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Habash M, Sheppard AJ, Steiner R. An evaluation of Indigenous Tobacco Program smoking prevention workshops with First Nations youth in Ontario, Canada. Canadian Journal of Public Health 2021; 112:697-705. [PMID: 33830477 DOI: 10.17269/s41997-021-00493-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/02/2021] [Indexed: 11/17/2022]
Abstract
SETTING The Indigenous Tobacco Program (ITP) operated by the Indigenous Cancer Care Unit at Cancer Care Ontario provides customized tobacco prevention workshops to First Nations youth across Ontario, in partnership with First Nations communities and partner organizations. INTERVENTION First Nations youth in Canada are more likely than non-Indigenous youth to be smokers. The ITP aims to address the negative health impacts of commercial tobacco, using culturally relevant approaches, tools and resources while remaining respectful to the significance of sacred tobacco. This paper aims to determine whether a culturally tailored tobacco prevention workshop increases tobacco-related knowledge among First Nations youth in Ontario. OUTCOMES The workshops exhibited promise in impacting First Nations youth knowledge on the harms of commercial tobacco, as after the workshop intervention, all indicators showed improved knowledge. Building strong and ongoing relationships with communities and partner organizations is vital to the success of the program. IMPLICATIONS Culturally tailored workshops grounded in traditional knowledge and values provide an opportunity to increase the knowledge of the harms of commercial tobacco among First Nations youth in Ontario. With commercial tobacco use and exposure having tremendous health consequences, such interventions are essential.
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Affiliation(s)
- Mara Habash
- Indigenous Cancer Care Unit, Ontario Health (Cancer Care Ontario), 505 University Avenue, Toronto, M5G 1X3, ON, Canada
| | - Amanda J Sheppard
- Indigenous Cancer Care Unit, Ontario Health (Cancer Care Ontario), 505 University Avenue, Toronto, M5G 1X3, ON, Canada.
| | - Richard Steiner
- Indigenous Cancer Care Unit, Ontario Health (Cancer Care Ontario), 505 University Avenue, Toronto, M5G 1X3, ON, Canada
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Heris C, Thurber KA, Wright D, Thomas D, Chamberlain C, Gubhaju L, Sherriff S, McNamara B, Banks E, Smith N, Eades S. Staying smoke-free: Factors associated with nonsmoking among urban Aboriginal adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Health Promot J Austr 2020; 32 Suppl 2:185-196. [PMID: 33034057 DOI: 10.1002/hpja.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 10/04/2020] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED To examine the factors associated with preventing regular smoking among Aboriginal adolescents. METHODS Cross-sectional analysis of data from 106 Aboriginal adolescents aged 12-17 years, and their caregivers, from four Aboriginal Community Controlled Health Services in urban New South Wales, 2008-2012. The relation of individual, social, environmental and cultural factors to having 'never' smoked tobacco regularly was examined using Poisson regression. RESULTS Overall, 83% of adolescents had never smoked regularly; 13 reported current and five past smoking. Most lived in smoke-free homes (60%) despite 75% reporting at least one current smoker caregiver. Participants were significantly more likely to have never smoked regularly if they had good mental health (PR = 1.4, 95% CI: 1.1-1.9), their mother as their primary caregiver (1.3, 1.0-1.6), good family relationships (1.2, 1.0-1.5), stable housing (1.3, 1.1-1.7), had never used alcohol (1.8, 1.3-2.4), were not sexually active (3.1, 1.3- 7.2) and had no criminal justice interactions (1.8, 1.2-2.8). CONCLUSIONS Most participants lived in smoke-free homes and the vast majority had never smoked regularly. Promoting good mental health and strengthening social connections may be protective against smoking as those experiencing less social disruption were more likely to have never smoked regularly. Smoking may be an indicator of psychosocial conditions and a prompt for screening and simultaneous treatment. SO WHAT?: Organisations should be resourced to deliver holistic adolescent health promotion programs. Programs and policies should support positive family relationships and stable housing as this may protect against the uptake of regular smoking.
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Affiliation(s)
| | | | - Darryl Wright
- Tharawal Aboriginal Corporation, Campbelltown, NSW, Australia
| | - David Thomas
- Menzies School of Health Research, Darwin, NT, Australia
| | | | - Lina Gubhaju
- University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Emily Banks
- Australian National University, Canberra, ACT, Australia
| | - Natalie Smith
- Sax Institute, Sydney, NSW, Australia.,Riverina Medical and Dental Aboriginal Corporation, Wagga Wagga, NSW, Australia
| | - Sandra Eades
- University of Melbourne, Melbourne, VIC, Australia
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Heris CL, Chamberlain C, Gubhaju L, Thomas DP, Eades SJ. Factors Influencing Smoking Among Indigenous Adolescents Aged 10–24 Years Living in Australia, New Zealand, Canada, and the United States: A Systematic Review. Nicotine Tob Res 2019; 22:1946-1956. [DOI: 10.1093/ntr/ntz219] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/26/2019] [Indexed: 11/13/2022]
Abstract
AbstractIntroductionSmoking rates are higher among Indigenous populations in most high-income countries with initiation primarily occurring in adolescence for all population groups. This review aims to identify protective and risk factors for smoking behavior among Indigenous adolescents and young adults.Aims and MethodsWe searched Medline, Embase, and Psychinfo for all original research published between January 2006 and December 2016 that reported influences on smoking for Indigenous adolescents or young adults aged 10–24 living in Australia, New Zealand, Canada, and the United States (US). Extracted data were coded to individual, social, and environmental level categories using a modified Theory of Triadic Influence framework.ResultsA total of 55 studies were included, 41 were descriptive quantitative and 14 qualitative, and 26 included Indigenous participants only. The majority were from the US (32). Frequently reported influences were at the individual and social levels such as increasing age; attitudes and knowledge; substance use; peer and family relationships; smoking norms; mental health; physical activity. At the environmental level, smoke-free spaces; second-hand smoke exposure; high community level prevalence; and social marketing campaigns were also frequently reported. Some studies referenced price, access, and traditional tobacco use. Few reported historical and cultural factors.ConclusionsYoung Indigenous people experience similar influences to other populations such as smoking among family and friends. Greater youth smoking is related to broader community level prevalence, but few studies explore the distal or historical contributing factors such as traditional tobacco use, colonization, experiences of intergenerational trauma and discrimination, or the role of cultural connection.ImplicationsThis review identified a range of factors that influence Indigenous youth smoking and contributes to an understanding of what prevention measures may be effective. Youth tobacco use occurs alongside other substance use and may also serve as an indicator of mental health. Comprehensive community-based programs that work more broadly to address the risk factors related to tobacco, including improving youth mental health, will be important for other behaviors as well. This research highlights the importance of social influence and need for ongoing denormalization of smoking. Future Indigenous led and community owned research is needed to identify likely protective cultural factors.
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Affiliation(s)
- Christina L Heris
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Lina Gubhaju
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - David P Thomas
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Sandra J Eades
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Gendron F. Aboriginal youth's perceptions of traditional and commercial tobacco in Canada. Health Promot Int 2018; 33:1033-1041. [PMID: 28973397 DOI: 10.1093/heapro/dax048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Although tobacco has played an important role in Aboriginal culture for millennia, its more recent recreational use has resulted in serious health concerns among Aboriginal users. In Canada, First Nations youth have higher smoking rates than non-Aboriginal youth. The goals of this study were to examine Aboriginal youth's perceptions of traditional and commercial tobacco and to evaluate perception changes following workshops on traditional uses of tobacco by Elders and other community members, native plants used in ceremony and health impacts of cigarette smoking. The twenty-five Aboriginal youth participants ranged in age from 9 to 14 years old. Results show that workshops did not alter participants' knowledge about tobacco and ceremonies but those studied were more effective at articulating their knowledge through open-ended questionnaires after the workshops. These participants were able to identify more traditional tobacco uses and plants that could be used in ceremonies instead of commercial tobacco. Culturally appropriate education about traditional and commercial tobacco use may be effective in limiting its misuse by Aboriginal youth.
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Affiliation(s)
- Fidji Gendron
- Department of Indigenous Science, Environment and Economic Development, First Nations University of Canada, 1 First Nations Way, Regina, SK, Canada
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Elton-Marshall T, Wijesingha R, Kennedy RD, Hammond D. Disparities in knowledge about the health effects of smoking among adolescents following the release of new pictorial health warning labels. Prev Med 2018; 111:358-365. [PMID: 29195760 DOI: 10.1016/j.ypmed.2017.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/13/2017] [Accepted: 11/26/2017] [Indexed: 11/28/2022]
Abstract
This paper examined knowledge about the health effects of smoking among health equity groups following the 2012 introduction of refreshed pictorial health warning labels (HWLs) in Canada. Data are from the 2012/2013 Youth Smoking Survey a representative school-based survey of 47,203 adolescents in Grades 6-12 in nine provinces. Regression models examined overall knowledge about eight health effects of smoking included in the HWLs. Less than one-third of adolescents (32.2%) knew that smoking causes vision loss/blindness and 33.7% knew that smoking causes bladder cancer. Whereas knowledge was high for lung cancer (93.9%), knowledge about other health effects ranged from 52.9% for chronic bronchitis/emphysema to 77.6% for gum or mouth disease. Non-smoking adolescents who were: susceptible to future smoking, male, ethnic minorities, and who had less spending money were significantly less likely to be knowledgeable of the health effects of smoking. There were fewer disparities in knowledge about the health effects of smoking among smokers. Smokers who bought loose or bagged cigarettes rather than cigarettes in packages or cartons were significantly less likely to be knowledgeable about the health effects of smoking. There are significant disparities in knowledge about the health effects of smoking by health equity groups particularly among non-smoking adolescents. Warning labels have the potential to reduce disparities in knowledge about the health effects of smoking when exposure to the warning labels is universal. Complementary strategies such as mass media campaigns are needed to address disparities in knowledge.
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Affiliation(s)
- Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Affiliated Scientist, Ontario Tobacco Research Unit, Toronto, Ontario, Canada.
| | - Rochelle Wijesingha
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, Ontario, Canada; Department of Sociology, McMaster University, Hamilton, Ontario, Canada
| | - Ryan David Kennedy
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Mazereeuw MV, Yurkiewich A, Jamal S, Cawley C, Jones CR, Marrett LD. Cancer risk factors and screening in First Nations in Ontario. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 37:186-193. [PMID: 28614046 DOI: 10.24095/hpcdp.37.6.02] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION A lack of identifiers in health administrative databases limits our understanding of the cancer burden in First Nations. This study compares cancer risk factors and screening between First Nations in Ontario (on and off reserve) and non-Aboriginal Ontarians using two unique health surveys. METHODS We measured age-standardized prevalence estimates using the First Nations Regional Health Survey (RHS) Phase 2, 2008/10 (for First Nations on reserve) and the Canadian Community Health Survey (CCHS), 2007-2013 (for First Nations off reserve and non-Aboriginal Ontarians). We used prevalence rate ratios (RR) and Pearson's chisquare tests for differences in proportions to compare estimates between First Nations (on and off reserve) and non-Aboriginal Ontarians. RESULTS A higher proportion of First Nation men, women and adolescents on reserve smoked (RR = 1.97, 2.78 and 7.21 respectively) and were obese (RR = 1.73, 2.33 and 3.29 respectively) compared to their non-Aboriginal counterparts. Similar patterns were observed for First Nations off reserve. Frequent binge drinking was also more prevalent among First Nation men and women living on reserve (RR = 1.28 and 2.22, respectively) and off reserve (RR = 1.70 and 1.45, respectively) than non-Aboriginal Ontarians. First Nation men and women on reserve were about half as likely to consume fruit at least twice per day and vegetables at least twice per day compared to non-Aboriginal men and women (RR = 0.53 and 0.54, respectively). Pap test uptake was similar across all groups, while First Nation women on reserve were less likely to have had a mammogram in the last five years than non-Aboriginal women (RR = 0.85). CONCLUSION First Nations, especially those living on reserve, have an increased risk for cancer and other chronic diseases compared to non-Aboriginal Ontarians. These results provide evidence to support policies and programs to reduce the future burden of cancer and other chronic diseases in First Nations in Ontario.
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Affiliation(s)
- Maegan V Mazereeuw
- Aboriginal Cancer Control Unit, Cancer Care Ontario, Toronto, Ontario, Canada
| | | | - Sehar Jamal
- Aboriginal Cancer Control Unit, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Caroline Cawley
- Aboriginal Cancer Control Unit, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Carmen R Jones
- Health Sector, Chiefs of Ontario, Toronto, Ontario, Canada
| | - Loraine D Marrett
- Aboriginal Cancer Control Unit, Cancer Care Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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International Approaches to Tobacco Use Cessation Programming and Prevention Interventions among Indigenous Adolescents and Young Adults. CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0186-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jetty R, Banerji A, Berry M, Leigh FR, Goldade R, Irvine J, Jetty R, Menard K, Pelletier V, Wong S, Bell S, Morningstar M, Monkman L, Ryan AC, Vides E, Wiebe P, Mazerolle M. L’utilisation du tabac à des fins rituelles et le tabagisme chez les enfants et les adolescents autochtones du Canada. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jetty R. Tobacco use and misuse among Indigenous children and youth in Canada. Paediatr Child Health 2017; 22:395-405. [PMID: 29491724 DOI: 10.1093/pch/pxx124] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
While tobacco is sacred in many Indigenous cultures, the recreational misuse of commercial tobacco is highly addictive and harmful. Tobacco misuse is the leading preventable cause of premature death in the world. Smoking rates among Canadian Indigenous youth are at least three times higher than for their non-Aboriginal peers, an alarming statistic on many levels. The tolls on health from extensive tobacco use range from disproportionately high individual mortality and morbidity to heavy socioeconomic burdens on Indigenous communities. Paediatric health care providers are uniquely positioned to collaborate with community stakeholders to prevent and treat tobacco misuse in young people and their families, while understanding the cultural value of tobacco for many Indigenous peoples. Targeted interventions can positively impact length and quality of life, improve overall health and decrease the immense social and human costs of tobacco misuse.
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Riediger ND, Lukianchuk V, Lix LM, Elliott L, Bruce SG. Between a rock and a hard place: Smoking trends in a Manitoba First Nation. Canadian Journal of Public Health 2015; 106:e184-8. [PMID: 26285188 DOI: 10.17269/cjph.106.4940] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 05/02/2015] [Accepted: 02/12/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this study is to estimate and compare smoking prevalence over two time periods in a Manitoba First Nation community. METHODS Data fromtwo independent Diabetes Screening Studies in Sandy Bay First Nation, collected in 2002/2003 (n = 482) and 2011/2012 (n = 596),were used. Crude prevalence of current and ever smoking as well as current smoke exposure was estimated. Change over time was tested using a χ² statistic. RESULTS The crude prevalence of current smoking was 74.0% (95% confidence interval [CI]: 70.1, 78.0) in 2002/2003 and 80.0% (95% CI: 76.8, 83.2) in 2011/2012. The crude prevalence of ever smoking was 83.0% in 2002/2003 and 91.4% in 2011/2012. The prevalence of both current smoking status and ever smoking were significantly higher in 2011/2012 compared to 2002/2003 (p = 0.020 and p < 0.001 respectively). Among participants who were not current smokers, 58.5% (95% CI: 49.6, 67.4) and 76.5% (95% CI: 68.9, 84.1) reported at least one person who smoked in the home in 2002/2003 and 2011/2012 respectively (p = 0.003). In 2011/2012, 96.5% (95% CI: 94.8, 98.2) of those who reported having any children under the age of 18 living in the home were either a current smoker and/or reported that someone else smoked in the home. CONCLUSION Public health and policy initiatives are needed to address the increase in smoking prevalence in the study community.
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Affiliation(s)
- Natalie D Riediger
- Manitoba First Nations Centre for Aboriginal Health Research Department of Community Health Sciences University of Manitoba.
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Bronchiolitis and pneumonia requiring hospitalization in young first nations children in Northern Ontario, Canada. Pediatr Infect Dis J 2014; 33:1023-6. [PMID: 24751861 DOI: 10.1097/inf.0000000000000361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND High rates of lower respiratory tract infection (LRTI), including bronchiolitis and pneumonia, have been reported in Inuit infants living in arctic Canada. We examined rates of LRTI in First Nations Canadian infants living in the Sioux Lookout Zone, in Northern Ontario. METHODS A retrospective review of hospital admissions for LRTI during a 5-year period, in patients <1 year of age was carried out at the Sioux Lookout Meno Ya Win Health Centre, an acute-care hospital that provides secondary care to 31 mainly isolated communities and the town of Sioux Lookout. Admission rates were compared with those in the province of Ontario, as a whole. RESULTS One-hundred and seventeen subjects were identified. The annualized rate of admission for nonbacterial LRTI was 44 per 1000 infants <1 year of age per year. This rate was significantly higher than for the whole province (P = 0.011). Admission rates also varied significantly between communities (P < 0.001).Thirteen percent of subjects required transfer to a tertiary care center. A virus was identified in 55% (36/65) of subjects tested for respiratory viruses, and respiratory syncytial virus and parainfluenza virus were identified most often. Of patients who had a blood culture performed, bacteria were found in 10% (6/59) of subjects. Many patients had radiographic evidence of consolidation, consistent with pneumonia. CONCLUSIONS Rates of LRTI are significantly elevated in First Nations infants living in the Sioux Lookout Zone. Varying rates between communities suggest that environmental factors may be contributing to rates of LRTI in this population.
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Walker JF, Loprinzi PD. Longitudinal examination of predictors of smoking cessation in a national sample of U.S. adolescent and young adult smokers. Nicotine Tob Res 2014; 16:820-7. [PMID: 24520129 DOI: 10.1093/ntr/ntu005] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION To better inform the development of smoking cessation programs for adolescents and young adults, a prospective study was employed to systematically examine behavioral, demographic, health, and psychosocial determinants of smoking cessation. METHODS Data from the 2003-2005 National Youth Smoking Cessation Survey were used. Of 2,582 smokers aged 16-24 years sampled, 1,354 provided complete baseline telephone interview data on the study variables, and their self-reported smoking status at 2-year follow-up was known (currently smoking vs. not smoking). Multivariable logistic regression analysis was employed to examine independent predictors of smoking status (outcome variable) at the 2-year follow-up period. RESULTS Four of 5 participants remained smokers after 2 years. Of the high nicotine dependence smokers, 90% remained smokers at follow-up; of the low nicotine dependence smokers, 77% remained smokers at follow-up. Higher nicotine dependence smokers started smoking earlier in life (13.2 vs. 14.3 years; p < .05). Similarly, those not smoking at the 2-year follow-up period started smoking later in life than those still smoking (14.5 vs. 13.7 years). Along with nicotine dependence, various psychosocial and demographic variables at baseline predicted smoking status at the 2-year follow-up period. CONCLUSIONS Identifiable demographic and psychosocial factors influence smoking behavior among U.S. adolescents and young adults. Even low nicotine dependence is a strong predictor of follow-up smoking behavior. This, coupled with the early smoking age of high nicotine dependence smokers, underscores the importance of early nicotine avoidance among youth.
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Affiliation(s)
- Jerome F Walker
- Department of Respiratory Therapy, Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY
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Baydala L, Saylor K, Ruttan L. Meeting standards for community-engaged Aboriginal health research. Paediatr Child Health 2014; 18:8-9. [PMID: 24381484 DOI: 10.1093/pch/18.1.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2012] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lola Baydala
- Pediatrics, University of Alberta, Edmonton, Alberta
| | - Kent Saylor
- Montreal Children's Hospital, Montreal, Quebec
| | - Lia Ruttan
- Pediatrics, University of Alberta, Edmonton, Alberta
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