Self-reported smoking among adolescents: How accurate is it with the urine cotinine strip test?

Association between adolescent lifestyle factors and high-energy traumas in early adulthood: A longitudinal study

INTRODUCTION

Longitudinal studies investigating lifestyle factors as risk factors for high-energy traumas from adolescence to adulthood are lacking. The aim of this study was to investigate the influence of 14 to 18-year old adolescent health-related behaviours, overweight, chronic disease, family socioeconomic status (SES), and adulthood education level on the risk of high-energy traumas during the average 27-year follow-up in Finland.

MATERIALS AND METHODS

The baseline data were surveys gathered biennially from 1981 to 1997 (the Adolescent Health and Lifestyle Survey) and individually linked with outcome data on high-energy traumas retrieved from the Care Register for Health Care until the year 2018. A logistic regression model was used to analyse the associations between the exposure variables in adolescence (frequent physical activity, overweight, smoking, monthly drunkenness, chronic disease, family SES, adulthood education level) and the overall risk for high-energy traumas. Adjusted odds ratios (aOR) with 95 % confidence intervals (CIs) were computed.

RESULTS

A total of 876 persons (1.8 %) had a high-energy trauma during the follow-up. High-energy trauma diagnoses overall were more common among males than among females (2.8 % vs 1.0 %). Follow-up showed that those who smoked (aOR 1.49, CI 1.40-1.58), were drunk monthly (aOR 1.49, CI 1.39-1.59), had a chronic disease (aOR 1.22, CI 1.12-1.34) in adolescence or had attained only low education level in adulthood (aOR 1.39, CI 1.30-1.48) had higher odds for high-energy traumas. Frequent physical activity or overweight in adolescence were not related to the higher odds for high-energy traumas.

CONCLUSION

Smoking, monthly drunkenness, self-reported chronic diseases in adolescence, and low educational level in adulthood increased the risk of high-energy traumas during the mean follow-up of 27-years. Frequent physical activity and overweight in adolescence did not predict the occurrence of high-energy traumas. Intervention programs should also focus on the long-term consequences of these risk factors.

Indoor air pollution is associated with respiratory symptoms in children in urban Vietnam

Exposure to indoor air pollution (IAP) is a leading environmental risk for respiratory diseases. We investigated the relationship between respiratory symptoms and polluting indoor activities such as smoking, cooking and contact with pets among children in Ho Chi Minh City (HCMC), Vietnam. A cross-sectional survey applied a multistage sampling method in 24 randomly selected secondary schools across the city. Approximately 15,000 students completed self-administrated questionnaires on risk factors and respiratory health outcomes within the preceding 12 months. Data were analyzed using a multivariable logistic regression model with robust standard errors. Wheeze was the most common respiratory symptom (39.5 %) reported, followed by sneezing and runny nose (28.3 %). A small percentage of students self-reported asthma (8.6 %). Approximately 56 % of participants lived with family members who smoked. A positive association between exposure to indoor secondhand smoke and respiratory symptoms was observed, with adjusted odds ratios (aOR) of 1.41 (95 % CI: 1.25-1.60, p < 0.001) for wheezing and 1.64 (95 % CI: 1.43-1.87, p < 0.001) for sneezing and runny nose, respectively. Using an open stove fuelled by coal, wood, or kerosene for cooking was associated with wheeze (aOR: 1.36, CI 95 %: 1.10-1.68, p = 0.01) and sneezing and runny nose (aOR: 1.36, CI 95 %: 1.09-1.69, p = 0.01). In the present study, IAP was associated with adverse health outcomes, as evidenced by an increase in respiratory symptoms reported within the previous 12 months.

National Trends of Adolescent Exposure to Tobacco Advertisements: 2012-2020

BACKGROUND AND OBJECTIVES

The objective of the current study is to evaluate the temporal trends in the prevalence of cigarette and electronic cigarette (e-cigarette) advertisement exposure by venue and sociodemographic correlates among US adolescents from 2012 to 2020.

METHODS

We conducted a serial cross-sectional analysis of nationally representative samples of middle and high school youth from the 2012-2020 National Youth Tobacco Survey. Advertisement exposure was defined as self-report of seeing advertisements "sometimes," "most of the time," and "always." The prevalence of cigarette (and other tobacco products) and e-cigarette advertisement exposure, including overall and at specific venues (Internet, press, screen, and retail stores), was estimated by survey year.

RESULTS

A total of 139 795 adolescents aged 11 to 19 years old were included in the analysis. The prevalence of exposure to combustible cigarette marketing remained high across all years (any venue ranging from 77.0% [2018] to 91.1% [2014]). An increasing trend for cigarette advertisement exposure was observed from 2017 to 2020 after a drop in 2015 (β2012-2015 = 2.8, P for trend < .001; β2017-2020 = .7, P for trend = .03), driven by retail store-based and Internet-based exposure. A similar increasing pattern in the estimated prevalence of e-cigarette marketing was observed (β2014-2016 = 4.6, P for trend < .001; β2017-2020 = 5.1, P for trend < .001).

CONCLUSIONS

Given the high estimated prevalence of cigarette and e-cigarette marketing exposure among US adolescents, further regulation efforts for both off-line and online tobacco marketing are needed to mitigate adolescent exposure to content regarding these products, reducing susceptibility to uptake.

Prevalence and factors related to secondhand smoke exposure among secondary school-going adolescents in Malaysia: Findings from Malaysia Global Health School Survey 2012 and 2017

INTRODUCTION

Secondhand (SHS) smoke exposure has caused various health problems. Therefore, continuous monitoring of SHS exposure is important to determine the efficacy of various anti-tobacco measure implemented. The study aims to compare the prevalence and factor(s) associated with SHS exposure among secondary school-going adolescents in Malaysia during 2012 and 2017.

METHODS

We derived data from the Global School Health Survey (GSHS) 2012 and GSHS 2017, which was carried out in Malaysia using multistage sampling to select representative samples of secondary school-going adolescents. Both surveys used similar questionnaires to measure SHS exposure. Descriptive and multivariate logistic regression was used to determine the prevalence and factors associated with SHS exposure.

RESULTS

Approximately four in ten respondents were exposed to SHS in the past week in both surveys (41.5% in GSHS 2012 and 42.0% in GSHS 2017, respectively). Both surveys revealed a significantly higher SHS exposure among respondents who smoked than among non-smokers and higher among males compared to females. The likelihood of SHS exposure in both surveys was also similar, with a higher likelihood of SHS exposure among smoking adolescents and non-smoking adolescents who had at least one smoking parent/guardian, regardless of their own smoking status. Male adolescents had a higher risk of SHS exposure compared to their female counterparts. Meanwhile, SHS risk also increased with age, regardless of smoking status.

CONCLUSIONS

Our findings suggested that there were no changes in the prevalence of SHS exposure and recorded only a slight change in the factors associated with exposure to SHS among school-going adolescents in Malaysia between the years 2012 and 2017. A more pro-active, extensive and comprehensive programme should be implemented to address the problem of SHS exposure. Parents should be advised to stop smoking or abstain from smoking in the presence of their children, and smoking cessation interventions are necessary for smoking adolescents and their parents.

Factors Associated With the Differences Between Self-Report Smoking and Urinary Cotinine Criteria

During self-reporting, respondents underreport their smoking status for various reasons. We aimed to evaluate the difference between smoking status self-reporting and urinary cotinine tests in Korea respondents. Logistic regression analyses were performed to identify factors associated with the differences between self-reporting and urinary cotinine criteria. The dependent variable was the underreporting of smoking status; independent variables were sociodemographic, health status, and secondhand smoke (SHS) exposure. Total underreporting was 3.6% when Cot ≥164 and 4.0% when Cot-variable (classified) criteria underreported. Positive associations were found between smoking and age, education, drinking, and SHS. Underreporting in the nonsmoker group (odds ratio [OR] = 2.336; confidence interval [CI] = 1.717-3.179) was significantly associated with SHS, but this difference was nonsignificant in the ex-smoker group (OR = 1.184; CI = 0.879-1.638). Underreporting was 3.6% to 4.0%, and C-statistics was about 0.7, indicating that outcomes could be classified. SHS in nonsmokers was positively associated with underreporting; however, only the nonsmoker group had positive associations, demonstrating unintentional underreporting due to SHS.

Tobacco use and other aspects related to smoking among school-going adolescents aged 13-15 years in Malaysia: Analysis of three cross-sectional nationally representative surveys in 2003, 2009 and 2016

INTRODUCTION

Periodic surveys on tobacco use patterns and other aspects of tobacco use among school-going adolescents in Malaysia provide information on the effectiveness of anti-smoking measures implemented. However, such information is limited in Malaysia. We investigated the prevalence of smoking and other related aspects among middle-secondary school students in Malaysia from the years 2003-2016 to fill this gap.

METHODS

We analyzed data from the Global Youth Tobacco Survey (GYTS) 2003, GYTS 2009, and the Tobacco and Electronic Cigarette Survey among Malaysia Adolescents (TECMA) 2016. The surveys employed multistage sampling to select representative samples of adolescents attending secondary school in Malaysia. Data were collected using a pre-validated self-administered anonymous questionnaire adopted from the GYTS.

RESULTS

Between 2003 and 2016, major changes occurred in which there were reductions in the prevalence of ever smoking, current smoking, and susceptibility to smoking. Reductions were also observed in exposure to SHS in public places and in the home. The proportion of school-going adolescents who support a ban on smoking in public places increased between 2013 to 2016, and there was a significant reduction in the proportion of respondents that were offered 'free' cigarettes by tobacco company representatives. However, there was no difference in the proportion of adolescents who initiated smoking before the age of 10 years and current smokers seeking advice to quit smoking across the time period.

CONCLUSIONS

Our study indicates that the smoking policies and measures have been effective in reducing smoking prevalence, secondhand smoke exposure, and access to cigarettes, among school-going adolescents in Malaysia. However, measures to reduce smoking initiation and increase smoking cessation need to be strengthened to reduce the burden of smoking-related diseases in Malaysia in the long-term.

Factors Predicting 6-Month Smoking Cessation in Korean Adults

The purpose of this study was to identify factors predicting 6-month smoking cessation in Korean adult smokers. This descriptive correlation study assessed levels of urine cotinine, serum cotinine, serum serotonin, and 5-hydroxyindoleacetic acid; tobacco withdrawal symptoms; and resilience among 164 Korean adult smokers. Serum cotinine levels were negatively related to resilience at six months (r = -.42, p = .019), but were positively related to the amount of smoking (r = .32, p = .008) and with the Week 6 tobacco withdrawal symptoms score (r = .48, p = .001, n = 41). Higher resilience was associated with a higher 5-HIAA concentration. Greater therapy attendance, resilience, and withdrawal symptoms explained 35.3% of the variance in 6-month smoking cessation (Nagelkerke R² = .35, p < .001, n = 76). Efforts to increase counseling attendance rates and resilience and decrease withdrawal symptoms could be useful ways to improve smoking cessation rates.