1
|
Cartujano-Barrera F, Rodríguez-Bolaños R, Arana-Chicas E, Allaham F, Sandoval L, Rubado M, Gallegos-Carrillo K, Colugnati FAB, Galil AG, Mejia RM, Cupertino AP. Smoking Cessation Mobile Interventions in Latin America: A Systematic Review. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:122-132. [PMID: 34263686 DOI: 10.1177/15404153211020410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To systematically review published articles reporting the use of smoking cessation mobile health (mHealth) interventions in Latin America. METHODS Five different databases were searched from database inception to 2020. Criteria: (1) the research was a smoking cessation randomized controlled trial (RCT), quasi-experimental research, or single-arm study; (2) the intervention used at least one type of mHealth intervention; (3) the research was conducted in Latin American; and (4) the research reported the cessation rate. RESULTS Of the seven selected studies, four were conducted in Brazil, two in Mexico, and one in Peru. Only one study was an adequately powered RCT. Interventions relied on text messages (n = 3), web-based tools (n = 2), and telephone calls (n = 3). Some studies (n = 4) provided pharmacotherapy support. Smoking cessation outcomes included self-reported (n = 5) and biochemically verified (n = 2) abstinence. Follow-ups were conducted at Month 6 (n = 2), Week 12 (n = 4), and Day 30 (n = 1). Cessation rates varied from 9.4% at Week 12 to 55.5% at Day 30. CONCLUSION Despite the promising cessation rates of mHealth interventions in Brazil, Mexico, and Peru, there is a need to rigorously evaluate these interventions in different Latin American countries with RCTs that are long-term, adequately powered, and use biochemical verification of cessation.
Collapse
Affiliation(s)
| | - Rosibel Rodríguez-Bolaños
- Departamento de Investigación sobre Tabaco, 37764Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Fatema Allaham
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Lizbeth Sandoval
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle Rubado
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Katia Gallegos-Carrillo
- Unidad de Investigación Epidemiológica y en Servicios de Salud Delegación Morelos, 37767Instituto Mexicano del Seguro Social. Cuernavaca, Morelos, Mexico
| | | | - Arise G Galil
- Faculdade de Medicina, Universidade Federal de Juiz de Fora. Juiz de Fora, Minas Gerais, Brazil
| | - Raul M Mejia
- Programa de Medicina Interna General, 28196Universidad de Buenos Aires. Buenos Aires, Argentina
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
2
|
Abu-Rmeileh NME, Alderete E, Husseini A, Livaudais-Toman J, Pérez-Stable EJ. Country and gender differences in the association between violence and cigarette smoking among youth. Confl Health 2020; 14:87. [PMID: 33317610 PMCID: PMC7734849 DOI: 10.1186/s13031-020-00332-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 11/30/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Exposure to violence in youth may be associated with substance use and other adverse health effects. This study examined cigarette smoking in two middle-income areas with different levels and types of exposure to violence. METHODS Association of exposure to verbal and physical violence with cigarette smoking in the West Bank oPt (2008) and in Jujuy Argentina (2006) was examined using cross-sectional surveys of 14 to 17-year old youth in 7th to 10th grade using probabilistic sampling. RESULTS Violence exposure rates were more than double for Palestinian girls (99.6% vs. 41.2%) and boys (98.7% vs. 41.1%) compared with Argentinians. The rate of current cigarette smoking was significantly higher among Argentinian girls compared with Palestinian girls (33.1% vs. 7.1%, p < 0.001). Exposure to verbal violence from family and to physical violence increased the odds of current cigarette smoking, respectively, among Argentinian girls (aOR = 1.3, 95% CI = 1.0-1.7; aOR = 2.5, 95%CI = 1.7-3.8), Palestinian girls (aOR 2.2, 95%CI = 1.1-2.4; aOR = 2.0, 95%CI = 1.1-3.6) and Argentinian boys (aOR = 1.5, 95%CI = 1.1-2.0; aOR = 2.2, 95%CI = 1.6-3.0), but not among Palestinian boys. CONCLUSION Findings highlight the importance of producing context and gender specific evidence from exposure to violence, to inform and increase the impact of targeted smoking prevention strategies.
Collapse
Affiliation(s)
- Niveen M. E. Abu-Rmeileh
- Institute of Community and Public Health- Birzeit University, West Bank, Occupied Palestinian Territory (oPt), Birzeit, Palestine
| | - Ethel Alderete
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional de Jujuy, Instituto de Ciencia y Tecnología Regional (ICTER), Jujuy, Argentina
| | - Abdullatif Husseini
- Institute of Community and Public Health- Birzeit University, West Bank, Occupied Palestinian Territory (oPt), Birzeit, Palestine
| | - Jennifer Livaudais-Toman
- Division of General Internal Medicine, Department of Medicine, at the University of California, San Francisco, USA
| | - Eliseo J. Pérez-Stable
- Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, USA
| |
Collapse
|
3
|
Quintana H, Roa R. Tobacco use and access among 13 to 15 year olds in Kuna Yala, an indigenous region of Panama. Tob Control 2020; 30:e158-e161. [PMID: 32887741 PMCID: PMC8666802 DOI: 10.1136/tobaccocontrol-2020-055736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 11/06/2022]
Abstract
Background Panama has the lowest overall prevalence of tobacco use in the Americas, however rates are almost three times higher in the indigenous territory of Kuna Yala compared with the national average. Most people who smoke started during adolescence, making this a key period for tobacco control efforts. Objective We aimed to examine tobacco access and use among adolescents (13 to 15 years old) in Kuna Yala compared with nationwide Panama using data from the 2017 Global Youth Tobacco Survey, a standardised international tool for assessing key tobacco control indicators among adolescents. Results The prevalence of current tobacco use among 13 to 15 year olds in Kuna Yala was 14.0% (95% CI: 11.6% to 16.9%)—almost twice the national average of 7.8% (95% CI: 6.3% to 9.4%). Half of all adolescents in Kuna Yala estimated the cost of a 20-cigarette pack as less than US$0.75, compared with 16.2% of adolescents across of Panama (p value <0.01). Conclusions Kuna Yala is one of the few indigenous territories in Spanish-speaking countries where key tobacco control indicators have recently been assessed. Higher tobacco use and lower reported cigarette prices in that region may be linked with the presence of barter economy which may give adolescents more ready access to cigarettes than in other parts of Panama. There is a need for more indigenous-specific data to help build the evidence base to improve tobacco control and reduce commercial tobacco use among indigenous peoples.
Collapse
Affiliation(s)
- Hedley Quintana
- Gorgas Memorial Institute for Health Studies, Panama, Panama
| | - Reina Roa
- PAHO/WHO Tobacco Control Focal Point, Health Ministry of Panama, Panama, Panama
| |
Collapse
|
4
|
Alderete E, Livaudais-Toman J, Kaplan C, Gregorich SE, Mejía R, Pérez-Stable EJ. Youth working in tobacco farming: effects on smoking behavior and association with health status. BMC Public Health 2020; 20:84. [PMID: 31959140 PMCID: PMC6971900 DOI: 10.1186/s12889-020-8169-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cultivation of tobacco raises concerns about detrimental health and social consequences for youth, but tobacco producing countries only highlight economic benefits. We compared sociodemographic and health-related characteristics of school-age youth who worked and did not work in tobacco farming and assessed the effects on smoking behavior and health at 1 year. METHODS We used existing data collected in the province of Jujuy, Argentina where 3188 youth 13 to 17 years of age from a random middle school sample responded to longitudinal questionnaires in 2005 and 2006. Multivariate logistic regression models predicted association of tobacco farming work with health status and smoking behavior at 1 year. RESULTS 22.8% of youth in the tobacco growing areas of the province were involved in tobacco farming. The mean age of initiation to tobacco farming was 12.6 years. Youth working in farming had higher rates of fair or poor versus good or excellent self-perceived health (30.3% vs. 19.0%), having a serious injury (48.5% vs. 38.5%), being injured accidentally by someone else (7.5% vs. 4.6%), being assaulted (5.5% vs. 2.6%), and being poisoned by exposure to chemicals (2.5% vs. 0.7%). Youth working in tobacco farming also had higher prevalence of ever (67.9% vs. 55.2%), current (48.0% vs. 32.6%) and established smoking (17.8% vs. 9.9%). In multivariate logistic regression models tobacco farming in 2005 was associated with significant increased reporting of serious injury (OR = 1.4; 95%CI 1.1-2.0), accidental injury by someone else (OR = 1.5; 95% 1.0-2.1), assault (OR = 2.2; 95% CI 1.3-3.8), and poisoning by exposure to chemicals (OR = 2.5; 95% CI 1.2-5.4). Tobacco farming in 2005 predicted established smoking 1 year later (OR = 1.5; 95% CI 1.1-2.0). CONCLUSION Youth who work in tobacco faming face a challenging burden of adversities that increase their vulnerability. Risk assessments should guide public policies to protect underage youth working in tobacco farming. (298 words).
Collapse
Affiliation(s)
- Ethel Alderete
- Instituto de Ciencia y Tecnología Regional (ICTER), UE CISOR Consejo Nacional de Investigaciones Científicas y Técnicas/Universidad Nacional de Jujuy, San Salvador de Jujuy, Argentina
| | - Jennifer Livaudais-Toman
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, USA
| | - Celia Kaplan
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, USA
| | - Steven E Gregorich
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, USA
| | - Raúl Mejía
- Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina
| | - Eliseo J Pérez-Stable
- Division of Intramural Research, National Heart, Lung and Blood Institute, and Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, 6707 Democracy Boulevard, Suite 800, Bethesda, MD, 20892, USA.
| |
Collapse
|
5
|
Mejia R, Perez A, Morello P, Santillan EA, Braun S, Sargent JD, Thrasher JF. Exposure to Alcohol Use in Movies and Problematic Use of Alcohol: A Longitudinal Study Among Latin American Adolescents. J Stud Alcohol Drugs 2019; 80:69-76. [PMID: 30807277 PMCID: PMC6396517 DOI: 10.15288/jsad.2019.80.69] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/12/2018] [Indexed: 11/27/2023] Open
Abstract
OBJECTIVE This study assesses the association between exposure to alcohol in movies and alcohol use transitions among Latin American adolescents. METHOD A school-based longitudinal study involving 33 secondary schools in Argentina and 57 in Mexico was performed. The baseline sample included 1,504 never drinker adolescents in Argentina and 5,264 in Mexico (mean age = 12.5 years), of whom 1,055 and 3,540, respectively, completed a follow-up survey a year and a half later. Exposure to the 500 popular contemporary films was assessed by querying adolescents on 50 randomly selected titles. Films were content-coded for alcohol and exposure estimated from films seen. Logistic regression models estimated adjusted relative risk (aRR) for the following outcomes, net covariates, at follow-up: use of alcohol (having ever drank), current drinking (drinking in the past 30 days), ever binge drinking (≥ 4 drinks [females] or 5 for males). RESULTS At follow-up, respective adolescent drinking rates for Mexico and Argentina were 31% and 36% for use of alcohol, 18% and 27% for current drinking, and 8% and 19% for ever binge drinking. Greater exposure to alcohol in movies was independently associated with trying alcohol (aRR = 1.30, 95% CI [1.17, 1.43]), current drinking (aRR = 1.22, 95% CI [1.03, 1.44]), and binge drinking (aRR = 1.71, 95% CI [1.30, 2.25]) in Mexican adolescents, whereas in Argentina, movie alcohol exposure was associated only with trying alcohol (aRR = 1.25, 95% CI [1.02, 1.53]). CONCLUSIONS Exposure to alcohol in movies predicted underage drinking transitions in these Latin American adolescents, replicating prior results for U.S. and European cohorts.
Collapse
Affiliation(s)
- Raul Mejia
- Centro de Estudios de Estado y Sociedad (CEDES)/Hospital de Clinicas, Universidad de Buenos Aires, Argentina
| | - Adriana Perez
- Grupo de Bioestadística Aplicada, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Argentina
| | - Paola Morello
- Centro de Estudios de Estado y Sociedad (CEDES), Argentina
| | | | - Sandra Braun
- Hospital de Clinicas, Universidad de Buenos Aires, Argentina
| | - James D. Sargent
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
| |
Collapse
|
6
|
Berg CJ, Fong GT, Thrasher JF, Cohen JE, Maziak W, Lando H, Drope J, Mejia R, Barnoya J, Nakkash R, Salloum RG, Parascandola M. The impact and relevance of tobacco control research in low-and middle-income countries globally and to the US. Addict Behav 2018; 87:162-168. [PMID: 30041132 DOI: 10.1016/j.addbeh.2018.07.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/11/2018] [Accepted: 07/15/2018] [Indexed: 11/15/2022]
Abstract
International and cross-cultural research is critical for understanding multilevel influences on health, health behaviors, and disease. A particularly relevant area of need for such research is tobacco control. The tobacco epidemic is one of the biggest public health threats globally, killing over 7 million people a year. Research critical to addressing this public health problem has leveraged variability in tobacco use, history, product market, and policies across different countries, settings, and populations, particularly in low- and middle-income countries (LMICs) where the tobacco burden is increasing. These efforts are needed in order to advance the science and inform practice and policy in various settings, including the US. Several funding agencies provide support for international research focused on tobacco control in LMICs because of the importance and implications of such research. This paper provides some concrete examples of how such research has advanced our knowledge-base and informed practice and policy globally, particularly in high-income countries including the US. Some prominent themes emphasized in this manuscript include: the development of knowledge regarding the diverse tobacco products on the market; better understanding of tobacco use and its impact among different populations; generating knowledge about the impacts including unintended consequences of tobacco control policy interventions; and better understanding tobacco industry strategies and informing advocacy efforts. In summary, international tobacco control research, particularly in LMICs, is critical in effectively and efficiently building the evidence base to advance tobacco control research, policy, and practice globally, including the US, with the ultimate goal of curbing the tobacco epidemic.
Collapse
Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Geoffrey T Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L G1 Canada, Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, United States; Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 2213 McElderry Street, Baltimore, MD 21205, United States.
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8h Street, AHC5 505, Miami, FL 33199, United States.
| | - Harry Lando
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN 55454, United States.
| | - Jeffrey Drope
- Department of Economic and Health Policy Research, American Cancer Society, 250 Williams St, Atlanta, GA, 30303, United States.
| | - Raul Mejia
- Centro de Estudios de Estado y Sociedad, Sánchez de Bustamante 27, C1173AAA, Buenos Aires, Argentina.
| | - Joaquin Barnoya
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, 660 South Euclid Ave, St. Louis, MS 63110, United States.
| | - Rima Nakkash
- Department of Health Promotion and Community Health, American University of Beirut, PO, Box 11-0236, Beirut, Lebanon.
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States.
| | - Mark Parascandola
- Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, United States.
| |
Collapse
|
7
|
Pérez A, Thrasher J, Cabrera N, Forsyth S, Peña L, Sargent JD, Mejía R. Exposure to tobacco in video games and smoking among gamers in Argentina. Tob Control 2018; 28:427-433. [PMID: 30030410 DOI: 10.1136/tobaccocontrol-2017-053973] [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: 08/04/2017] [Revised: 06/30/2018] [Accepted: 07/02/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Our objective was to assess whether exposure to tobacco in video games is associated with smoking among adolescent gamers from Argentina. METHODS Cross-sectional data were analysed from students in public and private middle schools in Argentina. Tobacco content in video games was estimated using previously validated methods and adolescents' tobacco exposure was assessed by multiplying tobacco content in the top three video games they play by the hours played per day. The primary outcome was current smoking. Multilevel logistic regression models adjusted for clustering within schools, regressing current smoking on tobacco exposure in video games (ie, none, low, high) after controlling for age, sex, parental education, parenting style, parental rules about the use of video games, rebelliousness, sensation seeking and 'technophilia'. RESULTS Of the 3114 students who participated, 92% of boys (1685/1802) and 56% of girls (737/1312) played video games and were included in the analytical sample. The prevalence of smoking was 13.8% among boys and 22.0% among girls; 74.5% of boys played video games more than 1 hour per day compared with 47.7% of girls. High exposure to tobacco content in video games compared with no exposure was independently associated with current smoking among girls (OR 1.78; 95% CI 1.02 to 3.09) but not among boys (OR 0.98; 95% CI 0.64 to 1.51). CONCLUSIONS Greater exposure to tobacco content in video games was associated with higher likelihood of smoking among Argentine girls who play video games, suggesting the need for policies that limit these exposures.
Collapse
Affiliation(s)
- Adriana Pérez
- Grupo de Bioestadística Aplicada, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - James Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Noelia Cabrera
- Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina
| | - Susan Forsyth
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California, USA.,School of Nursing, Samuel Merritt University, Oakland, California, USA
| | - Lorena Peña
- Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina
| | - James D Sargent
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Raúl Mejía
- Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina.,Hospital de Clínicas, Universidad de Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
8
|
Morello P, Pérez A, Braun SN, Thrasher JF, Barrientos I, Arillo-Santillán E, Mejía R. Smoking susceptibility as a predictive measure of cigarette and e-cigarette use among early adolescents. SALUD PUBLICA DE MEXICO 2018; 60:423-431. [PMID: 30137944 PMCID: PMC6275106 DOI: 10.21149/9193] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/11/2018] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To assess the validity of a standard measure of smoking susceptibility for predicting cigarette and e-cigarette use in a sample of early adolescents in Argentina and Mexico. MATERIALS AND METHODS A school-based longitudinal survey was conducted in 2014-16 among secondary students. We analyzed students who were never smokers of regular cigarettes or e-cigarettes at baseline and who completed both surveys. The main independent variable was smoking susceptibility. Multilevel logistic regression models were used, adjusting for sociodemographic and personal variables, social network use of cigarettes and exposure to advertising. RESULTS In the adjusted analysis, smoking susceptibility independently predicted cigarette initiation (Argentina: AOR 2.28; 95%CI 1.66-3.14; Mexico: AOR 2.07; 95%CI 1.74-2.45) and current smoking (Argentina: AOR 3.61; 95%CI 2.48-5.24; Mexico: AOR 1.69; 95%CI 1.29-2.22); however, it only predicted e-cigarette initiation in Mexico (Mexico: AOR 1.29; 95%CI 1.02-1.63). CONCLUSIONS Smoking susceptibility was a valid measure to predict future cigarette smoking in this sample.
Collapse
Affiliation(s)
- Paola Morello
- Centro de Estudios de Estado y Sociedad. Buenos Aires, Argentina
| | - Adriana Pérez
- Centro de Estudios de Estado y Sociedad. Buenos Aires, Argentina
| | | | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina. Columbia, USA
| | - Inti Barrientos
- Departamento de Prevención y Control del Tabaquismo, Instituto Nacional de Salud Pública. Cuernavaca, Mexico
| | - Edna Arillo-Santillán
- Departamento de Prevención y Control del Tabaquismo, Instituto Nacional de Salud Pública. Cuernavaca, Mexico
| | - Raúl Mejía
- Centro de Estudios de Estado y Sociedad. Buenos Aires, Argentina
| |
Collapse
|
9
|
Peña L, Lorenzo-Blanco EI, Pérez A, Morello P, Arillo Santillan E, Kollath-Cattano C, Thrasher JF, Sargent J, Mejia R. Parental Style and Its Association With Substance Use in Argentinean Youth. Subst Use Misuse 2017; 52:518-526. [PMID: 28010167 PMCID: PMC5577981 DOI: 10.1080/10826084.2016.1245337] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND In Europe and the United States, family relationships and parenting behavior can influence youth substance use, but less is known about their influence in Latin American countries. OBJECTIVE To explore whether parenting behavior is associated with substance use among Latin American youth. METHODS A cross-sectional, school-based survey of middle-school youth (n = 3172) in three Argentinian cities queried tobacco, alcohol, and drug use using items adapted from global youth surveys. Parenting behavior was assessed with previously validated items that tapped into demandingness and responsiveness, separately for mothers and fathers. Multilevel logistic regression models assessed associations between parenting behavior and substance use after adjusting for student characteristics, socioeconomic indicators, sensation seeking, and smoking amongst peers and family members. RESULTS Substance use prevalence was 10% for current smoking, 32% for current drinking alcohol, 17% for past 30-day binge drinking (≥5 drinks), and 8% for previous year illicit drug use (marijuana or cocaine). Greater maternal demandingness was independently associated with lower likelihood of current smoking (adjusted odds ratio [AOR] = 0.77; 95% confidence interval (CI): 0.64-0.92), current drinking (AOR = 0.81; 95% CI: 0.71-0.92), binge drinking (AOR = 0.77; 95% CI: 0.66-0.99, and drug use (AOR = 0.71; 95% CI: 0.61-0.83). No other parenting behavior were independently associated with substance use, except for paternal demandingness and binge drinking (AOR = 0.84; 95% CI: 0.74-0.97). For all outcomes, no interactions were found between parenting behavior and student gender. CONCLUSIONS Among Argentine adolescents, maternal demandingness was the strongest and most consistent correlate of substance use, regardless of adolescent substance use behavior or gender.
Collapse
Affiliation(s)
- Lorena Peña
- a Centro de Estudios de Estado y Sociedad (CEDES) , Buenos Aires , Argentina
| | - Elma I Lorenzo-Blanco
- b Department of Psychology , University of South Carolina , Columbia , South Carolina , USA
| | - Adriana Pérez
- a Centro de Estudios de Estado y Sociedad (CEDES) , Buenos Aires , Argentina.,c Facultad de Ciencias Exactas y Naturales , Universidad de Buenos Aires , Buenos Aires , Argentina
| | - Paola Morello
- a Centro de Estudios de Estado y Sociedad (CEDES) , Buenos Aires , Argentina
| | - Edna Arillo Santillan
- d Department of Tobacco Research , National Institute of Public Health (INSP) , Cuernavaca , Mexico
| | - Christy Kollath-Cattano
- e Department of Health and Human Performance , College of Charleston , Charleston , South Carolina , USA
| | - James F Thrasher
- f Department of Health Promotion, Education and Behavior , University of South Carolina , Columbia , South Carolina , USA
| | - James Sargent
- g Department of Pediatrics , Geisel School of Medicine at Dartmouth , Lebanon , New Hampshire , USA
| | - Raúl Mejia
- a Centro de Estudios de Estado y Sociedad (CEDES) , Buenos Aires , Argentina
| |
Collapse
|
10
|
Smoking in Movies and Adolescent Smoking Initiation: A Longitudinal Study among Argentinian Adolescents. J Pediatr 2017; 180:222-228. [PMID: 28029343 PMCID: PMC5362311 DOI: 10.1016/j.jpeds.2016.10.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/12/2016] [Accepted: 10/03/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To assess whether exposure to movie smoking is associated with cigarette smoking among Argentinian adolescents. STUDY DESIGN A school-based longitudinal study involving 33 secondary schools in Argentina was performed. The sample included 2502 never smokers (average age at entry = 12.5 years), 1700 (67.9%) of whom completed follow-up surveys 17 months later. Exposure to the top 100 highest-grossing films for each year between 2009 and 2013 was assessed by content-coding films for tobacco and then by asking adolescents whether they had seen each of 50 titles, randomly selected from the larger pool, then parsing exposure into tertiles. Logistic regression models estimated aOR for the following transitions: nonsusceptible to susceptible never smoker, never smoker to ever smoker, and never smoker to current smoking (last 30 days). RESULTS At follow-up, 34.4% of nonsusceptible never smokers became susceptible, 24.1% reported having tried smoking, and 9.4% were current smokers. Most exposure to movie smoking was from US-produced films (average 60.3 minutes compared with only 3.4 minutes from Argentine films). Greater exposure to smoking in movies was significantly associated with increased odds of becoming susceptible (aORfirst vs third tertile 1.77, 95% CI 1.30-2.41), of trying smoking (aORfirst vs third tertile 1.54, 1.14-2.08), and marginally associated with current smoking (AORfirst vs third tertile 1.54, 0.99-2.40). Exposure to smoking in US- or Argentine-produced films had similar associations. CONCLUSION In Argentina, exposure to smoking in the movies predicted future smoking transitions among early adolescents, with most exposure coming from viewing US movies.
Collapse
|
11
|
Beck NI, Arif I, Paumier MF, Jacobsen KH. Adolescent injuries in Argentina, Bolivia, Chile, and Uruguay: Results from the 2012-2013 Global School-based Student Health Survey (GSHS). Injury 2016; 47:2642-2649. [PMID: 27745690 DOI: 10.1016/j.injury.2016.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 10/03/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The goals of this study were to identify the proportion of early adolescents in southern South America who were injured in the past year, to identify risk behaviours and other exposures associated with injuries, and to evaluate the most common types and causes of injury in this population. METHODS We used complex samples analysis to examine cross-sectional data from more than 35,000 students from all four countries in South America that participated in the Global School-based Student Health Survey (GSHS) in 2012-2013. RESULTS The proportion of students reporting at least one injury in the past year that required medical treatment or caused at least one full day of missed school or usual activities was 27.1% in Argentina, 29.5% in Uruguay, 30.9% in Chile, and 36.8% in Bolivia. Significantly more boys than girls reported injuries. Injured students were more likely than non-injured students to report anxiety-induced insomnia, being physically attacked, being in a physical fight, and being lonely in the past year, and they were also more likely to report being bullied, using tobacco, drinking alcohol, and missing school in the past month. For both boys and girls, the most common type of injury reported was a broken bone or dislocated joint and the most common injury cause was the student falling. However, most students were not able to provide a specific answer to either question. CONCLUSION The GSHS has been conducted in 100 low- and middle-income countries and territories around the world, and new waves of data collection are currently being planned and implemented. The utility of the injury data from the GSHS would be improved if the injury type and cause response items were updated to better capture information about self-harm, sports injuries, and other statistics that will provide a stronger foundation for evidence-based injury prevention interventions in adolescent populations.
Collapse
Affiliation(s)
- Naja I Beck
- Department of Global & Community Health, George Mason University, United States
| | - Issra Arif
- Department of Global & Community Health, George Mason University, United States
| | - Michelle F Paumier
- Department of Global & Community Health, George Mason University, United States
| | - Kathryn H Jacobsen
- Department of Global & Community Health, George Mason University, United States.
| |
Collapse
|
12
|
Morello P, Pérez A, Peña L, Lozano P, Thrasher JF, Sargent JD, Mejía R. PREVALENCE AND PREDICTORS OF E-CIGARETTE TRIAL AMONG ADOLESCENTS IN ARGENTINA. Tob Prev Cessat 2016; 2. [PMID: 31355353 DOI: 10.18332/tpc/66950] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Introduction Over the last few years, the increasing use of electronic cigarettes has become a new public health problem. Since 2011, Argentina has had a complete ban on marketing and sale of e-cigarettes. However, e-cigarettes are marketed online and can be easily bought in stores. We conducted a longitudinal study to evaluate the determinants of e-cigarette trial among Argentinean early adolescents. Methods A school-based longitudinal study was conducted in 2014-15, in 3 large cities in Argentina. Among students who reported never smoking an e-cigarette at baseline, we assessed demographics, media use, sensation seeking, smoking behavior, network member smoking, use of other substances, and perception of e-cigarette risk as potential risk factors for e-cigarette trial at follow up (mean between-wave interval 17.1 months) using multilevel logistic regression models with random intercepts for schools. Results E-cigarette trial prevalence increased from baseline (1.8%; n=57) to follow up (7.1%; n=139). Independent predictors of e-cigarette use at follow up included: higher sensation seeking (OR: 1.49 95% CI 1.21-1.84); being a current smoker (OR: 2.58 95% CI 1.38-4.83); having close friends that smoke cigarettes (OR: 1.93 95% CI 1.25-2.99) and being highly exposed to tobacco product ads online (OR: 1.87 95% CI 1.04-3.36). Attending a public school was the only protective factor (OR: 0.40 95% CI 0.22-0.73). Conclusion In Argentina, illicit trial of e-cigarettes among early adolescents is low but appears to be rapidly increasing. Identifying students at risk could help identify policies and programs to prevent increasing use in this population.
Collapse
Affiliation(s)
- Paola Morello
- Centro de Estudios de Estado y Sociedad (CEDES), Argentina
| | - Adriana Pérez
- Centro de Estudios de Estado y Sociedad (CEDES), Argentina.,Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Argentina
| | - Lorena Peña
- Centro de Estudios de Estado y Sociedad (CEDES), Argentina
| | - Paula Lozano
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - James D Sargent
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, USA
| | - Raúl Mejía
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, USA
| |
Collapse
|
13
|
Mejia R, Pérez A, Peña L, Morello P, Kollath-Cattano C, Braun S, Thrashe JF, Sargent JD. Parental Restriction of Mature-rated Media and Its Association With Substance Use Among Argentinean Adolescents. Acad Pediatr 2016; 16:282-9. [PMID: 26615087 PMCID: PMC4821658 DOI: 10.1016/j.acap.2015.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 11/16/2015] [Accepted: 11/17/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the independent relation between parental restrictions on mature-rated media (M-RM) and substance use among South American adolescents. METHODS Cross-sectional school-based youth survey of 3,172 students (mean age, 12.8 years; 57.6% boys) in 3 large Argentinean cities. The anonymous survey queried tobacco, alcohol, and drug use using items adapted from global youth surveys. Adolescents reported M-RM restriction for internet and video game use, television programming, and movies rated for adults. Multivariate logistic regression models were used to assess the association between parental M-RM restriction and substance use after adjustment for hourly media use, measures of authoritative parenting style, sociodemographic characteristics, and sensation-seeking. RESULTS Substance use rates were 10% for current smoking, 32% for current drinking alcohol, 17% for past 30-day binge drinking, and 8% for illicit drug use (marijuana or cocaine). Half of the respondents reported parental M-RM restriction (internet 52%, TV 43%, adult movies 34%, video game 25%). Parental M-RM restriction was only modestly correlated with authoritative parenting measures. In multivariate analyses M-RM restriction on all 4 venues was strongly protective for all substance use outcomes. Compared with no restriction, odds ratios for substance use for full restrictions were 0.32 (0.18-0.59), 0.53 (0.38-0.07), 0.36 (0.22-0.59), and 0.49 (0.26-0.92) for current smoking, drinking, binge drinking, and illicit drug use, respectively. The most important single M-RM venue was movies. CONCLUSIONS Results of this study confirmed the protective association between parental M-RM restriction during adolescence and multiple substance use outcomes, including illicit drugs. M-RM restriction is independent of traditional parenting measures. The preponderance of the evidence supports intervention development.
Collapse
Affiliation(s)
- Raul Mejia
- Centro de Estudios de Estado y Sociedad (CEDES), Sánchez de Bustamante 27 (C1173AAA) CABA, Argentina,Hospital de Clinicas, Universidad de Buenos Aires, Paraguay 2153 (C1120AAF) CABA, Argentina
| | - Adriana Pérez
- Centro de Estudios de Estado y Sociedad (CEDES), Sánchez de Bustamante 27 (C1173AAA) CABA, Argentina,Hospital de Clinicas, Universidad de Buenos Aires, Paraguay 2153 (C1120AAF) CABA, Argentina,Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Intendente Güiraldes 2160, (C1428EGA) CABA, Argentina
| | - Lorena Peña
- Centro de Estudios de Estado y Sociedad (CEDES), Sánchez de Bustamante 27 (C1173AAA) CABA, Argentina
| | - Paola Morello
- Centro de Estudios de Estado y Sociedad (CEDES), Sánchez de Bustamante 27 (C1173AAA) CABA, Argentina
| | - Christy Kollath-Cattano
- Department of Health and Human Performance, College of Charleston, 66 George St Charleston, SC 29424
| | - Sandra Braun
- Centro de Estudios de Estado y Sociedad (CEDES), Sánchez de Bustamante 27 (C1173AAA) CABA, Argentina,Hospital de Clinicas, Universidad de Buenos Aires, Paraguay 2153 (C1120AAF) CABA, Argentina
| | - James F. Thrashe
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene St. Columbia, SC, 29208, USA
| | - James D. Sargent
- Department of Pediatrics, Geisel School of Medicine at Dartmouth. Rubin 8 One Medical Center Drive Lebanon, NH 03756
| |
Collapse
|
14
|
Alderete E, Gregorich SE, Monteban M, Kaplan CP, Mejia R, Livaudais-Toman J, Pérez-Stable EJ. Effect of appreciation for Indigenous cultures and exposure to racial insults on alcohol and drug use initiation among multiethnic Argentinean youth. Prev Med 2016; 85:60-68. [PMID: 26763165 PMCID: PMC5354355 DOI: 10.1016/j.ypmed.2015.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 11/25/2015] [Accepted: 12/24/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study evaluated the effect of factors reflecting appreciation of Indigenous culture and racial insults on alcohol and drug use initiation among multi-ethnic youth in Jujuy, Argentina. METHODS Students were surveyed from 27 secondary schools that were randomly selected to represent the province. A total of 3040 eligible students in 10th grade, age 14 to 18years were surveyed in 2006 and 2660 of these same students completed surveys in 11th grade in 2007. Multivariate logistic regression models assessed the effect of appreciation for Indigenous cultures and reported exposure to racial insults in 10th grade on incident current alcohol drinking in previous 30days, binge drinking (≥5 drinks at one sitting), and lifetime drug use (marijuana, inhalants or cocaine) in 11th grade among students not reporting these behaviors in 2006. RESULTS In 2006, 63% of respondents reported high appreciation for Indigenous cultures and 39% had ever experienced racial insults. In 2007, incident current drinking was 24.4%, binge drinking 14.8%, and any drug use initiation was 4.1%. Exposure to racial insults increased the likelihood of binge drinking (OR=1.6; 95% CI 1.2-2.1) but was not significant for any drug use. Appreciation for Indigenous cultures reduced the risk of any drug use initiation (OR=0.5, 95% CI 0.3-0.7) but had no effect for alcohol drinking outcomes. These effects were independent of Indigenous ethnicity. CONCLUSIONS Enhancing appreciation for Indigenous cultures and decreasing racial insults are achievable goals that can be incorporated into programs to prevent youth substance use.
Collapse
Affiliation(s)
- Ethel Alderete
- Consejo Nacional de Investigaciones Científicas y Técnicas, Universidad Nacional de Jujuy, and Instituto de Ciencia y Tecnología Regional (ICTER), Argentina
| | - Steven E Gregorich
- Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, University of California San Francisco, USA
| | | | - Celia P Kaplan
- Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, University of California San Francisco, USA; Helen Diller Family Comprehensive Cancer Center, UCSF, USA
| | - Raul Mejia
- Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina; Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Jennifer Livaudais-Toman
- Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, University of California San Francisco, USA
| | - Eliseo J Pérez-Stable
- Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, University of California San Francisco, USA; Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina.
| |
Collapse
|
15
|
Mejia R, Pérez A, Abad-Vivero EN, Kollath-Cattano C, Barrientos-Gutierrez I, Thrasher JF, Sargent JD. Exposure to Alcohol Use in Motion Pictures and Teen Drinking in Latin America. Alcohol Clin Exp Res 2016; 40:631-7. [PMID: 26857804 DOI: 10.1111/acer.12986] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 12/11/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Our objective was to assess whether exposure to alcohol use in films (AUF) is associated with alcohol use susceptibility, current alcohol use, and binge drinking in adolescents from 2 Latin American countries. METHODS We performed a cross-sectional study with 13,295 middle school students from public and private schools in Mexico and Argentina. Exposure to alcohol use in over 400 contemporary top box office films in each country was estimated using previously validated methods. Outcome measures included current drinking (i.e., any drink in the last 30 days), ever binge drinking (i.e., more than 4 or 5 drinks in a row for females and males, respectively) and, among never drinkers, alcohol susceptibility (i.e., might drink in the next year or accept a drink from a friend). Multivariate models were adjusted for age, sex, parental education, peer drinking, sensation seeking, parenting style, and media access. RESULTS Mean age was 12.5 years (SD = 0.7), and the prevalence of alcohol consumption and binge drinking was 19.8 and 10.9%, respectively. Mean exposure to alcohol from the film sample was about 7 hours in both countries. Adjusted models indicated independent dose-response associations between higher levels of exposure to AUF and all outcomes; the adjusted odds ratios (aORs) comparing quartiles 4 and 1, 1.99 (95% confidence interval [CI] 1.73 to 2.30) for current drinking, aOR 1.68 (CI 1.39 to 2.02) for binge drinking, and aOR 1.80 (1.52 to 2.12) for alcohol susceptibility. Compared to Mexican adolescents, Argentine adolescents were significantly more likely to have engaged in binge drinking (aOR 1.40, 95% CI 1.12 to 1.76) and, among never drinkers, were more susceptible to try drinking (aOR 1.40, 95% CI 1.20 to 1.64). CONCLUSIONS Higher levels of exposure to AUF were associated with higher likelihood of alcohol use, binge drinking, and alcohol susceptibility in Latin American adolescents.
Collapse
Affiliation(s)
- Raul Mejia
- Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina.,Hospital de Clinicas, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Adriana Pérez
- Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina.,Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Erika N Abad-Vivero
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Christy Kollath-Cattano
- Department of Health and Human Performance, College of Charleston, Charleston, South Carolina
| | - Inti Barrientos-Gutierrez
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - James F Thrasher
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.,Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, South Carolina
| | - James D Sargent
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| |
Collapse
|
16
|
Braun S, Kollath-Cattano C, Barrientos I, Mejía R, Morello P, Sargent JD, Thrasher JF. Assessing tobacco marketing receptivity among youth: integrating point of sale marketing, cigarette package branding and branded merchandise. Tob Control 2015; 25:648-655. [PMID: 26427528 DOI: 10.1136/tobaccocontrol-2015-052498] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/16/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND As countries prohibit tobacco marketing through traditional channels, marketing at point of sale (PoS) and through tobacco packaging is increasingly important for promoting tobacco consumption. OBJECTIVES Assess the validity of a novel marketing receptivity index that considers frequency of PoS exposures, tobacco brand recall and ownership of branded merchandise. METHODS Data come from a cross-sectional survey of 3172 secondary school students in Argentina. Questions assessed frequency of going to stores where tobacco is often sold; cued recall of brand names for 3 cigarette packages with brand name removed and ownership of branded merchandise. A four-level marketing receptivity index was derived: low PoS exposure only; high PoS exposure or recall of 1 brand; recall of 2 or more brands; and ownership of branded merchandise. Indicators of marketing receptivity and smoking involvement were regressed on the index, including in adjusted models that controlled for sociodemographics, social influences and sensation seeking. FINDINGS Among never-smokers, the index had independent positive associations with smoking susceptibility (ie, adjusted OR (AOR)2v1=1.66; AOR3v1=1.64; AOR4v1=2.95), willingness to try a specific brand (ie, AOR2v1=1.45; AOR3v1=2.38; AOR4v1=2.20) and positive smoking expectancies (ie, Badj 2v1=0.09; Badj 3v1=0.18; Badj 4v1=0.34). A more marked dose-response independent association was found with current smoking behaviour (ie, AOR2v1=2.47; AOR3v1=3.16; AOR4v1=3.62). CONCLUSIONS The marketing receptivity index was associated with important variation in smoking-related perceptions, intentions and behaviour among Argentine adolescents. Future research should determine the predictive validity and generalisability of this measure to other contexts, including the explanatory power gained by integrating cigarette package brand recognition tasks.
Collapse
Affiliation(s)
- Sandra Braun
- Hospital de Clínicas Universidad de Buenos Aires, Buenos Aires, Argentina.,Department of Health Economy & Society, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - Christy Kollath-Cattano
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | - Inti Barrientos
- Department of Tobacco Research, Center for Population Health Research National Institute of Public Health, Cuernavaca, Mexico
| | - Raúl Mejía
- Hospital de Clínicas Universidad de Buenos Aires, Buenos Aires, Argentina.,Department of Health Economy & Society, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - Paola Morello
- Department of Health Economy & Society, Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - James D Sargent
- Department of Pediatrics, Dartmouth Medical School, Hanover, New Hampshire, USA
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA.,Department of Tobacco Research, Center for Population Health Research National Institute of Public Health, Cuernavaca, Mexico
| |
Collapse
|
17
|
Salgado MV, Mejia R, Kaplan CP, Perez-Stable EJ. Smoking behavior and use of tobacco industry sponsored websites among medical students and young physicians in Argentina. J Med Internet Res 2014; 16:e35. [PMID: 24509433 PMCID: PMC3936273 DOI: 10.2196/jmir.2528] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 05/28/2013] [Accepted: 10/30/2013] [Indexed: 11/28/2022] Open
Abstract
Background Internet-based marketing has become an attractive option for promoting tobacco products due to its potential to avoid advertising restrictions. In Argentina, several cigarette brands have designed websites for the local market, which promote user participation. Objective The intent of the study was to report on the use of tobacco company-sponsored websites by medical students and recently graduated physicians. Methods An online self-administered survey was conducted among eligible medical students and recent graduates from the University of Buenos Aires (UBA). Sampling was from lists of email addresses of students enrolled in two required courses. Eligibility criteria were ages 18-30 years and reporting on smoking status. Questions on Internet use included accessing a tobacco brand website at least once during their lifetime and any use of tobacco promotional materials. Results The response rate was 35.08% (1743/4969). The final sample included 1659 participants: 73.06% (1212/1659) were women and mean age was 26.6 years (SD 1.9). The majority were current medical students (55.70%, 924/1659) and 27.31% (453/1659) were current smokers. Men were more likely to report having seen a tobacco advertisement on the Internet (P=.001), to have received a tobacco promotion personally addressed to them (P=.03), to have used that promotion (P=.02), and to have accessed a tobacco-sponsored website (P=.01). Among respondents, 19.35% (321/1659) reported having accessed a tobacco-sponsored website at least once in their lifetime and almost all of them (93.8%, 301/321) accessed these sites only when it was necessary for participating in a marketing promotion. Most people logging on for promotions reported entering once a month or less (58.9%, 189/321), while 25.5% (82/321) reported accessing the tobacco industry Internet sites once a week or more. In adjusted logistic regression models, participants were more likely to have accessed a tobacco brand website if they were former smokers (OR 2.45, 95% CI 1.42-4.22) or current (OR 8.12, 95% CI 4.66-14.16), if they reported having seen a tobacco advertisement on the Internet (OR 2.44, 95% CI 1.77-3.37), received a tobacco promotion personally addressed to them (OR 5.62; 95% CI 4.19-7.55), or used one of these promotions (OR 14.05, 95% CI 9.21-21.43). Respondents were more likely to be current smokers if they received a tobacco promotion (OR 2.64, 95% CI 2.02-3.45) or if they used one of these promotions (OR 1.93, 95% CI 1.31-2.85). Conclusions Our study suggests that tobacco industry websites reach medical students and young physicians in a middle-income country with their marketing promotions. Current or proposed legislation to ban tobacco advertising needs to include Internet sites and related social media.
Collapse
|
18
|
Mejia R, Kaplan CP, Alderete E, Gregorich SE, Pérez-Stable EJ. Influence of gender role attitudes on smoking and drinking among girls from Jujuy, Argentina. Prev Med 2013; 57:194-7. [PMID: 23732243 PMCID: PMC3748231 DOI: 10.1016/j.ypmed.2013.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 04/26/2013] [Accepted: 05/26/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Evaluate effect of gender role attitudes on tobacco and alcohol use among Argentinean girls. METHOD Cross-sectional survey of 10th grade students attending 27 randomly selected schools in Jujuy, Argentina. Questions about tobacco and alcohol use were adapted from global youth surveys. Five items with 5-point response options of agreement-disagreement assessed attitude towards egalitarian (higher score) gender roles. RESULTS 2133 girls, aged 13-18 years, 71% Indigenous, 22% mixed Indigenous/European, and 7% European responded. Of these, 60% had ever smoked, 32% were current smokers, 58% ever drinkers, 27% drank in previous month, and 13% had ≥5 drinks on one occasion. Mean response to the gender role scale was 3.49 (95% Confidence Intervals = 3.41-3.57) out of 5 tending toward egalitarian attitudes. Logistic regression models using the gender role scale score as the main predictor and adjusting for demographic and social confounders showed that egalitarian gender role was associated with ever smoking (Odds Ratio = 1.25; 95% Confidence Intervals 1.09-1.44), ever drinking (Odds Ratio = 1.24; 95% Confidence Intervals 1.10-1.40), drinking in prior month (Odds Ratio = 1.21; 95% Confidence Intervals 1.07-1.37) and ≥5 drinks on one occasion (Odds Ratio = 1.15; 95% Confidence Intervals 1.00-1.33), but was not significant for current smoking. CONCLUSION Girls in Jujuy who reported more egalitarian gender role attitudes had higher odds of smoking or drinking.
Collapse
Affiliation(s)
- Raul Mejia
- Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | | | | | | |
Collapse
|
19
|
Squires EC, McClure HH, Martinez CR, Eddy JM, Jiménez RA, Isiordia LE, Snodgrass JJ. Diurnal cortisol rhythms among Latino immigrants in Oregon, USA. J Physiol Anthropol 2012; 31:19. [PMID: 22738123 PMCID: PMC3541162 DOI: 10.1186/1880-6805-31-19] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 05/25/2012] [Indexed: 11/30/2022] Open
Abstract
One of the most commonly used stress biomarkers is cortisol, a glucocorticoid hormone released by the adrenal glands that is central to the physiological stress response. Free cortisol can be measured in saliva and has been the biomarker of choice in stress studies measuring the function of the hypothalamic-pituitary-adrenal axis. Chronic psychosocial stress can lead to dysregulation of hypothalamic-pituitary-adrenal axis function and results in an abnormal diurnal cortisol profile. Little is known about objectively measured stress and health in Latino populations in the United States, yet this is likely an important factor in understanding health disparities that exist between Latinos and whites. The present study was designed to measure cortisol profiles among Latino immigrant farmworkers in Oregon (USA), and to compare quantitative and qualitative measures of stress in this population. Our results indicate that there were no sex differences in average cortisol AUCg (area under the curve with respect to the ground) over two days (AvgAUCg; males = 1.38, females = 1.60; P = 0.415). AUCg1 (Day 1 AUCg) and AvgAUCg were significantly negatively associated with age in men (P<0.05). AUCg1 was negatively associated with weight (P<0.05), waist circumference (P<0.01) and waist-to-stature ratio (P<0.05) in women, which is opposite of the expected relationship between cortisol and waist-to-stature ratio, possibly indicating hypothalamic-pituitary-adrenal axis dysregulation. Among men, more time in the United States and immigration to the United States at older ages predicted greater AvgAUCg. Among women, higher lifestyle incongruity was significantly related to greater AvgAUCg. Although preliminary, these results suggest that chronic psychosocial stress plays an important role in health risk in this population.
Collapse
Affiliation(s)
- Erica C Squires
- Department of Anthropology, University of Oregon, Eugene, OR 97403, USA.
| | | | | | | | | | | | | |
Collapse
|
20
|
Smoking and exposure to racial insults among multiethnic youth in Jujuy, Argentina. Cancer Causes Control 2012; 23 Suppl 1:37-44. [PMID: 22350863 DOI: 10.1007/s10552-012-9906-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 01/27/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Exposure to racial insults among youth in Jujuy, Argentina, was examined as a factor associated with smoking behavior. METHODS Youth sampled from eighth-grade classes in 27 randomly selected middle schools completed annual surveys in the ninth and tenth grades. Demographics, race/ethnicity (Indigenous/Amazonian, Indigenous/Andean, Indigenous unspecified group, Mixed European-Indigenous, European), cigarette smoking, and other attitudinal and behavioral factors were measured. Exposure to racial insults, measured in the ninth grade, was modeled to predict cigarette smoking in the previous 30 days (defined as current) in the tenth grade conditional on ninth grade smoking. RESULTS Of the 3,122 respondents, 35.5% reported exposure to racial insults and 33.8% were current smokers. Factors associated with racial insults were being male, indigenous language spoken at home, ever and current smoking, smoking in a ceremonial context, exposure to second-hand smoke at home, number of friends who smoke, having low expectations for the future, low identification with conforming role models, high identification with defiant role models, and depressive symptoms. Reported exposure to racial insults increased the risk of current smoking in the 10th grade among Indigenous Amazonian respondents (OR = 3.8; 95% CI 1.4-10.4) and among the Indigenous-unspecified group (OR = 1.8; 95% CI 1.1-2.8), but not among European or Indigenous Andean youth. CONCLUSIONS Exposure to racial insults is commonplace among youth in Jujuy. Evidence of a longitudinal effect of ninth-grade racial insults on tenth-grade smoking rates provides support for an association of racial insults with smoking behavior.
Collapse
|
21
|
Salgado MV, Pérez-Stable EJ, Primack BA, Kaplan CP, Mejia RM, Gregorich SE, Alderete E. Association of media literacy with cigarette smoking among youth in Jujuy, Argentina. Nicotine Tob Res 2011; 14:516-21. [PMID: 22193569 DOI: 10.1093/ntr/ntr240] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Latin America has the highest prevalence of tobacco use by youth. Higher media literacy, defined as the ability to analyze and evaluate media messages, has been associated with lower smoking among youth in the United States. The objective of this study was to determine whether media literacy related to smoking is independently associated with current smoking and susceptibility to future smoking in a sample of mostly indigenous youth in Jujuy, Argentina. METHODS In 2006, a self-administered survey was conducted among 10th grade students sampled from 27 randomly selected urban and rural schools in Jujuy. Survey items measured smoking behavior (ever, never, and current), susceptibility to future smoking among never-smokers (definitely not accept a cigarette from a friend or to smoke in the future), 5 items assessing smoking media literacy (SML), and risk factors for smoking. RESULTS Of the 3,470 respondents, 1,170 (34%) reported having smoked in the previous 30 days (current). Of the 1,430 students who had never smoked, 912 (64%) were susceptible to future smoking. High media literacy was present in 38%. Using multiple logistic regression, fully adjusted models showed that high media literacy was significantly associated as a protective factor of being a current smoker (odds ratio [OR] = 0.81; 95% CI = 0.67-0.97) and of being susceptible to future smoking (OR = 0.73; 95% CI = 0.58-0.92) among those who had never smoked. CONCLUSIONS Among youth in Jujuy, higher SML was significantly associated with both lower current smoking and susceptibility to future smoking. Teaching SML may be a valuable component in a prevention intervention in this population.
Collapse
Affiliation(s)
- M Victoria Salgado
- Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, University of California San Francisco, San Francisco, CA 94143-0856, USA
| | | | | | | | | | | | | |
Collapse
|
22
|
Alderete E, Erickson PI, Kaplan CP, Pérez-Stable EJ. Ceremonial tobacco use in the Andes: implications for smoking prevention among indigenous youth. Anthropol Med 2010; 17:27-39. [PMID: 20419515 DOI: 10.1080/13648471003607607] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to identify Andean youth's beliefs regarding ceremonial tobacco use and to discuss potential applications of findings in tobacco control interventions. The study was conducted in the Province of Jujuy, Argentina among 202 boys and girls, 10 to 20 years of age, living in rural and urban areas. The world of beliefs and meanings became accessible by asking youth to focus on tangible experiences regarding the Pachamama ceremony, a ritual honoring Mother Earth. Concepts such as reciprocity, the unity of material and spiritual realms, and the complementary nature of opposite forces were linked to beliefs about ceremonial tobacco use. Three domains for understanding smoking behaviour beliefs and norms were identified including mechanisms of production, conceptual tenants and behavioural expressions. These findings suggest that tobacco control interventions based on solidarity, reciprocity, and non-rational ways of learning are more culturally appropriate for native populations in the Andes than the current individual behaviour change models and have the potential applications with other indigenous populations. The research methods also have the potential for generalized application in cross-cultural studies of health behaviours in understudied populations in middle and low-income countries.
Collapse
Affiliation(s)
- Ethel Alderete
- Consejo Nacional de Investigaciones Cientificas y Tecnicas, Universidad Nacional de Jujuy and Instituto de Ciencia y Tecnologia Regional, Argentina.
| | | | | | | |
Collapse
|
23
|
Use of alternative tobacco products in multiethnic youth from Jujuy, Argentina. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2010; 2010:795265. [PMID: 20300454 PMCID: PMC2841245 DOI: 10.1155/2010/795265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Accepted: 01/21/2010] [Indexed: 11/18/2022]
Abstract
This study examines alternative tobacco use among Latin American youth. A
self-administered survey in a random sample of 27 schools was administered
in 2004 in Jujuy, Argentina (N = 3218). Prevalence of alternative tobacco
product use was 24.1%; 15.3% of youth used hand-rolled cigarettes, 7.8% smoked cigars, 2.3% chewed tobacco leaf and 1.6% smoked pipe. Among youth
who never smoked manufactured cigarettes, alternative product use was rare
(2.9%), except for chewing tobacco (22%). In multivariate logistic
regression boys were more likely than girls to smoke pipe (OR = 3.1; 95% CI 1.1–8.7); indigenous language was associated with smoking hand-rolled
cigarettes (OR = 1.4; 95% CI-1.1–1.9) and pipe (OR = 2.2; 95% CI 1.5–3.4).
Working in tobacco sales was a risk factor for chewing tobacco (OR = 2.9; 95% CI: 1.7–4.9) and smoking hand-rolled cigarettes (OR = 1.4; 95% CI 1.1–1.8). Having friends who smoked was associated with chewing tobacco (OR = 1.8; 95% CI 1.0–3.2) and with smoking cigars (OR = 2.1; 95% CI 1.5–2.9).
Current drinking and thrill-seeking orientation were associated with cigars
and pipe smoking. Findings highlight the importance of surveillance of
alternative tobacco products use and availability among youth and for
addressing identified risk factors.
Collapse
|