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Liu J, McCauley D, Gaiha SM, Halpern-Felsher B. Perceptions of Harm and Addictiveness for Nicotine Products, THC e-Cigarettes, and e-Cigarettes with Other Ingredients Among Adolescents, Young Adults, and Adults. Subst Use Misuse 2024:1-11. [PMID: 39289177 DOI: 10.1080/10826084.2024.2403105] [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] [Indexed: 09/19/2024]
Abstract
BACKGROUND Perceptions of health harms and addictiveness related to nicotine products, THC e-cigarettes, and e-cigarettes with other ingredients are an important predictor of use. This study examined differences in perceived harm and addiction across such products among adolescents, young adults, and adults. METHODS We conducted a cross-sectional survey (N = 6,131, ages 13-40 years old) in which participants reported perceived harm and addictiveness for 11 products (cigarettes, disposable nicotine e-cigarettes, pod-based nicotine e-cigarettes, other nicotine e-cigarettes, THC e-cigarettes, e-cigarettes with other ingredients, nicotine pouches, nicotine lozenges, nicotine gums, nicotine tablets, nicotine toothpicks). We applied adjusted regression models and conducted pairwise comparisons between age groups (13-17, 18-20, 21-25, and 26-40) and product use status (never, ever, and past-30-day use), adjusting for gender, race/ethnicity, sexual orientation, and financial comfort. RESULTS Overall, participants in younger age groups perceived products to be more harmful and addictive than those in older age groups, with the exception of e-cigarettes with other ingredients. For all products, participants who never used perceived each product to be more harmful than those who ever used. For all products, participants who used the products in the past 30-days had lower perceived harm and addictiveness compared to never and ever use. Certain sociodemographic groups, such as people who identify as LGBTQ+, Non-Hispanic Black, or Hispanic, had lower perceived harm and addictiveness for most products. DISCUSSION Efforts should be made to educate all age groups and minoritized groups on harms and addictiveness of all nicotine products, THC e-cigarettes, and e-cigarettes with other ingredients.
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Affiliation(s)
- Jessica Liu
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Devin McCauley
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Shivani Mathur Gaiha
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Bonnie Halpern-Felsher
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, California, USA
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Habib DRS, Kady A. Applying Social Network Theory to Vaping in High School: Implications for Person-Centered Intervention. Subst Use Misuse 2024; 59:1667-1671. [PMID: 38946129 DOI: 10.1080/10826084.2024.2359714] [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] [Indexed: 07/02/2024]
Abstract
BACKGROUND Peer influence on risky behavior is particularly potent in adolescence and varies by gender. Smoking prevention programs focused on peer-group leaders have shown great promise, and a social influence model has proven effective in understanding adult smoking networks but has not been applied to adolescent vaping until 2023. This work aims to apply a social influence model to analyze vaping by gender in a high school network. METHODS A high school's student body was emailed an online survey asking for gender, age, grade level, vape status, and the names of three friends. Custom Java and MATLAB scripts were written to create a directed graph, compute centrality measures, and perform Fisher's exact tests to compare centrality measures by demographic variables and vape status. RESULTS Of 192 students in the school, 102 students responded. Students who vape were in closer-knit friend groups than students who do not vape (p < .05). Compared to males who vape, females who vape had more social ties to other students who vape, exhibiting greater homophily (p < .01). Compared to females who do not vape, females who vape were in closer-knit friend groups (p < .05) and had more ties to other students who vape (p < .01). CONCLUSION Differences in vaping by social connectedness and gender necessitate school and state policies incorporating the social aspect of vaping in public health initiatives. Large-scale research should determine if trends can be generalized across student bodies, and more granular studies should investigate differences in motivations and social influence by demographic variables to individualize cessation strategies.
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Affiliation(s)
| | - Annabel Kady
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA
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3
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Borm FJ, Cohen S, Milani GP, de Winter P, Cohen D. I will prevent disease whenever I can, for prevention is preferable to cure: doctors' role in the vaping epidemic. Eur J Pediatr 2024:10.1007/s00431-024-05548-w. [PMID: 38615128 DOI: 10.1007/s00431-024-05548-w] [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: 04/15/2024]
Affiliation(s)
- Frank J Borm
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sophie Cohen
- Department of Pediatrics, University Medical Center of Utrecht, Utrecht, The Netherlands
| | - Gregorio P Milani
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Peter de Winter
- Department of Pediatrics, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Child and Youth Institute, KU Leuven, Leuven, Belgium
| | - Danielle Cohen
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
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Beeres DT, Pulkki-Brännström AM, Nilsson M, Galanti MR. Child-Adult Contract for Prevention of Tobacco Use: "As-Treated" Analysis of a Cluster Randomized Controlled Trial (the TOPAS Study) at 3-Year Follow-Up. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:175-192. [PMID: 37875648 PMCID: PMC10830650 DOI: 10.1007/s11121-023-01598-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/26/2023]
Abstract
To estimate the effect of a 3-year commitment to remain tobacco free on tobacco uptake among high school students in Sweden. The commitment is developed in the form of a contract between a child and a significant adult, constituting the core component of Tobacco-free Duo (T-Duo), a Swedish school-based tobacco prevention program. Secondary analysis of data from a cluster randomized controlled trial. Participants were 586 students in high schools assigned to the intervention arm of T-Duo. At inception, participants attended grade 7 (i.e., age 12-13). Only students who were tobacco naïve at baseline for the respective outcome and participated in all follow-ups were included. The exposure was defined as signing a 3-year contract with a significant adult, categorized as "stable contract" (3 years contract with the same contract partner), "unstable" (signed a contract sometime during follow-up but this was not sustained over time and/or with the same partner), and "no contract" at all during the intervention period. The primary outcome was having never tried cigarette smoking at the end of grade 9. Exposure and outcomes were self-reported in yearly questionnaires. Of 586 students, 321 (55%) held a stable contract, 204 (35%) an unstable contract, and 61 (10%) did not sign a contract at all. At the end of grade 9 (age 15-16), the relative risk (RR) to remain cigarette free was 1.11 (95% CI 1.00-1.22) (Number Needed to Treat = 10) among students in any type of contract compared to students that did not write a contract at all. The RRs for remaining tobacco free (secondary outcomes) ranged from 1.07 (0.98-1.16) for regular snus use to 1.16 (1.00-1.35) for any type of tobacco use. A commitment to remain tobacco free through a child-adult contract seems to exert a preventive effect on the uptake of tobacco use among Swedish adolescents over 3 school years. The current findings apply to a selected sample of both schools and students. Registration: Current Controlled Trials ISRCTN52858080 Date: January 4, 2019, retrospectively registered.
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Affiliation(s)
- Dorien Tecla Beeres
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 17177, Stockholm, Sweden.
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
| | | | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Maria Rosaria Galanti
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 17177, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
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Bataineh BS, Wilkinson AV, Sumbe A, Clendennen SL, Chen B, Messiah SE, Harrell MB. Anxiety as a predictor of the age of initiation of tobacco and cannabis use in adolescents and young adults. Addict Behav 2024; 148:107876. [PMID: 37804749 DOI: 10.1016/j.addbeh.2023.107876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Previous research has shown important links between anxiety and the use of tobacco and cannabis. However, it remains unclear whether anxiety leads youth to start using tobacco and cannabis at an earlier age. METHODS Data were drawn from Texas Adolescent Tobacco and Marketing Surveillance System for the years 2019-2021(Waves 9-14). Participants were in 10th-grade, 12th-grade, and two years post-high school at baseline. The outcomes were the age of first use of cigarettes, e-cigarettes, and cannabis. Interval-censoring Cox proportional hazards models were fit to examine the differences in the estimated age of initiation of tobacco and cannabis use by anxiety. RESULTS Among the 10th-grade cohort, participants with anxiety had an increased risk of an earlier age of cigarette [AHR = 2.29(1.63-3.23)], e-cigarette [AHR = 1.53(1.17-2.00)], and cannabis [AHR = 1.59(1.23-2.05)] initiation. Among the 12th-grade cohort, participants with anxiety had an increased risk of an earlier age of cigarette [AHR = 1.52(1.21-1.90), e-cigarette [1.25(1.01-1.60)] and cannabis [AHR = 1.35(1.09-1.67] initiation. Among the post-high school cohort, the only significant association found was for cannabis initiation [AHR = 1.33(1.11-1.58). Between ages 18-to-19 years in the 10th-grade cohort, and between ages 20-21 years in the 12th-grade cohort, cumulative incidence of each of the three outcomes initiation doubled among anxious youth. CONCLUSIONS This study's findings show that anxiety symptoms can increase the risk of substance use initiation at an earlier age, especially among the youngest adolescent cohort (∼15-to-16-year-olds). These findings highlight the importance of early screening and treatment of anxiety symptoms as a preventive measure to delay or prevent the onset of substance use initiation.
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Affiliation(s)
- Bara S Bataineh
- University of Texas Health Science Center at Houston, School of Public Health, Dallas, TX, USA.
| | - Anna V Wilkinson
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA
| | - Aslesha Sumbe
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA
| | - Stephanie L Clendennen
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA
| | - Baojiang Chen
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA
| | - Sarah E Messiah
- University of Texas Health Science Center at Houston, School of Public Health, Dallas, TX, USA; Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX, USA; Department of Pediatrics, McGovern Medical School, Houston, TX USA
| | - Melissa B Harrell
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA
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MOUTAWAKKIL SG, EL-AMMARI A, EL MALKI H, RAGALA MEA, EL RHAZI K, ZARROUQ B. Prevalence of Tobacco Products' Use and Associated Factors Among Adolescents in Morocco: A Systematic Review. SUBSTANCE USE : RESEARCH AND TREATMENT 2024; 18:29768357241272370. [PMID: 39175911 PMCID: PMC11339743 DOI: 10.1177/29768357241272370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 07/11/2024] [Indexed: 08/24/2024]
Abstract
Introduction Tobacco use is the major preventable cause of premature death worldwide, responsible for about 8 million deaths per year, mostly in low- and middle-income countries, such as Morocco. Adolescents' tobacco use is a matter of concern, because early initiation increases the risk of becoming a lifelong user. There exists a notable gap in the synthesis of evidence concerning tobacco use among Moroccan adolescents. Thus, the purpose of this study was to provide a comprehensive view of the prevalence of tobacco products' use and associated factors among adolescents in Morocco. Methods We systematically searched PubMed, Scopus, Web of Science and ScienceDirect for relevant studies reporting prevalence rates of tobacco products' use among Moroccan adolescents, published until June 2024, using inclusion and exclusion criteria in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Additional searches were completed on other sources to reach unpublished reports. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the quality of included studies. Results After the final screening, 22 papers met the inclusion criteria. Life-time prevalence of tobacco use ranged from 7.8% to 20.4% for cigarettes smoking, from 10.6% to 21.9% for waterpipe, from 7.9% to 9.1% for chewing tobacco and from 9.2% to 12.4% for snuff. The last 12-month prevalence of cigarette smoking was comprised between 6.9% and 10.8%. As for the prevalence of current use, ranges of (1.8%-16.4%) and (4.9%-8.4%) were noted for cigarettes and waterpipe, respectively. The most commonly highlighted risk factors for tobacco use included male sex, older age, having friends or family members who use tobacco and low perception of risk associated with tobacco use. Conclusion Our findings reveal an alarming situation of tobacco use among Moroccan adolescents. Therefore, it is crucial that all stakeholders engage in concerted efforts to develop and implement evidence-based preventive interventions among early adolescents.
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Affiliation(s)
- Salma Ghofrane MOUTAWAKKIL
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Abdelfettah EL-AMMARI
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Hicham EL MALKI
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Mohammed El Amine RAGALA
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohammed Ben Abdallah University, Fez, Morocco
- Department of Biology and Geology, Teacher’s Training College (Ecole Normale Supérieure), Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Karima EL RHAZI
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohammed Ben Abdallah University, Fez, Morocco
| | - Btissame ZARROUQ
- Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine, Pharmacy, and Dental Medicine, Sidi Mohammed Ben Abdallah University, Fez, Morocco
- Department of Biology and Geology, Teacher’s Training College (Ecole Normale Supérieure), Sidi Mohammed Ben Abdallah University, Fez, Morocco
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Ba-Break M, Bewick B, Huss R, Ensor T, Abahussin A, Alhakimi H, Elsey H. Systematic review of intervention functions, theoretical constructs and cultural adaptations of school-based smoking prevention interventions in low-income and middle-income countries. BMJ Open 2023; 13:e066613. [PMID: 36787979 PMCID: PMC9930567 DOI: 10.1136/bmjopen-2022-066613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 01/09/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE To identify the approaches and strategies used for ensuring cultural appropriateness, intervention functions and theoretical constructs of the effective and ineffective school-based smoking prevention interventions that were implemented in low-income and middle-income countries (LMICs). DATA SOURCES Included MEDLINE, EMBASE, Global Health, PsycINFO, Web of Science and grey literature which were searched through August 2022 with no date limitations. ELIGIBILITY CRITERIA We included randomised controlled trials (RCTs) with ≥6 months follow-up assessing the effect of school-based interventions on keeping pupils never-smokers in LMICs; published in English or Arabic. DATA EXTRACTION AND SYNTHESIS Intervention data were coded according to the Theoretical Domains Framework, intervention functions of Behaviour Change Wheel and cultural appropriateness features. Using narrative synthesis we identified which cultural-adaptation features, theoretical constructs and intervention functions were associated with effectiveness. Findings were mapped against the capability-motivation and opportunity model to formulate the conclusion. Risk of bias was assessed using the Cochrane risk of bias tool. RESULTS We identified 11 RCTs (n=7712 never-smokers aged 11-15); of which five arms were effective and eight (four of the effective) arms had a low risk of bias in all criteria. Methodological heterogeneity in defining, measuring, assessing and presenting outcomes prohibited quantitative data synthesis. We identified nine components that characterised interventions that were effective in preventing pupils from smoking uptake. These include deep cultural adaptation; raising awareness of various smoking consequences; improving refusal skills of smoking offers and using never-smokers as role models and peer educators. CONCLUSION Interventions that had used deep cultural adaptation which incorporated cultural, environmental, psychological and social factors, were more likely to be effective. Effective interventions considered improving pupils' psychological capability to remain never-smokers and reducing their social and physical opportunities and reflective and automatic motivations to smoke. Future trials should use standardised measurements of smoking to allow meta-analysis in future reviews.
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Affiliation(s)
- Maryam Ba-Break
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Bridgette Bewick
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Tim Ensor
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Asma Abahussin
- Department of Biomedical Technology, King Saud University, Riyadh, Saudi Arabia
| | - Hamdi Alhakimi
- Head of MedGebra Centre for Research Consultations, Epidemiologist and Community Medicine Specialist, MedGebra Centre for Research Consultations, Utrecht, The Netherlands
| | - Helen Elsey
- Health Sciences, University of York, York, UK
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Bringing Treatment to the Patients: Community-Based Tobacco-Dependence Treatment and Interventions. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_10] [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: 03/04/2023]
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Liu J, Gaiha SM, Halpern-Felsher B. School-based programs to prevent adolescent e-cigarette use: A report card. Curr Probl Pediatr Adolesc Health Care 2022; 52:101204. [PMID: 35534403 PMCID: PMC9296568 DOI: 10.1016/j.cppeds.2022.101204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Given high rates and known health consequences of adolescent e-cigarette use as well as adolescents' susceptibility to nicotine addiction, school-based efforts to prevent and reduce adolescent e-cigarette use should continue to be developed, implemented, disseminated, and evaluated. This paper elaborates on best practices for developing and implementing prevention programs, including the importance of grounding programs in theories and frameworks that empower adolescents, including normative and interactive education, and having programs that are easily accessible and free of cost. Programs should also address key factors driving adolescent e-cigarette use, including discussing misperceptions, flavors, nicotine content, addiction, and the role that marketing plays in appealing to adolescents. The paper also discusses the gap areas of currently available prevention programs and highlights the need for evidence-based approaches and the importance of rigorous evaluation of programs.
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Affiliation(s)
- Jessica Liu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, United States
| | - Shivani Mathur Gaiha
- Stanford Reach Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford Research Park, 3145 Porter Drive, Wing A, Room A104, MC 5395, Palo Alto, CA 94304, United States
| | - Bonnie Halpern-Felsher
- Stanford Reach Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford Research Park, 3145 Porter Drive, Wing A, Room A104, MC 5395, Palo Alto, CA 94304, United States.
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Duan Z, Wang Y, Weaver SR, Spears CA, Zheng P, Self-Brown SR, Eriksen MP, Huang J. Effect modification of legalizing recreational cannabis use on the association between e-cigarette use and future cannabis use among US adolescents. Drug Alcohol Depend 2022; 233:109260. [PMID: 35152099 PMCID: PMC8957562 DOI: 10.1016/j.drugalcdep.2021.109260] [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: 08/05/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many states have legalized recreational cannabis use for adults. However, no study has examined how this policy may interact with youth vaping to influence cannabis use among US adolescents. This study investigates whether the association between baseline e-cigarette use and subsequent cannabis use differs by state recreational cannabis legalization status. METHODS This study analyzed data from the first four waves (2013-2018) of the Population Assessment of Tobacco and Health Study, a nationally representative longitudinal survey. The study sample included adolescents (aged 12-17) who reported never used cannabis at baseline. Generalized estimating equations were used to analyze the effect modification of state recreational cannabis law on the association between baseline e-cigarette use and cannabis use at 12-month follow-up, controlling for individual characteristics. RESULTS Among adolescents who have never used cannabis at baseline, baseline past-30-day e-cigarette use was significantly associated with past-30-day cannabis use at 12-month follow-up (aOR=5.92, 95% CI: 3.52-9.95). This association was different by state recreational cannabis legalization status, as indicated by the significant interaction term. Subgroup analysis showed that the aOR was 18.39 (95% CI: 4.25-79.68) for adolescents living in states that legalized adult recreational cannabis use and 5.09 (95% CI: 2.86-9.07) for adolescents living in states without such laws. CONCLUSIONS E-cigarette use is associated with cannabis initiation among youth. This association is stronger among those living in states that legalized adult recreational cannabis use. Further examination of the impact of e-cigarette use on cannabis initiation in relation to state cannabis laws is warranted.
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Affiliation(s)
- Zongshuan Duan
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Yu Wang
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Scott R. Weaver
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Claire A. Spears
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Pinpin Zheng
- School of Public Health, Fudan University, Shanghai 200433, China
| | | | - Michael P. Eriksen
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA.
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Göçmen A, Derin N, Metin A, Kariper IA. PROJECT STAR (Midwestern Prevention Project): Overview. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:1361-1375. [PMID: 34599833 DOI: 10.1002/jcop.22720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Abstract
The program designed to prevent substance use should be planned in multiple dimensions. One of these programs is Project Star. This study aims to evaluate the studies on the Project Star and identify the strengths and weaknesses of the program. For this purpose, the keywords "Project Star" and "Midwestern Prevention Project" were scanned from databases. The results of these studies were evaluated by giving a summary of the studies included in the study. As a result, the strengths of Project Star are that it is multidimensional, focuses on early development periods, includes the individual's ecological environment, and reduces substance use in later development periods, and not having an internet-based version. This situation has been identified as its weaknesses since its situation in other societies is unknown due to its cost and limited international applications.
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Affiliation(s)
- Aliye Göçmen
- Department of Science Education, Education Faculty, Erciyes University, Kayseri, Turkey
| | - Nur Derin
- Department of Science Education, Education Faculty, Erciyes University, Kayseri, Turkey
| | - Ahmet Metin
- Department of Science Education, Education Faculty, Erciyes University, Kayseri, Turkey
| | - I Afşin Kariper
- Department of Science Education, Education Faculty, Erciyes University, Kayseri, Turkey
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James PB, Kassim SA, Kabba JA, Kitchen C. Tobacco Use among School-Going Adolescents in Comoros: A Secondary Analysis of the 2015 Comoros Global Youth Tobacco Survey. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7134340. [PMID: 35299893 PMCID: PMC8923772 DOI: 10.1155/2022/7134340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/24/2022] [Indexed: 11/17/2022]
Abstract
Background Tobacco use among adolescents has long-term adverse health consequences, especially during adulthood. Currently, little is known about tobacco use behaviour among adolescents in Comoros. Our study aims at estimating the prevalence and identifying key factors associated with tobacco use among adolescents in Comoros using the 2015 Comoros Global Youth Tobacco Survey data. Methods A national cross-sectional survey secondary data of 2,810 eligible school-going adolescents aged between 11 and 17 years was analysed. Complex sample logistic regression analyses were used to determine the correlates of current cigarette smoking and current use of noncigarette tobacco products. Results The overall prevalence of current cigarette smoking was 14.3% [males (18.5%) and females (9.9%)]. The prevalence of current use of noncigarette tobacco products was 5.8% [males (6.7%) and females (4.9%)]. Being male (AOR = 2.24; 95% CI:1.39-3.63), exposure to secondhand smoke inside (AOR =3.88; 95% CI:2.84-5.31) and outside (AOR =1.49; 95% CI: 1.08-2.03) their home, and exposure to tobacco industry promotion (AOR =2.90; 95% CI:2.21-3.80) were associated with current cigarette use among school-going adolescents. However, parental smoke (AOR = 1.20; 95% CI:0.78-1.87) and not exposed to antismoking education in schools (AOR = 0.97; 95% CI:0.76-1.22) were not associated with current cigarette use. On the other hand, being male (AOR = 1.24; 95% CI:0.82-1.86) was not associated with the current use of noncigarette tobacco products. Adolescents who were exposed to tobacco industry promotion (AOR = .2.58; 95% CI:1.54-4.32) and not exposed to antismoking education in school (AOR = 0.52; 95% CI:0.32-0.85) were more and less likely associated with noncigarette tobacco use. Conclusion One in seven school-going adolescents smokes cigarettes, and approximately one in 20 school-going adolescents uses noncigarette tobacco products in Comoros. Exposure to secondhand smoke within and outside the home and exposure to tobacco industry promotion were associated with tobacco use in school-going adolescents in Comoros. Our findings suggest the need for adolescent-friendly gender-sensitive tobacco interventions, including strengthening existing tobacco control laws to prevent and reduce tobacco use among school-going adolescents in Comoros.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, New South Wales 2480, Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Said Abasse Kassim
- Département de Management, Centre de Recherche en Gestion Des Services de Sante, Faculté Des Sciences de l'administration (FSA), Université Laval (UL), Centre Hospitalière Universitaire (CHU) de Québec, Québec, Canada G1V 0A6
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an 710061, China
| | - Chenai Kitchen
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an 710061, China
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13
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Yang S, Geller A, Baciu A, Akman A, Aune M, Bailey R, Breau J, Cal E, Ching MM, Demissie E, Doyle A, Earland D, Edmonds C, Elobuike N, Forrester G, Fox H, Frank I, Gilliam G, Grover LS, Harmanli A, Hill C, Jenkins LB, Khayrullina G, King C, Lala LV, Mandeville EM, Martin N, Miles P, Murray A, Oguh C, Pham E, Putnam T, Rashad M, Shaffer E, Spencer MT, Szulanczyk B, Taormina E, Teigen E, Thomas T, Thomas A, Vilmenay K. Sixth Annual DC Public Health Case Challenge - Reducing Disparities in Cancer and Chronic Disease: Preventing Tobacco Use in African American Adolescents. NAM Perspect 2022; 2022:202202b. [PMID: 35402856 PMCID: PMC8970227 DOI: 10.31478/202202b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
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Bold K, Kong G, Cavallo D, Davis D, Jackson A, Krishnan-Sarin S. School-based E-cigarette cessation programs: What do youth want? Addict Behav 2022; 125:107167. [PMID: 34753093 PMCID: PMC8629945 DOI: 10.1016/j.addbeh.2021.107167] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE E-cigarette use is a problem among youth, yet few vaping cessation programs exist. This study aimed to understand what youth want in a school-based vaping cessation program to inform intervention development. METHODS We conducted 8 focus groups in Fall 2019 with Connecticut high school youth (N = 4-10 adolescents per group, total N = 62, 50% female). 6 groups were with youth who were current (i.e., past-month) e-cigarette users and 2 groups were with past users (i.e., lifetime users with no past-month use). Discussions focused on desired features and concerns about a vaping cessation program and analyses used an iterative inductive and deductive approach to identify qualitative themes. We also collected brief survey data assessing skills youth wanted to learn from a vaping cessation program. RESULTS Qualitative themes emerged indicating that youth want a vaping cessation program to include education about health effects of vaping, relatable personal anecdotes from others, and rewards for quitting. Potential concerns include confidentiality (e.g., ensuring teachers/coaches would not know about e-cigarette use), perceptions that youth may not want to participate due to lack of interest/apathy or embarrassment, and needing methods to verify abstinence to limit inaccurate reporting. The most frequently endorsed skills from the survey indicated youth want to learn ways to deal with stress (92%), relax (60%), and deal with poor concentration/attention (55%). CONCLUSIONS Findings identified key features to include and issues to address when developing school-based vaping cessation programs. Developing effective vaping cessation programs that appeal to youth is important for addressing youth e-cigarette use.
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Affiliation(s)
- Krysten Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Dana Cavallo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Danielle Davis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Asti Jackson
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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Sakthivel P, Shankar A, Ish P, Malhotra N, Kunal S. "A to Z"s of tobacco control and cessation. Oral Oncol 2022; 125:105708. [PMID: 34996716 DOI: 10.1016/j.oraloncology.2021.105708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 12/29/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Pirabu Sakthivel
- Department of Otorhinolaryngology and Head-Neck Surgery, KMCH Institute of Health Sciences and Research, Coimbatore 641014, India.
| | - Abhishek Shankar
- Department of Radiation Oncology, All India Institute of Medical Sciences, Patna, India
| | - Pranav Ish
- Department of Pulmonary Medicine, Safdurjung Hospital, New Delhi, India
| | - Nipun Malhotra
- Department of Pulmonary Medicine, Safdurjung Hospital, New Delhi, India
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Gaiha SM, Zorrilla M, Sachnoff I, Smuin S, Lazaro A, Ceballos RD, Razo A, Halpern-Felsher B. Development and Reach of the Stanford Tobacco Prevention Toolkit: Implementation of a Community-Based Participatory Approach. THE JOURNAL OF SCHOOL HEALTH 2021; 91:813-824. [PMID: 34426975 DOI: 10.1111/josh.13074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 12/28/2020] [Accepted: 01/18/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND We developed the Tobacco Prevention Toolkit (Toolkit) to enhance the impact of school-based tobacco education. This study describes the process of developing the Toolkit, its contents, and reach. METHODS Qualitative community-based participatory research (CBPR), including focus group discussions (N = 152) and working groups with parents, educators, researchers, and youth (N = 87) were used to develop the Toolkit and design its implementation. Toolkit reach was assessed through number of trained educators using the Toolkit, estimated number of youth recipients of the Toolkit resources, and using Google Analytics for online engagement. RESULTS The Toolkit is a free, online resource aimed at preventing tobacco use by middle and high school students. Toolkit content addresses varied forms of tobacco including electronic cigarettes, hookah, smokeless tobacco, and cigarettes; addiction; and positive youth development; and is available in multiple interactive formats such as real-time quizzes, factsheets, activities, and presentations. The Toolkit is mainly delivered by trained educators, who adapt its content and duration to tailor their drug prevention teaching to student needs. As of April 2020, when data for this paper were collected, 4,750 educators have reached an estimated 1.3 million youth. The Toolkit website has 186,116 users and 802,602 page views, growing steadily since 2016. As of August 2021, additional students have been reached, for now a total of 1.85 million students reached. CONCLUSION The Toolkit resources are evidence-based, comprehensive, responsive, interactive, easily accessible, and flexible. Applying CBPR was instrumental in developing the Toolkit and expanding its reach.
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Affiliation(s)
- Shivani Mathur Gaiha
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, 94304, USA
| | - Marcia Zorrilla
- Positive Youth Development, Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, 770 Welch Road, Suite 100, Stanford University, Palo Alto, CA, 94304, USA
| | - Ira Sachnoff
- Tobacco Prevention Toolkit, Consultant to the Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, 770 Welch Road, Suite 100, Stanford University, Palo Alto, CA, 94304, USA
| | - Stephen Smuin
- Tobacco Prevention Toolkit, Consultant to the Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, 770 Welch Road, Suite 100, Stanford University, Palo Alto, CA, 94304, USA
| | - Adrienne Lazaro
- Tobacco Prevention Toolkit, Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, 770 Welch Road, Suite 100, Stanford University, Palo Alto, CA, 94304, USA
| | - Richard Daniel Ceballos
- Tobacco Prevention Toolkit, Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, 770 Welch Road, Suite 100, Stanford University, Palo Alto, CA, 94304, USA
| | - Anabel Razo
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, 770 Welch Road, Suite 100, Stanford University, Palo Alto, CA, 94304, USA
| | - Bonnie Halpern-Felsher
- Tobacco Prevention Toolkit, Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, 770 Welch Road, Suite 100, Stanford University, Palo Alto, CA, 94304, USA
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Bataineh BS, Wilkinson AV, Case KR, Clendennen SL, Sumbe A, Chen B, Harrell MB. Emotional symptoms and sensation seeking: Implications for tobacco interventions for youth and young adults. Tob Prev Cessat 2021; 7:37. [PMID: 34046534 PMCID: PMC8138947 DOI: 10.18332/tpc/133571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/09/2021] [Accepted: 02/21/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Although emotional symptoms and sensation seeking are recognized as important risk factors for tobacco use among youth and young adults, to date, their joint influence on tobacco use has not been examined. METHODS Data used in this study are from the Texas Adolescent Tobacco and Marketing Surveillance study, a population-based cohort. At baseline, in 2014, participants were in the 10th grade. Mixed-effects logistic regression models examined associations between emotional symptoms and sensation seeking in 2014 and odds of past 30-day cigarette and e-cigarette use in 2018. Interactions between emotional symptoms and sensation seeking were examined to assess whether one modifies the effect of the other on cigarette and e-cigarette use. RESULTS After adjusting for age, sex, race/ethnicity, school type, and ever use of cigarettes or e-cigarettes at baseline, adolescents with high emotional symptoms (AORcig=1.97; 95% CI:1.07–3.60, and AORe-cig=1.68; 95% CI: 1.06–2.66) and with high sensation seeking tendencies (AORcig=2.05; 95% CI: 1.03–4.10, and AORe-cig=1.68; 95% CI: 1.02–2.76) had significantly higher odds of past 30-day cigarette and e-cigarette use four years later compared to adolescents with low emotional symptoms and low sensation seeking tendencies. The interaction was significant (p=0.01) for e-cigarette use only; among low sensation seekers, adolescents who reported high levels of emotional symptoms were at increased risk for past 30-day use (AORe-cig=3.43; 95% CI: 1.38–8.51), and among adolescents with low emotional symptoms, high sensation seekers were at increased for risk for past 30-day use (AORe-cig=3.50; 95% CI: 1.54–7.91). CONCLUSIONS It is important for tobacco use prevention programs to consider both behavioral risk factors – sensation seeking and emotional symptoms – in an integrative way, to target high risk subgroups and thereby increase the efficacy of existing effective intervention strategies in order to curb tobacco use among youth and young adults.
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Affiliation(s)
- Bara S Bataineh
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center, Dallas, United States
| | - Anna V Wilkinson
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center, Austin, United States
| | - Kathleen R Case
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center, San Antonio, United States
| | - Stephanie L Clendennen
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center, Austin, United States
| | - Aslesha Sumbe
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center, Austin, United States
| | - Baojiang Chen
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, Austin, United States
| | - Melissa B Harrell
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center, Austin, United States
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Mohd Radzi NA, Saub R, Mohd Yusof ZY, Dahlui M, Sujak SL. Nicotine Dependence among Adolescents Single and Dual Cigarette Users. CHILDREN-BASEL 2021; 8:children8020144. [PMID: 33672960 PMCID: PMC7918536 DOI: 10.3390/children8020144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 11/16/2022]
Abstract
The prevalence of concurrent use of combustible and electronic cigarettes (dual-use) is on the rise among Malaysian adolescents. This study compares nicotine dependence among exclusive cigarette users, e-cigarette users, and dual adolescent users. A total of 227 adolescent smokers completed a self-administrated questionnaire with items based on Hooked on Nicotine Checklist (HONC) incorporated. Endorsement of at least one HONC item indicates nicotine dependence. Exhaled carbon monoxide readings and salivary cotinine data were also collected. Over half (52.9%) of the participants were exclusive e-cigarette users (EC). The prevalence of exclusive conventional cigarette smokers (CC) and dual users was 11.9% and 35.2%, respectively. Adolescents who have mothers with secondary school education were more likely to become addicted to nicotine (Adjusted Odd Ratio (aOR) = 2.72; 95% CI = 1.17–6.32). Adolescents’ “mother’s education” level predicted nicotine dependence. This highlighted the need to target families within the identified demography with a more supportive anti-tobacco program.
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Affiliation(s)
- Nawwal Alwani Mohd Radzi
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.M.R.); (Z.Y.M.Y.)
- Centre of Population Oral Health and Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor 47000, Malaysia
| | - Roslan Saub
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.M.R.); (Z.Y.M.Y.)
- Correspondence:
| | - Zamros Yuzadi Mohd Yusof
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.M.R.); (Z.Y.M.Y.)
| | - Maznah Dahlui
- Centre of Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Sharol Lail Sujak
- Negeri Sembilan Oral Health Division, Ministry of Health Malaysia, Seremban, Negeri Sembilan 73000, Malaysia;
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Duan Z, Wang Y, Huang J. Sex Difference in the Association between Electronic Cigarette Use and Subsequent Cigarette Smoking among U.S. Adolescents: Findings from the PATH Study Waves 1-4. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1695. [PMID: 33578770 PMCID: PMC7916485 DOI: 10.3390/ijerph18041695] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 12/26/2022]
Abstract
E-cigarettes are the most-used tobacco products among U.S. adolescents. Emerging evidence suggests that adolescents using e-cigarettes are at elevated risk for initiating cigarette smoking. However, whether this risk may differ by sex remains unknown. This study analyzed data from Wave 1 to 4 of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal survey. Generalized estimation equations (GEE) were performed to estimate the associations between baseline e-cigarette use and subsequent cigarette smoking, controlling for sociodemographic characteristics, mental health conditions, and other tobacco use. Effect modifications by sex were examined. Multivariate analyses showed that, among baseline never cigarette smokers, past-30-day e-cigarette use at baseline waves was significantly associated with past-30-day cigarette smoking at follow-up waves (aOR = 3.90, 95% CI: 2.51-6.08). This association was significantly stronger for boys (aOR = 6.17, 95% CI: 2.43-15.68) than for girls (aOR = 1.10, 95% CI: 0.14-8.33). Additionally, using other tobacco products, older age, and having severe externalizing mental health problems at baseline were significantly associated with an increased likelihood of cigarette smoking at follow-up. The prospective association between e-cigarette use and cigarette smoking differs by sex among U.S. adolescents. Sex-specific tobacco control interventions may be warranted to curb the youth tobacco use epidemic.
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Affiliation(s)
| | | | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (Z.D.); (Y.W.)
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Gaiha SM, Duemler A, Silverwood L, Razo A, Halpern-Felsher B, Walley SC. School-based e-cigarette education in Alabama: Impact on knowledge of e-cigarettes, perceptions and intent to try. Addict Behav 2021; 112:106519. [PMID: 32890911 DOI: 10.1016/j.addbeh.2020.106519] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/21/2020] [Accepted: 06/21/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Educational programs are needed to combat the sharp rise in adolescent e-cigarette use. We assessed adolescent knowledge about e-cigarettes, perceptions of harmfulness and addictiveness and intent to try e-cigarettes before and after an e-cigarette educational session. METHODS We conducted a one-group pre- and post-test study among middle and high school students in Alabama in 2019. The intervention included a 30-minute educational session based on the Stanford Tobacco Prevention Toolkit on e-cigarette types, contents, marketing and advertising, health effects and nicotine addiction. McNemar tests of paired proportions and multi-level, mixed-effects logistic regression models were used to analyze intervention effects. RESULTS Surveys were completed by 2,889 middle and high school students. The intervention was associated with significantly increased knowledge about e-cigarettes and perceptions that e-cigarettes are harmful and addictive, and with significantly lower intent to try e-cigarettes. At pre-test, middle school students had lower knowledge, believed that e-cigarettes were not as addictive and showed higher intent to try both e-cigarettes and cigarettes compared to high school students. Groups that were associated with lower perceived harmfulness and addictiveness were: ever-users of e-cigarettes, ever-users of both e-cigarettes and cigarettes and prior users of mint/menthol flavored e-cigarettes. CONCLUSIONS A school-based educational session was significantly associated with improved adolescent knowledge about e-cigarettes, increased the perceived harmfulness and addictiveness of e-cigarettes, and reduced intent to try e-cigarettes. E-cigarette education should be prioritized for middle school students due to lower levels of knowledge and higher intent to try tobacco compared to high school students.
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21
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Liu J, Gaiha SM, Halpern-Felsher B. A Breath of Knowledge: Overview of Current Adolescent E-cigarette Prevention and Cessation Programs. CURRENT ADDICTION REPORTS 2020; 7:520-532. [PMID: 33204602 PMCID: PMC7661014 DOI: 10.1007/s40429-020-00345-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Adolescent use of electronic cigarettes (e-cigarettes) has risen rapidly, which is concerning given the health effects of e-cigarettes and youth susceptibility to nicotine addiction. It is critical that efforts to educate, prevent, and reduce adolescent use of e-cigarettes are developed and evaluated. The purpose of this paper is to review available current prevention and cessation programs. FINDINGS A web-based search of currently available e-cigarette prevention and cessation/treatment programs was conducted using Google in May of 2020. Programs were then reviewed on whether they included theory- and evidence-based practices of effective adolescent prevention and cessation programs. Eight prevention programs, seven cessation programs, and one program that addressed both prevention and cessation were identified and included in this review. Most prevention programs included the importance of understanding flavored e-cigarette products, addressed industry-targeted marketing, included social learning activities to develop refusal skills, delivered free-of-cost, available online, and explicitly stated their incorporation of theory. Five prevention programs and two cessation programs had empirically evaluated their e-cigarette-related components. CONCLUSIONS Although the programs reviewed largely incorporated theory and included key components known to be effective, there are some gaps in the programs' overall ability to prevent and stop adolescents from using e-cigarettes, such as lack of dedicated e-cigarette materials. More evidence-based tools, resources, and evaluations are needed to best inform adolescent e-cigarette cessation. Addressing the gaps that existing prevention and cessation programs present requires intervening at multiple systematic levels, conducting more rigorous program evaluations, and bolstering the availability of cessation programs.
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Affiliation(s)
- Jessica Liu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA USA
| | - Shivani Mathur Gaiha
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Road, Suite 100, Palo Alto, CA 94304 USA
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Road, Suite 100, Palo Alto, CA 94304 USA
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Galanti MR, Pulkki-Brännström AM, Nilsson M. Tobacco-Free Duo Adult-Child Contract for Prevention of Tobacco Use Among Adolescents and Parents: Protocol for a Mixed-Design Evaluation. JMIR Res Protoc 2020; 9:e21100. [PMID: 33000762 PMCID: PMC7661241 DOI: 10.2196/21100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/15/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Universal tobacco-prevention programs targeting youths usually involve significant adults, who are assumed to be important social influences. Commitment not to use tobacco, or to quit use, as a formal contract between an adolescent and a significant adult is a preventive model that has not been widely practiced or explored and has been formally evaluated even less. In this paper, we present the rationale and protocol for the evaluation of the Swedish Tobacco-free Duo program, a multicomponent school-based program the core of which rests on a formal agreement between an adolescent and an adult. The adolescent's commitment mainly concerns avoiding the onset of any tobacco use while the adult commits to support the adolescent in staying tobacco free, being a role model by not using tobacco themselves. OBJECTIVE To assess (1) whether Tobacco-free Duo is superior to an education-only program in preventing smoking onset among adolescents and promoting cessation among their parents, (2) whether exposure to core components (adult-child agreement) entails more positive effects than exposure to other components, (3) the impact of the program on whole school tobacco use, (4) potential negative side effects, and (5) school-level factors related to fidelity of the program's implementation. METHODS A mixed-design approach was developed. First, a cluster randomized controlled trial was designed with schools randomly assigned to either the comprehensive multicomponent program or its educational component only. Primary outcome at the adolescent level was identified as not having tried tobacco during the 3-year junior high school compulsory grades (12-15 years of age). An intention-to-treat cohort-wise approach and an as-treated approach complemented with a whole school repeated cross-sectional approach was devised as analytical methods of the trial data. Second, an observational study was added in order to compare smoking incidence in the schools participating in the experiment with that of a convenience sample of schools that were not part of the experimental study. Diverse secondary outcomes at both adolescent and adult levels were also included. RESULTS The study was approved by the Umeå Regional Ethics Review Board (registration number 2017/255-31) in 2017. Recruitment of schools started in fall 2017 and continued until June 2018. In total, 43 schools were recruited to the experimental study, and 16 schools were recruited to the observational study. Data collection started in the fall 2018, is ongoing, and is planned to be finished in spring 2021. CONCLUSIONS Methodological, ethical, and practical implications of the evaluation protocol were discussed, especially the advantage of combining several sources of data, to triangulate the study questions. The results of these studies will help revise the agenda of this program as well as those of similar programs. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN) 52858080; https://doi.org/10.1186/ISRCTN52858080. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/21100.
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Affiliation(s)
- Maria Rosaria Galanti
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Health, Stockholm, Sweden
| | | | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Mutaz M, de Vries N, Cheung KL, de Vries H. Towards a better understanding of factors affecting smoking uptake among Saudi male adolescents: A qualitative study. Tob Prev Cessat 2020; 6:29. [PMID: 32760864 PMCID: PMC7398134 DOI: 10.18332/tpc/120000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION An increased smoking uptake by Saudi male adolescents and a lack of data about its determinants emphasize the need for a better understanding of factors leading to the onset of smoking and identifying ways to prevent it. The aim of this qualitative study is to explore adolescents' views on smoking and their opinions about a smoking prevention program. METHODS A total of 103 school-going adolescents, aged 12-16 years, were purposely selected from grades seven, eight and nine from nine schools in Taif in Saudi Arabia. They were interviewed in 11 focus group discussions; five groups were held for smokers and six for non-smokers. An interview scheme was developed based on the I-Change Model, a model used for understanding smoking onset and prevention. We used QDA Lite version 2:0 software for data analysis. RESULTS Most of the participants agreed on the importance of social influences as determining factors to start smoking. The presence of smoking friend(s) and family member(s), especially the father, were mentioned. Factors such as having extra pocket money, absence of alternatives, showing off, to be seen as western, to be seen as an adult and the good taste of cigarettes were also mentioned as beliefs associated with smoking. Adolescents indicated to have low confidence not to smoke under peer pressure, suggesting self-efficacy problems. Intentions to smoke were also often mentioned. Almost all participants agreed that an interactive approach is optimal for an effective smoking prevention program. CONCLUSIONS Determinants of smoking seem to be very similar to those outlined by previous studies. A smoking prevention program for Saudi adolescents should address how to cope with social pressure to smoke, the advantages connected with smoking, and how to increase self-efficacy. Information should be presented in an interactive rather than static way.
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Affiliation(s)
- Mohammed Mutaz
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
| | - Nanne de Vries
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
| | - Kei L Cheung
- College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Hein de Vries
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
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24
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Pérez A, Bluestein M, Chen B, Perry CL, Harrell MB. PROSPECTIVELY ESTIMATING THE AGE OF INITIATION OF E-CIGARETTES AMONG U.S. YOUTH: FINDINGS FROM THE POPULATION ASSESSMENT OF TOBACCO AND HEALTH (PATH) STUDY, 2013-2017. JOURNAL OF BIOMETRICS & BIOSTATISTICS 2020; 11:https://www.hilarispublisher.com/open-access/prospectively-estimating-the-age-of-initiation-of-ecigarettes-among-us-youth-findings-from-the-population-assessment-of-.pdf. [PMID: 33552669 PMCID: PMC7861570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CONTEXT There is a lack of research that prospectively estimates the age of initiation of electronic cigarette use in U.S. youth. Younger ages of initiation of tobacco product use are associated with greater exposure to nicotine, and recently e-cigarette use has been associated with subsequent cigarette initiation. This study sought to estimate the distribution of the age of first reporting of e-cigarette use outcomes among youth never e-cigarette users overall, by sex and by race/ethnicity, prospectively. METHODS Secondary analysis of the Population Assessment of Tobacco and Health (PATH) youth dataset (ages 12-17) across waves 1 (2013-2014), 2 (2014-2015), 3 (2015-2016), and 4 (2016-2017) were conducted. Four outcomes are presented, age of first report of: (i) susceptibility to use, (ii) ever use, (iii) past 30-day use, and (iv) "fairly regular" e-cigarette use. Each outcome was prospectively estimated using participant age when they entered the study and the number of weeks between the last report of never use and the first report of each outcome across waves. Weighted survival analyses for interval censoring accounting for the complex survey design were implemented. RESULTS Among youth non-susceptible to e-cigarettes, 50.2% became susceptible to e-cigarette use by age 18. There were no statistically significant differences in the age of first report of susceptibility to e-cigarette use by sex or by race/ethnicity in this nationally representative sample of U.S. youth. Among never users, 41.7%, 23.5% and 10.3% initiated ever, past 30-day and "fairly regular" e-cigarette use by the age of 18, respectively. Less than 10% initiated ever e-cigarette use between the ages of 18 and 21. Boys had a higher risk of first reporting ever, past 30-day and "fairly regular" e-cigarette use at earlier ages than girls. Non-Hispanic Blacks and Other racial/ethnic groups were less likely than Non-Hispanic Whites to initiate ever e-cigarette use at earlier ages, and there was no difference between Non-Hispanic Whites and Hispanics. Hispanic, Non-Hispanic Black and Other racial/ethnic youth were less likely to first report past 30-day use and "fairly regular" e-cigarette use at earlier ages than Non-Hispanic White youth. CONCLUSION This paper provides information on specific ages of the first report of e-cigarette use behaviors by sex and by race/ethnicity that can be used to culturally tailor e-cigarette interventions on specific windows of opportunity before youth begin using e-cigarettes or escalating their use.
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Affiliation(s)
- Adriana Pérez
- Department of Biostatistics and Data Science, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX 78701
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX 78701
| | - Meagan Bluestein
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX 78701
| | - Baojiang Chen
- Department of Biostatistics and Data Science, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX 78701
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX 78701
| | - Cheryl L. Perry
- Department of Health Promotion and Behavioral Sciences at the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX 78701
| | - Melissa B. Harrell
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX 78701
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX 78701
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Riehm KE, Young AS, Feder KA, Krawczyk N, Tormohlen KN, Pacek LR, Mojtabai R, Crum RM. Mental Health Problems and Initiation of E-cigarette and Combustible Cigarette Use. Pediatrics 2019; 144:peds.2018-2935. [PMID: 31160343 PMCID: PMC6615573 DOI: 10.1542/peds.2018-2935] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES During adolescence, mental health problems may increase the risk of initiating combustible cigarette use. However, it is unknown if this association extends to electronic cigarettes (e-cigarettes). We examined whether internalizing and externalizing problems were associated with initiation of e-cigarette, combustible cigarette, and dual-product use among adolescents. METHODS Participants were drawn from the Population Assessment of Tobacco and Health Study, a nationally representative longitudinal study of US adolescents followed from 2013 to 2015. The study sample included 7702 adolescents aged 12 to 17 years who at baseline reported no lifetime use of tobacco products. We examined the respective associations between baseline internalizing and externalizing problems and initiating use of e-cigarettes, combustible cigarettes, or both at 1-year follow-up. RESULTS Compared with adolescents with low externalizing problems, adolescents with high externalizing problems were significantly more likely to initiate use of e-cigarettes (adjusted relative risk ratio [aRRR] = 2.78; 95% confidence interval [CI]: 1.76-4.40), combustible cigarettes (aRRR = 5.59; 95% CI: 2.63-11.90), and both products (aRRR = 2.23; 95% CI: 1.15-4.31). Adolescents with high internalizing problems were at increased risk of initiating use of e-cigarettes (aRRR = 1.61; 95% CI: 1.12-2.33) but not combustible cigarettes or both products. CONCLUSIONS Mental health problems are associated with increased risk for initiating e-cigarette, combustible cigarette, and dual-product use in adolescence. This association is more consistent for externalizing problems than internalizing problems. Addressing mental health problems could be a promising target for preventing initiation of nicotine- and/or tobacco-product use by adolescents.
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Affiliation(s)
| | - Andrea S. Young
- Division of Child and Adolescent Psychiatry, School
of Medicine, Johns Hopkins University, Baltimore, Maryland; and
| | | | | | | | - Lauren R. Pacek
- Department of Psychiatry and Behavioral Sciences,
School of Medicine, Duke University, Durham, North Carolina
| | | | - Rosa M. Crum
- Welch Center for Prevention, Epidemiology, and
Clinical Research and,Departments of Mental Health and,Epidemiology, Bloomberg School of Public Health
and
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McMenamin SB, Cummins SE, Zhuang YL, Gamst AC, Ruiz CG, Mayoral A, Zhu SH. Evaluation of the Tobacco-Use Prevention Education (TUPE) program in California. PLoS One 2018; 13:e0206921. [PMID: 30388176 PMCID: PMC6214574 DOI: 10.1371/journal.pone.0206921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/21/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIMS The California Tobacco-Use Prevention Education (TUPE) program promotes the use of evidence-based tobacco-specific prevention and cessation programs for adolescents within the school setting. Through a competitive grant process, schools are funded to provide programs for grades 6-12. This research evaluates the association between TUPE funding and tobacco prevention activities and tobacco use prevalence. METHODS This study utilized two data sources: (1) 2016 California Educator Tobacco Survey (CETS), and (2) 2015-2016 California Student Tobacco Survey (CSTS). The CETS collected data from educators about school prevention efforts, priority of tobacco prevention, and confidence in addressing tobacco issues with students. A total of 3,564 educators from 590 schools participated in CETS. The CSTS collected data from 8th, 10th, and 12th graders in California on their exposure to, attitudes about, and utilization of tobacco products. A total of 47,981 students from 117 schools participated in CSTS. RESULTS This study found that TUPE-funded schools were more likely to provide tobacco-specific health education programs, to place a priority on tobacco-prevention efforts, and to prepare educators to address tobacco use than non-TUPE schools. Educators at both types of schools felt better prepared to talk with students about traditional tobacco products than about emerging products such as e-cigarettes. Overall, students at TUPE-funded schools were more likely to report receiving anti-tobacco messages from school-based programs than those at non-TUPE schools. The former were also less likely to use tobacco products, even when the analysis controlled for demographics and school-level characteristics (OR = 0.82 [95% CI = 0.70-0.96]). CONCLUSIONS TUPE funding was associated with an increase in schools' tobacco-specific prevention activities and these enhanced activities were associated with lower tobacco use among students. This study also found that education and prevention efforts regarding emerging tobacco products need to be strengthened across all schools.
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Affiliation(s)
- Sara B. McMenamin
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Sharon E. Cummins
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
| | - Yue-Lin Zhuang
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
| | - Anthony C. Gamst
- Department of Mathematics, University of California San Diego, La Jolla, California, United States of America
| | - Carlos G. Ruiz
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
| | - Antonio Mayoral
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
| | - Shu-Hong Zhu
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
- Moores Cancer Center, University of California San Diego, La Jolla, California, United States of America
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The Juul Curriculum Is Not the Jewel of Tobacco Prevention Education. J Adolesc Health 2018; 63:527-528. [PMID: 30348276 DOI: 10.1016/j.jadohealth.2018.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 08/31/2018] [Indexed: 12/16/2022]
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29
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Andersen A, Bast LS, Due P, Thygesen LC. Evaluation of the smoking intervention X:IT after the second year: A randomized controlled trial. Scand J Public Health 2018; 47:885-889. [PMID: 30222087 DOI: 10.1177/1403494818799837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims:Review studies on the long-term effects of school-based smoking interventions show mixed results. X:IT was a three-year cluster randomized controlled trial to prevent uptake of smoking among Danish students from age 13 years until age 15 years which previously proved effective in preventing smoking after the first year of intervention. The aim of this paper was to conduct the pre-planned analyses of the effects of the X:IT intervention on smoking after the second year. Methods: We used self-reported questionnaire data from students at baseline, first, second, and third follow-up (n at second follow-up=3269, response rate=79.4%). Data from third follow-up were not suitable for analysis. Outcome measure: 'current smoking', dichotomised into smoke daily, weekly, monthly or more seldom versus do not smoke. We performed multilevel, logistic regression analyses of available cases and intention-to-treat (ITT) analyses, replacing missing outcome values by multiple imputation. Results: The prevalence of smoking increased from 5.8% at baseline to 17.0% at second follow-up among students at intervention schools, and from 7.6% to 18.7% among students at control schools. Analyses of available cases and ITT analyses did not support X:IT being effective in preventing smoking after the second year of intervention. Conclusions: Although X:IT was effective after the first year of intervention, we were not able to demonstrate any effects after the second year. Implementation of the intervention was lower in the second year compared to the first year which indicates that the missing effect of the intervention at second follow-up is due to lack of implementation.
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Affiliation(s)
- Anette Andersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lotus S Bast
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Verghese C, Redko C, Fink B. Screening for Lung Cancer Has Limited Effectiveness Globally and Distracts From Much Needed Efforts to Reduce the Critical Worldwide Prevalence of Smoking and Related Morbidity and Mortality. J Glob Oncol 2018; 4:1-7. [PMID: 30241213 PMCID: PMC6181518 DOI: 10.1200/jgo.2017.1700016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Cherian Verghese
- Cherian Verghese and Brian Fink, University
of Toledo Medical Center, Toledo; and Cristina Redko, Wright State
University, Dayton, OH
| | - Cristina Redko
- Cherian Verghese and Brian Fink, University
of Toledo Medical Center, Toledo; and Cristina Redko, Wright State
University, Dayton, OH
| | - Brian Fink
- Cherian Verghese and Brian Fink, University
of Toledo Medical Center, Toledo; and Cristina Redko, Wright State
University, Dayton, OH
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Alsubaiei ME, Cafarella PA, Frith PA, McEvoy RD, Effing TW. Factors influencing management of chronic respiratory diseases in general and chronic obstructive pulmonary disease in particular in Saudi Arabia: An overview. Ann Thorac Med 2018; 13:144-149. [PMID: 30123332 PMCID: PMC6073786 DOI: 10.4103/atm.atm_293_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The prevalence of chronic obstructive pulmonary disease in Saudi Arabia is
4.2% among the general population and 14.2% among smokers. Studies
showed that management of respiratory diseases is inadequate. In this article,
we have elaborated on how factors as health economic factors, lack of
health-care providers, culture, attitude, lifestyle (such as smoking and
physical inactivity), and lack of adherence to the evidence-based practice
guidelines may influence chronic respiratory disease management in Saudi Arabia.
We have to conclude that these factors should be taken into account while
seeking to improve and optimize the quality of care for patients with
respiratory diseases in Saudi Arabia.
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Affiliation(s)
- Mohammed E Alsubaiei
- Department of Respiratory Medicine, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia.,School of Medicine, Flinders University, Adelaide, South Australia, Australia.,Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Paul A Cafarella
- Department of Respiratory Medicine, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia.,School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Peter A Frith
- Department of Respiratory Medicine, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia.,School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - R Doug McEvoy
- School of Medicine, Flinders University, Adelaide, South Australia, Australia.,Department of Sleep and Respiratory Medicine, Adelaide Institute for Sleep Health, Southern Adelaide Local Health Network, School of Medicine, Flinders University, Adelaide, Australia
| | - Tanja W Effing
- Department of Respiratory Medicine, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia.,School of Medicine, Flinders University, Adelaide, South Australia, Australia
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Rezayat AA, Niroumand S, Shiehzadeh E, Saghebi A, Oskooie RR, Dadgarmoghaddam M. Assessment of life skills of medical students in Mashhad, Iran, in 2015. Electron Physician 2017; 9:5536-5540. [PMID: 29238495 PMCID: PMC5718859 DOI: 10.19082/5536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 08/10/2017] [Indexed: 11/25/2022] Open
Abstract
Background Developing social skills and mental health is a crucial part of the psychosocial health status of medical students. Objective The aim of this study was to assess the life skills of medical students in Mashhad University of Medical Sciences (MUMS). Methods This cross-sectional study was performed in Mashhad University of Medical Sciences, Iran in 2015. By census method, 146 interns were entered into the study. The life skill questionnaire, consisting of 144 questions, was used as the measurement tool. Over 3 months, all the medical students in internship period were asked to complete the questionnaire. Data were analyzed by independent-samples t-test, one-way ANOVA, and Mann-Whitney with SPSS version 11.5 software. Results Women were shown to have higher decision-making ability than men (p=0.046). It was also shown in the study that social behavior (p=0.018), participation in activities that improve benefits (p=0.006), critical thinking (p=0.007), observing and using safety points (p=0.005), and mental health status (p=0.034) were significantly lower in men than in women. The data also suggests that men (13.97±4.7249) are more likely to become global citizens than women (12.15±3.6298) (p=0.010). Furthermore, there was a significant difference when comparing smoking and non-smoking in freedom and justice (p=0.003) and becoming a global citizen (p=0.012). Conclusion Our study provides helpful information about medical students’ life skills for policy makers and university authorities. We suggest that gender differences should be considered during life skill training.
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Affiliation(s)
- Arash Akhavan Rezayat
- Medical Student, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shabnam Niroumand
- M.D, Community Medicine Specialist, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Shiehzadeh
- M.D., School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Saghebi
- M.D., Psychiatry, Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Rahimzadeh Oskooie
- Medical Student, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maliheh Dadgarmoghaddam
- M.D, Community Medicine Specialist, Assistant Professor of Community Medicine, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Andersen AM, Philibert RA, Gibbons FX, Simons RL, Long J. Accuracy and utility of an epigenetic biomarker for smoking in populations with varying rates of false self-report. Am J Med Genet B Neuropsychiatr Genet 2017; 174:641-650. [PMID: 28816414 PMCID: PMC5653254 DOI: 10.1002/ajmg.b.32555] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/05/2017] [Indexed: 01/08/2023]
Abstract
Better biomarkers to detect smoking are needed given the tremendous public health burden caused by smoking. Current biomarkers to detect smoking have significant limitations, notably a short half-life for detection and lack of sensitivity for light smokers. These limitations may be particularly problematic in populations with less accurate self-reporting. Prior epigenome-wide association studies indicate that methylation status at cg05575921, a CpG residue located in the aryl hydrocarbon receptor repressor (AHRR) gene, may be a robust indicator of smoking status in individuals with as little as half of a pack-year of smoking. In this study, we show that a novel droplet digital PCR assay for measuring methylation at cg05575921 can reliably detect smoking status, as confirmed by serum cotinine, in populations with different demographic characteristics, smoking histories, and rates of false-negative self-report of smoking behavior. Using logistic regression models, we show that obtaining maximum accuracy in predicting smoking status depends on appropriately weighting self-report and cg05575921 methylation according to the characteristics of the sample being tested. Furthermore, models using only cg05575921 methylation to predict smoking perform nearly as well as those also including self-report across populations. In conclusion, cg05575921 has significant potential as a clinical biomarker to detect smoking in populations with varying rates of accuracy in self-report of smoking behavior.
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Affiliation(s)
- Allan M. Andersen
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA 52242,To whom correspondence should be addressed: Department of Psychiatry, Rm 2-219 MEB, 500 Newton Road, Iowa City, IA, 52242, USA; phone 319-353-4537
| | - Robert A. Philibert
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA 52242,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA 52242,Behavioral Diagnostics, Coralville IA 52241
| | - Fredrick X. Gibbons
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269
| | - Ronald L. Simons
- Department of Sociology, University of Georgia, Athens, GA 30602
| | - Jeffrey Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA 52242,Department of Biostatistics, University of Iowa, Iowa City, IA USA 52242
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Small SP, Kushner KE, Neufeld A. Smoking Prevention among Youth: A Multipronged Approach Involving Parents, Schools, and Society. Can J Nurs Res 2017; 45:116-35. [DOI: 10.1177/084456211304500308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Razanamihaja N, Makino Y, Ogawa H, Ikeda N, Miyazaki H. The assessment of status of tobacco smoking among urban primary schoolchildren in Madagascar. Health Promot Int 2017; 32:351-359. [PMID: 27663777 DOI: 10.1093/heapro/daw077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The prevalence of tobacco smoking among adolescents aged 13-15 years old in Madagascar was previously reported to be higher than the average in other African regions. A preventive approach is urgently needed to avoid the initiation of early tobacco smoking. Therefore, the aims of this study were to evaluate the status of tobacco smoking among primary schoolchildren in Madagascar and explore the factors associated with initiation of tobacco smoking in the young. This study was conducted in the Mahajanga region of Madagascar. Three primary schools in this region and children of both genders between the ages of nine to 12 years old were randomly selected and approached to participate in this study. A self-administered questionnaire modified from the Global Youth Tobacco Survey Core Questionnaire 2007 was used to assess the status of tobacco smoking among primary schoolchildren. A total of 150 schoolchildren (14.0%) declared that they had smoked tobacco, with 30% starting to smoke tobacco at the age of seven or younger. The prevalence of tobacco smoking was lower among schoolchildren with non-smoking parents (p < 0.001) or non-smoking close friends (p < 0.001). Furthermore, schoolchildren's antismoking intention (p < 0.001) and their knowledge about the harmfulness of tobacco (p = 0.009) had significant effects on the prevalence of tobacco smoking. The results of this study indicate that tobacco smoking among schoolchildren in Madagascar may be influenced by peers, or parents, as well as smoking intention and knowledge about the harmfulness of tobacco use.
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Affiliation(s)
- Noeline Razanamihaja
- Postgraduate Department of Nutrition and Environment, University of Mahajanga, Mahajanga, Madagascar
- Faculty of Dentistry, Paris Diderot University, Paris 7, Paris, France
| | - Yuka Makino
- Division of Preventive Dentistry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- WHO Collaborating Center for Translation of Oral Health Science, Niigata University, Niigata, Japan
- Japan Consortium for Global School Health Research, Japan
| | - Hiroshi Ogawa
- Division of Preventive Dentistry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- WHO Collaborating Center for Translation of Oral Health Science, Niigata University, Niigata, Japan
- Japan Consortium for Global School Health Research, Japan
| | - Noriaki Ikeda
- Japan Consortium for Global School Health Research, Japan
- Bureau of International Medical Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hideo Miyazaki
- Division of Preventive Dentistry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- WHO Collaborating Center for Translation of Oral Health Science, Niigata University, Niigata, Japan
- Japan Consortium for Global School Health Research, Japan
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McCallum GB, Chang AB, Wilson CA, Petsky HL, Saunders J, Pizzutto SJ, Choo Su S, Shah S. Feasibility of a Peer-Led Asthma and Smoking Prevention Project in Australian Schools with High Indigenous Youth. Front Pediatr 2017; 5:33. [PMID: 28303238 PMCID: PMC5332358 DOI: 10.3389/fped.2017.00033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 02/03/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The high global burden of asthma and tobacco smoking among Indigenous people may potentially be reduced by appropriate interventions that target prevention of tobacco smoke uptake and improved asthma management. The latter includes targeted treatment based on airway inflammation. We undertook a feasibility study in two Darwin schools with a high proportion of Indigenous youth to determine the feasibility of an innovative, peer-led, school-based education program called the Asthma and Smoking Prevention Project (ASPP). A subset of children with reported persistent respiratory symptoms were also clinically evaluated to determine the lower airway inflammatory profile and optimize asthma management. METHODS The ASPP is founded on an evidence-based three-step program and targets improving asthma management and preventing the uptake of tobacco smoking. The program uses a student-centered approach in which senior students (peer leaders) deliver the ASPP to Grade 7 students using activities, videos, and games. Students completed questionnaires related to asthma and smoking at baseline and 3 months after program delivery. Students with respiratory symptoms at 3 months were invited for a comprehensive clinical evaluation and tests including sputum induction. RESULTS The ASPP was well received. Of the 203 students involved, 56 (28%) were Indigenous and 70% completed baseline and follow-up questionnaires. Self-reported asthma was high (19%), 10% of students reported smoking and 63% reported exposure to tobacco at home. Of the 22 students who were clinically evaluated, 41% were Indigenous. Clinically important airway inflammation was high; 23% had Fractional Exhaled Nitric Oxide Levels ≥35 ppb, 88% had airway neutrophilia (>15%), and 29% had airway eosinophilia (>2.5%). Optimization of medication and management was required in 59% of students. CONCLUSION Our study has demonstrated the implementation of the ASPP was well received by the schools as well as by the students. The high prevalence of clinically important airway inflammation and suboptimal asthma management highlights the need for a community-based study on persistent respiratory symptoms in adolescents to reduce the burden of chronic lung disease particularly for Indigenous Australians.
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Affiliation(s)
- Gabrielle B McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University , Darwin, NT , Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Children's Health Queensland, Queensland University of Technology, Brisbane, QLD, Australia
| | - Cate A Wilson
- Child Health Division, Menzies School of Health Research, Charles Darwin University , Darwin, NT , Australia
| | - Helen L Petsky
- Children's Health Queensland, Queensland University of Technology , Brisbane, QLD , Australia
| | | | - Susan J Pizzutto
- Child Health Division, Menzies School of Health Research, Charles Darwin University , Darwin, NT , Australia
| | - Siew Choo Su
- Children's Health Queensland, Queensland University of Technology , Brisbane, QLD , Australia
| | - Smita Shah
- Primary Health Care Education and Research Unit, Western Sydney Local Health District , Sydney, NSW , Australia
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Little MA, Pokhrel P, Sussman S, Rohrbach LA. The process of adoption of evidence-based tobacco use prevention programs in California schools. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2015; 16:80-9. [PMID: 24398826 DOI: 10.1007/s11121-013-0457-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Although there are a number of research-validated substance use prevention programs available for wide-scale dissemination, very little is known about the factors that influence adoption of evidence-based prevention programs in schools. We tested a model of the mechanisms of program adoption in schools that was guided by diffusion of innovations and social ecological theories. Cross-sectional data were collected from a sample of school district and county office of education tobacco use prevention education coordinators throughout California. Structural equation modeling was used to test the effects of community and organizational variables on the adoption of prevention programs via school administrators' beliefs and the organization's receipt of funding for the program. Results supported the hypothesis that the process of adoption begins with forming beliefs about the program, leading to adoption through the receipt of funding. In addition, we found direct effects of various community- and organizational-level factors on beliefs, receipt of funding, and adoption. These results are likely to inform policies that affect school districts' use of evidence-based substance use prevention programming, which should ultimately lead to reductions in negative health outcomes among adolescents. Specifically, this study identifies various factors that could be targeted for improvement to enhance evidence-based program adoption. To our knowledge, this is the first study to empirically elucidate the process of adoption of evidence-based tobacco prevention programs in schools.
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Affiliation(s)
- Melissa A Little
- University of Hawai'i Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA,
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Tahlil T, Woodman RJ, Coveney J, Ward PR. Six-months follow-up of a cluster randomized trial of school-based smoking prevention education programs in Aceh, Indonesia. BMC Public Health 2015; 15:1088. [PMID: 26499860 PMCID: PMC4619432 DOI: 10.1186/s12889-015-2428-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 10/16/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Smoking prevention programs have been taught in schools to reduce the high smoking prevalence and its related problems among adolescent populations. Although short-term benefits have been observed, the long-term effectiveness of such programs appear to be inconsistent. This study aims at investigating the long-term impact of both health and Islamic focused interventions amongst students in Indonesia. METHODS At 6 months after completion of the interventions, 427 of the original 447 participants (control group = 128, intervention groups = 299) from a school-based cluster randomized control trial were re-assessed for their smoking knowledge, attitudes, intentions and behaviours using a self-report questionnaire. Data was analyzed according to the study's 2 × 2 factorial design with adjustment for baseline scores, school and classroom clustering effects and multiple comparisons. RESULTS Compared to the control group, significant long term effects were found for the health-based intervention program in improved health (β = 4.3 ± 0.4, p < 0.001), Islamic (β = 1.1 ± 0.4, p = 0.01) knowledge and a reduction of smoking attitudes (β = -11.5 ± 1.8, p < 0.001). For the Islamic-based intervention programs there was an improvement of health (β = 3.7 ± 0.4, p < 0.001) and Islamic (β = 2.2 ± 0.5, p < 0.001) knowledge and a reduction towards smoking attitude (β = -6.0 ± 1.9, p < 0.01) and smoking behaviors in the past month (OR = 0.1, 95 % CI = 0.0-0.8, p = 0.03). The effects were greater but less than additive in the combined group for health (β = -3.2 ± 0.9, p < 0.001 for interaction) and Islamic knowledge (β = -2.3 ± 0.9, p = 0.01 for interaction) but were additive for smoking attitudes (β = 6.1 ± 3.2, p = 0.07 for interaction). No significant effects on smoking intentions were observed at 6 months follow-up in the health or Islamic-based intervention programs. CONCLUSION School-based programs can provide long term benefits on Indonesian adolescents' smoking knowledge and attitudes. Tailoring program intervention components with participants' religious background might maximise program effectiveness. A larger and more encompassing study is now required to confirm the effectiveness of this new Indonesia culturally-based program. Adolescents in similar areas might also benefit from this type of school-based smoking cessation program. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry, ACTRN12612001070820.
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Affiliation(s)
- Teuku Tahlil
- Nursing Faculty, Syiah Kuala University, Banda Aceh, 23111, Indonesia.
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Adelaide, SA, 5001, Australia.
| | - John Coveney
- Discipline of Public Health, School of Health Sciences, Flinders University, Adelaide, SA, 5001, Australia.
| | - Paul R Ward
- Discipline of Public Health, School of Health Sciences, Flinders University, Adelaide, SA, 5001, Australia.
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Khayyati F, Allahverdipour H, Shaghaghi A, Fathifar Z. Tobacco Use Prevention by Integrating Inside and Outside of School Based Programs: A Systematic Review Article. Health Promot Perspect 2015; 5:81-91. [PMID: 26290823 DOI: 10.15171/hpp.2015.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 07/01/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Experience of tobacco use in early ages will increase probability of addiction to nicotine therefore, efficient tobacco control programs for teenagers are crucial. This study was conducted to recognize elements of successful integrated inside and outside of school based smoking prevention programs. METHODS MeSH terms and related keywords were used to search PubMed, Cochrane, Medline, EMBASE, ERIC, SID databases from inception to 29th October 2013. Trials with random and non-random designs, systematic reviews and cohort studies that assessed or reported application of integrated tobacco control programs were included. Quality of the retrieved publications was checked independently by the authors and any disagreement was resolved by consensus. RESULT Among the 745 identified publications, only 15 studies had the inclusion criteria with a considerable methodological heterogeneity. While, precise out-come of integrated out of school/school-based interventions were not percepti-ble but this study's findings implied that outside of school intervention could strengthen school-based tobacco prevention programs. No study was found to examine school-based interventions integrated with primary health care such as anti-tobacco consultations, high-risk students screening and their referral to special centers. CONCLUSION Integration of outside and inside of school-based programs may boost probability of obtaining favorable outcomes and success rate in practice.
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Affiliation(s)
- Fariba Khayyati
- Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, Iran ; Department of Health Education & Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdolreza Shaghaghi
- Department of Health Education & Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Fathifar
- Central Library of the Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Isensee B, Maruska K, Hanewinkel R. Langzeiteffekte des Präventionsprogramms Klasse2000 auf den Substanzkonsum. SUCHT 2015. [DOI: 10.1024/0939-5911.a000365] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zielsetzung: Untersuchung der langfristigen Auswirkungen des für die Grundschule konzipierten Präventionsprogramms Klasse2000 auf den Substanzkonsum. Methodik: Klasse2000 will mittels interaktiver Methoden die Lebenskompetenzen fördern und zu einem gesunden Lebensstil motivieren. Die Daten wurden in schriftlichen Nachbefragungen einer Kontrollgruppenstudie mit Messwiederholung 16 Monate (N = 501, mittl. Alter 11,4 Jahre, 43,7 % männlich) und 36 Monate (N = 408, mittl. Alter 12,9 Jahre, 43,1 % männlich) nach Ende der Intervention gewonnen. Die Zuteilung zu den Gruppen erfolgte in der Ursprungsstudie auf Ebene der Schulen unter Berücksichtigung der Präferenz der Schulen. Ergebnisse: In beiden Nachbefragungen waren Lebenszeitprävalenz und Inzidenz des Rauchens in der Interventionsgruppe statistisch bedeutsam geringer als in der Kontrollgruppe. Beim Alkoholkonsum konnte nur in der ersten Nachbefragung eine signifikant geringere Lebenszeitprävalenz in der Interventionsgruppe gefunden werden. In der zweiten Nachbefragung war in der Untergruppe derjenigen Jugendlichen, die bereits Alkohol konsumiert hatten, in der Interventionsgruppe die Intensität des Alkoholkonsums geringer als in der Kontrollgruppe. Schlussfolgerungen: 16 bzw. 36 Monate nach Abschluss der Intervention finden sich Hinweise auf präventive Effekte des Programms Klasse2000 auf das Rauchverhalten. Für den Alkoholkonsum ist die Befundlage weniger überzeugend.
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Affiliation(s)
- Barbara Isensee
- Institut für Therapie- und Gesundheitsforschung, IFT-Nord, gGmbH, Kiel
| | - Karin Maruska
- Institut für Therapie- und Gesundheitsforschung, IFT-Nord, gGmbH, Kiel
| | - Reiner Hanewinkel
- Institut für Therapie- und Gesundheitsforschung, IFT-Nord, gGmbH, Kiel
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Shrivastav R, Nazar GP, Stigler MH, Arora M. Health promotion for primordial prevention of tobacco use. Glob Heart 2015; 7:143-50. [PMID: 25691311 DOI: 10.1016/j.gheart.2012.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 06/11/2012] [Indexed: 11/16/2022] Open
Abstract
Prevention of tobacco use is critical for primordial prevention of cardiovascular diseases. Low- and middle-income countries such as India face a burgeoning burden of tobacco-related cardiovascular diseases. A focus on adolescents and young people is consistent with a primordial approach to cardiovascular disease prevention and appropriate given the natural history of tobacco use, in regards to its onset and progression. The primordial prevention approach is feasible, because it attempts to bring about behavior change (sustained abstinence for nonusers) at the population level. This paper reviews effective strategies for population-based tobacco control among adolescents including settings-based interventions at school, at home, and in the community, as well as policy and media interventions. It goes on to briefly touch on the pivotal role that medical professionals, particularly cardiologists, play in fortifying such interventions and summarizes some key recommendations based on review of evidence on the effectiveness of these interventions.
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Affiliation(s)
- Radhika Shrivastav
- Health Related Information Dissemination Amongst Youth (HRIDAY), New Delhi, India
| | - Gaurang P Nazar
- Health Related Information Dissemination Amongst Youth (HRIDAY), New Delhi, India
| | - Melissa H Stigler
- Michael and Susan Dell Center for Healthy Living, School of Public Health, University of Texas, Austin Regional Campus, Austin, TX, USA
| | - Monika Arora
- Health Related Information Dissemination Amongst Youth (HRIDAY), New Delhi, India; Public Health Foundation of India (PHFI), New Delhi, India
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Ferland A, Chu YL, Gleddie D, Storey K, Veugelers P. Leadership skills are associated with health behaviours among Canadian children. Health Promot Int 2014; 30:106-13. [PMID: 25348102 DOI: 10.1093/heapro/dau095] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Life skills development is a core area for action in the Ottawa Charter for Health Promotion. The role of life skills in influencing health behaviours among children has received little attention in research. The purpose of this cross-sectional study was to investigate the relationship between self-leadership, as a model of life skills, and diet quality, physical activity, sleep duration and body weight. A provincially representative sample of 2328 grade 5 students (aged 10-11 years) was surveyed in Alberta, Canada. Self-leadership skills were assessed based on student responses indicating frequency of performing various leadership traits. Diet quality was based on responses to the Harvard Youth/Adolescent Food Frequency Questionnaire and physical activity on responses to the Physical Activity Questionnaire for Children. Sleep duration was assessed based on parent survey responses, and body mass index determined based on measured height and weight. Random effects regression models with children nested within schools were used to determine the associations. Higher self-leadership was associated with better diet quality (P < 0.01) and more physical activity (P < 0.01). Although not statistically significant, higher self-leadership was suggestive of healthier body weight status (OR = 0.91, 95% CI = 0.66, 1.27). No association of self-leadership with sleep duration was found. The incorporation of leadership skill development may enhance the effectiveness of school-based health promotion programs. This study reinforces the importance of leadership skill promotion in the promotion of healthy eating and active living, which may help curb the obesity epidemic in the short term, and prevention of chronic diseases and mounting healthcare costs in the long term.
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Affiliation(s)
- Adam Ferland
- Department of Public Health Sciences, University of Alberta, Edmonton, AL, Canada
| | - Yen Li Chu
- Department of Public Health Sciences, University of Alberta, Edmonton, AL, Canada
| | - Doug Gleddie
- Department of Elementary Education, University of Alberta, Edmonton, AL, Canada
| | - Kate Storey
- Department of Public Health Sciences, University of Alberta, Edmonton, AL, Canada
| | - Paul Veugelers
- Department of Public Health Sciences, University of Alberta, Edmonton, AL, Canada
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Lydon DM, Wilson SJ, Child A, Geier CF. Adolescent brain maturation and smoking: what we know and where we're headed. Neurosci Biobehav Rev 2014; 45:323-42. [PMID: 25025658 PMCID: PMC4451244 DOI: 10.1016/j.neubiorev.2014.07.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/30/2014] [Accepted: 07/03/2014] [Indexed: 11/22/2022]
Abstract
Smoking is a leading cause of mortality and morbidity worldwide. Smoking initiation often occurs during adolescence. This paper reviews and synthesizes adolescent development and nicotine dependence literatures to provide an account of adolescent smoking from onset to compulsive use. We extend neurobiological models of adolescent risk-taking, that focus on the interplay between incentive processing and cognitive control brain systems, through incorporating psychosocial and contextual factors specific to smoking, to suggest that adolescents are more vulnerable than adults to cigarette use generally, but that individual differences exist placing some adolescents at increased risk for smoking. Upon smoking, adolescents are more likely to continue smoking due to the increased positive effects induced by nicotine during this period. Continued use during adolescence, may be best understood as reflecting drug-related changes to neural systems underlying incentive processing and cognitive control, resulting in decision-making that is biased towards continued smoking. Persistent changes following nicotine exposure that may underlie continued dependence are described. We highlight ways that interventions may benefit from a consideration of cognitive-neuroscience findings.
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Affiliation(s)
- David M Lydon
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, 315 Health and Human Development - East, University Park, PA 16802, United States.
| | - Stephen J Wilson
- Department of Psychology, The College of the Liberal Arts, The Pennsylvania State University, 311 Moore Building, University Park, PA 16802, United States
| | - Amanda Child
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, 315 Health and Human Development - East, University Park, PA 16802, United States
| | - Charles F Geier
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, 315 Health and Human Development - East, University Park, PA 16802, United States
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Stucki S, Kuntsche E, Archimi A, Kuntsche S. Does smoking within an individual's peer group affect intervention effectiveness? An evaluation of the Smoke-Free Class Competition among Swiss adolescents. Prev Med 2014; 65:52-7. [PMID: 24786759 DOI: 10.1016/j.ypmed.2014.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 04/17/2014] [Accepted: 04/18/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study is to test whether participation in the Smoke-Free Class Competition (SFC), a classroom-based smoking prevention program, reduced smoking and increased smoking-related knowledge among those with and without smoking peers compared to control groups. METHOD Including smoking peers as a moderator in multilevel models, a quasi-experimental design with a post-test at seven months was used to analyze data from 1035 students in Switzerland (2011; mean age 13.3, 53.2% female). RESULTS Completing the SFC decreased smoking prevalence (OR=0.7; CI=0.5-1.0; ns) and increased smoking-related knowledge (b=1.0; p<.01) compared to control classes. However, the former effect was only significant among those without smoking peers (OR=0.3; CI=0.2-0.5; p<.001). With smoking peers, smoking prevalence was even higher at post-test (OR=3.7; CI=1.7-8.2; p<.01) in the classes that completed SFC compared to controls. No effect was found in classes that started SFC but had to pull out. CONCLUSIONS The results indicate that SFC should be applied early in adolescence, when individuals are less likely to have classmates who smoke and are therefore less likely to have to pull out of the program. This is particularly important because SFC was only effective among those who completed the program and did not have smoking peers.
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Affiliation(s)
- Stephanie Stucki
- Addiction Switzerland, Research Institute, Lausanne, Switzerland
| | - Emmanuel Kuntsche
- Addiction Switzerland, Research Institute, Lausanne, Switzerland; Radboud University, Behavioural Science Institute, Nijmegen, The Netherlands
| | - Aurélie Archimi
- Addiction Switzerland, Research Institute, Lausanne, Switzerland
| | - Sandra Kuntsche
- Addiction Switzerland, Research Institute, Lausanne, Switzerland.
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Hiemstra M, Ringlever L, Otten R, van Schayck OCP, Jackson C, Engels RCME. Long-term effects of a home-based smoking prevention program on smoking initiation: a cluster randomized controlled trial. Prev Med 2014; 60:65-70. [PMID: 24355576 DOI: 10.1016/j.ypmed.2013.12.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 11/29/2013] [Accepted: 12/09/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aims of the study were to evaluate the long-term effects of a home-based smoking prevention program 'Smoke-free Kids' during preadolescence on smoking initiation during adolescence and to test the potential moderating role of parental smoking, socioeconomic status, and asthma. METHOD In 2008, 1478 9-11year old children and their mothers were recruited from 418 elementary schools in the Netherlands. An independent statistician randomly allocated schools to one of the two conditions using a 1:1 ratio (single blind): 728 children in the intervention and 750 in the control condition. The intervention condition received five activity modules, including a communication sheet for mothers, by mail at four-week intervals and one booster module one year after baseline. The control condition received a fact-based intervention only. Intention-to-treat analysis was performed on 1398 non-smoking children at baseline. RESULTS In the intervention 10.8% of the children started smoking compared to 12% in the control condition. This difference was non-significant (odds ratio=0.90, 95% confidence interval=0.63-1.27). No moderating effects were found. CONCLUSION No effects on smoking initiation after 36months were found. Perhaps, the program was implemented with children that were too young. Programs closer to the age of smoking onset should be tested.
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Affiliation(s)
- Marieke Hiemstra
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
| | - Linda Ringlever
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Roy Otten
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Onno C P van Schayck
- Department of General Practice, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Christine Jackson
- Public Health and Environment Division, RTI International, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA
| | - Rutger C M E Engels
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
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Isensee B, Hansen J, Maruska K, Hanewinkel R. Effects of a school-based prevention programme on smoking in early adolescence: a 6-month follow-up of the 'Eigenstandig werden' cluster randomised trial. BMJ Open 2014; 4:e004422. [PMID: 24448850 PMCID: PMC3902526 DOI: 10.1136/bmjopen-2013-004422] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To test the effects of a school-based prevention programme on students' smoking-related behaviour, attitudes and knowledge 6 months after implementation over 2 school-years has ended. DESIGN Two-arm prospective cluster randomised controlled trial with a follow-up survey 6 months after end of programme implementation, that is, 26 months after baseline. SETTING 45 public secondary schools from four federal states in Germany (Bremen, Hesse, North Rhine-Westphalia, Schleswig-Holstein). PARTICIPANTS A total of 3444 students from 172 classes with a mean age of 10.37 years (SD=0.59) and 47.9% girls at baseline. Analysis sample with follow-up up data merged to baseline data comprises 2513 datasets (73%). INTERVENTION 'Eigenständig werden 5+6', a school-based prevention programme for grades 5 and 6 to enhance substance-specific and general life skills, consisting of 14 units (à 90 min) and two workshops (4-6 h) being taught over a time period of 2 school-years by trained teachers. OUTCOME MEASURES Lifetime and current smoking, incidence of smoking in baseline never smokers, smoking-related knowledge, attitudes, perceived norms of smoking and self-efficacy to refuse cigarette offers were assessed in students. RESULTS 6 months after the end of programme implementation, students of intervention classes showed significantly lower rates for lifetime smoking (adjusted OR=0.63; 95% CI 0.41 to 0.96; p=0.026) and incidence of smoking (adjusted OR=0.66; 95% CI 0.43 to 1.00; p=0.047), a higher increase of smoking-related knowledge (adjusted β=9.38; 95% CI 6.73 to 12.04; p<0.001) and a greater change in attitudes towards a more critical perception of risks and disadvantages of smoking (adjusted β=0.10; 95% CI 0.03 to 0.16; p=0.002). No group differences were found for current smoking, perceived norms of smoking and self-efficacy to refuse cigarette offers. CONCLUSIONS Participation in the school-based prevention programme 'Eigenständig werden 5+6' may have small effects on smoking behaviour and attitudes and a moderate effect on smoking-related knowledge. TRIAL REGISTRATION Current Controlled Trials ISRCTN99442407.
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Affiliation(s)
- Barbara Isensee
- Institute for Therapy and Health Research (IFT-Nord), Kiel, Germany
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Vardavas C, Girvalaki C, Gratsiou C, Behrakis P. 11th Annual Conference of the International Society for the Prevention of Tobacco Induced Diseases (ISPTID). Tob Induc Dis 2014; 12:A1-A37. [PMID: 25933439 PMCID: PMC4101274 DOI: 10.1186/1617-9625-12-s1-a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Lee G, Lee J, Lee S. Risk factors of future smoking among Thai youth: a secondary analysis of the Thai Global Youth Tobacco Survey. Asia Pac J Public Health 2013; 27:NP2602-9. [PMID: 23666838 DOI: 10.1177/1010539513487015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study aimed to identify the risk factors for future smoking among Thai youth aged 13 to 15 years (seventh to ninth grade). Data from the nationally representative 2005 Thai Global Youth Tobacco Survey (n = 15 774) were analyzed using descriptive statistics and logistic regression. Among nonsmoking Thai youth, boys were much more likely to have intention of future smoking (odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.37-0.84). Younger youth were more likely to be cigarette smokers in the future (OR = 0.70, 95% CI = 0.56-0.88). Youth having the intention of smoking from a friend's cigarette offer were 5.29 times more likely to have intention of future smoking, compared with those who did not (95% CI = 3.75-7.46). Understanding and targeting youth at higher risk for future smoking can provide for a lowering of the youth smoking rate in Thailand and contribute to the country's continued efforts in effective youth tobacco control.
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Affiliation(s)
| | - Joann Lee
- University of California, San Diego, La Jolla, CA, USA
| | - Sungkyu Lee
- University of California, San Francisco, San Francisco, CA, USA
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Tahlil T, Woodman RJ, Coveney J, Ward PR. The impact of education programs on smoking prevention: a randomized controlled trial among 11 to 14 year olds in Aceh, Indonesia. BMC Public Health 2013; 13:367. [PMID: 23596980 PMCID: PMC3640933 DOI: 10.1186/1471-2458-13-367] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 04/15/2013] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND School-based smoking prevention programs have been shown to increase knowledge of the negative effects of smoking and prevent tobacco smoking. The majority of evidence on effectiveness comes from Western countries. This study investigated the impact of school-based smoking prevention programs on adolescents' smoking knowledge, attitude, intentions and behaviors (KAIB) in Aceh, Indonesia. METHODS We conducted a 2 × 2 factorial randomized controlled trial among 7(th) and 8(th) grade students aged 11 to 14 years. Eight schools were randomly assigned to a control group or one of three school-based programs: health-based, Islamic-based, or a combined program. Students in the intervention groups received eight classroom sessions on smoking prevention education over two months. The KAIB impact of the program was measured by questionnaires administered one week before and one week after the intervention. RESULTS A total of 477 students participated (58% female, 51% eighth graders). Following the intervention, there was a significant main effect of the Health based intervention for health knowledge scores (β = 3.9 ± 0.6, p < 0.001). There were significant main effects of the Islamic-based intervention in both health knowledge (β = 3.8 ± 0.6, p < 0.001) and Islamic knowledge (β = 3.5 ± 0.5, p < 0.001); an improvement in smoking attitude (β = -7.1 ± 1.5, p < 0.001). The effects of Health and Islam were less than additive for the health and Islamic factors for health knowledge (β = -3.5 ± 0.9, p < 0.01 for interaction) and Islamic knowledge (β = -2.0 ± 0.8, p = 0.02 for interaction). There were no significant effects on the odds of intention to smoke or smoking behaviors. CONCLUSIONS Both Health and Islamic school-based smoking prevention programs provided positive effects on health and Islamic related knowledge respectively among adolescents in Indonesia. Tailoring program interventions with participants' religion background information may provide additional benefits to health only focused interventions. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Register, ACTRN12612001070820.
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Affiliation(s)
- Teuku Tahlil
- Discipline of Public Health, School of Medicine, Flinders University, Adelaide, SA 5001, Australia.
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Sussman S, Levy D, Lich KH, Cené CW, Kim MM, Rohrbach LA, Chaloupka FJ. Comparing effects of tobacco use prevention modalities: need for complex system models. Tob Induc Dis 2013; 11:2. [PMID: 23339410 PMCID: PMC3567972 DOI: 10.1186/1617-9625-11-2] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 01/17/2013] [Indexed: 11/29/2022] Open
Abstract
Many modalities of tobacco use prevention programming have been implemented including various policy regulations (tax increases, warning labels, limits on access, smoke-free policies, and restrictions on marketing), mass media programming, school-based classroom education, family involvement, and involvement of community agents (i.e., medical, social, political). The present manuscript provides a glance at these modalities to compare relative and combined impact of them on youth tobacco use. In a majority of trials, community-wide programming, which includes multiple modalities, has not been found to achieve impacts greater than single modality programming. Possibly, the most effective means of prevention involves a careful selection of program type combinations. Also, it is likely that a mechanism for coordinating maximally across program types (e.g., staging of programming) is needed to encourage a synergistic impact. Studying tobacco use prevention as a complex system is considered as a means to maximize effects from combinations of prevention types. Future studies will need to more systematically consider the role of combined programming.
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Affiliation(s)
- Steve Sussman
- Departments of Preventive Medicine and Psychology, University of Southern California, Soto Street Building 302A, 2001 N. Soto Street, Los Angeles, CA, 90033-9045, USA
| | - David Levy
- Department of Oncology, Georgetown University, Washington, DC, WA, USA
| | - Kristen Hassmiller Lich
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Crystal W Cené
- University of North Carolina, School of Medicine, Chapel Hill, NC, USA
| | - Mimi M Kim
- University of North Carolina, Cecil G. Sheps Center for Health Services Research and the NCTRaCS Institute, Chapel Hill, NC, USA
| | - Louise A Rohrbach
- Departments of Preventive Medicine and Psychology, University of Southern California, Soto Street Building 302A, 2001 N. Soto Street, Los Angeles, CA, 90033-9045, USA
| | - Frank J Chaloupka
- Institute for Health Research and Policy, Health Policy Center, University of Illinois, Chicago, IL, USA
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