Smoking and high-risk sexual behavior among young adults in Hong Kong

Associations between Lifestyle and Sociodemographic Factors in Medical Students: A Cross Sectional Study

Background

Identifying lifestyle characteristics in higher education can lead to effective interventions that benefit both individuals and communities.

Methods

This cross-sectional survey-based study was conducted on medical students of a private university using the Fantastic Lifestyle Questionnaire (FLQ) to assess healthy lifestyles, as well as a custom sociodemographic questionnaire. Additionally, correlations among sociodemographic factors and alcohol intake, activity, tobacco and toxins, family and friends, insight, nutrition, type of behavior, career, sleep, seatbelt, stress, and safe sex domains were assessed.

Results

This study assessed 188 lifestyle profiles, of which 148 have complete data for evaluating the total FLQ score. The majority of evaluated lifestyles were characterized as "good (42.5%)" and "very good (35.8%)", and correlations were identified between the total FLQ score and between the preclinical and later course phases, the 18-20 years and older age brackets, and any romantic relationship and being single. Additional associations were observed for the other domains with other sociodemographic factors.

Conclusion

Medical students frequently present with a lifestyle that may be improved through various targeted interventions.

Pattern of cigarette smoking: intensity, cessation, and age of beginning: evidence from a cohort study in West of Iran

BACKGROUND

Smoking is a social epidemic and one of the main risk factors for premature deaths and disabilities worldwide. In the present study, we investigated the Pattern of Cigarette Smoking: intensity, cessation, and age of the beginning.

METHODS

Data collected from the recruitment phase of Ravansar (a Kurd region in western Iran) Non-Communicable Disease (RaNCD) cohort study was analyzed by using Chi-square test, univariate and multivariate logistic regressions, Poisson regression, and linear regression.

RESULTS

Totally 10,035 individuals (47.42% males) participated in the study. Mean age was lower for males (47.45 yr) than for females (48.36 yr). Prevalence of smoking was 20% (36.4% of males and 5.23% of females). Compared to female participants, males showed a 7-fold higher prevalence of smoking and started smoking about 4 years earlier. Being married, having a lower BMI, living in rural areas, and being exposed to secondhand smoke (SHS) were predictors of higher smoking prevalence rates. Furthermore, current exposure to SHS, higher smoking intensity, later smoking initiation, male gender, younger age, lower education, and lower BMI were related to lower likelihood of stopping smoking. Heavy smokers began to smoke about 4 years earlier than casual smokers did. Finally, being divorced/ widow/ widower/ single and childhood exposure to SHS were found to increase the likelihood of becoming a smoker.

CONCLUSIONS

Based on present research results, health programs specific to smoking cessation should take socio-demographic factors, smoking history, and current smoking behavior into account.

Risk Behaviors Correlate with Higher Prevalence of Papanicolaou, Human Papillomavirus, and Human Immunodeficiency Virus Screening Among Women in the United States

Introduction: This study assesses whether women with human immunodeficiency virus (HIV) risk behavior have higher Papanicolaou (Pap), human papillomavirus (HPV), and HIV testing, and whether the level of selected variables associated with HIV risk behavior correlate with greater testing. Association between HIV risk situations and HPV vaccination is also evaluated. Methods: A cross-sectional assessment was performed in women at age 18 years and older completing the 2018 Behavioral Risk Factor Surveillance System (BRFSS) survey. Independent variables considered and adjusted for, included age, race/ethnicity, marital status, education, annual household income, smoking status, and health care status. Results: Prevalence of a Pap test in the past 3 years was 66.2%, of HPV test in the past 5 years was 40.2%, and of HIV test ever was 41.9%. HIV risk situations applied to 4.9% women (15.2% in ages 18-24, 7.2% in 25-44, 1.9% in 45-64, and 0.6% in 65 years and older). Adjusted odds (95% confidence interval) of a Pap, HPV, or HIV test according to HIV risk behavior status were 1.5 (1.3-1.8), 1.6 (1.4-1.8), and 2.6 (2.3-2.9), respectively. The positive association between HIV risk behavior and Pap testing depends on marital status. HIV risk behavior significantly correlates with several variables, which, in turn, correlate with testing. There was no association between HIV risk behavior and HPV vaccination. Conclusions: Women with HIV risk behavior are more likely to pursue Pap, HPV, and HIV testing. The significant positive associations are largest for HIV testing and smallest for Pap testing, after adjustment for the selected variables. HIV risk behavior is not associated with HPV vaccination.

Idols as Sunshine or Road Signs: Comparing Absorption-Addiction Idolatry With Identification-Emulation Idolatry

This study seeks to contrast absorption-addiction idolatry and identification-emulation idolatry. Whereas absorption-addiction idolatry progresses from entertainment/socializing to personalizing and obsession about the idol, identification-emulation idolatry unfolds in terms of identification, attachment, romantization, idealization, and consumption about the idol or his or her derivatives. Based on a sample of 1310 secondary school and university students in Hong Kong, the study verified the original factor model composed of five first-order identification-emulation idolatry and three first-order absorption-addiction idolatry factors, with the latter more predictable by fans’ club membership.

Sex knowledge, attitudes, and high-risk sexual behaviors among unmarried youth in Hong Kong

BACKGROUND

Little is known about sex knowledge, attitudes, and high-risk sexual behaviors among unmarried youth in Hong Kong. It is of public health importance to investigate this topic to inform sex education, policymaking, and prevention and intervention programs.

METHODS

Based on the Youth Sexuality Survey conducted by Hong Kong Family Planning Association (FPAHK) in 2011, this study explored the characteristics of sexual knowledge, attitudes, and high-risk sexual behaviors among 1,126 unmarried youth aged 18 to 27 years. Multiple logistic regressions were performed to examine factors associated with unmarried youth's premarital sex, casual relationships, multiple sex partners, and premarital pregnancy.

RESULTS

Unmarried youth in Hong Kong had adequate sex knowledge, but contraceptive knowledge was deficient. The majority of unmarried youth (63.8%) held liberal attitudes toward premarital sex and about half held liberal attitudes toward any form of sexual activity and premarital pregnancy. Around 60% held conservative attitudes toward causal sex relationships and multiple sex partners. Males tended to hold more liberal attitudes toward high-risk sex behaviors than female youth. Approximately 41.5% of unmarried youth reported having engaged in premarital sex, whereas less than 10% engaged in high-risk sexual behaviors. Males also reported higher amounts of premarital sex, casual sex relationships, and multiple sex partners. Females reported higher levels of sexual coercion. Logistic regressions indicated that being older, coming from a divorced family, out of school status and liberal attitudes toward risky sex behavior were more likely to engage in premarital sex or high-risk sex behaviors, and being female, being better educated and being immigrants were less likely to engage in premarital sex. However, being immigrants was more likely to engage in casual relationship and to have multiple partners.

CONCLUSIONS

Premarital sex is becoming more prevalent among unmarried youth in Hong Kong, and a small proportion of young adults are engaging in high-risk sexual behaviors. Sex education and HIV prevention programs should equip them with adequate knowledge on contraception and condom use. Intervention programs can start with their attitudes toward sex.

Consistent condom use increases spontaneous regression in high-risk non-HPV16 but not in HPV16 CIN2-3 lesions, a prospective population-based cohort study

Background

The major cause of cervical intraepithelial neoplasia (CIN) is persistent infection with human papillomavirus (HPV). Most CIN grade 2 and 3 lesions are treated with cone excision, although a substantial proportion (6-50%) of CIN2-3 lesions will regresses spontaneously. Predictors for regression of CIN2-3 are desirable in order to reduce this overtreatment.

Methods

In this prospective cohort study, 145 consecutive women with first-time onset CIN2-3 in colposcopy-directed biopsies and standardized biopsy-cone excision interval were included. The genotype of the high-risk human papillomaviruses (=hrHPV) and clinical factors including sexual behaviour, parity, contraception and smoking were assessed. Patients were divided into two groups according to lesions containing HPV16 (hrHPV16+) and high-risk non-HPV16 (hrHPV16-) genotypes.

Results

Women whose partners consistently used condoms showed a significantly higher regression rate than women using other types of contraception (53% versus 13%, p<0.0001). However, this effect was only seen in hrHPV16- patients (73% regression rate versus 13%, p<0.0001). HrHPV16+ patients had a significantly higher number of sexual partners and more current smokers compared to hrHPV16- patients. The regression rate was not significantly different in CIN2-3 lesions containing HPV16 (hrHPV16+) versus hrHPV16- genotypes.

Conclusions

Heterogeneity among hrHPV genotypes excists. HPV-genotype analyses can identify women who significantly increase their chance of regression by consistent condom use.

Nicotine alters limbic function in adolescent rat by a 5-HT1A receptor mechanism

Epidemiological studies have shown that adolescent smoking is associated with health risk behaviors, including high-risk sexual activity and illicit drug use. Using rat as an animal model, we evaluated the behavioral and biochemical effects of a 4-day, low-dose nicotine pretreatment (60 μg/kg; intravenous) during adolescence and adulthood. Nicotine pretreatment significantly increased initial acquisition of cocaine self-administration, quinpirole-induced locomotor activity, and penile erection in adolescent rats, aged postnatal day (P)32. These effects were long lasting, remaining evident 10 days after the last nicotine treatment, and were observed when nicotine pretreatment was administered during early adolescence (P28-31), but not late adolescence (P38-41) or adulthood (P86-89). Neurochemical analyses of c-fos mRNA expression, and of monoamine transmitter and transporter levels, showed that forebrain limbic systems are continuing to develop during early adolescence, and that this maturation is critically altered by brief nicotine exposure. Nicotine selectively increased c-fos mRNA expression in the nucleus accumbens shell and basolateral amygdala in adolescent, but not adult animals, and altered serotonin markers in these regions as well as the prefrontal cortex. Nicotine enhancement of cocaine self-administration and quinpirole-induced locomotor activity was blocked by co-administration of WAY 100 635 (N-{2-[4-(2-methoxyphenyl)-1-piperazinyl] ethyl}-N-(2-pyridinyl)cyclohexanecarboxamide), a selective serotonin 1A (5-HT1A) receptor antagonist. Early adolescent pretreatment with the mixed autoreceptor/heteroceptor 5-HT1A receptor agonist, 8-OH-DPAT, but not the autoreceptor-selective agonist, S-15535, also enhanced quinpirole-induced locomotor activation. Nicotine enhancement of quinpirole-induced penile erection was not blocked by WAY 100 635 nor mimicked by 8-OH-DPAT. These findings indicate that early adolescent nicotine exposure uniquely alters limbic function by both 5-HT1A and non-5-HT1A receptor mechanisms.

Lifestyle and socio-demographic factors associated with high-risk HPV infection in UK women

The world age-standardised prevalence of high-risk HPV (hrHPV) infection among 5038 UK women aged 20–59 years, with a low-grade smear during 1999–2002, assessed for eligibility for TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) was 34.2%. High-risk HPV prevalence decreased with increasing age, from 61% at ages 20–24 years to 14–15% in those over 50 years. The age-standardised prevalence was 15.1, 30.7 and 52.7%, respectively, in women with a current normal, borderline nuclear abnormalities (BNA) and mild smear. In overall multivariate analyses, tertiary education, previous pregnancy and childbirth were associated with reduced hrHPV infection risk. Risk of infection was increased in non-white women, women not married/cohabiting, hormonal contraceptives users and current smokers. In stratified analyses, current smear status and age remained associated with hrHPV infection. Data of this type are relevant to the debate on human papillomavirus (HPV) testing in screening and development of HPV vaccination programmes.

Human papillomavirus vaccine: knowledge and attitudes in two Appalachian Kentucky counties

OBJECTIVE

A vaccine against common high-risk types of human papillomavirus (HPV) associated with cervical cancer risk was recently approved. We assessed women's acceptance of HPV vaccination for themselves and for adolescent girls, in an Appalachian population with cervical cancer incidence and mortality rates among the highest in the United States.

METHODS

We conducted a population-based, random-digit telephone survey of over 600 adult women residing in two Appalachian Kentucky counties. The analysis focused on questions of HPV vaccine acceptance, and their relationship to several factors.

RESULTS

The majority of women indicated an interest in HPV vaccination for themselves (85.2%), but they were less accepting of a vaccine being administrated to girls of ages 10-15 (67.6%). Women who were younger, lower-income and smokers were more likely to support vaccination.

CONCLUSIONS

Although a relatively high percentage of women found the HPV vaccination acceptable for their own use, there was less enthusiasm for supporting vaccination to girls. This finding is of concern since the vaccine is being recommended for adolescent girls and young women, prior to sexual initiation. Educational campaigns will be needed for a successful vaccine implementation.

Depressive symptoms and smoking among Hong Kong Chinese adolescents

AIMS

To examine associations among depressive symptoms, smoking, smoking trajectories and quitting smoking in Hong Kong.

DESIGN

Prospective longitudinal design, with wave 1 at baseline (T1) and wave 2 (T2) 12 months later.

SETTING AND PARTICIPANTS

Form 1 (equivalent to 7th grade in the United States) students, mean age = 12.7 years, n = 1894.

MEASUREMENTS

Self-reported smoking status, attempts to quit and depressive symptoms.

FINDINGS

At both waves, current as well as ex-smokers had higher depressive symptoms than never smokers. T1 smoking predicted T2 depressive symptoms among those with low baseline depressive symptoms. Depressive symptoms at T1 predicted smoking at T2 among non-smokers at T1. Trajectories were defined by separating participants who were never smokers at both waves ('non-smokers'), those who smoked at both waves ('persistent smokers'), those who smoked at one time but were not smoking at either wave ('past smokers), and those who had never smoked at T1 but reported smoking a year later ('new smokers'). Persistent, past and new smokers had higher depressive symptoms at both waves than non-smokers. Smokers who reported not wanting or trying to quit and those who had been unsuccessful at quitting had higher depressive symptoms at T2 than those who successfully quit.

CONCLUSION

Our results suggest that depressive symptoms promote tobacco use in Asian adolescents by making it more likely that an adolescent will begin smoking and less likely that she or he will quit. These findings elucidate risk factors in Hong Kong for two important public health concerns for adolescents: smoking and depression.

Active and passive cigarette smoking and the risk of cervical neoplasia

OBJECTIVE

Evidence links active cigarette smoking to cervical neoplasia, but much less is known about the role of passive smoking. Using a prospective cohort design, we examined personal cigarette smoking and household passive smoke exposure in relation to the risk of cervical neoplasia.

METHODS

Cohorts were established based on data collected on the smoking status of all household members during private censuses of Washington County, Maryland in 1963 (n = 24,792) and 1975 (n = 26,381). Using the Washington County Cancer Registry, the occurrence of cervical neoplasia in the two cohorts was ascertained from 1963-1978 and from 1975-1994. Poisson regression models were fitted to estimate the relative risk of developing cervical neoplasia associated with active and passive smoking in both cohorts. The referent category for all comparisons was never smokers not exposed to passive smoking.

RESULTS

The adjusted relative risk and 95% confidence limits for passive smoking was 2.1 (1.3, 3.3) in the 1963 cohort and 1.4 (0.8, 2.4) in the 1975 cohort. The adjusted relative risk and 95% confidence limits for current smoking were 2.6 (1.7, 4.1) and 1.7 (1.1, 2.6) in the 1963 and 1975 cohort, respectively.

CONCLUSION

The associations were in the direction of increased risk for both passive smoking and current active smoking in both the 1963 and 1975 cohorts, but were stronger in the 1963 cohort. The results of this long-term, prospective cohort study corroborate the association between active cigarette smoking and cervical neoplasia and provide evidence that passive smoking is a risk factor for cervical neoplasia.

Correlates of sexual behaviors with health status and health perception in Chinese adolescents: a cross-sectional survey in schools

Sexual intercourse remains taboo among adolescents in a Chinese society such as Hong Kong. It is not openly discussed and little research has been done on its impact on health, although it carries serious risks of contracting sexually transmitted diseases (STDs)/HIV. In 1999, a cross-sectional, self-report survey on youth risk behaviors was carried out on 8382 students 15-18 years of age from 48 schools in Hong Kong. Three hundred seventy-seven (4.69%) reported that they had had sexual intercourse. Among them, forced sex (16.94%) was common, most often happening to boys (52.38%). They were more likely to have consulted doctors in the last month (odds ration [OR] 1.41 in boys 95% confidence interval [CI] 1.03, 1.94; OR 2.46 in girls 95% CI 1.81, 3.30) and 6 months (OR 1.33 in boys 95% CI 0.98, 1.78; OR 2.66 in girls 95% CI 1.80, 3.91). They also perceived poorer and deteriorating health. The sexually active female students were 6.70 times (95% CI 4.65, 9.66) more likely to attempt suicide than the other group and were more likely to take sick leaves (OR 3.56 in girls 95% CI 2.35, 5.41). Parental education and occupation, place of birth, and type of housing did not correlate in the initiation of sexual intercourse. The sexually experienced group reported worse physical and psychological health as well as health perception. Some of the characteristics and patterns identified in our study were quite different from the findings in the West but further studies are required to determine the reason for this.