Adolescent Perception on School Environment and Smoking Behavior: Analysis of Isfahan Tobacco use Prevention Program

Prevalence of substance use among Iranian male adolescents: Systematic review and meta-analysis

Background and aims

Substance use among adolescents is one of the most challenging behavioral disorders with direct consequences. It is of the essence (that) the prevalence of substance use is investigated among Iranian male adolescents.

Methods

The present study is a systematic review and meta-analysis. All published articles titled "prevalence of substance use among Iranian adolescents" authored in Persian and English from 2004 to 2020 on Pub Med, Scopus, SID, and Google Scholar, a top list of academic research databases, were reviewed. Thirty-three out of 805 articles, hinge on the inclusion and exclusion criteria, were eligible. Statistical analysis carried out in STATA 14.0.Q index, I2 index, and χ 2 test were applied.

Results

Overall prevalence reported with (95% confidence interval) for substance use 7% (4%-11%), methamphetamine 4% (3%-6%), tobacco 10% (3%-19%), and any addictive substances 4% (2%-7%) among male adolescents respectively. Besides, overall prevalence of alcohol consumption reported 10% (8%-11%).

Conclusion

The prevalence of substance use among male adolescents is high, so it is indispensable for researchers to pay special attention to this issue.

Social determinants of smoking among school adolescents in Beijing, China

INTRODUCTION

Understanding the social determinants that influence adolescent smoking behavior has a meaningful impact on adolescent health. Few studies have simultaneously analyzed the impact of teacher smoking and peer smoking on adolescent smoking. Therefore, the present study aims to investigate the impact of teacher smoking, peer smoking, and other social factors, on adolescent smoking.

METHODS

The participants were drawn from schools in Beijing, China, in 2011, 2013, and 2015, using a multi-stage random group sampling method. The number of schools selected for each year was 160. The study participants were 57240 adolescents aged 8-19 years. The generalized linear model with a binomial distribution and logarithmic link function was used to estimate the influence of social determinants on adolescent smoking behavior.

RESULTS

The results show that both teacher smoking and peer smoking were significantly associated with adolescent smoking. Compared to adolescents whose teachers did not smoke, the prevalence ratio (PR) was 1.28 for adolescents with one teacher who smoked and 1.34 for adolescents with two or more teachers who smoked (95% CI: 1.16-1.41/1.23-1.46, p<0.001/0.001, respectively). Compared to adolescents whose peers did not smoke, the prevalence ratio (PR) was 3.73 for adolescents with one peer who smoked and 8.52 for adolescents with two or more peers who smoked (95% CI: 3.20-4.35/7.48-9.69, p<0.001/0.001, respectively).

CONCLUSIONS

Teacher smoking and peer smoking are significant social determinants of adolescent smoking. Prevention programs should concurrently target peer groups, school settings, and individual students.

Genetics of Smoking Behaviors in American Indians

BACKGROUND

The smoking behavior of American Indians (AI) differs from that of non-Hispanic whites (NHW). Typically light smokers, cessation interventions in AIs are generally less effective. To develop more effective cessation programs for AIs, clinicians, researchers, and public health workers need a better understanding of the genetic factors involved in their smoking behavior. Our aim was to assess whether SNPs associated with smoking behavior in NHWs are also associated with smoking in AIs.

METHODS

We collected questionnaire data on smoking behaviors and analyzed blood and saliva samples from two Tribal populations with dramatically different cultures and smoking prevalence, one in the Northern Plains (n = 323) and the other in the Southwest (n = 176). A total of 384 SNPs were genotyped using an Illumina custom GoldenGate platform. Samples were also assessed for cotinine and 3-hydroxycotinine as markers of nicotine intake and nicotine metabolite ratio.

RESULTS

Among 499 participants, we identified, in the Northern Plains sample only, a variant of the gamma-aminobutyric acid receptor subunit alpha-2 (GABRA2) (rs2119767) on chromosome 4p that was associated with many of the intake biomarkers of smoking we examined, suggesting a role for this gene in modifying smoking behavior in this population. We also identified three SNPs, in the Southwest sample only, as significant correlates of only cigarettes per day: rs4274224, rs4245147 (both dopamine receptor D2 gene), and rs1386493 (tryptophan hydroxylase 2 gene).

CONCLUSIONS

The contribution of many genes known to underlie smoking behaviors in NHWs may differ in AIs.

IMPACT

Once validated, these variants could be useful in developing more effective cessation strategies.

Can the school environment influence oral health-related behaviours? A multilevel analysis of the Brazilian National Adolescent School-Based Health Survey 2015

OBJECTIVE

To investigate the association between the potential support of schools for oral health promotion and a set of oral health-related behaviours among adolescent students in Brazilian state capitals.

METHODS

A cross-sectional study using individual and school environment data from the 2015 Brazilian National Adolescent School-Based Health Survey (PeNSE) was conducted. The sample consisted of 51 192 students from 1339 public and private schools in the 27 Brazilian State Capitals, aged 11-19 years old. The outcomes were six oral health-related behaviours: dental visits; toothbrushing frequency; soft drink and sweets consumption; smoking and alcohol consumption. The explanatory variable was the Oral Health Promotion School Environment index (OHPSE). Covariates were the adolescents' sociodemographic characteristics and organizational aspects of the schools. A two-level multilevel mixed-effects Poisson regression analysis with fixed slopes and random intercepts was performed, considering the complex sample design.

RESULTS

The prevalence of risk behaviours was 28.0% for 'low frequency of annual dental visits', 6.9% for 'low daily toothbrushing frequency', 28.8% for 'high weekly soft drink consumption', 41.7% for 'high weekly sweet consumption', 18.9% for 'cigarette experimentation' and 52.6% for 'alcoholic beverage experimentation'. The schools were classified as low (36.3%), intermediate (30.4%) and high (33.3%) OHPSE. In the adjusted model, schools with 'high OHPSE' had lower prevalence of 'low frequency of annual dental visits' (PR = 0.94 [95% CI 0.90; 0.99]), 'high weekly frequency of soft drink consumption' (PR = 0.94 [95% CI 0.89; 0.99]) and 'sweet consumption' (PR = 0.96 [95% CI 0.93; 1.00]) than those with 'low OHPSE'. In addition, schools with 'intermediate OHPSE' had higher prevalence's of 'low daily toothbrushing frequency' (PR = 1.12 [95% CI 1.03; 1.23]) and 'cigarette experimentation' (PR = 1.08 [95% CI 1.01; 1.16]) than those with 'low OHPSE'. 'Alcoholic beverage experimentation' was not associated with OHPSE.

CONCLUSIONS

The potential support of schools for oral health promotion was associated with most of the oral health-related behaviours among adolescent students. Those attending schools with higher OHPSE scores reported a higher annual frequency of dental visits and a lower weekly frequency of soft drink and sweet consumption, while those in schools with intermediate OHPSE had a lower daily toothbrushing frequency and a higher rate of cigarette experimentation.

Association of violence in schools' vicinity and smoking in schools' premises with tobacco use among Brazilian adolescents

This study aims to quantify the overall importance of schools in explaining the individual variance of tobacco use and to test the association between characteristics of the school environment and its vicinity with the experimentation and current use of cigarettes. We analyzed data from 102,072 Brazilian adolescents interviewed in the 2015 National School Health Survey (PeNSE). Multilevel logistic regression models were performed to estimate the between-schools variance and to test the association between school-level variables and the use of tobacco. Violence in the vicinity of the school and presence of teachers or students smoking on school premises were the school-level characteristics. The analyses were adjusted by individual covariates and stratified by gender. Around 12.5% of the individual variance in ever smoking was explained by between-school variation among girls (9.2% among boys). The figures were even higher for current smoking (14.9% girls; 12.2% boys) and current use of other tobacco products (27.7% girls; 17.8% boys). In general, the use of tobacco was associated with the existence of violence in the vicinity of the schools and was higher among students whose schools reported that students and teachers (teachers only for use of other tobacco products among girls) smoke on school premises. Tobacco use on school premises and the safety of the neighborhood where the school is located are associated with some smoking behaviors among adolescents. Such findings reinforce the necessity to effectively consider interventions in the school environment and neighborhood to fight smoking among adolescents.

Visibility of smoking among school-teachers in Spain and associations with student smoking: a cross-sectional study

OBJECTIVE

Limited research has examined the association between smoking among schoolteachers and student smoking. This paper seeks to assess whether smoking visibility on school grounds among schoolteachers is associated with student smoking. We examine both smoking behaviour and the number of cigarettes consumed.

METHODS

We use a school-based cross-sectional survey carried out by the Spanish Government's Delegation for the National Plan on Drugs. A total of 27 503 students between 14 and 18 years of age completed an anonymous survey in 2013. Count data regressions were used to assess the association between observed teacher smoking and adolescent smoking behaviour.

RESULTS

High levels of visibility of teacher smoking on school grounds increased the odds of being a smoker among students (OR=2.09 and OR=1.64, for the highest levels of visibility), but the impact on the quantity of cigarettes smoked, although positive, was not significant.

CONCLUSION

Teacher smoking on school grounds is associated with student smoking behaviour. Consequently, smoking policies designed to prevent adolescent smoking should address this important social environment.

Link between perceived smoking behaviour at school and students smoking status: a large survey among Italian adolescents

OBJECTIVES

To investigate a possible link between sociodemographic factors, the perception of smoking habits at school and smoking status of Italian adolescents attending secondary school.

STUDY DESIGN

The study was a cross-sectional study.

METHODS

An anonymous online survey was employed to gather information on age, gender, smoking status and to examine the perception of smoking behaviour on the school premises. Chi-squared and Kruskal-Wallis tests were performed for the univariate analysis and logistic and multinomial regressions for the multivariate analysis.

RESULTS

The statistical analyses included 1889 students. Univariate analysis showed significant differences concerning knowledge between smoker and non-smoker concerning the harmfulness of smoking (P < 0.001). According to the multivariate analysis smokers had a higher perception of teacher, principal or janitor smoking at school (odds ratio: 1.54 [95% confidence interval 1.26-1.89]). Students older than 19 years most often begin smoking because their friends smoke compared with younger students (adjusted odds ratio: 1.18 [95% confidence interval 0.48-2.89]).

CONCLUSION

School environment and behaviour of role models play a crucial part in student smoking. To prevent and reduce youth tobacco smoking, not merely the presence of preventive measures is important but greater attention needs to be placed on the enforcement of smoking policies.

Predictors of Smoking among the Secondary High School Boy Students Based on the Health Belief Model

BACKGROUND

Smoking is one of the most important risk factors for health and also health problems, such as heart diseases, especially for young people. This study aimed to investigate the effect of factors related to smoking among the secondary high school students in the city of Marivan (Kurdistan-Iran), in 2015, based on the constructs of health belief model (HBM).

METHODS

This cross-sectional study was conducted in 470 secondary high school students in Marivan in 2015. The samples were selected by random cluster sampling. A question with four sections was used to collect data (demographic questions, knowledge section, attitude section, and questions related to e constructs of HBM).

RESULTS

According to the results, the correlation of smoking was stronger with attitude (r = 0.269 and odds ratio = 0.89) but weaker with perceived barriers (r = 0.101). There was not a significant correlation between smoking behavior and knowledge of the harms of smoking (r = -0.005). Moreover, Cues to action was effective predictor of smoking behavior (r = 0.259).

CONCLUSIONS

The findings of this study show that the prevalence of smoking in the studied sample is somewhat lower than other regions of Iran, but it should be noted that if no interventions are done to prevent smoking in this age group. The findings of the study also showed that the structure of attitudes, self-efficacy, and Cues to action are the strongest predictors of smoking among students. Albeit, attitude was strongest predictor of smoking that shows the prevalence of smoking can be reduced by focusing in this part. Considering the mean age of participants (16/2 ± 0.25 years), that shows the riskiest period for smoking is 16 years and authorities can make change in policies of cigarette selling only for over 18 years.