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Cole AG, Gohari MR, Leatherdale ST. Evaluating the One-Year Impact of School e-Cigarette Use Interventions among Current Youth e-Cigarette Users in the COMPASS Study, 2017/18-2018/19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6353. [PMID: 37510585 PMCID: PMC10379233 DOI: 10.3390/ijerph20146353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
There is a lack of evidence for the impact of school-based e-cigarette interventions among current e-cigarette users. This natural experimental evaluation study evaluated the one-year impact of various school-based e-cigarette prevention/cessation programs among a sample of current youth e-cigarette users. The COMPASS study sample included n = 3586 current e-cigarette users from n = 90 schools with data collected between 2017 and 2019. Student e-cigarette use patterns were categorized as "escalated", "maintained", and "reduced" based on the change in past 30-day e-cigarette use between baseline and follow-up. Intervention schools added e-cigarette use "prevention", "cessation", or "protection" programs, while control schools did not make any changes. Logistic regression models identified how each category of added programs was associated with e-cigarette use patterns. About one quarter of schools added an e-cigarette use prevention/cessation program over one year. Student e-cigarette use patterns between control and intervention groups differed in proportion ranging from a decrease of 3.35% to an increase of 5.80%. Regression models did not identify any significant differences in the odds of escalating or reducing e-cigarette use in intervention relative to control schools. While many schools implemented new e-cigarette programs over one year, none of the interventions led to significant changes in e-cigarette escalation or reduction among current youth e-cigarette users. Additional studies are needed to evaluate the impact of e-cigarette interventions among current e-cigarette users.
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Affiliation(s)
- Adam G Cole
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON L1G 0C5, Canada
| | - Mahmood R Gohari
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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Williams GC, Cole AG, de Groh M, Jiang Y, Leatherdale ST. More support needed: Evaluating the impact of school e-cigarette prevention and cessation programs on e-cigarette initiation among a sample of Canadian secondary school students. Prev Med 2022; 155:106924. [PMID: 34929224 DOI: 10.1016/j.ypmed.2021.106924] [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: 06/25/2021] [Revised: 12/01/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
Abstract
Given the recent increase in e-cigarette use among adolescents, there is a need to further explore how school programs are associated with e-cigarette initiation. The objective of this quasi-experimental study was to evaluate the impact of multiple school-based e-cigarette prevention and cessation programs on e-cigarette initiation among Canadian adolescents. This study used data from Year 6 (2017/18) and Year 7 (2018/19) of the COMPASS study in British Columbia, Alberta, Ontario, and Quebec, Canada. Students in grades 9 to 11 who had never tried e-cigarettes at baseline were included (n = 13,269). Schools (n = 88) reported whether they added programming that addressed e-cigarette or tobacco prevention or cessation. Generalized estimating equations were used to identify how added programs were associated with e-cigarette initiation at follow-up. At one-year follow-up (2018/19), 23% of schools added programs. Our evaluation results suggest that none of the activities taken by schools to prevent or reduce vaping among students significantly prevented vaping onset. In fact, female students at schools that reported adding a theme week had higher odds of e-cigarette initiation (OR 1.68 [95% CI 1.31-2.16]) and male students at schools that reported a cessation program had higher odds of e-cigarette initiation (OR 1.20 [95% CI 1.01-1.44]). These results suggest that schools may not know how to address e-cigarette use and that there can be risks to students if programs are not carefully implemented. Results point to the need for additional support to ensure that schools are taking evidence-based approaches that support all students.
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Affiliation(s)
- Gillian C Williams
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada; Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada.
| | - Adam G Cole
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Margaret de Groh
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Ying Jiang
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Mélard N, Grard A, Robert PO, Kuipers MAG, Schreuders M, Rimpelä AH, Leão T, Hoffmann L, Richter M, Kunst AE, Lorant V. School tobacco policies and adolescent smoking in six European cities in 2013 and 2016: A school-level longitudinal study. Prev Med 2020; 138:106142. [PMID: 32450162 DOI: 10.1016/j.ypmed.2020.106142] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 11/19/2022]
Abstract
Assessment of the effectiveness of school tobacco policies (STPs) in reducing adolescent smoking remains inconclusive. Previous studies took insufficient account of different dimensions of STPs, the different views of students and staff, and policy changes over time. This study assessed how a multidimensional STP, as perceived by students and staff, was associated with adolescent smoking over time in six European cities. The SILNE and SILNE-R surveys were conducted among students (n = 18,502) and staff (n = 438) in 38 schools in 2013 and 2016. Three dimensions (comprehensiveness, enforcement, and communication) were assessed and we calculated total STP scores. Multilevel logistic regressions estimated associations of STPs with adolescent smoking on and just outside school premises and with weekly smoking. Further analyses estimated associations between 2013 and 2016 STP changes and smoking outcomes in 2016, controlling for STP and smoking prevalence in 2013. On average, there were few increases in STP scores over time. Greater STP enforcement, as perceived by students, was associated with lower odds of weekly smoking (OR:0.93, 95%CI:0.89-0.97) and of smoking on school premises (OR:0.80, 95%CI:0.72-0.90). Higher total STP scores were associated with lower odds of smoking on school premises (OR:0.76, 95%CI:0.67-0.86), but not of smoking just outside premises or smoking weekly. Greater increases in STP scores over time were associated with lower odds of smoking on school premises in 2016 (OR:0.65, 95%CI:0.47-0.89). Well-enforced STPs may help reduce adolescent smoking at school. Schools should be supported in adopting comprehensive policies that also extend to the surroundings of their premises.
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Affiliation(s)
- Nora Mélard
- Institute of Health and Society (IRSS), Université catholique de Louvain, Belgium.
| | - Adeline Grard
- Institute of Health and Society (IRSS), Université catholique de Louvain, Belgium
| | | | - Mirte A G Kuipers
- Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Michael Schreuders
- Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Arja H Rimpelä
- Faculty of Social Sciences (SOC), Unit of Health Sciences, Tampere University, Finland; Tampere University Hospital, Department of Adolescent Psychiatry, Nokia. Finland
| | - Teresa Leão
- EpiUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Laura Hoffmann
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-, Wittenberg, Germany
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-, Wittenberg, Germany
| | - Anton E Kunst
- Department of Public Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Vincent Lorant
- Institute of Health and Society (IRSS), Université catholique de Louvain, Belgium
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Cole AG, Aleyan S, Battista K, Leatherdale ST. Trends in youth e-cigarette and cigarette use between 2013 and 2019: insights from repeat cross-sectional data from the COMPASS study. Canadian Journal of Public Health 2020; 112:60-69. [PMID: 32804379 PMCID: PMC7851234 DOI: 10.17269/s41997-020-00389-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 07/10/2020] [Indexed: 12/27/2022]
Abstract
Objectives E-cigarettes are an increasingly popular product among youth in Canada. However, there is a lack of long-term data presenting trends in use. As such, the objective of this study was to examine trends in e-cigarette and cigarette use across various demographic characteristics between 2013 and 2019 among a large sample of secondary school youth in Canada. Methods Using repeat cross-sectional data from a non-probability sample of students in grades 9 to 12, this study explored trends in the prevalence of ever and current e-cigarette use and cigarette smoking between 2013–2014 and 2018–2019 in British Columbia, Alberta, Ontario, and Quebec. Trends in ever and current e-cigarette use and cigarette smoking were studied across demographic variables among students in Ontario. Results The prevalence of e-cigarette ever and current use was variable across province and increased over time, particularly between 2016–2017 and 2018–2019. In contrast, the prevalence of current cigarette smoking was relatively stable over the study period, decreasing significantly in Alberta and Ontario between 2017–2018 and 2018–2019. In Ontario, the prevalence of ever and current e-cigarette use increased among all grades, both genders, and all ethnicities. Conclusion Consistent with data from the United States, the prevalence of e-cigarette use among our large sample of Canadian youth has increased substantially in a short period of time. Surveillance systems should continue to monitor the prevalence of tobacco use among youth. Additional interventions may be necessary to curb e-cigarette use among Canadian youth. Electronic supplementary material The online version of this article (10.17269/s41997-020-00389-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adam G Cole
- Faculty of Health Sciences, University of Ontario Institute of Technology, 2000 Simcoe Street North, Oshawa, Ontario, L1G 0C5, Canada. .,School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
| | - Sarah Aleyan
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kate Battista
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Zuckermann AME, Gohari MR, de Groh M, Jiang Y, Leatherdale ST. The role of school characteristics in pre-legalization cannabis use change among Canadian youth: implications for policy and harm reduction. HEALTH EDUCATION RESEARCH 2020; 35:297-305. [PMID: 32623462 DOI: 10.1093/her/cyaa018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
Reducing youth cannabis use in Canada is a public health priority with schools of interest as a potential modifier of behavior and as a venue for prevention programming. This work aimed to provide a basis for future policy and programming by evaluating pre-legalization cannabis use change patterns in schools and the impact of school characteristics on these patterns. Average rates of cannabis use behavior change (initiation, escalation, reduction, cessation) were collected from 88 high schools located in Ontario and Alberta, Canada participating in the COMPASS prospective cohort study. There was little variability in cannabis use behaviors between schools with intra-class correlation coefficients lowest for cessation (0.02) and escalation (0.02) followed by initiation (0.03) and reduction (0.05). Modest differences were found based on school province, urbanicity and student-peer use. Cannabis ease of access rates had no significant effect. Fewer than half the schools reported offering school drug use prevention programs; these were not significantly associated with student cannabis use behaviors. In conclusion, current school-based cannabis prevention efforts do not appear sufficiently effective. Comprehensive implementation of universal prevention programs may reduce cannabis harms. Some factors (urbanicity, peer use rates) may indicate which schools to prioritize.
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Affiliation(s)
- Alexandra M E Zuckermann
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue, Waterloo, ON N2L 3G1, Canada
- Applied Research Division, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON K1A 0K9, Canada
| | - Mahmood R Gohari
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue, Waterloo, ON N2L 3G1, Canada
| | - Margaret de Groh
- Applied Research Division, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON K1A 0K9, Canada
| | - Ying Jiang
- Applied Research Division, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON K1A 0K9, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue, Waterloo, ON N2L 3G1, Canada
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Borandegi F, Rahmanian F, Yazdanpanahi Z, Nematollahi A. The effect of self-care education regarding high-risk behaviors of acquired immune deficiency syndrome and smoking on knowledge and attitude of adolescent girls: An experimental study to health promotion. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:7. [PMID: 32154302 PMCID: PMC7032024 DOI: 10.4103/jehp.jehp_271_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The vulnerability of the youth to acquired immune deficiency syndrome (AIDS) and smoking is one of the most important public health issues around the world. Adequate knowledge about AIDS and smoking is a powerful tool for promoting positive attitudes and safe behaviors. OBJECTIVE This study aimed to determine the effect of self-care education on AIDS and smoking on the level of adolescents' knowledge and health attitude. MATERIALS AND METHODS This experimental study was conducted in the academic year of 2017-2018, and the participants were selected using randomized cluster sampling. These participants included 220 female students of the third grade of middle school in Isfahan (105 in the intervention group and 115 in the control group). Data were collected using a demographic questionnaire; a researcher-made questionnaire on knowledge about AIDS, knowledge about smoking, and attitudes toward smoking; and a standard questionnaire on students' attitude toward AIDS. After completing the pretest, the intervention group performed two training sessions and completed the posttest 1 month later. One month after completing the pretest, the control group completed the posttest and did not receive an intervention. Finally, the data were analyzed using descriptive statistics, statistical tests, and statistical software SPSS version 22. RESULTS The results showed that despite the similarity between the two groups at the beginning of the study, after self-care education, the knowledge level of AIDS (P < 0.001) and attitude toward AIDS (P < 0.001) and the knowledge level of smoking (P < 0.001) and attitude toward smoking (P < 0.001) in the intervention group were significantly higher than the control group. In intragroup analysis, it was also observed that the difference between the scores before and after was only significant in the intervention group. CONCLUSION It seems that education can promote the level of knowledge and attitude of adolescents toward AIDS.
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Affiliation(s)
- Forogh Borandegi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Rahmanian
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Yazdanpanahi
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azar Nematollahi
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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