Father's occupational group and daily smoking during adolescence: patterns and predictors

Targeting cognitive and emotional regulatory skills for smoking prevention in low-SES youth: A randomized trial of mindfulness and working memory interventions

Research to date provides striking evidence that youth from low socio-economic status (SES) households are at an increased risk for smoking. Converging evidence from developmental studies, psychopathology studies, intervention studies, and basic research on self-control abilities have identified working memory and distress tolerance as potential crucial modifiable risk factors to prevent smoking onset in this cohort. To confirm the value of these mechanistic targets, this randomized trial was designed to evaluate the influence of working memory and distress tolerance interventions on risk of smoking initiation. Recruiting primarily from low-income community afternoon programs, we randomized 93 adolescents to one of three intervention conditions, all of which were a prelude to a smoking-prevention informational intervention: (1) a working memory intervention, (2) a mindfulness training intervention to target distress tolerance, and (3) a wellness-focused control condition. Despite a number of adherence efforts, engagement in treatment was limited, and under these conditions no significant evidence was found either for differential efficacy for smoking prevention or for intervention effects on mechanistic targets. However, working memory capacity and distress tolerance were found to be negatively related to smoking propensity. As such, our mechanistic targets-working memory and distress tolerance--may well be processes undergirding smoking, despite the fact that our interventions did not adequately engage these targets.

Rescuing cognitive and emotional regulatory skills to aid smoking prevention in at-risk youth: A randomized trial

Adolescence is a vulnerable period for smoking initiation, with disadvantaged teens particularly at risk. In addition, emotional and cognitive dysregulation is associated with an increased risk of smoking and makes it particularly challenging to benefit from standard substance use prevention interventions. The goal of the current study is to investigate the extent to which interventions designed to improve cognitive (working memory) and emotional (distress tolerance) regulatory processes enhance the effectiveness of a standard smoking prevention informational intervention. We will study adolescents (12-16 years of age) predominantly from racial/ethnic-minority and low-income households. Proximal smoking-risk outcome measures are used to allow testing of prevention models outside a full longitudinal study. We hope to generate new insights and approaches to smoking prevention among adolescents from lower socio-economic status (SES) by documenting the influence of working memory training and distress tolerance (mindfulness) interventions on cognitive/affective targets that place individuals at risk for smoking initiation and maintenance.

CLINICAL TRIALS REGISTRATION

NCT03148652.

Life Course Changes in Smoking by Gender and Education: A Cohort Comparison Across France and the United States

Widening of educational disparities and a narrowing female advantage in mortality stem in good part from disparities in smoking. The changes in smoking and mortality disparities across cohorts and countries have been explained by an epidemic model of cigarette use but are also related to life course changes. To better describe and understand changing disparities over the life course, we compare age patterns of smoking in three cohorts and two nations (France and the United States) using smoking history measures from the 2010 French Health Barometer (N = 20,940) and the 2010 U.S. National Health Interview Survey Sample Adult File (N = 20,444). The results demonstrate statistically significant widening of gender and educational differences from adolescence to early and middle adulthood, thus accentuating the disparities already emerging during adolescence. In addition, the widening disparities over the life course have been changing across cohorts: Age differences in educational disparities have grown in recent cohorts (especially in France), while age differences in gender disparities have narrowed. The findings highlight the multiple sources of inequality in smoking and health in high-income nations.

Educational disparities in the intention to quit smoking among male smokers in China: a cross-sectional survey on the explanations provided by the theory of planned behaviour

OBJECTIVES

We aim to describe the intention to quit smoking among Chinese male smokers from different educational backgrounds and to explain this intention from their attitude, perceived social norms and self-efficacy regarding smoking cessation.

SETTING

Participants were recruited from workplaces and communities to reflect the occupational distribution in three cities (Shanghai, Nanning and Mudanjiang) in China.

DESIGN AND PARTICIPANTS

In 2013 interviews were conducted with 3676 male smokers aged 18 years and older.

OUTCOME MEASURES

Multivariate logistic regression analyses calculated educational differences in the intention to quit smoking as well as the association between the intention to quit smoking and attitude, subjective norms, and self-efficacy. Bootstrapping estimated to what extent the educational disparities in the intention to quit smoking were mediated by these three determinants.

RESULTS

No educational disparities in the intention to quit smoking within 1 or 6 months were observed among male Chinese smokers (p=0.623 and p=0.153, respectively). A less negative attitude, a higher perceived subjective norm towards smoking cessation, and a higher perceived self-efficacy to quit smoking were all associated with intention to quit (all p values <0.001). Perceived subjective norms were the only component of the theory of planned behaviour that statistically significantly mediated the differences in the intention to quit smoking (within 1 or 6 months) between the lowest educated Chinese men and the groups with lower (β=0.039, 95% CI 0.017 to 0.071 and β=0.043, 95% CI 0.019 to 0.073), higher (β=0.041, 95% CI 0.017 to 0.075 and β=0.045, 95% CI 0.019 to 0.077) and the highest education (β=0.045, 95% CI 0.019 to 0.080 and β=0.050, 95% CI 0.023 to 0.083).

CONCLUSIONS

In order to prevent future socioeconomic disparities in smoking cessation, investment in a more stimulating social environment and norms towards smoking cessation among particularly the lowest educated Chinese men is warranted.

Life course transitions in early adulthood and SES disparities in tobacco use

A huge literature has documented adult socioeconomic disparities in smoking but says less about how these disparities emerge over the life course. Building on findings that smoking among adolescents differs only modestly by parental SES, we utilize a life course perspective on social differentiation to help explain the widening disparities in smoking in young adulthood. Our theory suggests that achieved socioeconomic status and the nature and timing of adult role transitions affect age-based trajectories of smoking and widen disparities in adult smoking. The analyses use data from the National Longitudinal Study of Adolescent Health, which follows a representative national sample over four waves from ages 11-17 in 1994/1995 to 26-34 in 2007/2008. The results show divergent age trajectories in smoking by parental education and that achieved socioeconomic status and life course roles in young adulthood account in good part for differences in the age trajectories. The findings demonstrate the value of the life course perspective in understanding processes of increasing stratification in health behavior and health during the transition to adulthood.

Evidence of social contextual effects on adolescent smoking in South Korea

This study explores the effect of psychological and social factors on smoking behavior among male and female adolescents in South Korea. A cross-sectional analysis was carried out via multilevel logistic regression with pupils at the first level and schools at the second level. The data were collected in 2003 using a nationally representative sample of 3449 students from 100 South Korean middle schools. For both genders, adolescents were more likely to smoke if and when they had lower academic grades, had a higher disposable monetary allowance from their parents, had more friends who smoked, and if the smoking rate at their school was higher. Psychological factors, however, were not factors that significantly influenced smoking. Consequently, the principal contextual factors related to adolescent smoking are the smoking rates in schools and among peer groups. Thus, an antismoking campaign incorporating social environmental factors may be useful in reducing the rates of adolescent smoking.

Smoking behavior of US youths: a comparison between child welfare system and community populations

OBJECTIVES

We compared rates of smoking for 2 groups of youths aged 12 to 14 years: those involved in the child welfare system (CW) and their counterparts in the community population. We then investigated factors associated with smoking for each group.

METHODS

We drew data from 2 national-level US sources: the National Survey of Child and Adolescent Well-Being and the National Longitudinal Study of Adolescent Health. We estimated logistic regression models for 3 binary outcome measures of smoking behavior: lifetime, current, and regular smoking.

RESULTS

CW-involved youths had significantly higher rates of lifetime smoking (43% vs 32%) and current smoking (23% vs 18%) than did youths in the community population. For CW-involved youths, delinquency and smoking were strongly linked. Among youths in the community population, multiple factors, including youth demographics and emotional and behavioral health, affected smoking behavior.

CONCLUSIONS

Smoking prevalence was notably higher among CW-involved youths than among the community population. In light of the persistent public health impact of smoking, more attention should be focused on identification of risk factors for prevention and early intervention efforts among the CW-involved population.

Predictors of starting to smoke cigarettes in patients with first episode psychosis

INTRODUCTION

Cigarette smoking is common in psychotic disorders and may be initiated in an attempt to control features of illness. However, genetic, obstetric and early life conditions are risks for starting to smoke in the general population but their role in psychotic patients is unclear.

METHOD

Smoking history and the putative predictors of starting to smoke were assessed in a community-wide sample of 115 first episode psychosis patients. The proportion that initiated smoking was compared with that from population surveys and the impact of risk factors was assessed within the patient sample.

RESULTS

Most patients began smoking before illness onset and the proportion who initiated smoking was significantly high by the onset of a functional decline. Gestational tobacco exposure was a risk for smoking and was also associated with low birthweight, poor academic achievement, and obesity. Low familial socioeconomic position but not familial psychiatric problems also predicted smoking initiation.

DISCUSSION

In most cases, smoking preceded illness onset and was not a response to early features of illness. General population predictors of starting to smoke were also associated with smoking initiation in psychotic patients. Of these risks, exposure to tobacco during gestation is noteworthy in that it affects brain development and is associated with cognitive, behavioral, psychiatric and general health problems. In addition, nicotine interacts with other substances of abuse. The initiation of smoking before illness onset and the association with developmental problems raises the question of whether cigarette smoking influences some aspects of illness in patients with psychosis.

Decision-making program for rural adolescents with asthma: a pilot study

Although a high prevalence of substance use and its adverse effects on the course of the disease have been reported in adolescents with asthma, no studies have attempted to ameliorate the risk through adequate interventions. This pilot study evaluates and supports the feasibility and the effectiveness of a decision-making program in improving decision-making quality and reducing risk motivation over a 6-month study period. Differential effectiveness of the intervention was observed by race and gender. Although the improvement of decision-making quality was observed only in Whites, changes in risk motivation were detected only in non-Whites and girls. No significant reduction in actual substance use behavior was found. The intervention was favorably received by participants. An approach enhancing decision-making quality can be effective in addressing the risk of substance use in adolescent with asthma by altering motivations.

A survey on smoking habits and attitudes among adolescents in Greece

The objective of the present study was to investigate smoking habits among 699 secondary school students, along with their attitudes toward smoking and their perceptions on the consequences of tobacco use in their health. Our results indicate that Greek adolescents begin to smoke mainly due to curiosity and for stress reasons. Furthermore, having friends who smoke is highly associated with smoking and intention for smoking. Likewise, paternal smoking seems to reinforce students' intention for smoking. On the contrary, parental disapproval of smoking leads to anti-smoking behavior. Adolescents' attitudes toward smoking are also related to a series of similar factors such as parental educational status, parental smoking, and parental disapproval of smoking, friends who smoke, and, finally, adolescents' age, smoking behavior, and intention for smoking. The impact of tobacco use in human health seems to be understood better by older students. All these factors must be taken into account for a successful implementation of an anti-smoking intervention program.

Changes in Youth Smoking, 1976-2002: A Time-Series Analysis

During the past several decades, smoking prevalence among youth has fluctuated in puzzling and unexpected ways. To help understand these changes, this study tests seven explanations: (a) compositional changes, (b) sample selection, (c) adult smoking, (d) social strain, (e) cigarette prices, (f) tobacco advertising, and (g) other drug use. Figures on smoking prevalence come from the Monitoring the Future (MTF) Surveys from 1976-2002, whereas figures on aggregate determinants for the same time period come from government publications. Graphs of the time-series trends to determine temporal correspondence and time-series regression models to test for statistical influence reveal two variables that have expected effects. Increases in cigarette prices reduce smoking, particularly in the most recent years, and higher marijuana initiation (or use) is associated with greater smoking during most of the time period. However, much of the change in youth smoking, particularly the most recent rise and fall, remains unexplained.

Influence of parental education, childhood adversities, and current living conditions on daily smoking in early adulthood

AIMS

To assess the association of parental education, childhood living conditions and adversities with daily smoking in early adulthood and to analyse the effect of the respondent's own education, main economic activity, and current family structure on these associations.

METHODS

The study is based on a representative two-stage cluster sample (N = 1894, participation rate 79%) of young adults aged 18-29, in 2000, in Finland. The outcome measure is daily smoking.

RESULTS

Parental smoking and the respondent's own education had the strongest effects on daily smoking. If both parents of the respondent were smokers, then the respondent was most likely to be a smoker too (for men OR (odds ratio) = 3.01, for women OR = 2.41 after all adjustments). Young adults in the lowest educational category had a much higher risk of daily smoking than those in the highest category (OR = 5.88 for women, 4.48 for men). For women parental divorce (OR = 2.31) and current family structure also determined daily smoking. Parental education had a strong gradient in daily smoking and the effect appeared to be mediated largely by the respondent's own educational level.

CONCLUSIONS

Childhood living conditions are strong determinants of daily smoking. Much of their influence seems to be mediated through current living conditions, which are also determined by childhood conditions. Determinants of smoking behaviour are developed throughout the life course. The findings stress the importance of the respondent's education and parental smoking as determinants of smoking behaviour. Our results support the notion that intervention on smoking initiation and cessation should be considered throughout the life course. Parental involvement in fostering non-smoking would be important.