Factores asociados con el inicio del tabaquismo: seguimiento a los 3 años de una cohorte de escolares

Actividad física de adolescentes: implicación de sustancias nocivas, modalidad practicada y familia

Resumen Los objetivos de la investigación fueron: determinar los niveles de práctica de actividad física en adolescentes, consumo de tabaco y alcohol como fenómeno social, establecer qué tipo de actividad y nivel federativo y dictaminar el nivel de AF en los progenitores; y apreciar cómo influye en la práctica de actividad física regular, el consumo de sustancias, el tipo de deporte practicado y el nivel de práctica de padres y madres. Participaronun total de 2.134 adolescentes, empleándose una hoja de autoregistro para las variables: Práctica de AF, Modalidad, Estado Federativo y Nivel de Actividad Física Familiar; el FTND para determinar elConsumo de Tabacoy el AUDIT para elConsumo de Alcohol.Los principales resultados indican que los adolescentes que practican actividad física no consumen habitualmente sustancias nocivas, están influenciadospor parámetros familiares, realizanen mayor medida deportes de tipo colectivo y están federados en ellos.

Variables Associated with the Onset of Cigarette Smoking Among Adolescent Public Middle-School Students in Cartagena, Colombia

Objetivo: determinar la prevalencia y las variables asociadas al inicio del consumo de cigarrillo en adolescentes de media vocacional de Cartagena, Colombia. Materiales y método: estudio analítico observacional transversal con 1.100 estudiantes de básica secundaria de las instituciones educativas oficiales de la ciudad de Cartagena, matriculados durante el año 2012; la información se recolectó a través de la ficha demográfica, el inventario de consumo de cigarrillo y actitudes frente al mismo de la Encuesta Mundial Sobre Tabaquismo en jóvenes (Emta_Joven), la escala Apgar familiar, Rosenberg para autoestima y la escala de Zung de ansiedad. Se realizó análisis estadístico univariado, bivariado y multivariado. Resultados: participaron 1.090 estudiantes (de los 1.100 fueron descartados 10 por estar mal diligenciados) con edades entre 10 y 18 años, media = 12,3; 565 (51,8 %) estudiantes fueron de sexo masculino y 525 (48,2 %) de sexo femenino. El consumo de cigarrillo alguna vez en la vida se asoció a edades entre 13 y 18 años (OR = 2,86; IC95 %: 1,96-4,18), ser de sexo masculino (OR = 2,40; IC95 %: 1,63-3,56) y a alta intención de consumo de sustancias (cigarrillo, alcohol y marihuana) (OR = 3,18; IC95 %: 2,18-4,64). Conclusión: el consumo de cigarrillo alguna vez en la vida en estudiantes de media vocacional de Cartagena, Colombia, se asoció a tener alta intención de consumo de sustancias, ser adolescente y ser de sexo masculino.

Effectiveness of a complex intervention in reducing the prevalence of smoking among adolescents: study design of a cluster-randomized controlled trial

Background

The likelihood of an adolescent taking up smoking may be influenced by his or her society, school and family. Thus, changes in the immediate environment may alter a young person’s perception of smoking.

Methods/Design

The proposed multi-center, cluster-randomized controlled trial will be stratified by the baseline prevalence of smoking in schools. Municipalities with fewer than 100,000 inhabitants will be randomly assigned to a control or intervention group. One secondary school will be randomly selected from each municipality. These schools will be randomized to two groups: the students of one will receive any existing educational course regarding smoking, while those of the other school will receive a four-year, class-based curriculum intervention (22 classroom lessons) aimed at reinforcing a smoke-free school policy and encouraging smoking cessation in parents, pupils, and teachers. The intervention will also include annual meetings with parents and efforts to empower adolescents to change the smoking-related attitudes and behaviors in their homes, classrooms and communities.

We will enroll children aged 12-13 years as they enter secondary school during two consecutive school years (to obtain sufficient enrolled subjects). We will follow them for five years, until two years after they leave secondary school. All external evaluators and analysts will be blinded to school allocation.

The aim of this study is to analyze the effectiveness of a complex intervention in reducing the prevalence of smoking in the third year of compulsory secondary education (ESO) and two years after secondary school, when the participants are 14-15 and 17-18 years old, respectively.

Discussion

Most interventions aimed at preventing smoking among adolescents yield little to no positive long-term effects. This clinical trial will analyze the effectiveness of a complex intervention aimed at reducing the incidence and prevalence of smoking in this vulnerable age group.

Trial registration

Current Controlled Trials: NCT01602796.

Prevalence and attitude towards smoking in first, third and fifth-year pharmacy students in Spain: PRECOTABAC study

AIM OF THIS STUDY

The aim of this study is to calculate smoking prevalence among first, third and fifth-year pharmacy students in Spain, and to describe their attitude towards giving up smoking.

METHODS

Cross-sectional multi-center study using an ad hoc self-administered questionnaire in first, third and fifth-year pharmacy students at seven Spanish universities. Bivariate analysis with chi-square and Student's t-test, statistical significance p<0.05.

RESULTS

Smoking prevalence: 34.92%. The smokers smoke 31.04 (SD=43.182) cigarettes/week on average. Pharmacy students have a positive attitude towards giving up smoking, with differences between year groups (p=0.036).

CONCLUSIONS

Four in ten pharmacy students in Spain smoke every day by the time they finish their degree. Smoking prevalence is lower in the first few years of the degree and increases over time. Students also have a positive attitude towards giving up smoking, and are in favor of measures that can be taken to try to stop people smoking.

Association between family structure, maternal education level, and maternal employment with sedentary lifestyle in primary school-age children

OBJECTIVE

To determine the association between family structure, maternal education level, and maternal employment with sedentary lifestyle in primary school-age children.

METHOD

Data were obtained from 897 children aged 6 to 12 years. A questionnaire was used to collect information. Body mass index (BMI) was determined using the age- and gender-specific Centers for Disease Control and Prevention definition. Children were categorized as: normal weight (5(th) percentile≤BMI<85(th) percentile), at risk for overweight (85(th)≤BMI<95(th) percentile), overweight (≥ 95(th) percentile). For the analysis, overweight was defined as BMI at or above the 85(th) percentile for each gender. Adjusted odds ratios (adjusted ORs) for physical inactivity were determined using a logistic regression model.

RESULTS

The prevalence of overweight was 40.7%, and of sedentary lifestyle, 57.2%. The percentage of non-intact families was 23.5%. Approximately 48.7% of the mothers had a non-acceptable educational level, and 38.8% of the mothers worked outside of the home. The logistic regression model showed that living in a non-intact family household (adjusted OR=1.67; 95% CI=1.04-2.66) is associated with sedentary lifestyle in overweight children. In the group of normal weight children, logistic regression analysis show that living in a non-intact family, having a mother with a non-acceptable education level, and having a mother who works outside of the home were not associated with sedentary lifestyle.

CONCLUSION

Living in a non-intact family, more than low maternal educational level and having a working mother, appears to be associated with sedentary lifestyle in overweight primary school-age children.

Factors associated with commencing smoking in 12-year-old students in Catalonia (Spain): a cross-sectional population-based study

Background

Over the last decade notable progress has been made in developed countries on monitoring smoking although experimenting with cigarettes and smoking in young people remains a serious public health problem. This paper reports a cross-sectional study at the beginning of the 3-year follow-up community study TA_BES. The aim was to study the prevalence of smoking in addition to determining predictive factors for when smoking commences in a representative population of 12-year-old first year compulsory secondary education students.

Methods

Twenty-nine secondary schools (N = 29) from an area of Catalonia participated in the study. In these schools 2245 students answered a questionnaire to study the attitudes, behaviors, and tobacco consumption in the subject's surrounding circle and family in relation to smoking; carbon monoxide measurements were taken by means of co-oximetry on 2 different occasions. A smoker was defined as a student who had smoked daily or occasionally in the last 30 days. For non-smokers the criteria of not considering was set up for those who answered that in the future they would not be smokers and considering those who answered that they did not rule out becoming a smoker in the future.

Results

Among the total 2245 students included in the analysis 157(7%) were classified as smokers. Among non-smokers we differentiated between those not considering smoking 1757 (78.3%) and those considering smoking 288 (12.8%).

Age is among the factors related to commencing smoking. The risk of becoming a smoker increases 2.27 times/year. The influence of the group of friends with a very high risk for boys OR 149.5 and lower, albeit high, in girls OR 38.1. Tobacco consumption of parents produces different effects in young people. A smoking father does not produce alterations in the smoking behavior of young people. However having a smoking mother or former smoking is a risk factor for boys and a protective factor for girls.

We detected a gradual risk of becoming a smoker by means of the co-oximetry test. A boy/girl with a test between 6 p.p.m and 10 p.p.m increased the probability of smoking by 2.29 and co-oximetry values > 10 p.p.m multiplied the risk 4 times over.

Conclusions

Results indicate that the age of commencing smoking is maintained in spite of prevalence having decreased in the last few years. The risk factors identified should be used to involve families and the educational community by offering them tobacco weaning programmes.

[Comparison of two methods to identify factors associated with the onset of cannabis use in a cohort study]

OBJECTIVE

To compare the utility of two multivariate analytic methods, case-control (CC) analysis and nested case-control (NCC) analysis in a cohort, to identify the factors associated with the onset of cannabis use.

METHODS

A longitudinal cohort study of a sample of secondary school students (n = 1,056) in the first year of secondary school was carried out. Participating students were followed-up annually until the fourth year of secondary school. In the CC analysis, students in the fourth year who reported having consumed cannabis at some time were considered cases and those who had never consumed cannabis were considered controls. Logistic regression (LR) models were estimated. In the NCC analysis, cases in each year of follow-up were compared with a random sample of controls at risk in the same year and conditional LR models were estimated.

RESULTS

In the CC analysis, 6 variables in boys and 9 variables in girls in bivariate models and 3 variables in boys and 4variables in girls in multivariate models were identified. In the NCC analysis, 17 variables in univariate models and 4 in multivariate models were obtained in both boys and girls. The estimators of the CC analysis showed an average of 1.2-fold more variability.

CONCLUSIONS

A higher number of factors associated with cannabis use were identified in the NCC analysis and the estimators were more precise. NCC could be a more efficient option than CC analysis.

Negative mood states and related factors in a sample of adolescent secondary-school students in Barcelona (Spain)

INTRODUCTION

Poor mental health is a common problem in adolescence. Little information is available, however, about the factors influencing negative mood states in otherwise healthy adolescents. We aimed to describe the mood states and related factors in a sample of adolescents in the city of Barcelona (Spain).

METHODS

We administered a health survey to a sample of 2,727 students from public, subsidized, and private schools in Barcelona, aged approximately 14, 16, and 18 years old. To analyze the associations among moods and related factors, we used bivariate logistic regression, and fitted multivariate logistic regressions using the statistically significant variables from the bivariate analysis. To examine the possible group effects of the school on individual students, we employed multilevel analysis.

RESULTS

The frequencies of negative mood states increased with age, with girls consistently reporting more frequent negative mood states than boys. The factors associated with negative mood states were problematic alcohol use, perceived mistreatment or abuse, antisocial behavior, intention to use or current use of illegal drugs (not including cannabis), lower perceived academic performance, and feeling isolated.

CONCLUSIONS

Mood states are influenced by lifestyle and social factors, about which there is little local information. To plan and implement appropriate public health interventions, more complete information about the possible areas of influence is required. To complement the information obtained from studies such as the present study, longitudinal and qualitative studies would be desirable.

Prevalencia del consumo de tabaco en adolescentes. Influencia del entorno familiar

OBJECTIVE

To determine the prevalence of tobacco use among 12-18 year-olds in Biscay (Spain) and its relation with the family environment.

SUBJECTS AND METHOD

We performed a cross-sectional study in 12-18 year-olds. A self-administered, anonymous questionnaire was distributed in different schools of the region selected by stratified sampling, based on the type of school (public school or subsidized private school) and on the linguistic model. The final study sample comprised 1921 students. Information was obtained on tobacco, alcohol and other drug use, as well as on family and sociodemographic characteristics.

RESULTS

A total of 51.8 % of the students had used tobacco. One-third (29.9%) of the teenagers were current smokers and 50.4% were daily smokers. The mean age of first tobacco use was 13.1 +/- 1.85 years. The prevalence of tobacco use was higher in girls and increased with age until the age of 15-16 years. More than 90 % of smokers had experimented with alcohol, 86.3 % had used cannabis at some time and 11 % had used other illegal drugs. In multivariate analysis, the variables associated with a higher odds of smoking were age, female sex, available money, use of other drugs, and smoking by siblings in front of the adolescent.

CONCLUSIONS

The prevalence of tobacco use among 12-18 year-olds increased in relation to female gender, age, having siblings who smoked in their presence, available money, and the use of alcohol, cannabis and other illicit drugs. Maternal and sibling disapproval of smoking may be associated with lower tobacco use among adolescents.

Cigarette smoking among Greek adolescents: behavior, attitudes, risk, and preventive factors

This study was produced in the context of the first author's thesis at Athens University and was a collaboration between the Department of Clinical Care Medicine, Athens University, and Attiki Child Psychiatric Hospital. It was supported by a project grant from the THORAX Foundation, Greece.

OBJECTIVE

To study the smoking behavior, attitudes, and beliefs of Greek adolescents, as well as the risk and preventive factors for the onset of smoking and to obtain data to serve in the planning of comprehensive antismoking campaigns tailored to the Greek adolescent's specific profile.

SAMPLE AND METHOD

A stratified, nationwide, representative, school-based sample of 3827 Greek adolescents was surveyed during the academic year 2001-2002, using a questionnaire on smoking and Achenbach's Youth Self-Report.

RESULTS

Cigarette smoking is a serious problem among Greek youth. Family and peers play a primary role in shaping smoking attitudes and habits. Adolescents who smoke regularly have increased rates of psychopathology as indicated by higher scores on the Externalising and Attention Problem scales of Achenbach's Youth Self-Report, compared to adolescents who are non-smokers. The data obtained can indeed guide smoking prevention strategies in Greece.

[Analysis of factors related to smoking initiation and continued smoking in young adolescents]

OBJECTIVE

To analyse the determining of the acquisition and later consolidation of the tobacco consumption in young adolescents.

MATERIAL AND METHOD

Longitudinal study of three years of duration (2000-2002). Subjects were students of secondary education between 13 and 14 years old at the beginning of the study. The research was performed in Gran Canaria Island with a final sample of 745 subjects. Models of conditional binary election were considered for longitudinal data where the dependent variable reflects decisions of the adolescents through time, with regard to the probability of beginning to smoke, "beginning model", and the probability of being occasional or habitual smoker, "experimentation model".

RESULTS

In the last year, 57% of the young teenagers surveyed use tobacco, a 25% more than in the first year, some of them, 9% on a daily basis. In the "beginning model" the determining of the tobacco consumption are interest in studies (odds ratio [OR] = 0.27; 95% confidence interval (CI), 0.08-0.87 and OR = 0.14; 95% CI, 0.03-0.58 for the students having enough and much interest in studies, respectively), to have a smoker as the best friend (OR = 7.44; 95% CI, 2.59-21.4), the alcohol consumption (OR = 11.82; 95% CI, 4.96-28.2 and OR=15.42; 95% CI, 4.68-50.7 for youngs who drink alcohol occasionally or frequently) and having more pocket money (euros per week) (OR = 1.13; 95% CI, 1.07-1.19). For the "experimentation model", to have a smoker as the best friend (OR = 7.01; 95% CI, 2.96-16.5), the alcohol consumption (OR = 5.71; 95% CI, 1.98-16.4 and OR = 5.22; 95% CI, the 1.56-17.5 for youngs who drink alcohol occasionally or frequently) and the number of years since the student started smoking (OR = 1.44; 95% IC, 1.11-1.86).

CONCLUSIONS

Our study emphasizes, peer group effect, drinking alcoholic beverages and lack of interest in studies as factors associated to the tobacco consumption.