular smokers. Having the least disposable income in a class appeared linked with increased risk of tobacco initiation by 40% (95% confidence interval [CI]: 2%-91%). Pupils' odds to start smoking were lowered to .70 when the majority of schoolmates had low disposable income (95% CI: .51-.99). CONCLUSIONS Adolescent risk of smoking initiation may be differentially affected by individual- and contextual-level absolute and relative disposable income. Future research is needed to delineate possible mechanisms underlying unfavorable health behaviors associated with disposable incomes in early adolescence.
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Affiliation(s)
- Chuan-Yu Chen
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
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19
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Li DX, Guindon GE. Income, income inequality and youth smoking in low- and middle-income countries. Addiction 2013; 108:799-808. [PMID: 23216738 DOI: 10.1111/add.12075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Revised: 07/09/2012] [Accepted: 11/20/2012] [Indexed: 11/28/2022]
Abstract
AIMS To examine the relationships between income, income inequality and current smoking among youth in low- and middle-income countries. DESIGN Pooled cross-sectional data from the Global Youth Tobacco Surveys, conducted in low- and middle-income countries, were used to conduct multi-level logistic analyses that accounted for the nesting of students in schools and of schools in countries. PARTICIPANTS A total of 169 283 students aged 13-15 from 63 low- and middle-income countries. MEASUREMENTS Current smoking was defined as having smoked at least one cigarette in the past 30 days. Gross domestic product (GDP) per capita was our measure of absolute income. Contemporaneous and lagged (10-year) Gini coefficients, as well as the income share ratio of the top decile of incomes to the bottom decile, were our measures of income inequality. FINDINGS Our analyses reveal a significant positive association between levels of income and youth smoking. We find that a 10% increase in GDP per capita increases the odds of being a current smoker by at least 2.5%, and potentially considerably more. Our analyses also suggest a relationship between the distribution of incomes and youth smoking: youth from countries with more unequal distributions of income tend to have higher odds of currently smoking. CONCLUSIONS There is a positive association between gross domestic product and the odds of a young person in a low- and middle-income country being a current smoker. Given the causal links between smoking and a wide range of youth morbidities, the association between smoking and income inequality may underlie a substantial portion of the health disparities observed that are currently experiencing rapid economic growth.
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Affiliation(s)
- David X Li
- Centre for Global Health Research, St Michael's Hospital, University of Toronto, Toronto, ON, Canada.
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20
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Mao A. Space and power: young mothers' management of smoking in extended families in China. Health Place 2013; 21:102-9. [PMID: 23454731 DOI: 10.1016/j.healthplace.2013.01.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 01/25/2013] [Accepted: 01/29/2013] [Indexed: 11/26/2022]
Abstract
Multigenerational co-residence is a widespread phenomenon in China but there is little knowledge about the impact of power dynamics on smoking behaviors among extended family residents. Using a gender lens, this ethnographic study explored how young mothers in extended families in mainland China managed the smoking of their husbands and other family members. Analysis of data resulted in a model of 'two units-three domains' to reflect gendered relationships between young mothers and other family members, and young mothers' participation in family management. Exploration of the mothers' efforts to deal with household smoking using the model provided an explanation for why the young mothers had limited control over household space and could only impose partial restrictions on home smoking in the extended family.
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Affiliation(s)
- Aimei Mao
- Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, Canada V1V 1V7.
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21
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Soneji S, Lewis V, Tanski S, Sargent JD. Who is most susceptible to movie smoking effects? Exploring the impacts of race and socio-economic status. Addiction 2012; 107:2201-9. [PMID: 22724674 PMCID: PMC3465477 DOI: 10.1111/j.1360-0443.2012.03990.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 03/16/2012] [Accepted: 06/14/2012] [Indexed: 11/30/2022]
Abstract
AIMS This study assesses how race/ethnicity and socio-economic status modify the relationship between exposure to movie smoking and having tried smoking in adolescents. DESIGN Data come from a cross-sectional telephone survey and were analyzed using logistic regression models. A respondent reporting ever having tried smoking was regressed on exposure to movie smoking, race, socio-economic status, the interactions of these variables and family and background characteristics. SETTING National sample of US adolescents. PARTICIPANTS A total of 3653 respondents aged 13-18 years. MEASUREMENTS Outcome was if subjects reported ever having tried smoking. Movie smoking exposure was assessed through respondents' reporting having watched a set of movie titles, which were coded for smoking instances. FINDINGS The proportion having tried smoking was lower for blacks (32%) compared to Hispanics (41%) and whites (38%). The relationship between movie smoking and having tried smoking varied by race/ethnicity. Among whites and Hispanics exposure to movie smoking positively predicted smoking behavior, but movie smoking had no impact on blacks. Socio-economic status further modified the relation among whites; high socio-economic status white adolescents were more susceptible to movie smoking than low socio-economic status white adolescents. CONCLUSIONS Exposure to movie smoking is not experienced uniformly as a risk factor for having ever tried smoking among US adolescents. Whites and Hispanics are more likely to try smoking as a function of increased exposure to movie smoking. In addition, higher socio-economic status increases susceptibility to movie smoking among whites. Youth with fewer risk factors may be more influenced by media messages on smoking.
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Affiliation(s)
- Samir Soneji
- Cancer Control Research Program, Norris Cotton Cancer Center, Dartmouth Medical School,The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School
| | - Valerie Lewis
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School
| | - Susanne Tanski
- Cancer Control Research Program, Norris Cotton Cancer Center, Dartmouth Medical School
| | - James D. Sargent
- Cancer Control Research Program, Norris Cotton Cancer Center, Dartmouth Medical School,The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School
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Community social structure, social capital and adolescent smoking: a multi-level analysis. Health Place 2012; 18:796-804. [PMID: 22503516 DOI: 10.1016/j.healthplace.2012.03.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2011] [Revised: 03/01/2012] [Accepted: 03/15/2012] [Indexed: 11/22/2022]
Abstract
Using a sample of 6818 individuals in 83 public school districts in Iceland, this study explored the influence of three community characteristics: Residential mobility, proportion of single-parent families, and poverty on adolescent daily smoking. Building on Coleman's social capital theory, we also examined the mediating and moderating role of several measures of social capital. Both self-reported and official data were used to measure key variables. The main findings are consistent with theoretical predictions showing that social capital partly mediates the association between community characteristics and adolescent daily smoking both on the community and individual levels. Likewise, the findings show that the association between individual level poverty and adolescent daily smoking varies across levels of neighborhood social capital.
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Hong NS, Kim KY, Park SW, Kim JY, Bae J, Lee WK, Kim KS. Trends in cigarette use behaviors among adolescents by region in Korea. J Prev Med Public Health 2012; 44:176-84. [PMID: 21894066 PMCID: PMC3249254 DOI: 10.3961/jpmph.2011.44.4.176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives Understanding recent trends in cigarette smoking among adolescents is important in order to develop strategies to prevent cigarette smoking. The aim of this study was to compare recent trends in cigarette smoking for adolescents living in rural areas, small towns and metropolitan cities in Korea. Methods The raw data from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2005 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Logistic regression models were used to evaluate significant linear time trends in cigarette smoking. The indicators of cigarette use behaviors were 'current smoking rate', 'frequent smoking rate', 'heavy smoking rate' and 'smoking experience rate before 13 years of age'. All analyses were conducted according to gender. Results Statistically significant increasing trends in current smoking rate and frequent smoking rate were observed and borderline significant increasing trends in heavy smoking rate were shown among rural boys. Among metropolitan city boys, statistically significant increasing trends were also seen for frequent smoking. Statistically significant decreasing trends in current smoking rate were observed among small town and metropolitan city girls. Smoking experience rate before 13 years of age for rural girls decreased significantly. Conclusions Cigarette smoking prevalence among adolescents in the rural areas has increased in the last five years especially among boys. Our findings suggest that anti-tobacco program for adolescents should be conducted primarily for those in rural areas.
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Affiliation(s)
- Nam Soo Hong
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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24
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Généreux M, Roy M, Montpetit C, Azzou SAK, Gratton J. Regional surveillance of social and geographic inequalities in smoking: the case of Montréal, Canada. Health Place 2011; 18:240-9. [PMID: 22019850 DOI: 10.1016/j.healthplace.2011.09.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 07/08/2011] [Accepted: 09/22/2011] [Indexed: 11/30/2022]
Abstract
Surveillance of social inequalities in health is a platform for action. We examined the trends in smoking behaviours (current and ever smoking, quit ratios) according to education and place of residence and we quantified the observed inequalities. Data were from repeated cross-sectional surveys (2003-2009) of Montreal (Canada) residents ≥15 years (n=12,053). Trends in smoking behaviours according to education were measured with logistic and log-binomial regressions. Spatial distribution of smoking behaviours across local areas was assessed with Morans' Index. Observed inequalities were quantified with prevalence ratio and difference, population attributable risk, and slope index of inequality. Results showed that ever smoking rose among low-educated individuals. Among their high-educated fellow-citizens, current smoking decreased and quit ratios increased. Adverse smoking behaviours (current and ever smoking) were clustered in south-central areas. We conclude that smoking inequalities in Montreal are growing. We thus encourage a closer monitoring of smoking social differentials.
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Affiliation(s)
- Mélissa Généreux
- Department of Community Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada.
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