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Richard J, King SM. Annual Research Review: Emergence of problem gambling from childhood to emerging adulthood: a systematic review. J Child Psychol Psychiatry 2023; 64:645-688. [PMID: 36347261 DOI: 10.1111/jcpp.13713] [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] [Accepted: 09/02/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND The risk for problematic gambling and associated high-risk behaviors is elevated during adolescence and emerging adulthood. Activities with gambling-like features and novel forms of gambling may place youth at an increased risk for problem gambling. AIM AND METHOD The aim of this review is to provide an overview of the association between both activities with gambling-like features and novel gambling activities and problem gambling among youth while examining the role of psychopathology and cognitive processes. Six databases (PsychINFO, MEDLINE, PubMed, Social Work Abstracts, Technology Collection, and Scopus) were searched in November 2021 for peer-reviewed articles investigating the association between the aforementioned variables among youth up to the age of 25 years. Risk of bias was assessed using the Observational Study Quality Evaluation. FINDINGS Forty-five articles were included in the review. Positive associations were observed between engagement in activities with gambling-like features (e.g., video games, social casino games, loot boxes) and problem gambling. Increased involvement with novel forms of gambling (e.g., online sports betting, fantasy sports, and esports betting) were also associated with a greater risk for problematic gambling. Males reported higher rates of engagement in these activities and a greater risk of problem gambling than females. Impulsivity, risk taking, cognitive distortions, and specific emotional vulnerabilities were associated with an increased risk of problem gambling. CONCLUSIONS Despite the need for additional longitudinal research controlling for relevant confounders, these findings underline how engagement in activities with gambling-like features are relevant in the developmental trajectory toward problem gambling.
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Affiliation(s)
- Jérémie Richard
- Department of Educational and Counselling Psychology, International Centre for Youth Gambling Problems and High-Risk Behaviors, McGill University, Montreal, Quebec, Canada
| | - Serena M King
- Department of Psychology, Hamline University, St. Paul, Minnesota, USA
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The Impact of Adverse Childhood Experiences on Problem Gambling in New Mexico. JOURNAL OF PREVENTION (2022) 2023; 44:309-324. [PMID: 36759431 DOI: 10.1007/s10935-023-00725-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Abstract
The study of Adverse Childhood Experiences (ACEs) has consistently demonstrated a strong relationship with poor behavioral health outcomes. Further research is needed to understand if a specific ACE, or subcategorizations of ACEs, matter more for behavioral health outcomes. A study of the association between ACEs and problem gambling involving a racially mixed sample (13,217 participants) in New Mexico is presented to illustrate how certain ACEs may have a larger impact on behavioral health outcomes. The researchers examined: 1.) the impact that each individual ACE have on participant's reported problem gambling; 2) which group (abuse or household challenges) had a greater odds ratio and marginal impact on participant's self-reported gambling; and 3) which BRFSS subcategories (emotional abuse, physical abuse, sexual abuse, IPV, substance abuse, mental illness, parental separation or divorce, and incarcerated household member) had a greater odds ratio and marginal impact on participant's self-reported gambling. The results of this study indicate ACEs had a significant influence on problem gambling, and data suggests that when BRFSS data is examined in groups or subcategories there is a difference in the influence that ACEs have on problem gambling. In particular, we found that odds ratio to be significant when participants reported mental health problems in the home (OR = 1.34, 95% CI [1.02, 1.76], p < 0.04), living with incarcerated household members (OR = 1.75, 95% CI [1.28, 2.41], p < 0.001), how often adults hit each other (OR = 1.29, 95% CI [1.10, 1.52], p < 0.001), and how often anyone at least 5 years older than them forced them to have sex (OR = 1.42, 95% CI [1.10, 1.82], p < 0.01) In relation to types of abuse, There was a significant difference in self-reported problem gambling for individuals who reported sexual abuse (OR = 1.64, 95% CI [1.10, 2.46], p < 0.016), as well as participants reporting living with an incarcerated household member (OR = 2.08, 95% CI [1.34, 3.22], p < 0.001); approaching significant results also included individuals who witnessed their parents act violent towards one another (OR = 1.52, 95% CI [.99, 2.33], p < 0.055), and having parents who were separated or divorced (OR = 0.68, 95% CI [0.46, 1.00], p < 0.053). Finally, there was a significant difference in self-reported problem gambling for individuals who reported abuse (OR = 1.36, 95% CI [1.11, 1.66], p < 0.003), while participants reporting household challenges did not quite reach statistical significance (OR = 1.49, 95% CI [0.99, 1.33], p < 0.062. These findings show us that the way we ask questions about the precedence and outcomes of risky behavior matter and warrant further attention.
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Richard J, Temcheff C, Fletcher É, Lemieux A, Derevensky J, Déry M. Externalizing and internalizing trajectories to adolescent gambling: a longitudinal study. INTERNATIONAL GAMBLING STUDIES 2022. [DOI: 10.1080/14459795.2022.2154378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Jérémie Richard
- International Centre for Youth Gambling Problems and High-Risk Behaviors, Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Caroline Temcheff
- International Centre for Youth Gambling Problems and High-Risk Behaviors, Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Émilie Fletcher
- International Centre for Youth Gambling Problems and High-Risk Behaviors, Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Annie Lemieux
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Jeffrey Derevensky
- International Centre for Youth Gambling Problems and High-Risk Behaviors, Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Michèle Déry
- Groupe de recherche et d’intervention sur les adaptations sociales de l’enfance, Département de Psychoéducation, Université de Sherbrooke, Sherbrooke, Canada
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Temcheff CE, Martin-Storey A, Lemieux A, Latimer E, Déry M. Trajectories of medical service use among girls and boys with and without early-onset conduct problems. Front Psychiatry 2022; 13:915991. [PMID: 36684010 PMCID: PMC9846218 DOI: 10.3389/fpsyt.2022.915991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 11/21/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Children with conduct problems (CP) have been found to be heavy and costly medical service users in adulthood. However, there is little knowledge on how medical service use develops during childhood and adolescence among youth with and without childhood CP. Knowing whether differences in developmental trajectories of medical service use for specific types of problems (e.g., injuries) are predicted by childhood CP would help clinicians identify developmental periods during which they might intensify interventions for young people with CP in order to prevent later problems and associated increased service use. METHODS Participants were drawn from an ongoing longitudinal study of boys and girls with and without childhood CP as rated by parents and teachers. Medical service use was assessed using administrative data from a public single payer health plan. Latent growth modeling was used to estimate the mean trajectory of four types of medical visits (psychiatric, injury-related, preventative, total visits) across time and evaluate the effect of CP and other covariates. RESULTS Support the hypothesis that early CP predicts higher medical service use at nine years old, and that this difference persists in a chronic manner over time, even when controlling the effects of ADHD and family income. Girls had fewer medical visits for psychiatric reasons than boys at baseline, but this difference diminished over time. CONCLUSIONS Clinicians should be aware that childhood CP already predicts increased medical service use in elementary school. Issues specific to different contexts in which injuries might occur and sex differences are discussed.
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Affiliation(s)
- Caroline E Temcheff
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Alexa Martin-Storey
- Département de psychoéducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Annie Lemieux
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.,Département de psychoéducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Eric Latimer
- Douglas Mental Health University Institute and McGill University, Montreal, QC, Canada
| | - Michèle Déry
- Département de psychoéducation, Université de Sherbrooke, Sherbrooke, QC, Canada
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An Exploration of Intra-individual Mechanisms for the Association Between Childhood Conduct Problems and Early Adolescent Substance Use. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00701-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Baiden P, Jahan N, Onyeaka HK, Thrasher S, Tadeo S, Findley E. Age at first alcohol use and weapon carrying among adolescents: Findings from the 2019 Youth Risk Behavior Survey. SSM Popul Health 2021; 15:100820. [PMID: 34141851 PMCID: PMC8187826 DOI: 10.1016/j.ssmph.2021.100820] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/08/2021] [Accepted: 05/11/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Although studies have investigated the association between alcohol use and violent behaviors such as weapon carrying, few studies have examined the association between age at first alcohol use and weapon-carrying among adolescents. The objective of this study was to investigate the association between age at first alcohol use and weapon carrying among adolescents. METHODS Data for this study came from the 2019 Youth Risk Behavior Survey. An analytic sample of 13,442 adolescents aged 14-18 years old (51% female) was analyzed using binary logistic regression. The outcome variable investigated in this study was weapon carrying during the past 30 days, and the main explanatory variable investigated was age at first alcohol use. RESULTS Of the 13,442 adolescents, 13.5% carried a weapon during the past 30 days, and 15.4% reported having their first alcoholic drink before age 13. In the multivariable logistic regression, adolescents who reported having alcohol before age 13 had more than double the odds of carrying a weapon when compared to those who never had alcohol before age 13 (AOR = 2.32, p < .001, 95% CI = 1.87-2.89). Other significant factors associated with weapon carrying include male gender, victim of bullying, teen dating violence, sexual violence, suicidal ideation, and history of substance use. Adolescents who self-identified as Black/African American or Hispanic were significantly less likely to carry a weapon when compared to adolescents who self-identified as non-Hispanic White. CONCLUSION The findings of this study underscore the importance of developing age appropriate intervention strategies to curb early initiation of alcohol use and weapon carrying among adolescents.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019, USA
| | - Nusrat Jahan
- The University of Texas at Arlington, Department of Psychology, 501 Nedderman Dr., Box 19528, Arlington, TX, 76019, USA
| | - Henry K. Onyeaka
- Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital/McLean Hospital, Boston, MA, 02115, USA
| | - Shawndaya Thrasher
- University of Kentucky, College of Social Work, 619 Patterson Office Tower, Lexington, KY, 40506, USA
| | - Savarra Tadeo
- Florida State University, College of Social Work, 296 Champions Way, University Center, Building C-Suite 2500, Tallahassee, FL, 32306, USA
| | - Erin Findley
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019, USA
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Akçayır M, Nicoll F, Baxter DG, Palmer ZS. Whose Responsibility Is It to Prevent or Reduce Gambling Harm? A Mapping Review of Current Empirical Research. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-020-00459-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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King SM, Whelan JP. Gambling and Alcohol Problems during the College Years: Personality, Physical and Emotional Health and Gambling Beliefs. Issues Ment Health Nurs 2020; 41:1095-1103. [PMID: 32857625 DOI: 10.1080/01612840.2020.1804019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Gambling and alcohol problems commonly co-occur during emerging adulthood. Co-occurring problems may relates to personality factors, physical health, mental health and gambling belief systems. In a large sample of colleges students (N = 513), we examined alcohol, gambling and co-occurring problem groups relative to a group without alcohol or gambling problems from large sample of college students. Group differences were found on Constraint and Negative Emotionality (ps ≤ .05). All three groups had a higher score on gamblers' beliefs of illusion of control compared to the group with no problems (all ps < .05). Those with co-occurring problems had a higher score on illusion of control beliefs than those with alcohol problems only. For luck/perseverance gambling beliefs, those with co-occurring problems had higher levels than other groups on these beliefs. The group with alcohol problems and significantly poorer mental health outcomes than those without alcohol or gambling problems. Individuals with gambling problems or alcohol problems only had significantly poorer self-rated overall physical health (p < .01). Differences were found between groups (alcohol, gambling, alcohol + gambling and neither) on self-rated energy and fatigue as well as pain (ps < .05). Gambling and alcohol problems may relate to emotional and health problems, and personality and belief systems may be related to the co-occurrence of gambling and alcohol problems.
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Affiliation(s)
- Serena M King
- Department of Psychology, Hamline University, Psychology, Saint Paul, Minneapolis, Minnesota, USA
| | - James P Whelan
- Department of Psychology, Hamline University, Psychology, Saint Paul, Minneapolis, Minnesota, USA
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Fletcher É, Richard J, Derevensky J, Ivoska W, Temcheff C. Nonmedical Benzodiazepine Use in Adolescents: Indirect Effects of Internalizing and Externalizing Symptoms. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00233-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Sharman S, Butler K, Roberts A. Psychosocial risk factors in disordered gambling: A descriptive systematic overview of vulnerable populations. Addict Behav 2019; 99:106071. [PMID: 31473572 DOI: 10.1016/j.addbeh.2019.106071] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Gambling is a behaviour engaged in by millions of people worldwide; for some, gambling can become a severely maladaptive behaviour, and previous research has identified a wide range of psychosocial risk factors that can be considered important for the development and maintenance of disordered gambling. Although risk factors have been identified, the homogeneity of risk factors across specific groups thought to be vulnerable to disordered gambling is to date, unexplored. METHODS To address this, the current review sought to conduct a systematic overview of literature relating to seven vulnerable groups: young people and adolescents, older adults, women, veterans, indigenous peoples, prisoners, and low socio-economic/income groups. RESULTS Multiple risk factors associated with disordered gambling were identified; some appeared consistently across most groups, including being male, co-morbid mental and physical health conditions, substance use disorders, accessibility and availability of gambling, form and mode of gambling, and experience of trauma. Further risk factors were identified that were specific to each vulnerable group. CONCLUSION Within the general population, certain groups are more vulnerable to disordered gambling. Although some risk factors are consistent across groups, some risk factors appear to be group specific. It is clear that there is no homogenous pathway in to disordered gambling, and that social, developmental, environmental and demographic characteristics can all interact to influence an individual's relationship with gambling.
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Affiliation(s)
- Steve Sharman
- University of East London School of Psychology, University of East London, Water Lane, Stratford, London E15 4LZ, United Kingdom.
| | - Kevin Butler
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, United Kingdom.
| | - Amanda Roberts
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, United Kingdom.
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Werner KB, Cunningham-Williams RM, Ahuja M, Bucholz KK. Patterns of gambling and substance use initiation in African American and White adolescents and young adults. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 34:382-391. [PMID: 31750700 DOI: 10.1037/adb0000531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The focus of the current investigation is to examine the temporal relationship of gambling onset and alcohol, tobacco, and cannabis initiation in adolescents and young adults (M age = 20.3 years) by examining the prevalence and pattern of onset for each substance and gambling pairing and the associated risk between gambling and each substance use. Data were drawn from the multiwave Missouri Family Study (n = 1,349) of African American (AA; n = 450) and White families (n = 317) enriched for risk for alcohol use disorder and includes those who were assessed for gambling behaviors and problems: AA (360 males, 390 females) and White (287 males, 312 females). Findings indicated racial differences in the overall prevalence of gambling behaviors and substance use as well as patterns of initiation-particularly within gambling/alcohol and gambling/tobacco for males. Survival models revealed some similarities as well as differences across race and gender groups in associations of gambling with initiation of substances, as well as substances with initiation of gambling. Alcohol use (AA males only) and cannabis use (AA males and White females) elevated the hazards of initiating gambling. In contrast, gambling significantly elevated the hazards of initiation alcohol across 3 of 4 groups and of cannabis use in AA males only. The results highlight some overlapping as well as distinct risk factors for both gambling and substance use initiation in this cohort enriched for vulnerability to alcohol use disorder (AUD). These findings have implications for integrating gambling prevention into existing substance use prevention and intervention efforts-particularly but not exclusively for young AA males. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | - Manik Ahuja
- Department of Health Services Management and Policy
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Investigating the association between age at first alcohol use and suicidal ideation among high school students: Evidence from the youth risk behavior surveillance system. J Affect Disord 2019; 242:60-67. [PMID: 30172226 DOI: 10.1016/j.jad.2018.08.078] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although various studies have investigated and found a significant link between age at first alcohol use and health risk behaviors, few studies have investigated the effect of age at first alcohol use on suicidal ideation among adolescents. The objective of this study was to investigate the effect of age at first alcohol use on suicidal ideation. METHODS Data for this study were obtained from the 2015 Youth Risk Behavior Surveillance system. A sample of 10,745 adolescents aged 14-18 years (50.9% males) were analyzed using logistic regression with suicidal ideation as the outcome variable and age at first alcohol use as the main explanatory variable. RESULTS About 17% of adolescents experienced suicidal ideation during the past 12 months and 15.6% started having alcohol before age 13. Adolescents who started having alcohol before age 13 had 1.60 times higher odds of experiencing suicidal ideation and adolescents who started having alcohol by age 13 or over had 1.47 times higher odds of experiencing suicidal ideation. Other significant factors associated with suicidal ideation include experience of forced sex, physical teen dating violence, bullying, and feeling sad or hopeless. Having sufficient sleep lowered the odds of suicidal ideation. LIMITATIONS The use of cross-sectional data limits the extent to which we can make causal claims regarding age at first alcohol use and suicidal ideation. CONCLUSIONS Younger age at first alcohol use was associated with increased likelihood of suicidal ideation. Public health initiatives that seek to address the co-occurring problems of alcohol use and mental health illness, sexual violence, and victimization among sexual minority youth could help in reducing suicidal ideation.
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Lange SM. Editorial Perspective: Based on current evidence, should mental health clinicians assess children for substance use initiation and substance use disorders? Child Adolesc Ment Health 2018; 23:384-386. [PMID: 32677142 DOI: 10.1111/camh.12275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2018] [Indexed: 11/30/2022]
Abstract
This perspective summarizes weaknesses in our understanding of childhood use of alcohol and other drugs, providing recommendations for future research directions and clinical practice.
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Sylvestre MP, Wellman RJ, O'Loughlin EK, Dugas EN, O'Loughlin J. Gender differences in risk factors for cigarette smoking initiation in childhood. Addict Behav 2017; 72:144-150. [PMID: 28399489 DOI: 10.1016/j.addbeh.2017.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 03/09/2017] [Accepted: 04/01/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION We investigated whether established risk factors for initiating cigarette smoking during adolescence (parents, siblings, friends smoke; home smoking rules, smokers at home, exposure to smoking in cars, academic performance, susceptibility to smoking, depressive symptoms, self-esteem, school connectedness, use of other tobacco products) are associated with initiation in preadolescents, and whether the effects of these factors differ by gender. METHODS In spring 2005, baseline data were collected in self-report questionnaires from 1801 5th grade students including 1553 never-smokers (mean age=10.7years), in the longitudinal AdoQuest I Study in Montréal, Canada. Follow-up data were collected in the fall and spring of 6th grade (2005-2006). Poisson regression analyses with robust variance estimated the effects of each risk factor on initiation and additive interactions with gender were computed to assess the excess risk of each risk factor in girls compared to boys. RESULTS 101 of 1399 participants in the analytic sample (6.7% of boys; 7.7% of girls) initiated smoking during follow-up. After adjustment for age, gender and maternal education, all risk factors except academic performance and school connectedness were statistically significantly associated with initiation. Paternal and sibling smoking were associated with initiation in girls only, and girls with lower self-esteem had a significant excess risk of initiating smoking in 6th grade. CONCLUSIONS Risk factors for smoking initiation in preadolescents mirror those in adolescents; their effects do not differ markedly by gender. Preventive programs targeting children should focus on reducing smoking in the social environment and the dangers of poly-tobacco use.
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Affiliation(s)
- Marie-Pierre Sylvestre
- University of Montréal, Montréal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | | | | | - Erika N Dugas
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Jennifer O'Loughlin
- University of Montréal, Montréal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada; Institut National de Santé Publique du Québec, Montréal, QC, Canada.
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