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Lareyre O, Cousson-Gélie F, Pereira B, Stoebner-Delbarre A, Lambert C, Gourlan M. Effect of a peer-led prevention program (P2P) on smoking in vocational high school students: Results from a two-school-year cluster-randomized trial. Addiction 2024. [PMID: 38780044 DOI: 10.1111/add.16528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/17/2024] [Indexed: 05/25/2024]
Abstract
AIMS The aim of this work was to measure the impact of P2P (i.e. peer-to-peer), a peer-led smoking prevention intervention, on daily smoking prevalence of adolescents over 2 school years. DESIGN A cluster-randomized controlled trial was performed over a 16-month follow-up (trial status: closed to follow-up). P2P was implemented 1-3 and 13-15 months after baseline. Assessments took place at baseline and 4, 10 and 16 months after baseline. The research team, assessors and adolescents were blinded to the study-arm assignment only at baseline. SETTING Fifteen vocational high schools in France were randomized into two clusters, using a 1:1 allocation ratio per French department (n intervention = 7, n control = 8). PARTICIPANTS Participants comprised a sample of 2010 students in year 11 (i.e. 15-16 years) in vocational high schools. A total of 437 students could not be assessed at baseline (absent or left school), yielding a total sample of 1573 students (n intervention = 749, n control = 824). INTERVENTION AND COMPARATOR The P2P programme trained voluntary students to become peer educators and design smoking prevention actions for their schoolmates in the intervention group (n = 945 students), compared with a passive control group (n = 1065 students). MEASUREMENTS The primary outcome was change from baseline in the prevalence of self-reported daily smoking (i.e. at least one cigarette per day) at 16 months. FINDINGS The 'time × group' interaction indicated that, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 16 months [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.20, 0.53]. Similarly, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 4 months (OR = 0.50, 95% CI = 0.30, 0.82) and 10 months (OR = 0.60, 95% CI = 0.37, 0.98). No adverse events of P2P2 were reported. CONCLUSIONS A cluster-randomized trial found evidence that the peer-led P2P (peer-to-peer) smoking prevention intervention reduced the uptake of daily smoking among high school students in France over 16 months.
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Affiliation(s)
- Olivier Lareyre
- Epidaure-Prevention Department of the Montpellier Cancer Institute, Montpellier Cancer Institute, Montpellier, France
- Univ. Paul Valéry Montpellier 3, EPSYLON UR 4556, F34000, Montpellier, France
| | - Florence Cousson-Gélie
- Epidaure-Prevention Department of the Montpellier Cancer Institute, Montpellier Cancer Institute, Montpellier, France
- Univ. Paul Valéry Montpellier 3, EPSYLON UR 4556, F34000, Montpellier, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Biostatistics Unit, DRCI, Clermont-Ferrand, France
| | - Anne Stoebner-Delbarre
- Onco-Addiction and Patient Education Unit-Supportive Care Department, Montpellier Cancer Institute, Montpellier, France
| | - Céline Lambert
- CHU Clermont-Ferrand, Biostatistics Unit, DRCI, Clermont-Ferrand, France
| | - Mathieu Gourlan
- Epidaure-Prevention Department of the Montpellier Cancer Institute, Montpellier Cancer Institute, Montpellier, France
- Univ. Paul Valéry Montpellier 3, EPSYLON UR 4556, F34000, Montpellier, France
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Fekom M, Nguyen TL, Lepeule J, Nakamura A, Keyes K, Martins S, Strandberg-Larsen K, Melchior M. Intergenerational transmission of tobacco smoking: The role of the child's behavioral difficulties. Data from the Danish National Birth cohort (DNBC). Drug Alcohol Depend 2024; 255:111056. [PMID: 38128363 DOI: 10.1016/j.drugalcdep.2023.111056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
AIMS This study explores the role of offspring behavioral difficulties in the intergeneration transmission of tobacco smoking. METHODS This longitudinal cohort study is based on children born in Denmark in 1996-2003 participating in the Danish National Birth Cohort (DNBC), followed-up until 18years of age. We included mother-child pairs with complete data regarding the exposure (4 trajectories of maternal daily smoking quantity during pregnancy: low, intermediate/stable, intermediate/decreasing and high), outcome (offspring daily smoking status at 18 years) and mediator (offspring symptoms of hyperactivity-inattention at 11 years), that is 24,588 mother-child pairs. RESULTS In our study population, during pregnancy respectively 86.2%, 6.80%, 4.08% and 2.97% mothers belonged to the low, intermediate/stable, intermediate/decreasing and high smoking trajectory groups. After controlling for covariates using propensity scores, the direct effect of maternal smoking in pregnancy on offspring smoking in adolescence was statistically significant, especially when the mother belonged to the intermediate/stable smoking trajectory group (ORIPW = 2.09, 95% CI: 1.70 - 2.61) or to the high smoking trajectory group (ORIPW = 2.08, 95% CI: 1.52 - 3.11) compared to the low smoking trajectory group. None of the indirect effects of maternal smoking in pregnancy were statistically significant, and neither were the proportions mediated. CONCLUSION Maternal pregnancy smoking seems to have an influence on offspring smoking in early adulthood, which does not appear to be mediated by offspring behavioral difficulties. Women should be strongly encouraged to quit smoking in pregnancy to reduce both short and long-term health risks among their offspring.
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Affiliation(s)
- Mathilde Fekom
- Pierre Louis Institute of Epidemiology and Public Health (iPLesp), Department of Social Epidemiology (ERES), INSERM, Sorbonne Université, Paris F-75012, France.
| | - Tri-Long Nguyen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
| | - Johanna Lepeule
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Grenoble, France
| | - Aurélie Nakamura
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Grenoble, France
| | - Katherine Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
| | - Silvia Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
| | | | - Maria Melchior
- Pierre Louis Institute of Epidemiology and Public Health (iPLesp), Department of Social Epidemiology (ERES), INSERM, Sorbonne Université, Paris F-75012, France
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Dalibalta S, Makhlouf Z, Rabah L, Samara F, Elsayed Y. A literature review addressing midwakh and e-cigarette use in the Gulf region. J Egypt Public Health Assoc 2023; 98:21. [PMID: 38110669 PMCID: PMC10728422 DOI: 10.1186/s42506-023-00146-4] [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: 04/05/2023] [Accepted: 11/09/2023] [Indexed: 12/20/2023]
Abstract
A notable decrease in conventional cigarette smoking has been witnessed on a global scale. However, this decrease has been accompanied by an equally striking global increase in the consumption of alternative tobacco products (ATPs), namely e-cigarettes and midwakh in the Arabian Gulf region. A literature review was used to outline the chemical composition of these two ATPs and review their impacts on health. The study was conducted using databases like PubMed, Google Scholar, MDPI, and WorldCat. The literature search included terms such as "e-cigarettes," "midwakh," "dokha," "heath impacts," "psychological effects," "social influences," and "cigarette smoking" with emphasis on literature from the Arabian Gulf region. Data shows that midwakh contains markedly high levels of tar, nicotine, and various compounds of notable effects on the human body. Similarly, it was found that e-cigarettes contain non-negligible amounts of nicotine and other chemical compounds that may not have been extensively investigated. Alarming reports of system-specific effects brought about by midwakh, and e-cigarette consumption, have been reported, although further research is needed to deduce the mechanism. We also discussed some of the social and psychological factors leading to their consumption within this population. Hence, this review raises questions around the safety of these two types of ATPs and encourages comprehensive studies globally and regionally.
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Affiliation(s)
- Sarah Dalibalta
- Department of Biology, Chemistry & Environmental Sciences, American University of Sharjah, Sharjah, UAE.
| | - Zinb Makhlouf
- Department of Biology, Chemistry & Environmental Sciences, American University of Sharjah, Sharjah, UAE
| | - Layal Rabah
- Department of Biology, Chemistry & Environmental Sciences, American University of Sharjah, Sharjah, UAE
| | - Fatin Samara
- Department of Biology, Chemistry & Environmental Sciences, American University of Sharjah, Sharjah, UAE
| | - Yehya Elsayed
- Advanced Research and Development, Fiber Media at Donaldson, Donaldson, MN, USA
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4
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Lin M, Chu M, Li X, Ma H, Fang Z, Mao L, Wang P, Chen T, Chiang YC. Factors influencing adolescent experimental and current smoking behaviors based on social cognitive theory: A cross-sectional study in Xiamen. Front Public Health 2023; 11:1093264. [PMID: 37033036 PMCID: PMC10073720 DOI: 10.3389/fpubh.2023.1093264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction China has the largest youth population in the world. To better implement the Smoke-free School Initiative, this study aims to examine the protective and risk factors for different smoking behaviors (never smoked, experimental smoking, and current smoking) among school adolescents based on social cognitive theory. Methods This research was a secondary analysis of a cross-sectional survey of middle schools in Huli District of Xiamen, China. The final sample consisted of 1937 participants with an average age of 15.41 (SD = 1.64). Descriptive statistics were used to summarize the sociodemographic characteristics of the sample. Multivariate multinomial logistic regression analysis was performed using four models. Results Of the respondents, 1685 (86.99%) were never smokers, 210 (10.84%) were experimental smokers, and 42 (2.17%) were current smokers. Social norms, positive outcome expectations, anti-smoking self-efficacy, and attitudes toward control tobacco policies were associated with adolescents' smoking behaviors. The number of smoking family members, classmates smoking, the perception that smoking is cool and attractive, and attitudes toward control tobacco policies were the predictors of current smoking behavior (p < 0.05). In contrast, friends smoking and individual and social relationship motivation were associated with only experimental smoking (p < 0.05). Discussion The relationship of social norms, positive outcome expectations, anti-smoking self-efficacy, and attitudes toward control tobacco policies varied across smoking behaviors. Family, school, society and the government need to cooperate in prevention and intervention programs for adolescent smoking. The relationships between these factors and adolescents' different smoking behaviors needs to be further verified.
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Affiliation(s)
- Manzhi Lin
- Xiamen Huli District Center for Disease Control and Prevention, Xiamen, China
| | - Meijie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Xian Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Honghao Ma
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Zhiwei Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Li Mao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Pengjun Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
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Legleye S, Bricard D, Khlat M. Roles of parental smoking and family structure for the explanation of socio-economic inequalities in adolescent smoking. Addiction 2023; 118:149-159. [PMID: 35971293 DOI: 10.1111/add.16026] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 08/03/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Among European countries, France is particularly concerned by adolescent tobacco smoking, especially in disadvantaged socio-economic backgrounds (SES). We measured the respective contributions of parental smoking and family living arrangement to social disparities in smoking during adolescence. DESIGN Secondary analysis of survey data. SETTING A cross-sectional nation-wide exhaustive 12-day survey in March 2017 of French youth aged 17-18.5 years participating in the national mandatory civic information day. PARTICIPANTS A total of 13 314 adolescents answering a pen-and-paper questionnaire about their own tobacco consumption and the smoking of their parents. MEASUREMENTS Risk ratios (RRs) were computed using modified Poisson regressions, and population-attributable fraction (PAF) was used as a measure of the explanatory roles of the different factors as mediators of SES. FINDINGS Adolescents living within very privileged and privileged SES were significantly less likely to report daily tobacco smoking (20.4 and 22.7%, respectively) than those within modest and disadvantaged ones (26.0 and 28.6%, respectively). Parental smoking and family living arrangement independently explained the smoking inequalities among adolescents. After adjusting for schooling factors, the risks associated with parental smoking ranged between RR = 1.64 [95% confidence interval (CI) = 1.50-1.79] when the father only smoked and RR = 2.17 (95% CI = 1.99-2.36) when both parents smoked, compared with non-smoking parents; the risk associated with living in a non-intact family was 1.35 (95% CI = 1.26-1.43) and that of living outside the parental home was 1.20 (95% CI = 1.10-1.30). Apprentices and adolescents out of school had higher risks than those at school (RR = 1.82, 95% CI = 1.68-1.98) and RR = 2.10, 95% CI = 1.92-2.29). The contribution of parental smoking to adolescent smoking (PAF = 32%) was greater than that of SES (PAF = 9%), family living arrangement (PAF = 17%) or schooling factors (14%). The share of SES decreased from 18 to 9% when considering these mediating factors. CONCLUSION In France, parental smoking appears to be the factor that most influences adolescent smoking, followed by family living arrangement; the role of family socio-economic status is small in comparison.
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Affiliation(s)
- Stéphane Legleye
- Université Paris-Saclay, Faculté de médecine UVSQ, Université Paris-Sud, Villejuif, France.,Institut national de la statistique et des études économiques, Montrouge, France
| | - Damien Bricard
- Institut de recherche et documentation en économie de la santé (Irdes), Paris, France
| | - Myriam Khlat
- Institut national d'études démographiques (INED), Aubervilliers, France
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Al-Jamaei AAH, Helder MN, Forouzanfar T, Brakenhoff RH, Leemans CR, de Visscher JGAM, van Dijk BAC. Age-group-specific trend analyses of oropharyngeal squamous cell carcinoma incidence from 1989 to 2018 and risk factors profile by age-group in 2015-2018: a population-based study in The Netherlands. Eur J Cancer Prev 2022; 31:158-165. [PMID: 34267108 DOI: 10.1097/cej.0000000000000678] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally and the human papillomavirus (HPV) has been linked to this increase. This study aimed to present a comprehensive overview of OPSCC trends in incidence rates by age group and investigate differences in risk factors profile. Netherlands Cancer Registry data from 1989-2018 were analyzed to calculate the annual percentage change (APC) over European standardized incidence rates by gender and age group using joinpoint regression software. Smoking, alcohol drinking and HPV-status were available for 2015-2018. During 1989-2018, 13 048 cases of OPSCC were reported with a male-to-female ratio of 2.1:1. The overall incidence rate increased by 5.4% (APC) annually from 1989 to 1996 but slowed thereafter by 1.2%. Significant declines were found in patients of 35-44 years (APCs -3.7%). Adults aged 45-59 years displayed significant increases from 1989 to 2001, followed by a significant decline. In patients ≥60 years, the incidence rates increased overall, with APC for women being consistently higher than men. The data on HPV status was available for 69% of the patients, of whom 47% were HPV+. Smoking and alcohol consumption were more prevalent, that is 75 and 76 % respectively. The declining trends of OPSCC for Dutch people aged 35-44 years from 1989 to 2018 and for those aged 45-59 years from 2002 onwards are inconsistent to trends reported elsewhere in the developed countries. The prevalence of smoking and drinking alcohol was quite high in all age groups, whereas the proportion of HPV-positivity was relatively low.
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Affiliation(s)
- Aisha A H Al-Jamaei
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam
| | - Marco N Helder
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam
| | - Ruud H Brakenhoff
- Amsterdam UMC, Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam
| | - C René Leemans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam
| | - Jan G A M de Visscher
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC-location VUMC/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam
| | - Boukje A C van Dijk
- The Netherlands Comprehensive Cancer Organization (IKNL), Department of Research and Development, Utrecht
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Fujii M, Kuwabara Y, Kinjo A, Imamoto A, Jike M, Otsuka Y, Itani O, Kaneita Y, Minobe R, Maesato H, Higuchi S, Yoshimoto H, Kanda H, Osaki Y. Trends in the co-use of alcohol and tobacco among Japanese adolescents: periodical nationwide cross-sectional surveys 1996-2017. BMJ Open 2021; 11:e045063. [PMID: 34348945 PMCID: PMC8340282 DOI: 10.1136/bmjopen-2020-045063] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 07/13/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This study aimed to assess trends in the prevalence of alcohol use depending on smoking behaviours and that of smoking depending on drinking behaviours among Japanese adolescents. DESIGN This was a retrospective study using Japanese school-based nationwide surveys conducted between 1996 and 2017. SETTING Surveyed schools, both junior and senior high schools, considered representative of the entire Japanese population, were sampled randomly. PARTICIPANTS We enrolled 11 584-64 152 students from 179 to 103 schools yearly. They completed a self-reported and anonymous questionnaire on smoking and drinking behaviour. RESULTS Since 1996, the prevalence of alcohol use and smoking among adolescents decreased in each survey (p<0.01). The prevalence of alcohol use in the non-smokers group was 29.0% in 1996 and 4.0% in 2017, and in the smokers group, it was 73.3% in 1996 and 57.4% in 2017. The reduction rate (the difference in prevalence between 1996 and 2017 divided by the prevalence in 1996) was 0.86 in the non-smokers group and 0.22 in the smokers group. The prevalence of smoking in the non-drinkers group was 6.7% in 1996 and 0.7% in 2017, while that in the drinkers group was 32.5% in 1996 and 18.9% in 2017. The reduction rate was 0.90 in the non-drinkers group and 0.42 in the drinkers group. Therefore, downward trends differed among the groups. In a subanalysis of senior high school students, we divided students into three groups according to their intention to pursue further education. Between 1996 and 2017, there was a consistent difference in the prevalence of alcohol use and smoking among these groups. CONCLUSIONS Alcohol use and smoking among Japanese adolescents seem to have reduced. However, certain groups showed poor improvements, and health risk behaviour disparity exists, which may widen further. We need to focus on high-risk groups and implement appropriate measures or interventions accordingly.
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Affiliation(s)
- Maya Fujii
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Yuki Kuwabara
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Aya Kinjo
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Aya Imamoto
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
- Department of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Maki Jike
- Department of Food Safety and Management, Faculty of Food and Health Sciences, Showa Women's University, Setagaya, Tokyo, Japan
| | - Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Osamu Itani
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Ruriko Minobe
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Hitoshi Maesato
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Hisashi Yoshimoto
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hideyuki Kanda
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
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Rolland B, Haesebaert F, Zante E, Benyamina A, Haesebaert J, Franck N. Global Changes and Factors of Increase in Caloric/Salty Food Intake, Screen Use, and Substance Use During the Early COVID-19 Containment Phase in the General Population in France: Survey Study. JMIR Public Health Surveill 2020; 6:e19630. [PMID: 32589149 PMCID: PMC7505683 DOI: 10.2196/19630] [Citation(s) in RCA: 181] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/18/2020] [Accepted: 06/25/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The international outbreak of coronavirus disease (COVID-19) has led many countries to enforce drastic containment measures. It has been suggested that this abrupt lockdown of populations will foster addiction-related habits such as caloric/salty food intake, screen use, and substance use. OBJECTIVE Our aim was to assess the global changes and factors of increase in addiction-related habits during the early COVID-19 containment phase in France. METHODS A web-based survey was provided from day 8 to day 13 of the containment and was completed by 11,391 participants. The questions explored sociodemographic features, psychiatric/addiction history, material conditions of lockdown, general stress, mental well-being, and reported changes in several addiction-related behaviors. Global changes were described and factors of increase were explored using population-weighted and adjusted logistic regression models, providing adjusted odds ratios (aORs) and their 95% confidence intervals. RESULTS Overall, the respondents reported more increases in addiction-related habits than decreases, specifically 28.4% (caloric/salty food intake), 64.6% (screen use), 35.6% (tobacco use), 24.8% (alcohol use), and 31.2% (cannabis use). Reduced well-being scores and increased stress scores were general factors of increase in addiction-related habits (P<.001 for all habits). Factors of increase in caloric/salty food intake (n=10,771) were female gender (aOR 1.62, 95% CI 1.48-1.77), age less than 29 years (P<.001), having a partner (aOR 1.19, 95% CI 1.06-1.35), being locked down in a more confined space (per 1 square meter/person decrease: aOR 1.02, 95% CI 1.01-1.03), being locked down alone (aOR 1.29, 95% CI 1.11-1.49), and reporting current (aOR 1.94, 95% CI 1.62-2.31) or past (aOR 1.27, 95% CI 1.09-1.47) psychiatric treatment. Factors of increase in screen use (n=11,267) were female gender (aOR 1.31, 95% CI 1.21-1.43), age less than 29 years (P<.001), having no partner (aOR 1.18, 95% CI 1.06-1.32), being employed (P<.001), intermediate/high education level (P<.001), being locked down with no access to an outdoor space (aOR 1.16, 95% CI 1.05-1.29), being locked down alone (aOR 1.15, 95% CI 1.01-1.32), living in an urban environment (P<.01), and not working (P<.001). Factors of increase in tobacco use (n=2787) were female gender (aOR 1.31, 95% CI 1.11-1.55), having no partner (aOR 1.30, 95% CI 1.06-1.59), intermediate/low education level (P<.01), and still working in the workplace (aOR 1.47, 95% CI 1.17-1.86). Factors of increase in alcohol use (n=7108) were age 30-49 years (P<.05), a high level of education (P<.001), and current psychiatric treatment (aOR 1.44, 95% CI 1.10-1.88). The only significant factor of increase in cannabis use (n=620) was intermediate/low level of education (P<.001). CONCLUSIONS The early phase of COVID-19 containment in France led to widespread increases in addiction-related habits in the general population. Reduced well-being and increased stress were universal factors of increase. More specific factors were associated with increases in each of the explored habits.
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Affiliation(s)
- Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon, CH Le Vinatier, Hospices Civils de Lyon, Bron, France.,Inserm U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Bron, France
| | - Frédéric Haesebaert
- Centre Ressource de Réhabilitation Psychosociale, CH Le Vinatier, Lyon, France
| | - Elodie Zante
- Centre Ressource de Réhabilitation Psychosociale, CH Le Vinatier, Lyon, France
| | - Amine Benyamina
- PSYCOMADD 4872, Université Paris-Saclay, Paris, France.,CH Le Vinatier, Pôle Centre Rive Gauche, Bron, France
| | - Julie Haesebaert
- Service de recherche et d'épidémiologie, Pôle de santé publique, Hospices Civils de Lyon, Lyon, France
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Chyderiotis S, Benmarhnia T, Spilka S, Beck F, Andler R, Legleye S, Menvielle G. Why do apprentices smoke much more than high school students? Understanding educational disparities in smoking with a Oaxaca-blinder decomposition analysis. BMC Public Health 2020; 20:924. [PMID: 32532252 PMCID: PMC7291761 DOI: 10.1186/s12889-020-09050-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 06/04/2020] [Indexed: 12/04/2022] Open
Abstract
Background Educational disparities in daily smoking begin during adolescence and can lead to educational disparities in health among adults. In particular, vocational students including apprentices have higher daily smoking rates compared to non-vocational students. This study aimed to identify the determinants of the gap in daily smoking between French apprentices and high school students aged 17 in 2008 and in 2017. Methods We used data from a cross-sectional repeated survey representative of all French adolescents aged 17 in 2008 and 2017. We conducted a non-linear extension of the Oaxaca-Blinder decomposition technique and included the following variables: sociodemographic and familial characteristics, parental smoking, cannabis and alcohol use, suicidal attempt, grade repetition and money received. Results Daily smoking was about two times higher among French apprentices compared to high school students in 2008. This gap did not decrease between 2008 and 2017. Differences in measured characteristics between the two groups explained this gap partly, from 28.6 to 51.2%. Cannabis and alcohol use, money received and parental smoking contributed the most to the daily smoking gap. Conclusions Prevention programs could target cannabis and alcohol use as well as parental smoking to help decrease educational disparities in smoking status among French adolescents.
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Affiliation(s)
- Sandra Chyderiotis
- Université Paris-Sud, Université Paris-Saclay, faculté de médecine, faculté de médecine UVSQ, Inserm, CESP, 92541, Villejuif, France. .,Observatoire français des drogues et des toxicomanies (OFDT), 69, rue de Varenne, 75007, Paris, France.
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.,Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Stanislas Spilka
- Université Paris-Sud, Université Paris-Saclay, faculté de médecine, faculté de médecine UVSQ, Inserm, CESP, 92541, Villejuif, France.,Observatoire français des drogues et des toxicomanies (OFDT), 69, rue de Varenne, 75007, Paris, France
| | - François Beck
- Institut national de la statistique et des études économiques, 88, avenue Verdier, CS 70058, 92541, Montrouge Cedex, France
| | - Raphaël Andler
- Santé Publique France, 12, rue du Val d'Osne, 94415, Saint-Maurice Cedex, France
| | - Stéphane Legleye
- Université Paris-Sud, Université Paris-Saclay, faculté de médecine, faculté de médecine UVSQ, Inserm, CESP, 92541, Villejuif, France.,Institut national de la statistique et des études économiques, 88, avenue Verdier, CS 70058, 92541, Montrouge Cedex, France
| | - Gwenn Menvielle
- Department of Social Epidemiology, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, 75012, Paris, France
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