Parents, Peers, and Trajectories of Cigarette Smoking: A Group-Based Approach

Electronic cigarettes use and parental factors among children and adolescents, Jeddah. A cross-sectional study

E-cigarettes are gaining popularity worldwide, necessitating their control. This study investigated the impact of parental factors on E-cigarette use among children-adolescents in Jeddah, Saudi Arabia. A cross-sectional survey involving 1,044 parents of children aged 10- to 21 was conducted in malls. A structured questionnaire assessed parental socio-economic status, smoking/vaping habits, and attitudes toward E-cigarette use.Data were analysed using chi-square, Mann-Whitney, and binary logistic regression (significance set at 0.05). Results showed 176 (16.9%) parents reported their children using E-cigarettes. Older adolescents (18-21 age group) were significantly more likely to use E-cigarettes compared to younger ones (adjusted odds ratio [AOR]:6.456, 95% CI:3.664-11.374). Parents with a permissive attitude were more likely to have children who vape. (AOR:1.643, 95% CI:1.149-2.348). While open parent-child communication about traditional smoking reduced E-cigarettes use (AOR:0.772, 95% CI:0.639-0.934). Parental attitudes and open communication are crucial for mitigating youth E-cigarette use.

Injury, substance abuse, verbal abuse, and emotional and behavioral issues among adolescents in Uttarakhand, India: A categorical principal component analysis of global school-based health survey

Background

Adolescents in low-middle-income countries face increasing physical and mental health challenges. The present study aimed to assess status of injury, verbal abuse, substance use, and emotional behavior of adolescents of Uttarakhand, India, and evaluate the importance of each component.

Methods

A cross-sectional study was conducted among adolescents in 13 government schools in Uttarakhand using the Global School-based Health Survey (GSHS). Categorical principal component analysis (CATPCA) using Varimax rotation was performed to analyze principal components among two domains of GSHS (substance abuse domain and verbal abuse and emotional behavior domain). Factorability was assessed using Kaiser-Meyer-Olkin and Bartlett's test. Variance Accounted For index was used to evaluate the importance of each component.

Results

A total of 634 adolescents completed the questionnaire. 41.3% students suffered from serious injury with a significant difference (P < 0.0001) between both genders. Girls were more likely to report having felt lonely most of the time or always in the past 12 months (11.0% vs 4.6%, P = 0.018). Boys were more likely to miss classes on 3 or more days (9.9% vs 4.9%, P = 0.043). Initiation of smoking cigarettes (9.6% vs 1.2%, P <0.0001) and tobacco chewing (3.4% vs 0.3%, P = 0.001) was more likely in 12-15-year-old boys. One-third of the students reported male guardians to use either alcohol or some form of tobacco. CATPCA yielded an 11-factor model accounting for 58.26% of variances with the most important principal component named "Tobacco (Smoking and Chewing): Initiation, Frequency and Attempt to Stop" (eigenvalue: 4.109).

Conclusion

Significant differences in various items of injury, verbal abuse, substance use, and emotional behavior were recorded between boys and girls. CATPCA revealed patterns among injury, verbal abuse, emotional behavior, and substance abuse domains of GSHS by categorizing them into 11 components. On the basis of these patterns, prioritizing and development of appropriate school-based interventions may be implemented by various stakeholders of Uttarakhand.

Peers' parental education and cardiovascular disease risk in adulthood: The mediating role of health-related behaviors

RATIONALE

Although there is a growing body of empirical evidence on the relationship between peers' parental education and adolescents' educational outcomes, little is known about whether exposure to highly educated peers' parents is associated with improved physical health in adulthood.

OBJECTIVE

This study investigated the relationship between the education level of peers' parents (Wave I) and the risk of developing cardiovascular disease (CVD) in adulthood (Wave IV). Moreover, we considered a set of health-related behaviors (Wave II) as the underlying mechanisms linking peers' parental education to later-life physical health such as substance use (smoking, binge drinking, and marijuana use) and other lifestyle behaviors (physical activity, sedentary behavior, and unhealthy dietary habits).

METHODS

Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), spanning respondents' adolescence to adulthood, were used. To address the endogenous school selection problem and account for the unobserved school-level confounders, this study exploited quasi-experimental within-school/across-cohort variation in peer composition. To formally test for mediation, Sobel tests were conducted.

RESULTS

The results of this study revealed that independent of own parents' education levels, exposure to higher levels of peers' parental education is associated with a lower CVD risk score in adulthood. For a one-standard-deviation increase in peers' parental education-that is, about a 0.98-year increase in grademates' parental educational attainment, a CVD risk in adulthood increased by about 6.2%. Our mediation analyses showed that part of this association is explained by a decrease in substance use (27% for smoking, 10% for binge drinking, and 11% for marijuana use). In contrast, none of the other lifestyle behaviors evaluated significantly mediated the association.

CONCLUSION

The study's findings suggest that the role of peers' parents should not be overlooked when developing health-promoting interventions for adolescents. Policymakers and practitioners may wish to increase opportunities for students to benefit from health-related social learning from their peers' highly educated parents.

Classmates' Discrimination Experiences and Adolescent Depressive Symptoms: Evidence From Random Assignment of Students to Classrooms in South Korea

PURPOSE

The purpose of this study is to examine the association between classmates' discrimination experiences and an individual student's depressive symptoms. A set of social-psychological and behavioral variables were considered as potential mechanisms underlying this association.

METHODS

The data came from the Gyeonggi Education Panel Study of seventh graders in South Korea. This study leveraged quasi-experimental variation generated from random assignment of students to classes within schools to address the endogenous school selection problem and account for the unobserved school-level confounders. To formally test for mediation, Sobel tests were conducted and peer attachment, school satisfaction, smoking, and drinking were explored as mechanism variables.

RESULTS

An increase in classmates' discrimination experiences was positively associated with an individual student's depressive symptoms. This association remained statistically significant even after adjusting for personal discrimination experience, a myriad of individual- and class-level covariates, as well as school fixed effects (b = 0.325, p < .05). Classmates' discrimination experiences were also associated with a decline in peer attachment and school satisfaction (b = -0.386, p < .01 and b = -0.399, p < .05, respectively). These psychosocial factors explained about one-third of the association between classmates' discrimination experiences and individual students' depressive symptoms.

DISCUSSION

The findings of this study suggest that exposure to peer-level discrimination experience leads to friend detachment and school dissatisfaction, which in turn increases an individual student's depressive symptoms. This study reaffirms the importance of fostering a more cohesive and nondiscriminatory school environment to promote adolescents' psychological health and well-being.

Intergenerational transmission of parental risky health behaviors in Chinese children: Are there socioeconomic status differences?

Background

Risky health behaviors in childhood, including smoking, alcohol consumption, and having a poor diet, are the major sources of non-communicable diseases in adulthood. This study aimed to examine how parents affect children's risky health behaviors and whether intergenerational transmission differs based on socioeconomic status (SES).

Methods

Data were extracted from the 1991-2015 China Health and Nutrition Survey (CHNS). Smoking (n = 5,946), alcohol consumption (n = 7,821), and sugar-sweetened beverages (SSBs) consumption (n = 3,537) were used as proxies for risky health behaviors in children. A binary choice model for panel data with a random-effect specification was employed to examine whether risky health behaviors can be transmitted from parents to their children. Subsequently, we conducted a seemingly unrelated estimation test (SUEST) to explore the differences in parental transmission between the different SES groups.

Results

We found strong intergenerational persistence of smoking, alcohol drinking, and SSBs drinking behaviors, except for the mothers' smoking behavior. Mothers had a greater influence on children's alcohol drinking and SSBs drinking behaviors than fathers both in urban and rural areas and in different SES groups. The intergenerational transmission of SSBs drinking behavior exhibited a decreasing trend with increasing SES for both urban and rural families. In urban areas, mothers' alcohol drinking behavior has a decreasing trend with increasing education level, occupation, and income; however, in rural areas, the influence of mothers' alcohol drinking behavior occurred in the same direction with increasing education level and occupation type. In rural areas, the influence of fathers' drinking and smoking behaviors on children appears to mostly increase with increasing SES. Meanwhile, the influence of such behaviors among urban fathers would decrease with increasing SES.

Conclusion

Parents' behaviors and SES can influence the initiation of risky health behaviors in their offspring. Thus, to promote healthy behaviors, policymakers can introduce health education programs for parents, particularly for those living in rural areas and with a low SES.

Adolescent Context and Depressive Symptom Trajectories in a National Sample: Ages 13 to 34

Background

Group-based trajectory analyses of depressive symptoms are often conducted with convenience samples, over limited developmental periods, or with a limited set of predictors in the adolescent context. Examinations of protective and risk factors in robust national samples are needed.

Aim

Using an ecological approach, this study's purpose is to identify key relational and contextual factors associated with trajectory groups of depressive symptoms that span ages 13 to 34.

Method

12,248 respondents in the National Study of Adolescent to Adult Health (Waves 1, 3, and 4) were analyzed with a group-based, cohort sequential design to identify trajectory classes, shapes, and adolescent (i.e., Wave 1) risk and protective factors for depressive symptom trajectories.

Results

A four-class quadratic solution was identified. Close attachment to parents was strongly associated with decreased odds of membership on elevated trajectories. No relationship with a mother or father was associated with better mental health than a poor relationship with that parent. Peer support, teacher support, and educational achievement were highly protective. Romantic relationships, increased number of sexual partners, and prayer were modestly associated with higher depressive symptom burden. Pregnancy was associated with increased burden later in life relative to the teenage years.

Conclusions

Assessing adolescent family, school, peer, and religious contexts indicates several protective and risk factors for depressive symptoms that are persistent over time.