Cigarette smoking among Greek adolescents: behavior, attitudes, risk, and preventive factors

The science of child and adolescent mental health in Greece: a nationwide systematic review

Evidence-based information is essential for effective mental health care, yet the extent and accessibility of the scientific literature are critical barriers for professionals and policymakers. To map the necessities and make validated resources accessible, we undertook a systematic review of scientific evidence on child and adolescent mental health in Greece encompassing three research topics: prevalence estimates, assessment instruments, and interventions. We searched Pubmed, Web of Science, PsycINFO, Google Scholar, and IATPOTEK from inception to December 16th, 2021. We included studies assessing the prevalence of conditions, reporting data on assessment tools, and experimental interventions. For each area, manuals informed data extraction and the methodological quality were ascertained using validated tools. This review was registered in protocols.io [68583]. We included 104 studies reporting 533 prevalence estimates, 223 studies informing data on 261 assessment instruments, and 34 intervention studies. We report the prevalence of conditions according to regions within the country. A repository of locally validated instruments and their psychometrics was compiled. An overview of interventions provided data on their effectiveness. The outcomes are made available in an interactive resource online [ https://rpubs.com/camhi/sysrev_table ]. Scientific evidence on child and adolescent mental health in Greece has now been cataloged and appraised. This timely and accessible compendium of up-to-date evidence offers valuable resources for clinical practice and policymaking in Greece and may encourage similar assessments in other countries.

Analyzing big tobacco's global youth marketing strategies and factors influencing smoking initiation by Nigeria youths using the theory of triadic influence

Background

Major transnational tobacco companies (TTCs) have identified Nigeria, the seventh most populous country in the world, as a market with a significant revenue potential, given its high youth population and growing gross domestic product (GDP). This research analyses tobacco industry-related strategies and activities targeting youth (aged 15 to 24 years) in Nigeria involving existing, but most importantly, future tobacco users. Nigeria is the focus of this study because the tobacco industry has viewed it as a major emerging market since the 1990s. Successful marketing in Nigeria could provide the industry with a template for similar initiatives in other emerging markets in low- and middle-income countries.

Methods

The research began with a systematic review of secondary literature to determine how the tobacco industry has targeted youth globally and factors contributing to youth smoking initiation. It then used the theory of triadic influence as a heuristic framework to categorize the various factors influencing youth smoking initiation and industry strategies related to increasing tobacco use among youths. Quotations from internal tobacco industry documents were organized into the three streams of the theory of triadic influence: biology/personality, social and cultural/environmental streams. A total of 12 interviews were conducted with 6 policymakers and governmental officials, 2 civil society organization representatives, a high school principal, a journalist and 2 researchers to investigate how the tobacco industry had targeted youth in Nigeria.

Results

The findings indicate that TTCs have actively targeted youth in Nigeria since the 1990s, focusing on changing behaviour through the biology/personality, social and environmental/ cultural streams.

Conclusion

The study suggests that Nigeria implement and vigorously enforce its 2015 National Tobacco Control Bill as well as a package of other measures to prevent tobacco companies targeting youth.

Psychosocial perspective and suicidal behaviors correlated with adolescent male smoking and illicit drug use

OBJECTIVES

To assess the prevalence of smoking and drug use among adolescent boys, and to examine adolescents' psychosocial factors, and suicidal behaviors associated with adolescents' substance use.

METHODS

The Kuwait Global School-Based Student Health Survey employed a two-stage cluster sample design targeting a representative sample of adolescents. This study focused on the participated 1310 boys. Statistical analysis included Chi-square test, student t-test, and multivariate analysis.

RESULTS

The mean age was 14.5 ± 0.03 years. The reported prevalence of: smoking, ever drug use, and both smoking and drug use were 26.6% (95% CI:24.2-29.1%) and 7.4% (95% CI:6.1-9.0%) and 5.5% (95% CI:4.4-6.9%) respectively. Logistic regression model analysis revealed that adolescents whose parents smoke, suffered from insomnia, were victims of bullying, and had negative social school environment, were more likely than others to be smokers, drug users or both. Addendum, suicidal ideation, and its combination with suicidal planning and/or suicidal attempt were significantly associated with smoking. The odds of these life-threatening behaviors increased when drug use was reported and augmented when both smoking and drug use were experienced.

CONCLUSIONS

Prevalence of smoking and illicit drug use were high among adolescent boys. This study confirmed the association between adolescents' smoking and substance use with psychosocial context, and suicidal behaviors. Addressing these predictors would be crucial in the development of effective strategies targeting the prevention of smoking and substance use, which might consequently reduce suicidal behaviors among adolescents.

[Cigarette smoking initiation among Tunisian adolescents: Risk and protective factors]

BACKGROUND

Since smoking is a major public health problem among Tunisian teenagers, it is important to identify the underlying risk and protective factors associated with initiation of this behavior.

METHODS

A cross-sectional, school-based survey of students was conducted by the Tunisian Ministry of Health among a nationally representative sample of 4172 adolescents aged between 12 and 20 years attending public, private, and professional secondary schools across Tunisia who participated in the Survey of the Health of Tunisian adolescents in 2000. For data analysis, we first calculated crude odds ratios (OR) followed by calculating adjusted OR after using multivariate logistic regression models.

RESULTS

Almost one-third of respondents had already started smoking at an average age of 13 years, 6.4% among them smoked daily. Demographic vulnerabilities to smoking behavior were gender (boys more than girls), age and residence in urban areas and particularly in Greater Tunis and the North East. Familial and school factors were parental divorce, poor relationship with parents, poor integration into the peer group, and poor school investment. Psychological and behavioral factors were low self-esteem level and the occurrence of stressful life events, risk taking and alcohol consumption when there was no association with the depression, anxiety and body image. Protective factors against the experimental cigarettes were mainly sports and reading.

CONCLUSION

There are many factors associated with smoking behavior among adolescents. All of these predictors need to be considered in smoking prevention among Tunisian teenagers.

Predicting students' intention to smoke by theory of planned behaviour variables and parental influences across school grade levels

Differences were examined in Theory of Planned Behaviour determinants of students' intention to smoke including parents' attitudes towards smoking and parents' current cigarette use among Greek students of different school grade levels. Students (N = 763) aged 10-18 years reported their attitudes towards smoking, subjective norms, perceived behavioural control, self-identity and intention to smoke while their parents (N = 525) reported their attitudes towards smoking and their current cigarette use. All the TPB variables increased from lower to higher school grade level. Multi-sample path analyses showed that parent's attitudes towards smoking positively predicted students' intention to smoke only for elementary school children. Parents' current cigarette use did not contribute significantly. Students' attitudes, perceived behavioural control and self-identity predicted systematically intention to smoke in contrast to the subjective norm that did not contribute at all. Perceived behavioural control contributed to a higher degree in intention to smoke for senior high school students compared to the junior high school and elementary students. Self-identity contributed to a higher degree in intention to smoke for elementary compared to the junior high school students. The results of this study suggests that the determinants of smoking vary between early and late adolescence.

Critical discussion of social-cognitive factors in smoking initiation among adolescents

Social-cognitive models have often been used in research on prevention in adolescent populations, even though the models were designed to describe adult behavior. The aim of the study reported here was to examine critically and constructively the five social-cognitive factors in the 'attitude, social influence, self-efficacy' (ASE) model. Methods. The examination draws on the results of a qualitative follow-up study of smoking initiation based on semi-structured interviews and observations of 12 adolescents in two Danish school classes, grades 7 and 8. The qualitative study was conducted in connection with and sampled from a large quantitative study and the results of both studies are discussed. In the analyses, we explored the ASE constructs according to how they are described in the ASE theory. Furthermore, we examined contradictions and aspects which are not explained in the model and if relevant discussed these aspects using other theoretical frameworks. Results. The results showed that aspects other than those in the ASE model are also important. Smoking initiation was often situational and unplanned and was sometimes used in negotiating social relationships and identity. Furthermore, the social-cognitive models are based on the assumption that adolescents talk about smoking norms and have a high degree of individual reflexivity, which is not always characteristic of adolescent behavior. Conclusion. Applying theoretical models in health research should be a continuous process of both applying the model and discussing the theoretical assumptions of the model when applied to a specific sample. The results of the qualitative study provide some support for use of the ASE model, but the results also suggest that further studies are needed to explore how social-cognitive models can be expanded to be more comprehensive behavioral models.

Adolescent lifestyle and behaviour: a survey from a developing country

INTRODUCTION

Adolescents form two-thirds of our population. This is a unique group of people with special needs. Our survey aims to identify the lifestyle and behavioral patterns in this group of people and subsequently come up with issues that warrant special attention.

METHODS

A survey was performed in various schools of Karachi. Data collection was done via a face-to-face interview based on a structured, pre-tested questionnaire. Participants included all willing persons between 12-19 years of age.

RESULTS

Most adolescents with lifestyle issues fell in the age group of 16-18 years. Females were more depressed than males and had more sleep problems. Substance abuse and other addictions were documented more in males. Watching television or listening to music was stated as the most common late night activity (61.8%) and therefore was also referred to as the contributory factor for less than eight hours of sleep each day. (58.9%) of the respondents are getting less than eight hours of sleep daily. (41.5%) of the respondents who felt depressed sought treatment for it. Quite a few of them were also indulged in substance abuse and other addictions. Only (16.8%) of the respondents opined that physical activity is essential for health. Thirty-five adolescents out of all the respondents were smoking cigarettes currently, whereas 7% of the respondents chewed paan (areca nut). Peer pressure was the most common reason (37.1%) to start smoking.

CONCLUSION

Adolescents need to be treated as a distinct segment of our population and it is important to realize and address their health and lifestyle problems. Inadequate sleep, depression and smoking were the leading unhealthy behaviours among the respondents. Families can play an important role to help these adolescents live a healthier life. Further research studies should be carried out to highlight issues of concern and their possible solutions in this population.