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Pepper JK, Malterud AS, Farrelly MC, Taylor NH, Nonnemaker JM, Petrun Sayers EL. The Impact of Social Media Use and Gaming on Initiation of Smokeless Tobacco Use Among Rural Male Youth. J Adolesc Health 2023; 72:383-389. [PMID: 36529619 DOI: 10.1016/j.jadohealth.2022.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/23/2022] [Accepted: 09/17/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Smokeless tobacco (SLT) use is more common among White male youth in rural locations than among other youth. Previous literature documents risk factors for SLT use (e.g., perceived harm). However, no research has examined whether SLT initiation is associated with the use of social media and video games, despite the high prevalence of those behaviors among adolescent males. METHODS As part of the evaluation of "The Real Cost" smokeless prevention campaign, we conducted a baseline survey of a cohort of US males aged 11-16 in 2016 and four follow-up surveys conducted approximately every 8 months. We used discrete-time survival analysis to examine factors associated with SLT initiation. Logistic regression estimated the odds of initiation as a function of lagged values of key predictors (social media use in tertiles and frequency of gaming) and other baseline and lagged correlates. The model controlled for campaign exposure. RESULTS Relative to the lowest tertile of social media use, moderate (odds ratio [OR] = 1.80) or high use (OR = 2.77) was associated with increased risk of SLT initiation at the subsequent survey wave. Relative to playing every few weeks or less, playing video games once a day (OR = 0.50) or several times a day (OR = 0.33) was associated with decreased risk of SLT initiation. DISCUSSION SLT initiation was positively associated with social media use and negatively associated with gaming. Future research should explore reasons for the protective nature of gaming (e.g., social support, improved mood) and whether parental supervision of social media use could mitigate its negative impact.
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Affiliation(s)
| | - Andie S Malterud
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
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Lund L, Bast LS, Rubæk M, Andersen S. Exploring factors associated with smokeless tobacco use among young people: A systematic scoping review. Drug Alcohol Depend 2022; 240:109627. [PMID: 36167002 DOI: 10.1016/j.drugalcdep.2022.109627] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE While smoking is declining among young people, smokeless tobacco use is increasing. Identifying who is using smokeless tobacco and why is essential in preventing smokeless tobacco use. This study aimed to comprehensively explore the factors of young people's use of smokeless tobacco in western countries and identify research gaps. METHODS We conducted a systematic scoping review of studies that examined factors associated with smokeless tobacco use among young people (ages 13-29) from western countries published between January 2011 and September 2021. Searches were conducted in CINAHL, Medline, and Scopus. Studies on adults, total tobacco use (i.e., did not differentiate between tobacco product types), dual and multiple uses of tobacco, and studies on smokeless tobacco cessation programs were excluded. RESULTS A total of 160 studies were included in this scoping review. The studies were primarily undertaken in the US and the Scandinavian countries, and the majority explored smokeless tobacco use without distinguishing between the specific types. Smokeless tobacco users were more likely to be male, non-Hispanic white, engaging in physical activity, and using other substances, including cigarettes and alcohol. The role of friends and family were identified as critical factors that were related to the use of smokeless tobacco. CONCLUSIONS This scoping review suggests that preventative measures against smokeless tobacco use should focus on peer and family members' roles and that these measures may benefit from targeting males. Additional research, including systematic reviews on this area to validate the identified associated factors, would improve the understanding of smokeless tobacco use.
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Affiliation(s)
- Lisbeth Lund
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Mette Rubæk
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
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Solhi M, Fattahi E, Manzari ZS, Gupta PC, Kargar M, Kasmaei P, Barati H. The Reasons for Using Smokeless Tobacco: A Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:492-501. [PMID: 34178796 PMCID: PMC8214603 DOI: 10.18502/ijph.v50i3.5589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: Smokeless tobacco use is a public health problem in some parts of the world. The major objective of this study was to investigate the reasons and factors of consumption. Methods: A content analysis was conducted on articles for the past thirty years (1989–2019). We reviewed and selected 400 abstracts of original articles from PubMed databases by the search strategy, and reviewed one by one. Among these, 45 abstracts were selected, in which the patterns of use, the reasons for using, and the determinants and predictors were described. Eleven papers were selected based on the results and related to the research objectives. The results of these articles were evaluated precisely word by word and phrase by phrase with content analysis method and inductive approach. Results: The reasons for the use of smokeless tobacco fell in two main themes: socio-cultural structure; and, beliefs, each contained Sub-themes such as “culture and living conditions”, “laws”, “family and peer relationships”, “beliefs related to psychological” and “beliefs related to physical influences”, “beliefs”, “The role of harm perceptions “. Conclusion: There was a difference between beliefs, cultures and social conditions among the people about using of smokeless tobacco and the association of these factors is investigated in future studies. We also suggest for the prevention and control of smokeless tobacco use, cultural norms and beliefs will need to address adequately.
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Affiliation(s)
- Mahnaz Solhi
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Fattahi
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Sadat Manzari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Prakash C Gupta
- Healis-Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India
| | - Mehdi Kargar
- Department of Health Education & Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Kasmaei
- Health and Environment Research Center, Department of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Hadis Barati
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Pardavila-Belio MI, Canga-Armayor A, Duaso MJ, Pueyo-Garrigues S, Pueyo-Garrigues M, Canga-Armayor N. Understanding how a smoking cessation intervention changes beliefs, self-efficacy, and intention to quit: a secondary analysis of a pragmatic randomized controlled trial. Transl Behav Med 2019; 9:58-66. [PMID: 30590861 DOI: 10.1093/tbm/ibx070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although beliefs, self-efficacy, and intention to quit have been identified as proximal predictors of initiation or quitting in young adults, few studies have studied how these variables change after a smoking cessation intervention. To evaluate the changes in the beliefs, self-efficacy, and intention to avoid smoking and determine if these are potential mediators in quitting, following a smoking cessation intervention, aimed at tobacco-dependent college students. Single-blind, pragmatic randomized controlled trial with a 6-month follow-up. A total of 255 smoker students were recruited from September 2013 to February 2014. Participants were randomly assigned to intervention group (n = 133) or to control group (n = 122). The students in the intervention group received a multicomponent intervention based on the Theory of Triadic Influence (TTI). The strategies of this program consisted of a 50 min motivational interview conducted by a nurse and online self-help material. The follow-up included a reinforcing e-mail and group therapy. The smoking-related self-efficacy, belief, and intention scale was used to assess outcomes. Intention to quit smoking is partial moderator explaining 36.2% of the total effects in smoking cessation incidence. At 6 month follow-up, the differences in the mean scores of self-efficacy and intention related to stopping smoking were significantly higher in the intervention than in the control group. A multicomponent intervention based on the TTI, tailored to college students, positively increased the self-efficacy to avoid smoking and the intention to quit, suggesting intention as potential mediator of quitting.
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Affiliation(s)
- Miren I Pardavila-Belio
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
| | - Ana Canga-Armayor
- IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain.,Department of Nursing Care of the Adult Person, University of Navarra, Pamplona, Navarra, Spain
| | - María J Duaso
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | - Sara Pueyo-Garrigues
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain
| | - María Pueyo-Garrigues
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain
| | - Navidad Canga-Armayor
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
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Mantey DS, Harrell MB, Case K, Crook B, Kelder SH, Perry CL. Subjective experiences at first use of cigarette, e-cigarettes, hookah, and cigar products among Texas adolescents. Drug Alcohol Depend 2017; 173:10-16. [PMID: 28182981 PMCID: PMC5432196 DOI: 10.1016/j.drugalcdep.2016.12.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 12/06/2016] [Accepted: 12/10/2016] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Subjective experiences ("SEs") at first cigarette use have been thoroughly examined; however, limited research has examined SEs at first use of non-cigarette products. This study addresses this gap in the literature. METHODS Cross-sectional data from 6th, 8th and 10th grade students in four metropolitan areas of Texas (n=3907/N=461,069). Nausea, coughing, relaxation, rush/buzz, and dizziness at first use were assessed for cigarettes, e-cigarettes, hookah, and cigar products. Chi-square analyses examined differences in the prevalence of first use SEs by product. Weighted multiple logistic regression analyses examined the association of SEs and current product use. Covariates were grade, gender, race/ethnicity, and current other tobacco product use. RESULTS Exploratory factor analysis of SEs determined differing factor structures across tobacco products. For example, the following items loaded onto the positive SE factor: 1) relaxation, rush, and dizziness for cigarettes, and 2) relaxation and rush for e-cigarettes, hookah, and cigar products. Prevalence of negative SEs (coughing and nausea) were higher for cigarette and cigar products compared to e-cigarettes and hookah. Positive SEs for cigarettes were associated with increased odds of current cigarette use (AOR=1.51); similarly positive SEs for cigars were associated with increased odds of current cigar use (AOR=2.11). Feeling nauseous at first use of cigars was associated with decreased odds of current cigar use (AOR=0.18). No SEs were associated with current e-cigarette or hookah use. CONCLUSIONS Subjective experiences at first use differ by tobacco product. Longitudinal studies are needed to examine temporal relationships between SEs at first use and sustained tobacco use.
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Affiliation(s)
- Dale S Mantey
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA.
| | - Melissa B Harrell
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
| | - Kathleen Case
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
| | - Brittani Crook
- Center for Health Communication Affiliated Fellow, Moody College of Communication, University of Texas at Austin,300 W. Dean Keeton St., Austin, TX 78712, USA
| | - Steven H Kelder
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
| | - Cheryl L Perry
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
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Case KR, Cooper M, Creamer M, Mantey D, Kelder S. Victims of Bullying and Tobacco Use Behaviors in Adolescents: Differences Between Bullied at School, Electronically, or Both. THE JOURNAL OF SCHOOL HEALTH 2016; 86:832-840. [PMID: 27714875 DOI: 10.1111/josh.12437] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 03/08/2016] [Accepted: 05/16/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND Being a victim of bullying is associated with greater risk of youth substance use; however, research specifically examining whether tobacco use behaviors differ among adolescents who were bullied at school only, electronically only, or both at school and electronically is limited. METHODS We examined the associations between being a victim of bullying (at school only, electronically only, or both at school and electronically) and use of tobacco products using data from the 2013 national Youth Risk Behavior Survey. RESULTS Girls who were bullied both at school and electronically reported the highest odds of all tobacco use behaviors (ever use of cigarettes, current use of cigarettes, and current use of any tobacco product) as compared with girls who were not bullied after adjusting for covariates. Conversely, for boys, only the association between being bullied electronically only and ever use of cigarettes remained significant after adjusting for covariates. CONCLUSIONS Results from this study indicate that electronic bullying may differentially influence the odds of tobacco use in high school students as compared with bullying that occurs at school only. Confirmation of these findings could inform interventions to reduce both bullying and tobacco use in high school.
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Affiliation(s)
- Kathleen R Case
- University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701.
| | - Maria Cooper
- University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701.
| | - MeLisa Creamer
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701.
| | - Dale Mantey
- University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701.
| | - Steven Kelder
- UTSPH Austin Regional Campus, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701; Professor, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701.
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Association between Peer Cigarette Smoking and Electronic Cigarette Smoking among Adolescent Nonsmokers: A National Representative Survey. PLoS One 2016; 11:e0162557. [PMID: 27695093 PMCID: PMC5047474 DOI: 10.1371/journal.pone.0162557] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 08/24/2016] [Indexed: 11/25/2022] Open
Abstract
We assessed the association between electronic cigarette (e-cigarette) use and peer cigarette smoking, a major risk factor for the initiation of cigarette smoking in adolescents. Data from the 2013 Korea Youth Risk Behavior Web-based Survey of 65,753 nonsmokers aged 13–18 years were analyzed using multiple logistic regression. A total of 3.8% of the Korean adolescents were ‘ever e-cigarette’ users and 1.2% were current users. Adjusted odds ratios (ORs) for current and ever e-cigarette use compared to those whose closest friends were non-smokers ranged from 2.05 (95% confidence interval [CI], 1.82–2.30) to 5.50 (95% CI, 4.77–6.34), and from 2.23 (95% CI, 1.77–2.81) to 7.82 (95% CI, 5.97–10.25) for those who had ‘some’ close friends to ‘most/all’ friends who smoked, respectively. The slopes of the adjusted ORs for e-cigarette use in ‘never smokers’ were more than twice as steep as those in ‘former smokers’, showing a significant interaction effect between the proportion of smoking closest friends and cigarette smoking status (never or former smokers) (p<0.001 for interaction). Peer cigarette smoking had a significant association with e-cigarette use in adolescent nonsmokers, and this association was greater on never smokers than former smokers.
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Pardavila-Belio MI, García-Vivar C, Pimenta AM, Canga-Armayor A, Pueyo-Garrigues S, Canga-Armayor N. Intervention study for smoking cessation in Spanish college students: pragmatic randomized controlled trial. Addiction 2015; 110:1676-83. [PMID: 26053958 DOI: 10.1111/add.13009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 04/28/2015] [Accepted: 05/29/2015] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the effectiveness of a nurse intervention aimed at helping college student smokers quit smoking. DESIGN Single-blind, pragmatic randomized controlled trial which compares a multi-component intervention, tailored specifically to college students, with a brief advice session with a 6-month follow-up. SETTINGS This study was conducted at the University of Navarra, Spain. PARTICIPANTS A total of 255 college student smokers (age range = 18-24 years) were randomized to an intervention group (n = 133) or to a control group (n = 122). INTERVENTION A multi-component intervention based on the Theory of Triadic Influence of Flay was developed. The intervention consisted of a 50-minute motivational interview conducted by a nurse and online self-help material. The follow-up included a reinforcing e-mail and group therapy. MEASUREMENTS The primary outcome was self-reported abstinence, with biochemical verification at 6 months. The secondary outcomes consisted of the mean number of cigarettes smoked per day, self-reported attempts to quit smoking and stage of change at 6 months. FINDINGS At the 6-month follow-up, the smoking cessation incidence was 21.1% in the intervention group compared with 6.6% in the control group (difference = 14.5 confidence interval = 6.1-22.8; relative risk = 3.41, 95% confidence interval = 1.62-7.20). The difference in the mean number of cigarettes at 6 months was significantly different (difference = -2.2, confidence interval = -3.6 to -0.9). CONCLUSIONS A multi-component intervention tailored to college students and managed by a nurse is effective in increasing smoking cessation among college students.
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Affiliation(s)
- Miren I Pardavila-Belio
- Department of Community Nursing and Maternal and Child Health Care, University of Navarra, Pamplona, Navarra, Spain
| | - Cristina García-Vivar
- Department of Community Nursing and Maternal and Child Health Care, University of Navarra, Pamplona, Navarra, Spain
| | - Adriano Marçal Pimenta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Canga-Armayor
- Department of Psychiatry and Psychology, University Clinic of Navarra, Pamplona, Navarra, Spain
| | - Sara Pueyo-Garrigues
- Department of Nursing Care for Adults, University of Navarra, Pamplona, Navarra, Spain
| | - Navidad Canga-Armayor
- Department of Community Nursing and Maternal and Child Health Care, University of Navarra, Pamplona, Navarra, Spain
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Adkison SE, O'Connor RJ, Bansal-Travers M, Cummings KM, Rees VW, Hatsukami DK. Validation of a Measure of Normative Beliefs About Smokeless Tobacco Use. Nicotine Tob Res 2015; 18:801-8. [PMID: 26187390 DOI: 10.1093/ntr/ntv156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 07/08/2015] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Validated methods to evaluate consumer responses to modified risk tobacco products (MRTPs) are needed. Guided by existing literature that demonstrates a relationship between normative beliefs and future intentions to use tobacco the current research sought to (1) develop a measure of normative beliefs about smokeless tobacco (ST) and establish the underlying factor structure, (2) evaluate the structure with confirmatory factor analysis utilizing an independent sample of youth, and (3) establish the measure's concurrent validity. METHODS Respondents (smokers and nonsmokers aged 15-65; N = 2991) completed a web-based survey that included demographic characteristics, tobacco use history and dependence, and a measure of attitudes about ST adapted from the Normative Beliefs about Smoking scale. A second sample of youth (aged 14-17; N = 305) completed a similar questionnaire. RESULTS Exploratory factor analysis produced the anticipated three-factor solution and accounted for nearly three-quarters of the variance in the data reflecting (1) perceived prevalence of ST use, (2) popularity of ST among successful/elite, and (3) approval of ST use by parents/peers. Confirmatory factor analysis with data from the youth sample demonstrated good model fit. Logistic regression demonstrated that the scales effectively discriminate between ST users and nonusers and are associated with interest in trying snus. CONCLUSIONS Assessment of MRTPs for regulatory purposes, which allows messages of reduced risk, should include measurement of social norms. Furthermore, surveillance efforts that track use of new MRTPs should include measures of social norms to determine how norms change with prevalence of use.
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Affiliation(s)
- Sarah E Adkison
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo NY;
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo NY
| | | | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Vaughan W Rees
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA
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Pilarska A, Pilarski R. Zasoby odpornościowe i czynniki ryzyka a używanie alkoholu i marihuany w okresie wczesnej dorosłości. ALCOHOLISM AND DRUG ADDICTION 2015. [DOI: 10.1016/j.alkona.2015.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Decrease in Self-Reported Tanning Frequency among Utah Teens following the Passage of Utah Senate Bill 41: An Analysis of the Effects of Youth-Access Restriction Laws on Tanning Behaviors. J Skin Cancer 2014; 2014:839601. [PMID: 25215240 PMCID: PMC4158105 DOI: 10.1155/2014/839601] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 08/06/2014] [Accepted: 08/07/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction. Adolescent use of indoor tanning facilities is associated with an increased risk in later development of melanoma skin cancers. States that have imposed age restrictions on access to indoor tanning generally show lower self-reported rates of indoor tanning than states with no restrictions, but currently no studies have assessed indoor tanning use before and after such restrictions. Methods. In 2013, we compared self-reported indoor tanning data collected in the Prevention Needs Assessment (PNA) survey in 2011 to PNA 2013 data. We also assessed predictors of continued tanning after passage of the bill. Results. Prior to the passage of Senate Bill 41, 12% of students reported at least one incident of indoor tanning in the past 12 months. After passage, only 7% of students reported indoor tanning in the past 12 months (P < 0.0001). Students who continued indoor tanning were more likely to be older and female and to engage in other risk behaviors, including smoking and alcohol use. Lower parental education levels were also associated with continued tanning. Conclusion. Indoor tanning restrictions showed beneficial impact on tanning rates in adolescents in Utah. Stricter restrictions may show even greater impact than restrictions that allow for parental waivers. Stronger enforcement of bans is needed to further reduce youth access.
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