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Amara A, Omri N, Bannour R, Limam M, El Ghardallou M, Mellouli M, Sahli J, Mtiraoui A. Association of tobacco experimentation with anxiety and depression: findings from a representative sample of Tunisian adolescents. Int J Adolesc Med Health 2024; 36:85-94. [PMID: 38414110 DOI: 10.1515/ijamh-2023-0197] [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: 12/15/2023] [Accepted: 01/28/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES Emerging evidence points to tobacco experimentation being associated with a vast array of mental disorders, particularly anxiety and depression. We aimed to assess the prevalence of tobacco experimentation, its predictive factors and its potential links with anxiety and depressive disorders among in school adolescents in a Tunisian delegation. METHODS We carried out a cross sectional study among adolescents schooling in middle and high schools in the delegation of Nfidha, Sousse, Tunisia, during the period from January to March of the 2019-2020 school year using an anonymous questionnaire self-administered to a representative sample of 1,353 randomly selected pupils. Data were collected using the Arabic versions of the Beck Depression Inventory short form (13 items) and the Screen for Child Anxiety Related Disorders (SCARED-C) and a socio-demographic questionnaire with reference to the literature. RESULTS Tobacco was experimented by (17.5 %; CI 95 %: 14.8-18.8 %) of pupils. Almost three out of four pupils (73.2 %; CI 95 %: 70.8-75.6 %) reported experiencing depressive symptoms and (65 %; CI 95 %: 62.5-67.5 %) anxiety symptoms. Pupils who exhibited depressive disorder indicators were significantly more prone to experiment with tobacco (20.2 vs. 9.9 %, p<0.001; crude OR=2.301 CI 95 %: 1.74-3.58). Similarly, the prevalence of tobacco experimentation was found to be higher among pupils who reported having experienced anxiety disorders (21.0 vs. 14.5 %, p<0.001; crude OR=1.56 CI 95 %: 1.06-2.27). Being a male pupil (AOR=5.48 95 % CI: 3.62-8.31), being be enrolled in a high school (AOR=2.86, 95 % CI: 1.92-4.26), tobacco use by father and siblings (respectively AOR=1.76, 95 % CI: 1.19-2.60; AOR=2.47, 95 % CI: 1.52-4.02) and experiencing depressive disorders (AOR=2.69, 95 % CI: 1.60-4.53) were the determinants of tobacco experimentation in the multivariate analysis. CONCLUSIONS Tobacco experimentation in adolescence has been shown to be significantly associated with anxiety and depression. National smoking prevention strategies should be reinforced with a focus on mental health disorders.
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Affiliation(s)
- Amel Amara
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Nihel Omri
- Department of Community and Family Medicine, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Rania Bannour
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Manel Limam
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Meriam El Ghardallou
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Menel Mellouli
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Jihene Sahli
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Ali Mtiraoui
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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Amara A, Omri N, Sahli J, Zedini C, El Ouni T, Mtiraoui A, Mallouli M, Ghardalou M. Prevalence and predictors of tobacco, alcohol and illicit drug experimentation among Tunisian middle and high school-adolescents. Int J Adolesc Med Health 2023; 35:363-373. [PMID: 37561158 DOI: 10.1515/ijamh-2022-0117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 07/31/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVES Psychoactive substance experimentation among Tunisian adolescents remains one of the most threatening public health concerns. In spite of this, little is known about the prevalence and predictors of these behaviors in the Tunisian context. This study aims to assess the prevalence of tobacco, alcohol and illicit drug experimentation and its predictive factors among adolescents in the delegation of Nfidha, Sousse governorate, Tunisia. METHODS We conducted a cross sectional study in middle and high schools in the delegation of Nfidha, Sousse governorate, Tunisia, during the first trimester of the 2019-2020 school year using an anonymous questionnaire self-administered to a randomly drawn representative sample of 1,352 pupils. Data collected included socio-demographic characteristics, substance experimentation among school-adolescents, academic performance as well as family and peer' factors. RESULTS Tobacco was the most commonly experimented substance with a prevalence rate of 17.5 % (CI 95 %: 14.8-18.8 %). The prevalence of alcohol and illicit drugs use were 3.3 % [CI 95 %: (2.1-3.9 %)] and 2 % [CI 95 %: (1.1-2.6 %)] respectively. Being male (Adjusted (AOR)=4.09, p<0.001), being a high school pupil (AOR=2.81, p<0.001), having experiencing academic failure (AOR=1.60, p=0.007) and having a father and siblings who use tobacco (AOR=1.72, p=0.002; AOR=2.03, p=0.001 respectively) were the predictors of tobacco experimentation in the multivariate logistic regression analysis. Additionally, being male (AOR=8.40, p<0.001), having experienced academic failure (AOR=2.76, p=0.017) as well as having a father and siblings who use alcohol (AOR=5.90, p<0.001; AOR=3.03, p=0.045 respectively) and having experienced tobacco (AOR=4.28, p<0.001) were the determinants of alcohol experimentation. Similarly, having a history of academic failure (AOR=3.44, p=0.041), having peers who use illicit drugs (AOR=3.22, p=0.028), having a history of tobacco and alcohol experimentation (AOR=6.52, p<0.001; AOR=3.49, p=0.046 respectively) were the predictors of illicit drug experimentation among adolescents. CONCLUSIONS A substantial number of socio-demographic and environmental factors have been identified as being involved in experimentation with psychoactive substance during adolescence. Therefore, further prevention programs targeting not only adolescents, but also all risk factors are needed.
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Affiliation(s)
- Amel Amara
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Nihel Omri
- Department of Community and Family Medicine, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Jihene Sahli
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Chakib Zedini
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Tasnim El Ouni
- Department of Community and Family Medicine, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Ali Mtiraoui
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Manel Mallouli
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Mariem Ghardalou
- Department of Community and Family Medicine, Sousse, Tunisia
- Research Laboratory LR12ES03, Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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Bendaou B, Zarrouq B, Kinany KE, Lyoussi B, Benjelloun MC, Nejjari C, Rhazi KE. Risk factors and prevalence of use of different tobacco products among school adolescents in the North Central region of Morocco: a cross-sectional study. Pan Afr Med J 2018; 30:73. [PMID: 30344857 PMCID: PMC6191258 DOI: 10.11604/pamj.2018.30.73.10896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 04/04/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction The rising number of youth smokers is a major concern to public health in Morocco. The implementation of appropriate preventive measures would require information about the prevalence and determinants of tobacco use. Data on tobacco consumption among adolescents in the North Center of Morocco are scarce. Therefore, the current study aims at investigating the risk factors of smoking and the prevalence of the use of different forms of tobacco among school teenagers in the North-Centre region of Morocco. Methods A cross-sectional study was conducted in North Central Region of Morocco among students in public secondary schools selected by stratified cluster random sampling. The statistical unit devised was a school class from the seventh to the twelfth grade of the Moroccan educational system. Results A total of 3020 students (53% were males) and an average age = 16 ± 2.1 years were included in the study. The prevalence of the use of cigarettes was 16.1% (95% CI: 14.8% - 17.4%).For other tobacco types such as hookah, snuff and tobacco chewing, the prevalence was respectively 70.6%, 42.8% and 35.0% for cigarettes smokers. The level of current tobacco use was noticeably higher among boys (15.0% vs. 2.5%, p < 0,001) and high school students in comparison to middle school pupils (21.2% versus 11.9%; p < 0,001). Conclusion Among young people, all types of smoking are growing increasingly in our Moroccan society; this alarming result can contribute to help the decision-makers to make decisions and force us obviously to take preventive measures rapidly.
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Affiliation(s)
- Belkacem Bendaou
- Laboratory of Epidemiology, Clinical Research and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.,Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco.,Pneumology Service, Centre Hospitalier Universitaire Hassan II of Fez, University Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Btissame Zarrouq
- Laboratory of Epidemiology, Clinical Research and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.,Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Khaoula El Kinany
- Laboratory of Epidemiology, Clinical Research and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Badiaa Lyoussi
- Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Mohamed Chakib Benjelloun
- Pneumology Service, Centre Hospitalier Universitaire Hassan II of Fez, University Sidi Mohamed Ben Abdellah, Fez, Morocco
| | - Chakib Nejjari
- Laboratory of Epidemiology, Clinical Research and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology, Clinical Research and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
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Sendi I, Chouikh A, Ammar A, Bouafia N. Depression in a sample of Tunisian adolescents: prevalence, associated factors and comorbidity with anxiety disorders. Int J Adolesc Med Health 2018; 33:/j/ijamh.ahead-of-print/ijamh-2018-0068/ijamh-2018-0068.xml. [PMID: 30267630 DOI: 10.1515/ijamh-2018-0068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/03/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Adolescent depression is a significant health problem which can lead to detrimental consequences. This study aimed to determine the prevalence of the depression in a sample of secondary school students, to identify its associated factors and to explore the co-occurrence with symptoms of anxiety disorders. MATERIALS AND METHODS We conducted, in March 2017, a cross-sectional study that included, using a cluster sampling technique, 386 students from five public secondary schools in El Kef (Tunisia). Data were collected using a socio-demographic questionnaire and the Arabic versions of the Beck Depression Inventory (13 items) and the Screen for Child Anxiety Related Disorders. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20. RESULTS The prevalence of depression among participants was 75.9%. Of depressed students, 30.4% had mild depression, 48.8% had moderate depression and 20.8% had severe depression. The logistic regression analysis showed an association between the depression and the female gender [odds ratio (OR) = 2.59, 95% confidence interval (CI): 1.52-4.17], the 1st and 4th school grades (OR = 1.79, 95% CI: 1.09-2.94), the low and medium socioeconomic status (SES) (OR = 1.91, 95% CI: 1.14-3.18), the school dissatisfaction (OR = 2.77, 95% CI: 1.41-5.44) and the anxiety disorders (OR = 5.86, 95% CI: 3.54-9.70). The comorbidity "depression and anxiety" was found in 86.1% of students. CONCLUSION This high prevalence of depressive symptoms reported in the present study seems to have many implications especially for school health-care services.
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Affiliation(s)
- Ibtissem Sendi
- Higher School of Health Sciences and Techniques, Sousse University, Rue de Tadjikistan, Sahloul II Sousse 4054, Tunisia, Phone: +21654775810
| | - Amira Chouikh
- Department of Psychiatry, Farhat Hachad University Hospital, Sousse, Tunisia
- Ibn Al Jazzar Faculty of Medicine, Sousse University, Sousse, Tunisia
| | - Asma Ammar
- Department of Infection Prevention and Control, Farhat Hached University Hospital, Sousse, Tunisia
| | - Nabiha Bouafia
- Department of Infection Prevention and Control, Farhat Hached University Hospital, Sousse, Tunisia
- Department of Infection Prevention and Control, King Faisal Medical Complex, Taif, KSA
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Zenic N, Ban D, Jurisic S, Cubela M, Rodek J, Ostojic L, Jelicic M, Bianco A, Sekulic D. Prospective Analysis of the Influence of Sport and Educational Factors on the Prevalence and Initiation of Smoking in Older Adolescents from Croatia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040446. [PMID: 28425977 PMCID: PMC5409646 DOI: 10.3390/ijerph14040446] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 04/15/2017] [Accepted: 04/18/2017] [Indexed: 01/16/2023]
Abstract
The prevalence of smoking among Croatian adolescents is alarmingly high, but no previous study has prospectively examined the sport- and academic-factors associated with smoking and smoking initiation. This study aimed to prospectively examine the associations between scholastic (educational) achievement and sport factors and smoking in 16- to 18-year-old adolescents. This two-year prospective cohort study included 644 adolescents who were 16 years of age at baseline (46% females). Baseline testing was implemented at the beginning of the 3rd year of high school (September 2014) when participants were 16 years old. Follow-up testing was completed at the end of the fourth year of high school, which occurred 20 months later. The evaluated predictor variables were educational-achievement- and sport-related-factors. The outcome variables were (i) smoking at baseline; (ii) smoking at follow-up; and (iii) smoking initiation over the course of the study. We assessed the associations between predictors and outcomes using logistic regression models adjusted for age, gender, socioeconomic status, and conflict with parents. The educational variables were consistently associated with smoking, with lower grade-point-average (Baseline: odd ratio (OR): 2.01, 95% confidence interval (CI): 1.61–2.55; Follow-up: 1.59, 1.31–1.94), more frequent absence from school (Baseline: OR: 1.40, 95% CI: 1.19–1.69; Follow-up: 1.30, 1.08–1.58), and lower behavioral grades (Baseline: OR: 1.80, 95% CI: 1.10–2.89; Follow-up: 1.57, 1.03–2.41) in children who smoke. Adolescents who reported quitting sports were at greater odds of being smokers (Baseline: 2.07, 1.31–3.32; Follow-up: 1.66, 1.09–2.56). Sport competitive achievement at baseline was protective against smoking initiation during following two-year period (0.45, 0.21–0.91). While the influence of the educational variables on smoking initiation has been found to be established earlier; sport achievement was identified as a significant protective factor against initiating smoking in older adolescents. Results should be used in development of an anti-smoking preventive campaign in older adolescents.
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Affiliation(s)
- Natasa Zenic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia.
| | - Djivo Ban
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia.
- University of Dubrovnik, 20000 Dubrovnik, Croatia.
| | - Sanja Jurisic
- Faculty of Medicine, University of Mostar, 88000 Mostar, Bosnia and Herzegovina.
| | - Mladen Cubela
- Faculty of Medicine, University of Mostar, 88000 Mostar, Bosnia and Herzegovina.
| | - Jelena Rodek
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia.
| | - Ljerka Ostojic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia.
- Faculty of Medicine, University of Mostar, 88000 Mostar, Bosnia and Herzegovina.
- Academy of Medical Sciences, 71000 Sarajevo, Bosnia and Herzegovina.
| | - Mario Jelicic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia.
| | - Antonino Bianco
- Sport and Exercise Research Unit, SPPF Department, University of Palermo, 90144 Palermo, Italy.
| | - Damir Sekulic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia.
- University Department of Health Care Studies, University of Split, 21000 Split, Croatia.
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