Smoking, alcohol consumption, and illicit substances use among adolescents in Poland

The Relation of Social-ecological Factors and Health Literacy to Medical Students' Alcohol Use Behavior in Hubei Province, China

BACKGROUND

Health literacy (HL) plays a crucial role in the adolescent's behavior. Inadequate HL can contribute to engaging in risky alcohol consumption, but little is known about this relationship among medical students. We aimed to investigate the relationship between HL and alcohol use among Chinese medical students. Study Design: A cross-sectional design.

METHODS

This research was conducted on 1146 medical students in Hubei province, China. The data were collected using a web-based online questionnaire. Multiple logistic regression was applied to investigate factors related to alcohol use.

RESULTS

Approximately 45.3% of medical students were drinkers, about 11.5% were hazardous drinkers, and 33.8% were low-risk drinkers; furthermore, about 49.3% of them reported lower levels of HL. In both the low-risk and hazardous drinking groups, the subjects who had low levels of all six dimensions of HL were more likely to use alcohol after adjusting for other covariates, including cognitive skill (adjORfor low-risk=3.50; 95% CI: 2.41, 5.07, adjORhazardous=2.07; 95% CI: 1.22, 3.51), access skill (adjORfor low-risk=2.11; 95% CI: 1.46, 3.05, adjORhazardous=2.40; 95% CI: 1.37, 4.19), communication skill (adjORfor low-risk=1.72; 95% CI: 1.20, 2.47, adjORhazardous=2.21; 95% CI: 1.22, 4.00), self-management skill (adjORfor low-risk=1.73; 95% CI: 1.15, 2.59, adjORhazardous=4.01; 95% CI: 1.91, 8.44), media skill (adjORfor low-risk=1.50; 95% CI: 1.01, 2.23, adjORhazardous=4.68; 95% CI: 2.15, 10.17), and decision skill (adjORfor low-risk=2.12; 95% CI: 1.49, 3.00, adjORhazardous=2.25; 95% CI: 1.35, 3.74).

CONCLUSION

Inadequate HL plays an important role in increasing alcohol use. Thus, prevention and intervention strategies should be based on improving medical students' HL.

Substance Use and Psychological Distress in Mexican Adults during COVID-19 Pandemic: A Cross-Sectional Study

OBJECTIVES

This observational cross-sectional study examined changes in substance use during the coronavirus disease 2019 (COVID-19) pandemic in the Mexican population and evaluated whether depression or anxiety was associated with these new consumption patterns.

METHODS

An online survey was distributed to the general population. Participants were questioned about their demographics, situation during the COVID-19 pandemic, and substance consumption patterns. The Patient Health Questionnaire-9 for depression and the Coronavirus Anxiety Scale were used.

RESULTS

A total of 866 individuals completed the survey. The mean scores for the Patient Health Questionnaire-9 and Coronavirus Anxiety Scale were 8.89 ± 6.20 and 3.48 ± 3.22, respectively. The preferred substances were alcohol (19%), tobacco (16.5%), and marijuana (5.6%). Consumption of alcohol (p = 0.042) significantly increased during the pandemic and it was higher in women than in men (p = 0.040).

CONCLUSIONS

Substance use patterns were affected by the pandemic, with an increase in the number of users and consumption rate, as well as the reported psychiatric symptoms.

Self-perceived substance and behavioral addictions among Jewish Israeli adolescents during the COVID-19 pandemic

This study examined self-perceived substance and behavioral addictions among Israeli adolescents during the COVID-19 pandemic across different sociodemographic categories. The sample comprised 2,074 adolescents (40% males, 60% females) aged 12-19 years who completed the survey anonymously and with parental consent. We examined what is the prevalence of self-perceived substance and behavioral addictions in this population in the COVID-19 pandemic context. Participants reported self-perceived addictions to social networks (70%), shopping (46%), binge eating (34%), gaming (30%), sex-related behavior (15%), psychoactive substance (31%, including alcohol, tobacco, cannabis, and/or cocaine), and gambling (3%). Moreover, differences were found to be directly related to age, biological sex, religiosity, socioeconomic status, and immigration status. From a lay epidemiological perspective, the current research expands our knowledge about self-perceived addiction among adolescents during the COVID-19 pandemic, offering better understanding of the likelihood probability factors for self-perceived addiction among adolescents and its related negative outcomes, including increased risk factors for later adult life.

Deriving Normative Data on 24-Hour Ambulatory Blood Pressure Monitoring for South Asian Children (ASHA): A Clinical Research Protocol

BACKGROUND

The global prevalence of hypertension in children and adolescents has increased over the past 2 decades and is the strongest predictor of adult hypertension. South Asians have an increased prevalence of metabolic syndrome associated risk factors including abdominal obesity, diabetes, and hypertension. All these factors contribute to their increased cardiovascular disease burden. Accurate and early identification of hypertension in South Asian children is a necessary aspect of cardiovascular disease prevention. Ambulatory blood pressure monitoring (ABPM) is considered the gold-standard for pediatric blood pressure (BP) measurement. However, its utilization is limited due to the lack of validated normative reference data in diverse, multiethnic pediatric populations.

OBJECTIVE

The primary objective is to establish normative height-sex and age-sex-specific reference values for 24-h ABPM measurements among South Asian children and adolescents (aged 5-17 years) in Ontario and British Columbia, Canada. Secondary objectives are to evaluate differences in ABPM measurements by body mass index classification, to compare our normative data against pre-existing data from German and Hong Kong cohorts, and to evaluate relationships between habitual movement behaviors, diet quality, and ABPM measurements.

DESIGN

Cross-sectional study, quasi-representative sample.

SETTING

Participants will be recruited from schools, community centers, and places of worship in Southern Ontario (Greater Toronto and Hamilton area, including the Peel Region) and Greater Vancouver, British Columbia.

PARTICIPANTS

We aim to recruit 2113 nonoverweight children (aged 5-17 years) for the primary objective. We aim to recruit an additional 633 overweight or obese children to address the secondary objectives.

MEASUREMENTS

Ambulatory BP monitoring measurements will be obtained using Spacelabs 90217 ABPM devices, which are validated for pediatric use. The ActiGraph GT3X-BT accelerometer, which has also been validated for pediatric use, will be used to obtain movement behavior data.

METHODS

Following recruitment, eligible children will be fitted with 24-h ABPM and physical activity monitors. Body anthropometrics and questionnaire data regarding medical and family history, medications, diet, physical activity, and substance use will be collected. Ambulatory BP monitoring data will be used to develop height-sex- and age-sex-specific normative reference values for South Asian children. Secondary objectives include evaluating differences in ABPM measures between normal weight, overweight and obese children; and comparing our South Asian ABPM data to existing German and Hong Kong data. We will also use compositional data analysis to evaluate associations between a child's habitual movement behaviors and ABPM measures.

LIMITATIONS

Bloodwork will not be performed to facilitate recruitment. A non-South Asian comparator cohort will not be included due to feasibility concerns. Using a convenience sampling approach introduces the potential for selection bias.

CONCLUSIONS

Ambulatory BP monitoring is a valuable tool for the identification and follow-up of pediatric hypertension and overcomes many of the limitations of office-based BP measurement. The development of normative ABPM data specific to South Asian children will increase the accuracy of BP measurement and hypertension identification in this at-risk population, providing an additional strategy for primary prevention of cardiovascular disease.

Clinical characteristics and health outcomes in patients with alcohol withdrawal syndrome: an observational study from Oman

BACKGROUND

Globally, alcohol withdrawal syndrome (AWS) is considered a serious medical diagnosis associated with increasing morbidity and mortality. Little information has been reported on the scope of the problem in Oman.

OBJECTIVE

Study clinical characteristics, management, quality of care, and health outcomes of patients managed for AWS.

DESIGN

Retrospective medical record review.

SETTINGS

University hospital.

PATIENTS AND METHODS

The study included all patients with AWS admitted from 1 October 2019 to 30 September 2020. We collected demographic and clinical characteristics and did a univariate analysis of factors related to 90-day readmission.

MAIN OUTCOME MEASURES

Length of hospital stay, 90-day read-mission, referral rate to alcohol rehabilitation center.

SAMPLE SIZE AND CHARACTERISTICS

150 male patients with median (IQR) age of 39.5 (32-48) years.

RESULTS

Most patients (70.7%, n=106) were smokers and 44 (29.3%) had a history of drug abuse. The average length of hospital stay was 2.3 (0.9-4.6) days. Approximately 9% of total hospital bed days were used to care for patients with AWS. Chronic liver disease (35.3%), diabetes mellitus (24.7%), and hypertension (24.0%) were common among AWS patients. The 90-day readmission rate (32.7%) was high, and there was low referral to alcohol rehabilitation (16.7%). Diabetes and epilepsy were associated with 90-day readmission.

CONCLUSION

AWS is an important diagnosis that represents an important burden on acute medical services. Establishing a drug and alcohol service in our institution is an essential step to optimise care for patients with alcohol-related disorders.

LIMITATIONS

Retrospective, so unable to collect data on manifestations of AWS such as delirium tremens, which is the most severe form of AWS. Also, the reason for the lack of referral to an outpatient alcohol rehabilitation program was not apparent.

CONFLICT OF INTEREST

None.

Factors Related to Adolescent Smoking: A Nationally Representative Cross-Sectional Study in Thailand

Objective: This study aimed to explore the individual, familial, and social factors associated with different smoking status in Thai adolescents from the 2017 Cigarette Smoking and Alcohol Drinking Behavior Survey (CSAD) Methods: The nationally representative sample of 6046 adolescents aged 15-19 years who took part in the 2017 CSAD in Thailand. Multinomial logistic regression analysis was conducted to explore the associations between the individual, familial, and social factors and different smoking status.   Results: The daily smoking and occasional smoking was 6.4% and 3.3%, respectively. Gender, alcohol use, substance use, attitudes toward smoking, exposure to secondhand smoke at home, anti-smoking social media campaign, and graphic warning labels were related to both daily and occasional smoking. Daily smoking was associated with exposure to secondhand smoke at school, restaurant, and public transport, and exposure to tobacco advertising. Conclusion: These findings suggest that smoking prevention intervention should particularly focus on these factors and also need to develop the anti-smoking policies for smoking prevention among adolescents.

Illicit Drug Use Pattern, Health-Risk Behaviors, and Social Contexts Among Indonesian Students

Health-risk behaviors (smoking, alcohol consumption, and premarital sex) among Indonesian students are important issues. Understanding the association of these health-risk behaviors and adolescents’ social contexts (family, peers, and neighborhood characteristics) to illicit drug use is required to develop strategies in preventing illicit drug use in Indonesia. The study used a multi-stage cluster random sampling method to collect data from the 2016 National Narcotics Survey of Indonesian students. The sample included 31,439 students. The result shows that the illicit drug use pattern was different from previous studies: the most prevalent was at the senior high school level. Multiple logistic regression analyses showed that smoking, alcohol consumption, premarital sex, peers, sex, family, and neighborhood were associated with illicit drug use. The study highlighted the importance of health-risk behaviors, social contexts of adolescents, and the illicit drug use pattern as considering factors in developing strategies to reduce illicit drug use prevalence.

Awareness and Attitudes of Mongolian Adolescents and Youth toward Alcohol Consumption and Alcohol-related Harm

BACKGROUND

This study aimed to examine alcohol consumption among Mongolian adolescents and youth, as well as their awareness and attitudes toward alcohol-related consequences.

METHODS

We analyzed cross-sectional data collected from students in secondary schools, colleges, and universities in Ulaanbaatar, Mongolia, using descriptive analysis methods.

FINDINGS

More than half of respondents had tried alcohol in the past, and 15.9% of high school students and 58.8% of university students had consumed alcohol in the last month (P = 0.0001). In total, 70.0% of respondents celebrated holidays with alcohol, 23.4% had economic problems due to alcohol consumption, 7.8% had health problems 1-2 times in the last 30 days, and roughly 36.0% had negative attitudes toward alcohol. Approximately, 15.0% of adolescents and young people had an insufficient understanding of anti-alcohol measures and laws.

CONCLUSION

Our findings suggest that Mongolian adolescents and youth have a high level of alcohol consumption and insufficient awareness and attitude regarding alcohol-related harm.

Polish High School Students' Knowledge about Cancer

Background: Cancer, as the second most common cause of death after cardiovascular diseases, is a global health problem. There is still an increasing number of cancer incidences and deaths. Methods: The study was conducted as a part of the health promotion educational project concerning oncological education to develop the knowledge of cancer risk factors among high school students in Poland. A special questionnaire was filled out by students before the educational lesson on cancer conducted by medical students and young doctors. Results: The study was carried out on 227 high school students (aged 17–18 years). Most students (67.5%) indicated that genetic predisposition is the most important cancer risk factor. Only about a quarter of students pointed to the relationship between lifestyle and cancer. Moreover, 41% of students admitted to smoking cigarettes. Most of them (80.6%) claimed that they can modify their own cancer risk. Almost all responders believed that early detected cancer is curable. Conclusions: High school students do not know about cancer risk factors and they do not relate cancer with lifestyle. Some students indicated bad lifestyle habits such as tobacco smoking. It is necessary to emphasize cancer prevention in early education, especially focusing on modification of lifestyle.

The Association between Sociocultural Factors and Substance Use among Haramaya University Students

All the associated risk factors were not equally responsible for influencing individuals either in alcohol use, khat use, tobacco, or cannabis use. This study attempted to examine sociocultural factors influencing university students in substance use by comparing one with another. A cross-sectional study was carried out. The study used a quantitative approach to collect data from 384 students. Compared with their involvement in khat use, female students were positively influenced in cigarette and hashish use (Adjusted Odds Ratio, AOR = 1.102, 95% CI: 1.056, 1.149) and alcohol use (AOR = 1.066, 95% CI: 1.021, 1.113). The involvement of students in alcohol use (AOR = 0.884, 95% CI: 0.838, 0.932) and cigarettes and hashish use (AOR = 0.909, 95% CI: 0.866, 0.953) were negatively associated with stress related to their academic activities. The involvement of students in alcohol use (AOR = 0.942, 95% CI: 0.906, 0.979) was negatively associated with parental influences; involved in alcohol use (AOR = 0.445, 95% CI: 0.210, 0.941) was negatively associated with the thoughts of considering substances as an energizer. The involvement of students in alcohol use (AOR = 4.980, 95% CI: 1.614, 15.368) was positively associated with peer influences. It was, thus, suggested that the management of Haramaya University should work on creating awareness of the negative consequences of substance use. Concerned professionals, including sociologists, psychologists, and health workers, should work on raising students’ awareness as it was possible to undertake their studies without substance use. Moreover, the university management is strongly recommended to expand recreational centers within the campus. Lastly, Haramaya woreda administration should restrict the availability and accessibility of these substances around the campus.

Clustering of South Korean Adolescents' Health-Related Behaviors by Gender: Using a Latent Class Analysis

Background: Health-related behaviors during adolescence could influence adolescents’ health outcomes, leading to either advantageous or deteriorative conditions. Clustering of adolescents’ health-related behaviors by gender identifies the target groups for intervention and informs the strategies to be implemented for behavioral changes. Methods: Data from 1807 adolescents in grades 7 and 10 in a city in South Korea were used. Health-related behaviors including eating habits, physical activity, hand washing, brushing teeth, drinking alcohol, smoking, and Internet use were examined. Latent class analysis (LCA) was used to identify subgroups of adolescents with regard to their health-related behaviors. Results: A four-class model was the most adequate grouping classification across genders: adolescents with (1) healthy behaviors, (2) neither health-promoting nor health-risk behaviors, (3) good hygiene behaviors, and (4) unhealthy behaviors. The majority of both male and female adolescents were classified into the healthy group. Male adolescents belonging to the healthy group were more likely to engage in vigorous physical activities, while vigorous physical activity was not important for female adolescents. The smallest group was the unhealthy group, regardless of gender; however, the proportion of boys in the unhealthy group was almost twice that of girls. Only female adolescents engaged in excessive Internet use, especially the group with neither health-promoting nor health-risk behaviors. Conclusion: To improve adolescents’ health-related behaviors, it would be more effective to develop tailored interventions considering the behavioral profiles of the target groups.

Serum proteome assessment in nonalcoholic fatty liver disease in children: a preliminary study

OBJECTIVES

Nonalcoholic fatty disease (NAFLD) affects 3-10% of the pediatric population, making it the most common chronic liver disease among children. The aim of the study is to identify potential biomarkers enabling the diagnosis of NAFLD and monitoring the course of the disease.

METHODS

Proteome analysis was performed in a group of 30 patients (19 boys and 11 girls) in total, of whom 16 children had previously diagnosed NAFLD based on the abdominal ultrasound after excluding other diseases of this organ.

RESULTS

A total of 297 proteins have been identified. Thirty-seven proteins (responsible for inflammation, stress response, and regulation of this process) differentiating both experimental groups were identified. Up-regulated proteins included afamin, retinol-binding protein-4, complement components, and hemopexin; while serum protease inhibitors, clusterin, immunoglobulin chains, and vitamin D binding protein were found in the down-regulated group. The correlation between selected proteins and indicators of noninvasive assessment of liver fibrosis (APRI, FIB-4) as well as differences between the serum proteome of patients with normal weight, overweight, and obesity were also assessed.

CONCLUSION

The plasma protein profile is significantly altered in nonalcoholic liver disease in children and may prove to be a valuable source of biomarkers to evaluate the extent of liver disease.

Factors influencing alcohol use among female in-school adolescents in the Western Cape, South Africa

The increasing levels and more frequent use of alcohol among females, especially those in younger age groups, is a worldwide concern. An in-depth understanding of this phenomenon is, however, limited. This study aimed to explore the factors influencing alcohol use among female adolescent students as guided by the ecological systems theory of Bronfenbrenner. Data were collected from 25 female high school students in Grade 9 in the Western Cape, South Africa, using five individual semi-structured interviews and two focus group discussions with each group comprising 10 students. Thematic analysis was used to analyse the data. The findings of the study indicated that participants begin drinking at an early age and due to low self-esteem, which makes them prone to peer influence. Female adolescents are also influenced by various factors residing within the microsystem (family members and peers), mesosystem (lack of parental attention, weak mother-to-daughter relationship, influence of peers and dating partners), exosystem (media advertisement and lifestyle of celebrities), macrosystem (change in societal roles), and chronosystem (transition to higher education). Interventions are needed in schools to help female adolescents resist peer pressure and cope with the changing environment of high school. Also, parents should be educated on the influence of their drinking behaviour on their children in order for them to be more cautious when drinking at home. Adolescent students will benefit from educational materials on the harmfulness of alcohol use.

Mental health states and influencing factors of risky and problem drinking in South Korean female adolescents

OBJECTIVES

Alcohol is one of the most used and abused psychoactive substances by adolescents. We investigated influencing factors of risky and problem drinking in Korean female adolescents.

STUDY DESIGN

The study design used is a cross-sectional modeling.

METHODS

We used data from the 13th Korean Youth Risk Behavior Web-based Survey (KYRBS) conducted in 2017. KYRBS data were obtained from a stratified, multistage, clustered sample. Risky drinking was binge drinking and problem drinking was drinking with several conflicts association with alcohol consumption.

RESULTS

Among 62,276 participants, the rates of current, risky, and problem drinking among all participants were 16.1%, 8.3%, and 6.1%, respectively. Although all of these rates were higher in males, risky and problem drinking rates among current female drinkers were higher than those of males (55.4 vs 48.5%, 38.9 vs 37.2%, respectively). Problem drinking was most strongly associated with risky drinking (adjusted odds ratio: 17.53 [95% confidence interval: 14.63-21.00]), similarly, risky drinking was most strongly associated with problem drinking in female current drinkers (17.76 [14.84-21.27]). Current smoking was the second strongest risk factor for risky and problem drinking in females (5.22 [3.92-6.95] and 2.93 [2.21-3.89], respectively).

CONCLUSION

Many female adolescents in Korea drink alcohol in an unhealthy manner. The female risky and problem drinking rates among current drinkers were higher than those of males. Risky drinking and problem drinking was most significant influencing factor among females, reciprocally. Public education on abstinence in female adolescents is warranted.

Determinants of substance use among young people attending an urban primary health center in Delhi

Introduction Substance abuse remains one of the major challenges in young people, as it is one of the top five causes of disability-adjusted life years (DALY). The present study aims to find the prevalence and determinants of substance use among young people attending an urban primary health center in Delhi. Methodology Systematic random sampling was used to enroll the calculated sample size of 190. Substance use was assessed using ASSIST (an Alcohol Smoking Substance Involvement Screening Tool) and brief intervention was given based on the standard guidelines of ASSIST. The total score among the substance users is calculated and divided into Grades 1, 2 or 3. Log binomial regression was performed to quantify the association between substance use and covariates such as age, sex, education, occupation, family history of substance use, socio-economic status and family type. The association was expressed in odds ratio (OR) with 95 percent confidence interval (CI). Result The mean age of study participants was 18.6 ± 4.1, ranges from 10 to 24 years. Out of 48 substance users, 43.7% were consuming only tobacco, 22.9% were consuming only alcohol and 33.3% were polysubstance users. The history of substance use among family members of participants was found to be 46.3%. Median substance involvement score of tobacco, alcohol and cannabis users was 19 (IQR: 14.5-22), 19 (IQR: 13.5-25) and 22.5 (IQR: 22-23), respectively. Among tobacco users, 2.7% were Grade 1 and 7.2% were Grade 2. Four (16%), 20 (80%) and one (4%) of alcohol users were Grades 1, 2 and 3, respectively. Among the cannabis users, four (100%) were in the Grade 2 category. The median age of initiation of substance use among users was 16 (range 13-21) years. The analysis shows substance use was almost 25 times (adjusted OR = 25.84, 95% CI 5.65-118.09) more common among males and it increase by 2.5 times with a decrease in socio-economic status (adjusted OR = 2.52, 95% CI 1.27-5.02) and the result is significant. The substance use was almost 7 times higher when there is a family history of substance usage (adjusted OR = 7.40, 95% CI 2.15-25.4). Residential and marital status were not significantly associated with substance use. Conclusion Male sex, lower socio-economic status, participants currently not going to school/college, family history of substance use were found to be significant predictors of substance use among the study participants.

[High level of student smokers in Madrid compared with a similar previous study of 2014]

Smoking is a public health problem that affects young people, and influenced by the environment and cultural level.

OBJECTIVES

To determine smoking prevalence among high-level baccalaureate students in the Autonomous Community of Madrid during the 2018-2019 academic year. To assess the influence of the socio-cultural environment on the onset of youth smoking. To compare the results with previous studies conducted on students of baccalaureate of excellence (BE) and the general population.

POPULATION AND METHODS

Cross-sectional study on BE students in the Autonomous Community of Madrid. Using an anonymous questionnaire, they were asked about tobacco, alcohol and drug consumption, as well as the influence of the environment, friends, and family in the beginning. To compare with previous studies.

RESULTS

A total of 740 valid questionnaires were collected, of which 430 (58.1%) were female, an overall mean age of 16.57±0.61 years, and 53 (7.18%) were smokers. The majority 39 (78%) of smokers acknowledged their friends' influence at its onset. Alcohol was consumed by 349 (47.48%) and other drugs by 109 (15.27%). Being a smoker was related to alcohol, other drugs, a smoking mother, smoking siblings and smoking friends.

CONCLUSIONS

Smoking prevalence among students of BE in Autonomous Community of Madrid continues to be lower than the prevalence of adolescents of their age and there are no variations from previous reports. Starting smoking is related to smoking by friends, siblings, and the mother and with the consumption of alcohol and other substances. Education is very important in the beginning and prevention of smoking, and it is necessary to implement prevention programs at early ages in order to promote their effectiveness, and aimed at young people, parents and teachers.