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Ollila H, Konttinen H, Ruokolainen O, Karvonen S. Are educational aspirations associated with susceptibility to smoking, e-cigarette use, and smokeless tobacco use in adolescence? Eur J Public Health 2024; 34:962-969. [PMID: 39111777 PMCID: PMC11430905 DOI: 10.1093/eurpub/ckae107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2024] Open
Abstract
The early socio-economic differences in smoking build on the interplay between individual-, family-, peer-, and school-related factors. The present study aimed to add knowledge to this by examining susceptibility to smoking (S-SM), electronic cigarette (e-cigarette) use (S-EC), and smokeless tobacco (snus) use (S-SN) by educational aspirations in a country with advanced tobacco control policies. National cross-sectional School Health Promotion study survey was conducted among 8.-9. grade students (av. 15-year-olds) in 2017 with no prior smoking (n = 47 589), e-cigarette use (n = 49 382), or snus use (n = 53 335). Gender-stratified, age-adjusted multilevel logistic regression analyses with S-SM, S-EC, and S-SN were considered as outcomes and student- and school-level (aggregated) factors were considered as independent variables. The highest prevalence was observed for S-EC (girls 29%, boys 35%), followed by S-SM (16%, 15%) and S-SN (10%, 16%). Compared to those planning for general upper secondary education, S-SM was the highest for those without educational aspirations (OR = 1.20, 95% CI = 1.04-1.40), S-EC for those planning for vocational education [1.15 (1.05-1.25)], and S-SN for those planning for extra year/discontinuation [1.65 (1.04-2.60)] among girls. Among boys, both S-SM [1.37 (1.23-1.52)] and S-EC [1.19 (1.09-1.29)] were the highest among those planning for vocational education, with no clear associations with S-SN. Current other tobacco/e-cigarette use [OR range 1.27-8.87], positive attitude towards product use in one's age group [3.55-6.63], and liking school [0.58-0.68] consistently associated with susceptibility. Students not planning for academically oriented education had higher susceptibility to different nicotine products. High S-EC warrants monitoring to strengthen policy evaluation and prevention.
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Affiliation(s)
- Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Social Psychology, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Hanna Konttinen
- Social Psychology, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Otto Ruokolainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sakari Karvonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Liu S, Zhou H, He W, Yang J, Yin X, Shalayiding S, Ren N, Zhou Y, Rao X, Zhang N, Xiong M, Wang Y, Yang W, Wu Y, Chen J. Risk profiling of tobacco epidemic and estimated number of smokers living in China: a cross-sectional study based on PBICR. BMC Public Health 2024; 24:2219. [PMID: 39148035 PMCID: PMC11325620 DOI: 10.1186/s12889-024-18559-x] [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] [Received: 09/15/2023] [Accepted: 04/09/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Evidence on the prevalence of smoking in China remains insufficient, with most previous studies focusing on a single region. However, smoking prevalence exhibits significant inequalities across the entire country. This study aimed to evaluate the risk of tobacco prevalence across the country, taking into account spatial inequalities. METHODS The data used in this study were collected in 23 provinces, 5 autonomous regions, and 4 municipalities directly under the central government in 2022. Large population survey data were used, and a Bayesian geostatistical model was employed to investigate smoking prevalence rates across multiple spatial domains. FINDINGS Significant spatial variations were observed in smokers and exposure to secondhand smoke across China. Higher levels of smokers and secondhand smoke exposure were observed in western and northeastern regions. Additionally, the autonomous region of Tibet, Shanghai municipality, and Yunnan province had the highest prevalence of smokers, while Tibet, Qinghai province, and Yunnan province had the highest prevalence of exposure to secondhand smoke. CONCLUSION We have developed a model-based, high-resolution nationwide assessment of smoking risks and employed rigorous Bayesian geostatistical models to help visualize smoking prevalence predictions. These prediction maps provide estimates of the geographical distribution of smoking, which will serve as strong evidence for the formulation and implementation of smoking cessation policies. HIGHLIGHTS Our study investigated the prevalence of smokers and exposure to secondhand smoke in different spatial areas of China and explored various factors influencing the smoking prevalence. For the first time, our study applied Bayesian geostatistical modeling to generate a risk prediction map of smoking prevalence, which provides a more intuitive and clear understanding of the spatial disparities in smoking prevalence across different geographical regions, economic levels, and development status. We found significant spatial variations in smokers and secondhand smoke exposure in China, with higher rates in the western and northeastern regions.
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Affiliation(s)
- Siyuan Liu
- School of Public Health, Southern Medical University, Guangzhou510515, Guangzhou510515, China
| | - Haozheng Zhou
- School of Public Health, Southern Medical University, Guangzhou510515, Guangzhou510515, China
| | - Wenjun He
- School of Public Health, Southern Medical University, Guangzhou510515, Guangzhou510515, China
| | - Jiao Yang
- School of Health Management, Southern Medical University, Guangzhou510515, China
| | - Xuanhao Yin
- School of Public Health, Southern Medical University, Guangzhou510515, Guangzhou510515, China
| | - Sufelia Shalayiding
- School of Health Management, Southern Medical University, Guangzhou510515, China
| | - Na Ren
- Institute of Chinese Medical Sciences, University of Macau, Macau, China
- Operation Management Department, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China
| | - Yan Zhou
- Operation Management Department, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China
| | - Xinyi Rao
- School of Health Management, Southern Medical University, Guangzhou510515, China
| | - Nuofan Zhang
- School of Health Management, Southern Medical University, Guangzhou510515, China
| | - Man Xiong
- School of Health Management, Southern Medical University, Guangzhou510515, China
| | - Yueying Wang
- School of Health Management, Southern Medical University, Guangzhou510515, China
| | - Wenfu Yang
- School of Health Management, Southern Medical University, Guangzhou510515, China
| | - Yibo Wu
- School of Public Heath, Peking University, Beijing100091, China.
| | - Jiangyun Chen
- School of Public Health, Southern Medical University, Guangzhou510515, Guangzhou510515, China.
- School of Health Management, Southern Medical University, Guangzhou510515, China.
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Collonnaz M, Minary L, Riglea T, Kalubi J, O'Loughlin J, Kestens Y, Agrinier N. Lack of consistency in measurement methods and semantics used for network measures in adolescent health behaviour studies using social network analysis: a systematic review. J Epidemiol Community Health 2024; 78:303-310. [PMID: 38290822 DOI: 10.1136/jech-2023-220980] [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] [Received: 06/10/2023] [Accepted: 01/21/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Social network analysis (SNA) is often used to examine how social relationships influence adolescent health behaviours, but no study has documented the range of network measures used to do so. We aimed to identify network measures used in studies on adolescent health behaviours. METHODS We conducted a systematic review to identify network measures in studies investigating adolescent health behaviours with SNA. Measures were grouped into eight categories based on network concepts commonly described in the literature: popularity, position within the network, network density, similarity, nature of relationships, peer behaviours, social norms, and selection and influence mechanisms. Different subcategories were further identified. We detailed all distinct measures and the labels used to name them in included articles. RESULTS Out of 6686 articles screened, 201 were included. The categories most frequently investigated were peer behaviours (n=201, 100%), position within the network (n=144, 71.6%) and popularity (n=110, 54.7%). The number of measurement methods varied from 1 for 'similarity on popularity' (within the 'similarity' category) to 28 for the 'characterisation of the relationship between the respondent and nominated peers' (within the 'nature of the relationships' category). Using the examples of 'social isolation', 'group membership', 'individuals in a central position' (within the 'position within the network' category) and 'nominations of influential peers' (sub within the 'popularity' category), we illustrated the inconsistent reporting and heterogeneity in measurement methods and semantics. CONCLUSION Robust methodological recommendations are needed to harmonise network measures in order to facilitate comparison across studies and optimise public health intervention based on SNA.
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Affiliation(s)
| | | | - Teodora Riglea
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
- École de Santé Publique de l'Université de Montréal, Département de médecine sociale et préventive, Montréal, Quebec, Canada
| | - Jodi Kalubi
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
- École de Santé Publique de l'Université de Montréal, Département de médecine sociale et préventive, Montréal, Quebec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal & CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Université de Montréal, Montréal, Quebec, Canada
| | - Jennifer O'Loughlin
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
- École de Santé Publique de l'Université de Montréal, Département de médecine sociale et préventive, Montréal, Quebec, Canada
| | - Yan Kestens
- École de Santé Publique de l'Université de Montréal, Département de médecine sociale et préventive, Montréal, Quebec, Canada
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal (UdeM), Montréal, Québec, QC, Canada
| | - Nelly Agrinier
- Université de Lorraine, Inserm, INSPIIRE, Nancy, France
- CHRU-Nancy, INSERM, Université de Lorraine, CIC-EC, Epidémiologie Clinique, Nancy, France
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Radó MK, Kisfalusi D, Laverty AA, van Lenthe FJ, Been JV, Takács K. Socio-economic inequalities in smoking and drinking in adolescence: Assessment of social network dynamics. Addiction 2024; 119:488-498. [PMID: 37994195 DOI: 10.1111/add.16384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/04/2023] [Indexed: 11/24/2023]
Abstract
AIMS We investigated whether (1) adolescents selected friends with a similar socio-economic status (SES), (2) smoking and alcohol consumption spread in networks and (3) the exclusion of non-smokers or non-drinkers differed between SES groups. DESIGN This was a longitudinal study using stochastic actor-oriented models to analyze complete social network data over three waves. SETTING Eight Hungarian secondary schools with socio-economically diverse classes took part. PARTICIPANTS This study comprised 232 adolescents aged between 14 and 15 years in the first wave. MEASUREMENTS Self-reported smoking behavior, alcohol consumption behavior and friendship ties were measured. SES was measured based upon entitlement to an income-tested regular child protection benefit. FINDINGS Non-low-SES adolescents were most likely to form friendships with peers from their own SES group [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.02-1.11]. Adolescents adjusted their smoking behavior (OR = 24.05, 95% CI = 1.27-454.86) but not their alcohol consumption (OR = 1.65, 95% CI = 0.62-4.39) to follow the behavior of their friends. Smokers did not differ from non-smokers in the likelihood of receiving a friendship nomination (OR = 0.98, 95% CI = 0.87-1.10), regardless of their SES. Alcohol consumers received significantly more friendship nominations than non-consumers (OR = 1.16, 95% CI = 1.01-1.33), but this association was not significantly different according to SES. CONCLUSIONS Hungarian adolescents appear to prefer friendships within their own socio-economic status group, and smoking and alcohol consumption spread within those friendship networks. Socio-economic groups do not differ in the extent to which they encourage smoking or alcohol consumption.
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Affiliation(s)
- Márta K Radó
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Institute for Analytical Sociology, Department of Management and Engineering, Linköping University, Norrköping, Sweden
- Division of Neonatology, Department of Paediatrics, Erasmus MC, Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Dorottya Kisfalusi
- HUN-REN Centre for Social Sciences, Computational Social Science-Research Center for Educational and Network Studies (CSS - RECENS), Budapest, Hungary
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Frank J van Lenthe
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, the Netherlands
| | - Jasper V Been
- Division of Neonatology, Department of Paediatrics, Erasmus MC, Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, the Netherlands
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Károly Takács
- Institute for Analytical Sociology, Department of Management and Engineering, Linköping University, Norrköping, Sweden
- HUN-REN Centre for Social Sciences, Computational Social Science-Research Center for Educational and Network Studies (CSS - RECENS), Budapest, Hungary
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Mikhaylova O. Russian young people's subjective health evaluations, self-care practices, and therapeutic networks. Front Psychol 2024; 15:1247445. [PMID: 38586288 PMCID: PMC10995920 DOI: 10.3389/fpsyg.2024.1247445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 02/13/2024] [Indexed: 04/09/2024] Open
Abstract
This study investigates the relationship between young people's subjective health evaluations, self-care practices, and therapeutic networks using semi-structured interviews and the computerized qualitative thematic analysis capabilities of the MAXQDA software. In the summer of 2022, 41 Russian youths, ages 16 to 25, took part in this investigation. The major findings demonstrate that young people who had low health evaluations were more likely to conduct self-care with the intention of enhancing their health and to have mothers and other medical experts in their therapeutic networks. Furthermore, individuals who claimed that their health was inadequate engaged in more sports and took care of themselves even when they were ill. There was no association between the objectives of self-care practices, members of the therapeutic network, and self-care activities in terms of the type of health evaluation. Overall, it is possible to suggest that the practices and the structure of therapeutic networks are related to self-evaluated health, but quantitative study is needed to verify the causal relationship.
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Affiliation(s)
- Oxana Mikhaylova
- Centre for Modern Childhood Research, HSE University, Moscow, Russia
- Department for Social Institutions Analysis, HSE University, Moscow, Russia
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Littlecott HJ, Moore GF, Evans RE, Melendez-Torres GJ, McCann M, Reed H, Mann M, Dobbie F, Jennings S, Donaldson C, Hawkins J. Perceptions of friendship, peers and influence on adolescent smoking according to tobacco control context: a systematic review and meta-ethnography of qualitative research. BMC Public Health 2023; 23:424. [PMID: 36869343 PMCID: PMC9983235 DOI: 10.1186/s12889-022-14727-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/25/2022] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND A relationship between smoking and interpersonal influences has been well established within the literature. There have been cultural shifts in denormalisation and a reduction in tobacco smoking in many countries. Hence there is a need to understand social influences on adolescents' smoking across smoking normalisation contexts. METHODS The search was conducted in July 2019 and updated in March 2022 within 11 databases and secondary sources. Search terms included schools, adolescents, smoking, peers, social norms and qualitative research. Screening was conducted by two researchers independently and in duplicate. Study quality was assessed using the eight-item Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-centre) tool for the appraisal of qualitative studies. Results were synthesised using a meta-narrative lens for meta-ethnography and compared across smoking normalisation contexts. RESULTS Forty one studies were included and five themes were developed, mapping onto the socio ecological model. The social processes by which adolescents take up smoking differed according to a mixture of school type, peer group structure and the smoking culture within the school, as well as the wider cultural context. Data available from smoking denormalised contexts, described changes in social interactions around smoking to cope with its stigmatisation. This was manifested through i) direct peer influence, whereby subtle techniques were employed, ii) group belonging whereby smoking was less likely to be seen as a key determinant of group membership and smoking was less commonly reported to be used as a social tool, and iii) popularity and identity construction, whereby smoking was perceived more negatively in a denormalised context, compared with a normalised context. CONCLUSIONS This meta-ethnography is the first study to demonstrate, drawing on international data, that peer processes in adolescent smoking may undergo changes as smoking norms within society change. Future research should focus on understanding differences across socioeconomic contexts, to inform the adaptation of interventions.
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Affiliation(s)
- H J Littlecott
- Pettenkofer School of Public Health (PSPH), Institute for Medical Information Processing, Biometry and Epidemiology (IBE), LMU Munich, Elisabeth-Winterhalter-Weg 6, Munich, 81377, Germany.
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK.
| | - G F Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
| | - R E Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group (PenTAG), South Cloisters, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - M McCann
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - H Reed
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
| | - M Mann
- Specialist Unit for Review Evidence, Cardiff University, 6th Floor, Neuadd Meirionnydd, Heath Park Campus, Cardiff, CF14 4YS, UK
| | - F Dobbie
- Usher Institute- University of Edinburgh, Doorway 1, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - S Jennings
- Teaching and Learning for Health Professionals, Bristol Medical School, Faculty of Health Sciences, University of Bristol, 39-41 St Michael's Hill, Bristol, BS2 8EZ, UK
| | - C Donaldson
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
| | - J Hawkins
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK
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