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Lloyd K, Harrison S, Sallis HM, Davey Smith G, Munafò MR, Wootton RE. Exploring the bidirectional causal pathways between smoking behaviours and headache: A Mendelian randomisation study. Nicotine Tob Res 2023:ntad173. [PMID: 37702655 DOI: 10.1093/ntr/ntad173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Although observational data suggests a relationship between headache and smoking, there remain questions about causality. Smoking may increase headache risk, individuals may smoke to alleviate headaches, or smoking and headache may share common risk factors. Mendelian randomisation (MR) is a method that uses genetic variants as instruments for making causal inferences about an exposure and an outcome. METHODS First, we conducted logistic regression of observational data in UK Biobank assessing the association between smoking behaviours (smoking status, cigarettes per day amongst daily smokers and lifetime smoking score) on risk of self-reported headache (in the last month and for more than 3 months). Second, we used genetic instruments for smoking behaviours and headache (identified in independent genome-wide association studies) to perform bidirectional MR analysis. RESULTS Observationally, there is a weak association between smoking behaviour and experiencing headache, with increased cigarettes per day associated with increased headache risk. In the MR analysis, genetic liability to smoking initiation and lifetime smoking increased odds of headache in the last month but not odds of headaches lasting more than three months. In the opposite direction there was weak evidence for higher genetic liability to headaches decreasing the chance of quitting. CONCLUSION There was weak evidence for a partially bidirectional causal relationship between smoking behaviours and headache in the last month. Given this relationship is distinct from smoking heaviness, it suggests headache and smoking may share common risk factors such as personality traits. IMPLICATIONS Using Mendelian Randomisation, this study addresses the uncertainty regarding the observed relationship between headache and smoking. There was evidence for weak causal effects of smoking initiation and lifetime smoking (but not smoking heaviness) on likelihood of experiencing headache in the last month, but not over a prolonged period of more than three months. Those at higher genetic liability for headaches were also less likely to successfully stop smoking. This partially bidirectional causal relationship distinct from smoking heaviness, suggests that observed associations are unlikely due to biological effects of tobacco smoke exposure and may be explained by shared personality traits.
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Affiliation(s)
- Katherine Lloyd
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol
| | - Sean Harrison
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol
- MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Road, Bristol
| | - Hannah M Sallis
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol
- MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Road, Bristol
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol
| | - George Davey Smith
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol
- MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Road, Bristol
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Road, Bristol
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Robyn E Wootton
- MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Road, Bristol
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Spångbergveien 25, Oslo, 0853, Norway
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Noh JW, Kim J, Lee Y, Kwon YD. Factors Related to Oversleeping in Korean Young Adults, with a Focus on Sociodemographic Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10485. [PMID: 36078200 PMCID: PMC9518058 DOI: 10.3390/ijerph191710485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
Young adults the year after high school experience changes in lifestyle and circumstances and tend to experience more oversleeping. However, there are few studies on oversleeping in young adults. This study aims to identify the sociodemographic factors related to oversleeping among young adults in Korea using nationally representative data. This study analyzed self-reported and cross-sectional data in 2016 from a sample of 1876 participants from the Korean Children and Youth Panel Survey, which included respondents one year after high school graduation. Oversleeping was defined as sleeping 9 or more hours a day on average. Logistic regression models were analyzed to test a multivariate association between independent sociodemographic variables and oversleeping. Over one-tenth of young adults reported oversleeping. Oversleeping was associated with household income (OR = 0.99, p = 0.011) and smoking (OR = 1.52, p = 0.041). In addition, when compared to non-working college students, college students who were working (OR = 2.58, p = 0.021), non-students who were working (OR = 1.68, p = 0.048), and non-students who were not working (OR = 3.07, p < 0.001) were more likely to report oversleeping. Oversleeping among young adults was associated with major sociodemographic factors including household income (-), smoking (+), and academic and working status (+). These findings suggest the significant role of sociodemographic factors as predictors of oversleeping and emphasize the importance of examining various factors to achieve a better understanding of oversleeping in young adults.
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Affiliation(s)
- Jin-Won Noh
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju 26493, Korea
| | - Jinseok Kim
- Department of Social Welfare, Seoul Women’s University, Seoul 01797, Korea
| | - Yejin Lee
- Department of Public Health, Graduate School, Korea University, Seoul 02841, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine, Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul 06591, Korea
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Smuck M, Schneider BJ, Ehsanian R, Martin E, Kao MCJ. Smoking Is Associated with Pain in All Body Regions, with Greatest Influence on Spinal Pain. PAIN MEDICINE 2021; 21:1759-1768. [PMID: 31578562 DOI: 10.1093/pm/pnz224] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Examine the interrelationship between smoking and pain in the US population. DESIGN A cross-sectional population-based study. SETTING Nationwide survey. METHODS Comprehensive pain reports categorically defined as head, spine, trunk, and limb pain; smoking history; demographics; medical history from a total of 2,307 subjects from the 2003-2004 National Health and Nutrition Examination Survey obtained from the Centers for Disease Control were analyzed. Unpaired t tests were used to analyze independent continuous variables, and chi-square tests were used to analyze categorical variables between smoker and nonsmoker groups. Weighted multivariate logistic regression analyses determined the association of current smoking with the presence of pain in various body regions. RESULTS Smoking is most strongly associated with spine pain (odds ratio [OR] = 2.89, 95% confidence interval [CI] = 2.21-3.77), followed by headache (OR = 2.47, 95% CI = 1.73-3.53), trunk pain (OR = 2.17, 95% CI = 1.45-2.74), and limb pain (OR = 1.99, 95% CI = 1.45-2.73). CONCLUSIONS Current smoking is associated with pain in every region of the body. This association is strongest for spine and head pain. Given that pain is a strong motivator and that current smoking was associated with pain in all body regions, we recommend that these results be used to further raise public awareness about the potential harms of smoking.
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Affiliation(s)
- Matthew Smuck
- Physical Medicine and Rehabilitation, Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Byron J Schneider
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee.,Vanderbilt University Medical Center, Center for Musculoskeletal Research
| | - Reza Ehsanian
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee.,Department of Neurosurgery, Stanford University, Palo Alto, California.,Division of Physical Medicine and Rehabilitation, Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Elizabeth Martin
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, Tennessee.,Division of Physical Medicine and Rehabilitation, Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Ming-Chih J Kao
- Physical Medicine and Rehabilitation, Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Stanford University, Stanford, California
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Raucci U, Boni A, Evangelisti M, Della Vecchia N, Velardi M, Ursitti F, Terrin G, Di Nardo G, Reale A, Villani A, Parisi P. Lifestyle Modifications to Help Prevent Headache at a Developmental Age. Front Neurol 2021; 11:618375. [PMID: 33603708 PMCID: PMC7884344 DOI: 10.3389/fneur.2020.618375] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
Headache is the world's seventh most significant cause of disability-adjusted-life in people aged between 10 and 14 years. Therapeutic management is based on pharmacological approaches and lifestyle recommendations. Many studies show associations between each migraine-promoting lifestyle, behavioral triggers, frequency, and intensity of headaches. Nevertheless, the overall aspects of this topic lack any definitive evidence. Educational programs advise that pediatric patients who suffer from migraines follow a correct lifestyle and that this is of the utmost importance in childhood, as it will improve quality of life and assist adult patients in avoiding headache chronicity, increasing general well-being. These data are important due to the scarcity of scientific evidence on drug therapy for prophylaxis during the developmental age. The "lifestyle recommendations" described in the literature include a perfect balance between regular sleep and meal, adequate hydration, limited consumption of caffeine, tobacco, and alcohol, regular physical activity to avoid being overweight as well as any other elements causing stress. The ketogenic diet is a possible new therapeutic strategy for the control of headache in adults, however, the possible role of dietary factors requires more specific studies among children and adolescents. Educational programs advise that the improvement of lifestyle as a central element in the management of pediatric headache will be of particular importance in the future to improve the quality of life of these patients and reduce the severity of cephalalgic episodes and increase their well-being in adulthood. The present review highlights how changes in different aspects of daily life may determine significant improvements in the management of headaches in people of developmental age.
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Affiliation(s)
- Umberto Raucci
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | | | - Melania Evangelisti
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Nicoletta Della Vecchia
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Margherita Velardi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Fabiana Ursitti
- Division of Neurology, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Gianluca Terrin
- Department of Gynecological Obstetric and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Giovanni Di Nardo
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Antonino Reale
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Pasquale Parisi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
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Evans DS, O'Farrell A, Sheridan A, Kavanagh P. Comparison of the health and well-being of smoking and non-smoking school-aged children in Ireland. Child Care Health Dev 2019; 45:694-701. [PMID: 31039602 DOI: 10.1111/cch.12681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although most young people are aware of the long-term consequences of smoking, it has been shown that young smokers expect to give up before any health damage occurs. Little is known in an Irish context about the association between smoking and young people's current health. This could be helpful to help reduce smoking initiation and encouraging quitting. The study aimed to determine the association between smoking and health and well-being indicators among Irish school-aged children. METHODS The 2014 Irish Health Behaviour in School-aged Children study was analysed, which comprised a random stratified sample of 9,623 schoolchildren (aged 10-18). The prevalence of eight self-reported health complaints and two subjective well-being measures were compared across strata classified by self-reported smoking status using Pearson's chi square and independent t tests. Logistic regression and ordinal regression were used to control for age, gender, and social class. RESULTS A significantly larger proportion of smokers (p < .001) reported fair to poor health (32% versus 11% for non-smokers), lower mean life satisfaction scores (6.2 compared with 7.5), and each of eight health complaints at least once a week (range = 25-50% compared with 15-21%). These patterns remained significant after adjusting for differences in age, gender, and social class profile (p < .001). CONCLUSIONS The study demonstrates the potential of developing initiatives, which target smoking in adolescence as opposed to the longer term health effects of smoking which are well known. The findings can be utilized to counteract positive perceptions of smoking among schoolchildren. This, combined with providing supports to help children quit, may help achieve government targets to reduce smoking prevalence.
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Affiliation(s)
- David S Evans
- Merlin Park Hospital, Department of Public Health, Health Service Executive West, Galway, Republic of Ireland
| | - Anne O'Farrell
- Health Intelligence Unit, Strategic Planning and Transformation, Research and Development, Health Service Executive, Dublin, Republic of Ireland
| | - Aishling Sheridan
- Tobacco Free Ireland Programme, Health Service Executive, Navan, Republic of Ireland
| | - Paul Kavanagh
- Tobacco Free Ireland Programme, Health Service Executive, Dublin, Republic of Ireland
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Heshmat R, Qorbani M, Safiri S, Eslami-Shahr Babaki A, Matin N, Motamed-Gorji N, Motlagh ME, Djalalinia S, Ardalan G, Mansourian M, Asayesh H, Kelishadi R. Association of passive and active smoking with self-rated health and life satisfaction in Iranian children and adolescents: the CASPIAN IV study. BMJ Open 2017; 7:e012694. [PMID: 28196944 PMCID: PMC5318555 DOI: 10.1136/bmjopen-2016-012694] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the joint association of passive and active smoking with self-rated health and life satisfaction among Iranian children and adolescents. METHODS Using a multistage random cluster sampling method, a representative sample of 14 880 school students were selected from urban and rural areas of 30 provinces of Iran. Data were gathered using a questionnaire, a weight scale and metre. Participants were classified into four groups based on their smoking patterns: 'non-smoker', 'only active smoker', 'only passive smoker' and 'active and passive smoker'. Life satisfaction (LS) and self-rated health (SRH) were assessed by self-administered validated questionnaires based on the WHO-Global School-based student Health Survey (WHO-GSHS). Data were analysed using a t-test, χ2 test and multiple logistic regression. RESULTS A total of 13 486 individuals (6640 girls and 6846 boys) out of 14 880 invited participated in the study (response rate 90.6%). LS and good SRH showed linearly negative associations with smoking status in both sexes. The proportions of LS and SRH categories were significantly different among all subsets of smoking status. Those classified as 'non-smokers' had the highest proportions of LS and good SRH, followed by 'only passive smokers' and 'only active smokers', while those with 'active and passive smoking' had the lowest proportions of LS and good SRH. In a multivariate model, students in the 'active and passive smoking' group had lower odds of LS (OR 0.43; 95% CI 0.32 to 0.57) and good SRH (OR 0.51; 95% CI 0.38 to 0.68) than those in the 'non-smoker' group. Students in the 'only passive smoker' group also had lower odds of LS (OR 0.75; 95% CI 0.67 to 0.83) and good SRH (OR 0.72; 95% CI 0.66 to 0.80) compared with the 'non-smoker' group. CONCLUSIONS Adolescents with different smoking habits and exposure patterns have poorer SRH and LS than non-smokers. Both active and passive smoking status could affect LS and SRH in adolescents. Therefore, smoking prevention strategies should be considered as a health priority in school health services for promoting psychological well-being in children and adolescents.
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Affiliation(s)
- Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Amir Eslami-Shahr Babaki
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nassim Matin
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazgol Motamed-Gorji
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shirin Djalalinia
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Gelayol Ardalan
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Mansourian
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Sex differences in asthma in swimmers and tennis players. Ann Allergy Asthma Immunol 2017; 118:311-317. [PMID: 28126431 DOI: 10.1016/j.anai.2016.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/13/2016] [Accepted: 12/15/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Elite athletes, independent of sport, have increased risk of developing asthma, but little is known about sex difference among adolescent athletes. OBJECTIVE To investigate and compare sex-related differences according to symptoms and treatment of asthma, allergy, and health among elite athletes and a reference group. METHODS Adolescent elite swimmers (n = 101), tennis players (n = 86), and a reference group (n = 1,628) responded to a questionnaire about respiratory symptoms, allergy, health behavior, psychosomatic symptoms, self- esteem, and well-being. The athletes performed a mannitol provocation and a sport-specific exercise provocation. Atopy was assessed by skin prick tests, and fractional exhaled nitric oxide was measured. RESULTS The females reported more asthma symptoms than the males in both the reference group (29.1% vs 22.3%) and the athlete group (56.4% vs 40.2%). However, no significant differences were found in physician-diagnosed asthma or treatment with inhaled corticosteroids. More female athletes had a positive mannitol provocation result (48.7% vs 35.8% in male athletes), and more female swimmers had a positive exercise provocation result (15.1% vs 7.7% in male swimmers). The females in all groups had more psychosomatic symptoms compared with the respective males, and the males in the reference group reported higher self-esteem and felt more well-being compared with the reference group females. CONCLUSION Overall, we found a higher prevalence of asthma symptoms in the females. However, the frequency of physician-diagnosed asthma and the prescription of inhaled corticosteroids were the same in both sexes. This finding demonstrates an insufficient diagnosis of asthma in females.
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Kinnunen JM, Lindfors P, Rimpelä A, Salmela-Aro K, Rathmann K, Perelman J, Federico B, Richter M, Kunst AE, Lorant V. Academic well-being and smoking among 14- to 17-year-old schoolchildren in six European cities. J Adolesc 2016; 50:56-64. [DOI: 10.1016/j.adolescence.2016.04.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 04/26/2016] [Accepted: 04/30/2016] [Indexed: 12/01/2022]
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Zwart JA, Dyb G, Holmen TL, Stovner LJ, Sand T. The Prevalence of Migraine and Tension-Type Headaches Among Adolescents in Norway. The Nord-Trøndelag Health Study (Head-Hunt-Youth), A Large Population-Based Epidemiological Study. Cephalalgia 2016; 24:373-9. [PMID: 15096226 DOI: 10.1111/j.1468-2982.2004.00680.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to examine the prevalence of headache and primary headache disorders like migraine and tension-type headaches among adolescents, and to explore the differences in headache prevalence and frequency by gender and age. This cross-sectional study was conducted in Nord-Trøndelag county, Norway, during the years 1995-97. In total, 8984 (88%) out of 10 202 invited adolescents aged 12-19 years participated in the youth part of the Nord-Trøndelag Health Study [Helseundersøkelsen i Nord-Trøndelag (HUNT)]. The total study population in this study consisted of 8255 individuals after exclusion of invalid questionnaires and students outside the target range of 13-18 years of age. The students completed a comprehensive questionnaire, and one of the questions was whether the students had experienced any headaches during the last 12 months. In addition, 5847 of these students were also subject to an interview in which they were asked whether they had experienced recurring headaches during the last year and, if so, were they classified as migraine (MI), tension-type headache (TTH) or non-classifiable headache. In the total questionnaire-based population, 76.8% reported having had headaches during the last 12 months (69.4% boys and 84.2% girls). Among those who also were interviewed, 29.1% reported having recurrent headaches (21.0% boys and 36.5% girls). The overall 1-year prevalence of migraine was 7%, of tension-type headache 18%, and of non-classifiable headache 4.8%. Higher prevalence rates were found for girls in all age groups and for all headache categories. The overall frequency of recurrent headaches did not vary significantly with age, but girls had significantly more frequent headaches than boys. We concluded that headache in general, and recurrent primary headache disorders like migraine and tension-type headaches, are common somatic complaints among Norwegian adolescents, especially among girls.
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Affiliation(s)
- J-A Zwart
- Department of Clinical Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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Braverman MT, Stawski RS, Samdal O, Aarø LE. Daily Smoking and Subjective Health Complaints in Adolescence. Nicotine Tob Res 2016; 19:102-110. [PMID: 27206973 DOI: 10.1093/ntr/ntw133] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 05/04/2016] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Using data from the Health Behaviour in School-aged Children survey, this study used a repeated cross-sectional design to examine associations between daily smoking, gender, and self-reported health complaints in five cohorts of adolescents over a 16-year period. METHODS Data were from nationally representative cohorts of 15-year-old youth in Norway in 1993/1994, 1997/1998, 2001/2002, 2005/2006, and 2009/2010 (n total = 7761). Dependent variables were psychological, somatic, and total health complaints. A mixed GLM model examined main and interaction effects of smoking (daily, intermittent, nonsmoking), year, and gender in predicting complaints. Time periods were segmented to compare trends across smoking groups in specific periods. RESULTS Prevalence of daily smoking declined from 15.5% (1993/1994) to 6.0% (2009/2010). All health complaint scores were significantly higher for smokers and for girls (vs. boys). Smoking status by year interactions were significant for all complaint variables during the period of sharpest decline of daily smoking prevalence (2001/2002-2005/2006), with daily smokers experiencing increases in health complaints while intermittent and nonsmokers did not. Smoking status by gender interactions were significant for all health complaint variables, indicating that the main effect for gender (females higher) was even stronger among smokers compared with nonsmokers. Using year as unit of analysis, the size of mean differences between daily smokers and intermittent/nonsmokers in total complaints was significantly negatively correlated with daily smoking prevalence (-.963, n = 5, p < .01). CONCLUSIONS As prevalence of daily smoking declined, daily smokers reported higher levels of complaints, suggesting increasing health problems within this group. Girls who smoke daily had particularly elevated levels of complaints. IMPLICATIONS This study indicates that the relationship between daily smoking and concurrent health symptomatology in adolescents is changing over time, with higher levels of health complaints reported as overall smoking prevalence declines. To our knowledge, this finding has not previously been reported. If youth are smoking to cope with distress, pain, or other health concerns, tobacco control objectives will be increasingly difficult to achieve with adolescents. Levels of health complaints are particularly high among girls who are daily smokers. The findings suggest that restrictive measures and persuasive communications may not be sufficient tobacco prevention strategies for adolescent populations. Young smokers may need counseling and support.
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Affiliation(s)
- Marc T Braverman
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR;
| | - Robert S Stawski
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR
| | - Oddrun Samdal
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Leif Edvard Aarø
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
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Hansen K, Lindström M, Rosvall M. Age at smoking initiation and self-rated health among second grade high school boys and girls in Scania, Sweden, a cross-sectional study. BMC Public Health 2015; 15:1143. [PMID: 26581335 PMCID: PMC4652342 DOI: 10.1186/s12889-015-2457-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 10/26/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Smoking is usually initiated early in life and most adult regular smokers have started smoking before 18 years of age. A younger age at smoking initiation is associated with risk taking behaviours and worse health outcomes regarding psychological and somatic conditions, suggested to be caused by exposure during critical developmental periods. The present study aims to investigate self-rated health among second grade high school boys and girls related to age at smoking initiation (<14 years of age and ≥ 14 years of age) among current and former smokers, compared to never smokers. METHODS Data was derived from the Scania public health survey among children and adolescents in 2012. The study was cross-sectional with retrospective information about first time cigarette smoking experiences among 3245 boys and 3434 girls in second grade of high school. Self-rated health was assessed with the question "How do you rate your general health". Associations of age at smoking initiation, current smoking status and poor self-rated health were investigated with logistic regression models. RESULTS Crude odds ratios of poor self-rated health were increased for all smoking groups compared to never smokers. Former smoking boys and currently smoking girls with early smoking initiation had the highest odds ratios of poor self-rated health, with odds ratios (OR) 2.4 (95 % confidence interval (CI): 1.5-3.7) and OR 2.9 (95 % CI: 2.3-3.6), respectively. After adjustments for sociodemographic factors, health-related behaviours, psychosocial factors, weight and functional disabilities, the results were attenuated, but remained statistically significant regarding former and current smoking boys with early smoking initiation, OR 2.0 (95 % CI: 1.1-3.7) and OR 1.7 (95 % CI: 1.1-2.4) and for current smoking girls with early and later smoking initiation, OR 2.1 (95 % CI: 1.5-2.8) and OR 1.5 (95 % CI: 1.1-2.0). CONCLUSION Boys and girls in second grade of high school with early smoking initiation reported poorer self-rated health than later initiators and never smokers. Poorer self-rated health persisted also after smoking cessation among early initiating boys. Further studies are needed to understand the adverse health effects associated with timing of smoking initiation.
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Affiliation(s)
- Kristina Hansen
- Department of Clinical Sciences, Social Medicine and Health Policy, CRC, Scania University Hospital, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
| | - Martin Lindström
- Department of Clinical Sciences, Social Medicine and Health Policy, CRC, Scania University Hospital, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
| | - Maria Rosvall
- Department of Clinical Sciences, Social Medicine and Health Policy, CRC, Scania University Hospital, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
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Cassidy RN, Roberts ME, Colby SM. Validation of a Respiratory Symptom Questionnaire in Adolescent Smokers. TOB REGUL SCI 2015; 1:121-128. [PMID: 26236764 PMCID: PMC4517836 DOI: 10.18001/trs.1.2.2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Adolescent smokers experience respiratory symptoms as a consequence of smoking, which may be impacted by harm-reduction products. We sought to validate the American Thoracic Society Questionnaire (ATSQ), a measure of respiratory symptoms, in adolescent smokers. METHODS Data were drawn from 2 studies of adolescents (ages 14 to 19). Study 1 (N = 118) comprised daily smokers. Study 2 (N = 216) comprised 118 smokers and 98 nonsmokers; a subset of the total sample comprised 70 matched pairs of smokers and non-smokers. RESULTS The ATSQ showed high internal consistency. In Study 1, ATSQ scores were positively correlated with dependence. In Study 2, scores were positively correlated with CO, cotinine, and cigarettes per day; and scores were significantly greater for smokers than non-smokers. CONCLUSIONS The ATSQ offers a psychometrically valid method for measuring respiratory symptoms in adolescent smokers.
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Affiliation(s)
- Rachel N Cassidy
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
| | - Megan E Roberts
- Center of Excellence in Regulatory Tobacco Science, The Ohio State University, Columbus, OH
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
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Abstract
BACKGROUND Migraineurs variably attribute the cause of their headache to tobacco exposure, whereas tobacco is often stated to cause headache-related disability worldwide. Given tobacco's physiological and emotional addictiveness and migraine's substantial economic impact, improved functionality can be difficult for those with migraine exposed to tobacco products. Environmental tobacco exposure in indoor spaces and workplaces is associated with exacerbation of headache. Avoidance of headache triggers is included in most comprehensive migraine treatment programs, yet tobacco awareness, avoidance, or coping is rarely emphasized as part of that regimen. OBJECTIVE The aims of this study were to examine the various types of tobacco products to which headache sufferers are exposed and the known basic mechanisms by which tobacco (nicotine) exposure promotes headache pain, and to review the extensive literature on tobacco related to headache with a detailed descriptive narrative providing the basis for conclusions regarding association of noncluster headache-related tobacco exposure. Tobacco-related recommendations are offered. METHODS MEDLINE, EMBASE, and Google Scholar databases were searched without yearly restriction through the date of submission (May 2015), using the MeSH terms "tobacco," "tobacco products," "smoking," "tobacco use," "headache," and "headache disorders." The selection of articles was not limited to English studies or to humans. Articles were excluded when "headache" and "tobacco" were not both mentioned with data provided. Case series were included. Bibliographies of all articles were screened for additional relevant articles. RESULTS Although migraineurs worldwide report tobacco smoke among triggers, it is rarely among the highest in frequency, and biases abound with predominantly noncontrolled retrospective data. Prospective population-based diary data are extremely limited, and no controlled trials exist to confirm a cause and effect for headache of any type. Although some studies are nonsupportive and even conflicting, headache, pain, and tobacco exposure currently remain associated. CONCLUSION Conflicting data support the validity of patient-reported environmental tobacco exposure as a headache trigger. Prospective controlled studies are needed, but unlikely to be performed, to determine the extent that tobacco influences the headache process, in addition to other under-recognized factors. Meanwhile, because of numerous other negative health effects, decreased tobacco exposure should be recommended to headache patients of all ages in hopes of decreasing disability and improving functionality.
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Affiliation(s)
- Frederick R Taylor
- Department of Neurology, University of Minnesota School of Medicine, Minneapolis, MN, USA
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McKelvey K, Attonito J, Madhivanan P, Yi Q, Mzayek F, Maziak W. Determinants of cigarette smoking initiation in Jordanian schoolchildren: longitudinal analysis. Nicotine Tob Res 2015; 17:552-8. [PMID: 25143297 PMCID: PMC4432393 DOI: 10.1093/ntr/ntu165] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 08/11/2014] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To identify determinants of cigarette smoking initiation, by gender, among schoolchildren in Irbid, Jordan. METHODS Between 2008 and 2011, data were collected annually using self-reported questionnaires over 4-years in a prospective cohort of 1,781 students recruited from all 7th grade classes in 19 secondary schools, selected out of a total 60, using probability-proportionate-to-size method. Independent predictors of smoking initiation were identified among the cigarette naïve participants (N = 1,454) with mixed-effect multivariable logistic regression. RESULTS Participants were 12.6 years of age on average at baseline. 29.8% of the 1,454 students (37.2% of boys and 23.7% of girls) initiated cigarette smoking by 10th grade. Of those who initiated (n = 498), 47.2% of boys and 37.2% of girls initiated smoking in the 8th grade. Determinants of cigarette smoking initiation included ever smoking a waterpipe, low cigarette refusal self-efficacy, intention to start smoking cigarettes, and having friends who smoked. For girls, familial smoking was also predictive of cigarette initiation. CONCLUSION This study shows that many Jordanian youth have an intention to initiate cigarette smoking and are susceptible to cigarette smoking modeled by peers and that girls are influenced as well by familial cigarette smoking. Prevention efforts should be tailored to address culturally relevant gender norms, help strengthen adolescents' self-efficacy to refuse cigarettes, and foster strong non-smoking social norms.
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Affiliation(s)
- Karma McKelvey
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL;
| | - Jennifer Attonito
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
| | - Qilong Yi
- Department of Biostatistics, ScienceDocs Inc., Portland, OR
| | - Fawaz Mzayek
- Department of Epidemiology and Biostatistics, School of Public Health, University of Memphis, Memphis, TN
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL; Syrian Center for Tobacco Studies, Aleppo, Syria
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Prospective relationships between sleep problems and substance use, internalizing and externalizing problems. J Youth Adolesc 2014; 44:379-88. [PMID: 25385390 DOI: 10.1007/s10964-014-0213-9] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 10/28/2014] [Indexed: 12/21/2022]
Abstract
While research has shown that sleep problems and substance use are reciprocally associated in adults, much less is known about this association in early adolescence. The main aim of the current longitudinal study was to explore bidirectional relationships between sleep problems, substance use, internalizing and externalizing problems in young adolescents. A prospective design was used incorporating two waves (approximately 1 year interval). A total of 555 young adolescents (290 females, M age = 13.96) participated in this study. All participants completed self-report measures in classrooms during regular school hours (questionnaires about sleep quality and sleep hygiene were used to measure sleep problems). The results indicated that sleep problems predicted changes in substance use, internalizing and externalizing problems over time, but problem behaviours did not predict changes in sleep problems, adjusted for gender, age and puberty. One exception was that alcohol use negatively predicted changes in sleep problems. This study suggests that sleep problems are important precursors of substance use, internalizing and externalizing problems in adolescence.
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Cogollo-Milanés Z. Variables Associated with the Onset of Cigarette Smoking Among Adolescent Public Middle-School Students in Cartagena, Colombia. AQUICHAN 2014. [DOI: 10.5294/aqui.2014.14.2.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
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.
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Abstract
Several dietary habits and lifestyles can be associated with different headache types or with their progression to chronic forms. Different population-based studies have tried to investigate this relationship with poor or contradictory results. We shortly reported the current knowledges available in literature in this regard, paying particular attention to the role that certain factors play in modifying frequency and intensity of headache in adults and in adolescents. Future studies are necessary to clarify the real weight which the different factors have in natural history and in clinic evolution of headache, especially in adolescence, but the already known data suggest an important modulating action. If they will be confirmed, these results will be likely to influence clinical practice as well to address educational programs in preadolescents and adolescents.
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Jeppesen E, Bjelland I, Fosså SD, Loge JH, Dahl AA. Psychosocial Problems of Teenagers Who Have a Parent With Cancer: A Population-Based Case-Control Study (Young-HUNT Study). J Clin Oncol 2013; 31:4099-104. [DOI: 10.1200/jco.2013.50.7061] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose High prevalence of psychosocial problems has been observed in clinical studies of teenagers who have a parent with cancer. In contrast, we used a population-based design to study such problems in teenagers who have a parent with cancer (cases) compared with matched teenagers with cancer-free parents (controls). We hypothesized that higher prevalence of psychosocial problems would be observed in cases compared with controls and that sex differences would be observed between cases and controls. Methods We used data from a cross-sectional population-based survey of teenagers (Young-HUNT study). Among 8,986 teenage participants, 120 of their parents had invasive cancer before the Young-HUNT study according to the Norwegian Cancer Registry. These parents had 143 teenagers (cases) participating in the Young-HUNT study. Matched on sex, age, and municipality, 429 control teenagers with cancer-free parents were drawn from the Young-HUNT study. Six psychosocial problems were studied. Results No significant differences in psychosocial problems were observed between cases and controls in the total sample. Fewer case daughters reported eating problems compared with control daughters, and more case sons reported eating problems compared with control sons. More case daughters than case sons reported somatic stress symptoms and low self-esteem and displayed more caseness of anxiety/depression. These three sex differences were also observed among controls, indicating that they were general sex differences. Conclusion In this population-based study, teenagers who had a parent with cancer did not have higher prevalence of psychosocial problems than controls. Sex differences observed in previous clinically based studies were confirmed but may simply reflect sex differences observed among teenagers in general.
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Affiliation(s)
- Elisabeth Jeppesen
- Elisabeth Jeppesen, Sophie D. Fosså, Jon H. Loge, and Alv A. Dahl, Oslo University Hospital, The Norwegian Radiumhospitalet, and University of Oslo, Oslo; Ingvar Bjelland, Haukeland University Hospital and University of Bergen, Bergen, Norway
| | - Ingvar Bjelland
- Elisabeth Jeppesen, Sophie D. Fosså, Jon H. Loge, and Alv A. Dahl, Oslo University Hospital, The Norwegian Radiumhospitalet, and University of Oslo, Oslo; Ingvar Bjelland, Haukeland University Hospital and University of Bergen, Bergen, Norway
| | - Sophie D. Fosså
- Elisabeth Jeppesen, Sophie D. Fosså, Jon H. Loge, and Alv A. Dahl, Oslo University Hospital, The Norwegian Radiumhospitalet, and University of Oslo, Oslo; Ingvar Bjelland, Haukeland University Hospital and University of Bergen, Bergen, Norway
| | - Jon H. Loge
- Elisabeth Jeppesen, Sophie D. Fosså, Jon H. Loge, and Alv A. Dahl, Oslo University Hospital, The Norwegian Radiumhospitalet, and University of Oslo, Oslo; Ingvar Bjelland, Haukeland University Hospital and University of Bergen, Bergen, Norway
| | - Alv A. Dahl
- Elisabeth Jeppesen, Sophie D. Fosså, Jon H. Loge, and Alv A. Dahl, Oslo University Hospital, The Norwegian Radiumhospitalet, and University of Oslo, Oslo; Ingvar Bjelland, Haukeland University Hospital and University of Bergen, Bergen, Norway
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Richter M, Kuntsche E, de Looze M, Pförtner TK. Trends in socioeconomic inequalities in adolescent alcohol use in Germany between 1994 and 2006. Int J Public Health 2013; 58:777-84. [DOI: 10.1007/s00038-013-0486-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 05/04/2013] [Accepted: 06/20/2013] [Indexed: 11/29/2022] Open
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Smoking as a risk factor for chronic musculoskeletal complaints is influenced by age. The HUNT Study. Pain 2013; 154:1073-9. [DOI: 10.1016/j.pain.2013.03.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 02/01/2013] [Accepted: 03/11/2013] [Indexed: 11/17/2022]
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Gill DK, Davis MC, Smith AJ, Straker LM. Bidirectional relationships between cigarette use and spinal pain in adolescents accounting for psychosocial functioning. Br J Health Psychol 2013; 19:113-31. [DOI: 10.1111/bjhp.12039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 01/29/2013] [Indexed: 01/17/2023]
Affiliation(s)
- Davinder K. Gill
- School of Psychology and Speech Pathology; Curtin University; Perth Western Australia Australia
- Curtin Health Innovation Research Institute; Curtin University; Perth Western Australia Australia
| | - Melissa C. Davis
- School of Psychology and Speech Pathology; Curtin University; Perth Western Australia Australia
- Curtin Health Innovation Research Institute; Curtin University; Perth Western Australia Australia
| | - Anne J. Smith
- Curtin Health Innovation Research Institute; Curtin University; Perth Western Australia Australia
- School of Physiotherapy; Curtin University; Perth Western Australia Australia
| | - Leon M. Straker
- Curtin Health Innovation Research Institute; Curtin University; Perth Western Australia Australia
- School of Physiotherapy; Curtin University; Perth Western Australia Australia
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Spein AR, Pedersen CP, Silviken AC, Melhus M, Kvernmo SE, Bjerregaard P. Self-rated health among Greenlandic Inuit and Norwegian Sami adolescents: associated risk and protective correlates. Int J Circumpolar Health 2013; 72:19793. [PMID: 23396865 PMCID: PMC3567202 DOI: 10.3402/ijch.v72i0.19793] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 11/08/2012] [Accepted: 11/11/2012] [Indexed: 12/16/2022] Open
Abstract
Objectives Self-rated health (SRH) and associated risk and protective correlates were investigated among two indigenous adolescent populations, Greenlandic Inuit and Norwegian Sami. Design Cross-sectional data were collected from “Well-being among Youth in Greenland” (WBYG) and “The Norwegian Arctic Adolescent Health Study” (NAAHS), conducted during 2003–2005 and comprising 10th and 11th graders, 378 Inuit and 350 Sami. Methods SRH was assessed by one single item, using a 4-point and 5-point scale for NAAHS and WBYG, respectively. Logistic regressions were performed separately for each indigenous group using a dichotomous measure with “very good” (NAAHS) and “very good/good” (WBYG) as reference categories. We simultaneously controlled for various socio-demographics, risk correlates (drinking, smoking, violence and suicidal behaviour) and protective correlates (physical activity, well-being in school, number of close friends and adolescent–parent relationship). Results A majority of both Inuit (62%) and Sami (89%) youth reported “good” or “very good” SRH. The proportion of “poor/fair/not so good” SRH was three times higher among Inuit than Sami (38% vs. 11%, p≤0.001). Significantly more Inuit females than males reported “poor/fair” SRH (44% vs. 29%, p≤0.05), while no gender differences occurred among Sami (12% vs. 9%, p≤0.08). In both indigenous groups, suicidal thoughts (risk) and physical activity (protective) were associated with poor and good SRH, respectively. Conclusions In accordance with other studies of indigenous adolescents, suicidal thoughts were strongly associated with poorer SRH among Sami and Inuit. The Inuit–Sami differences in SRH could partly be due to higher “risk” and lower “protective” correlates among Inuit than Sami. The positive impact of physical activity on SRH needs to be targeted in future intervention programs.
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Affiliation(s)
- Anna Rita Spein
- Centre for Sami Health Research, Faculty of Health Sciences, University of Tromsø, Karasjok, Norway.
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Holmen TL, Bratberg G, Krokstad S, Langhammer A, Hveem K, Midthjell K, Heggland J, Holmen J. Cohort profile of the Young-HUNT Study, Norway: a population-based study of adolescents. Int J Epidemiol 2013; 43:536-44. [PMID: 23382364 DOI: 10.1093/ije/dys232] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Young-HUNT Study is the adolescent part (13-19 years) of HUNT, the Nord-Trøndelag Health Study, Norway. Three cross-sectional surveys have been conducted: Young-HUNT1 (1995-97), Young-HUNT2 (2000-01) and Young-HUNT3 (2006-08). Major public health issues, including somatic and mental health, quality of life and health behaviours are covered. Young-HUNT was performed in schools visited by trained nurses. Data collection included self-reported questionnaires, structured interviews, clinical measurements and, in Young-HUNT3, buccal smears. The total response rates varied from 90% to 83% and the Young-HUNT database includes 17 820 teenagers. Some Young-HUNT1 participants constitute the baseline for two follow-up studies: a 4-year follow-up through adolescence to Young-HUNT2 and an 11-year follow-up into young adulthood to the adult HUNT3. Longitudinal data are also obtained by linkage of data from Young-HUNT to different national health registers. Linkage to family registers allows the possibility of studying genetic and environmental interactions through generations. Presently 20 PhD students are working with the data, 11 Young-HUNT based PhD theses have been completed and more than 50 scientific papers published.
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Affiliation(s)
- Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway and Levanger Hospital, Nord-Trøndelag Hospital Trust, Central Norway Regional Health Authority, 7600 Levanger, Norway
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Okoli C, Greaves L, Fagyas V. Sex differences in smoking initiation among children and adolescents. Public Health 2013; 127:3-10. [DOI: 10.1016/j.puhe.2012.09.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 04/04/2012] [Accepted: 09/27/2012] [Indexed: 11/16/2022]
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OPRM1 genetic polymorphisms are associated with the plasma nicotine metabolite cotinine concentration in methadone maintenance patients: a cross sectional study. J Hum Genet 2012; 58:84-90. [DOI: 10.1038/jhg.2012.139] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Urayama KY, Jarrett RF, Hjalgrim H, Diepstra A, Kamatani Y, Chabrier A, Gaborieau V, Boland A, Nieters A, Becker N, Foretova L, Benavente Y, Maynadié M, Staines A, Shield L, Lake A, Montgomery D, Taylor M, Smedby KE, Amini RM, Adami HO, Glimelius B, Feenstra B, Nolte IM, Visser L, van Imhoff GW, Lightfoot T, Cocco P, Kiemeney L, Vermeulen SH, Holcatova I, Vatten L, Macfarlane GJ, Thomson P, Conway DI, Benhamou S, Agudo A, Healy CM, Overvad K, Tjønneland A, Melin B, Canzian F, Khaw KT, Travis RC, Peeters PHM, González CA, Quirós JR, Sánchez MJ, Huerta JM, Ardanaz E, Dorronsoro M, Clavel-Chapelon F, Bueno-de-Mesquita HB, Riboli E, Roman E, Boffetta P, de Sanjosé S, Zelenika D, Melbye M, van den Berg A, Lathrop M, Brennan P, McKay JD. Genome-wide association study of classical Hodgkin lymphoma and Epstein-Barr virus status-defined subgroups. J Natl Cancer Inst 2012; 104:240-53. [PMID: 22286212 DOI: 10.1093/jnci/djr516] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Accumulating evidence suggests that risk factors for classical Hodgkin lymphoma (cHL) differ by tumor Epstein-Barr virus (EBV) status. This potential etiological heterogeneity is not recognized in current disease classification. METHODS We conducted a genome-wide association study of 1200 cHL patients and 6417 control subjects, with validation in an independent replication series, to identify common genetic variants associated with total cHL and subtypes defined by tumor EBV status. Multiple logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) assuming a log-additive genetic model for the variants. All statistical tests were two-sided. RESULTS Two novel loci associated with total cHL irrespective of EBV status were identified in the major histocompatibility complex region; one resides adjacent to MICB (rs2248462: OR = 0.61, 95% CI = 0.53 to 0.69, P = 1.3 × 10(-13)) and the other at HLA-DRA (rs2395185: OR = 0.56, 95% CI = 0.50 to 0.62, P = 8.3 × 10(-25)) with both results confirmed in an independent replication series. Consistent with previous reports, associations were found between EBV-positive cHL and genetic variants within the class I region (rs2734986, HLA-A: OR = 2.45, 95% CI = 2.00 to 3.00, P = 1.2 × 10(-15); rs6904029, HCG9: OR = 0.46, 95% CI = 0.36 to 0.59, P = 5.5 × 10(-10)) and between EBV-negative cHL and rs6903608 within the class II region (rs6903608, HLA-DRA: OR = 2.08, 95% CI = 1.84 to 2.35, P = 6.1 × 10(-31)). The association between rs6903608 and EBV-negative cHL was confined to the nodular sclerosis histological subtype. Evidence for an association between EBV-negative cHL and rs20541 (5q31, IL13: OR = 1.53, 95% CI = 1.32 to 1.76, P = 5.4 x 10(-9)), a variant previously linked to psoriasis and asthma, was observed; however, the evidence for replication was less clear. Notably, one additional psoriasis-associated variant, rs27524 (5q15, ERAP1), showed evidence of an association with cHL in the genome-wide association study (OR = 1.21, 95% CI = 1.10 to 1.33, P = 1.5 × 10(-4)) and replication series (P = .03). CONCLUSION Overall, these results provide strong evidence that EBV status is an etiologically important classification of cHL and also suggest that some components of the pathological process are common to both EBV-positive and EBV-negative patients.
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Affiliation(s)
- Kevin Y Urayama
- Genetics Section, International Agency for Research on Cancer, Lyon, France
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Hong NS, Kim KY, Park SW, Kim JY, Bae J, Lee WK, Kim KS. Trends in cigarette use behaviors among adolescents by region in Korea. J Prev Med Public Health 2012; 44:176-84. [PMID: 21894066 PMCID: PMC3249254 DOI: 10.3961/jpmph.2011.44.4.176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives Understanding recent trends in cigarette smoking among adolescents is important in order to develop strategies to prevent cigarette smoking. The aim of this study was to compare recent trends in cigarette smoking for adolescents living in rural areas, small towns and metropolitan cities in Korea. Methods The raw data from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2005 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Logistic regression models were used to evaluate significant linear time trends in cigarette smoking. The indicators of cigarette use behaviors were 'current smoking rate', 'frequent smoking rate', 'heavy smoking rate' and 'smoking experience rate before 13 years of age'. All analyses were conducted according to gender. Results Statistically significant increasing trends in current smoking rate and frequent smoking rate were observed and borderline significant increasing trends in heavy smoking rate were shown among rural boys. Among metropolitan city boys, statistically significant increasing trends were also seen for frequent smoking. Statistically significant decreasing trends in current smoking rate were observed among small town and metropolitan city girls. Smoking experience rate before 13 years of age for rural girls decreased significantly. Conclusions Cigarette smoking prevalence among adolescents in the rural areas has increased in the last five years especially among boys. Our findings suggest that anti-tobacco program for adolescents should be conducted primarily for those in rural areas.
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Affiliation(s)
- Nam Soo Hong
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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Wang MP, Ho SY, Lo WS, Lai MK, Lam TH. Smoking is associated with poor self-rated health among adolescents in Hong Kong. Nicotine Tob Res 2011; 14:682-7. [PMID: 22180586 DOI: 10.1093/ntr/ntr266] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION To investigate the association between smoking and self-rated health (SRH) among adolescents in Hong Kong. METHODS Form 1 (U.S. Grade 7) to 5 students (N = 36,225) from 85 randomly selected secondary schools were surveyed using anonymous, self-administered questionnaires to collect information about smoking, SRH, secondhand smoke exposure, drinking, illicit drug use, physical activities, medical services use, health complaints, and sociodemographic characteristics. Logistic regression yielded adjusted odds ratios (AORs) for poor SRH due to smoking in boys and girls. RESULTS Compared with never-smoking, smoking experimentation, ex-smoking, and current smoking were associated with AORs (95% CI) for poor SRH of 1.22 (1.07-1.40), 1.43 (1.12-1.83), and 1.31 (1.13-1.53), p for trend <.001, in boys and 1.26 (1.10-1.39), 1.42 (1.08-1.85), and 1.75 (1.53-2.00, p for trend <.001, in girls. The AOR of poor SRH for current smoking was higher in girls than boys, p for interaction <.001. Current and experimental smoking but not ex-smoking were significantly associated with poor SRH among healthy students who had no health complaints or recent medical consultations. Increasing cigarette consumption, years of smoking, and smoking urge were also significantly associated with poor SRH. CONCLUSIONS Smoking was associated with poor SRH among Chinese adolescents, especially girls. This finding is useful for discouraging smoking initiation and motivating quitting in adolescent smokers.
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Affiliation(s)
- Man Ping Wang
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Botello-Harbaum M, Haynie DL, Murray KW, Iannotti RJ. Cigarette smoking status and recurrent subjective health complaints among US school-aged adolescents. Child Care Health Dev 2011; 37:551-8. [PMID: 20825423 PMCID: PMC3010296 DOI: 10.1111/j.1365-2214.2010.01147.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Subjective health complaints are common among adolescents. There is evidence that girls are more likely to register complaints than boys. This study examines gender differences in the relationship between daily smoking and recurrent subjective health complaints in school-aged adolescents in the USA. METHODS A cross-sectional design with a multistage probability sample was used to survey 13,339 middle and high school students (grades 6 through 10) with the US 2001-2002 Health Behavior in School-Aged Children Survey. RESULTS Recurrent subjective health complaints were higher for adolescents who smoke daily and experiment with cigarettes than for those who never smoke. In logistic regression analyses, the odds of daily smoking increased twofold for both boys and girls who report recurrent irritability/bad temper. For girls, the odds of daily smoking were higher among those who reported recurrent headache, stomachache and backache compared with never smokers. For boys only recurrent backache and feeling dizzy were associated with increased odds of daily smoking. CONCLUSIONS The relationship between recurrent subjective health complaints and daily smoking provides new insights into both conditions for school-aged adolescents. Findings from this study suggest different patterns of association between daily smoking and recurrent subjective health complaints occur for girls and boys. Further studies are needed to explore causes and treatment of daily smoking and recurrent health complaints among school-aged children.
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Affiliation(s)
- M Botello-Harbaum
- The EMMES Corporation NICHD, Eunice Kennedy Shriver National Institute of Child Health and Human Developmen), Rockville, MD 20580, USA.
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Heaps N, Davis MC, Smith AJ, Straker LM. Adolescent drug use, psychosocial functioning and spinal pain. J Health Psychol 2011; 16:688-98. [DOI: 10.1177/1359105310386822] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study tested whether there is an independent relationship between adolescent drug use and neck and shoulder pain (NSP) and back pain (BP) when psychosocial functioning is controlled in a community sample of 1608 14-year-old Australian adolescents. Multivariable logistic regression was used to calculate the odds ratios of alcohol and cigarette use for NSP and BP before and after adjusting for a range of psychosocial variables. Results showed that the use of alcohol, but not cigarettes or marijuana, has a significant independent association with adolescent spinal pain. Future research needs to investigate these variables longitudinally to inform interventions for adolescent spinal pain.
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Affiliation(s)
| | | | - Anne J. Smith
- Curtin University, Perth, Western Australia, Telethon Institute for Child Health Research, Perth, Western Australia
| | - Leon M. Straker
- Curtin University, Perth, Western Australia, , Telethon Institute for Child Health Research, Perth, Western Australia
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Yen CF, King BH, Tang TC. The association between short and long nocturnal sleep durations and risky behaviours and the moderating factors in Taiwanese adolescents. Psychiatry Res 2010; 179:69-74. [PMID: 20472300 DOI: 10.1016/j.psychres.2009.02.016] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Revised: 02/13/2009] [Accepted: 02/22/2009] [Indexed: 10/19/2022]
Abstract
Sleep quantity and risky behaviours are important health issues in adolescents. This cross-sectional study aimed to examine the association between short and long nocturnal sleep durations and a variety of adolescent risky behaviours, including suicidality, violence, regular alcohol consumption, illicit drug use, truancy, unprotected sex, tattooing and criminal record of theft in a large-scale, representative population of Taiwanese adolescents, and to examine the moderating factors for the association between nocturnal sleep duration and risky behaviours. A total of 8319 adolescent students in southern Taiwan were recruited into this study and completed the questionnaires. The associations between short and long nocturnal sleep durations and adolescent risky behaviours, as well as the moderating effects of depression and socio-demographic characteristics on these associations, were examined. The results indicated that short nocturnal sleep duration was significantly associated with all risky behaviours, and long nocturnal sleep duration was significantly associated with all risky behaviours except for suicidality. Meanwhile, depression, sex, age, and maternal education level had moderating effects on the association between nocturnal sleep duration and several risky behaviours. The findings imply that professionals should investigate the concomitant risky behaviours in adolescents with short or long nocturnal sleep duration.
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Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, and Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Guo SE, Ratner PA, Johnson JL, Okoli CTC, Hossain S. Correlates of smoking among adolescents with asthma. J Clin Nurs 2010; 19:701-11. [PMID: 20500312 DOI: 10.1111/j.1365-2702.2009.03096.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AIMS AND OBJECTIVE This study examined the correlates of smoking among asthmatic adolescents to gain a better understanding of who is at particular risk. BACKGROUND Smoking is especially harmful to individuals with asthma. However, smoking is surprisingly prevalent among asthmatic individuals, with prevalence rates similar to or higher than those of the general adult or adolescent populations. Despite this notable finding, there has been little research about factors (i.e. biophysical, psychosocial and behavioural) influencing asthmatic adolescents' tobacco use patterns. DESIGN A Canadian provincial cross-sectional survey. METHOD The study about adolescents' tobacco use and health status was conducted in secondary schools in 2004, 608 asthmatic adolescents participated. Demographic factors, biophysical (body mass index and physical health), psychosocial factors (parents' and peers' smoking, environmental tobacco smoke exposure and depression) and behavioural factors (marijuana use, alcohol use and exercise frequency) were explored. Multinomial logistic regression analyses were conducted to identify risk factors associated with tobacco use. RESULTS AND CONCLUSIONS Of the 608 asthmatic adolescents, 17.4% currently smoked and 12.0% formerly smoked. Girls, compared with boys, were more likely to smoke (OR: 3.34, 95% CI: 1.62-6.96) after adjusting for differences in the other demographic, biophysical, psychosocial and behavioural factors. Asthmatic girls who had relatively higher body mass index, were in the higher school grades, used marijuana or alcohol, had minor to severe depressive symptoms, had environmental tobacco smoke exposure in their homes and had friends who smoked or were currently more likely to smoke. The former smokers had similar risk factors including higher body mass index, environmental tobacco smoke exposure at home, friends who smoked and marijuana use. RELEVANCE TO CLINICAL PRACTICE Despite their health condition, asthmatic adolescents continue currently or formerly to smoke. Gender appropriate prevention and cessation interventions for asthmatic adolescents may need to address important psychosocial and environmental factors that increase the risk of these adolescents initiating and maintaining tobacco use.
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Affiliation(s)
- Su-Er Guo
- School of Nursing, University of Victoria, Victoria, BC, Canada.
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Context, relationship transitions and conflict: explaining outcomes for Australian youth from non-intact families. JOURNAL OF POPULATION RESEARCH 2010. [DOI: 10.1007/s12546-010-9033-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Yolton K, Xu Y, Khoury J, Succop P, Lanphear B, Beebe DW, Owens J. Associations between secondhand smoke exposure and sleep patterns in children. Pediatrics 2010; 125:e261-8. [PMID: 20083521 PMCID: PMC4900537 DOI: 10.1542/peds.2009-0690] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The objective of this study was to investigate the relationship between exposure to secondhand smoke (SHS) and child sleep patterns among a group of children with asthma who were exposed regularly to tobacco smoke at home. METHODS We studied 219 children who were enrolled in an asthma intervention trial and were exposed regularly to SHS. Serum cotinine levels were used to measure exposure to tobacco smoke, and sleep patterns were assessed through parent reports using the Children's Sleep Habits Questionnaire. Covariates in adjusted analyses included gender, age, race, maternal marital status, education, and income, prenatal tobacco exposure, maternal depression, Home Observation for Measurement of the Environment total score, household density, asthma severity, and use of asthma medications. RESULTS Exposure to SHS was associated with sleep problems, including longer sleep-onset delay (P = .004), sleep-disordered breathing (P = .02), parasomnias (P = .002), daytime sleepiness (P = .022), and overall sleep disturbance (P = .0002). CONCLUSIONS We conclude that exposure to SHS is associated with increased sleep problems among children with asthma.
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Affiliation(s)
- Kimberly Yolton
- Cincinnati Children's Hospital Medical Center, Division of General and Community Pediatrics, 3333 Burnet Ave, ML 7035, Cincinnati, OH 45229-3039, USA.
| | - Yingying Xu
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati, Ohio
| | - Jane Khoury
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Division of Biostatistics and Epidemiology, Cincinnati, Ohio
| | - Paul Succop
- University of Cincinnati, Department of Environmental Health, Cincinnati, Ohio
| | - Bruce Lanphear
- Simon Frasier University and British Columbia Children's Hospital, British Columbia, Vancouver
| | - Dean W. Beebe
- Cincinnati Children's Hospital Medical Center, Department of Behavioral Medicine and Clinical Psychology, Cincinnati, Ohio
| | - Judith Owens
- Brown University, Department of Pediatrics, Providence, Rhode Island
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Is the relationship between smoking and mental health influenced by other unhealthy lifestyle factors? Results from a 3-year follow-up study among adolescents in Oslo, Norway. J Adolesc Health 2009; 45:609-17. [PMID: 19931834 DOI: 10.1016/j.jadohealth.2009.04.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2008] [Revised: 04/06/2009] [Accepted: 04/15/2009] [Indexed: 11/20/2022]
Abstract
PURPOSE Several studies have confirmed that smoking is a risk factor for depression in adolescence. These studies have not controlled for other lifestyle factors. The aim of this longitudinal study was to assess the relationship between smoking and depressive symptoms, controlling for other lifestyle factors. METHODS This school-based longitudinal self-report survey was conducted among 15- and 18-year-old students in Oslo, Norway. From a baseline cohort of 3811 students, 2489 (65%) participants were followed up after 3 years and completed questionnaires at baseline and follow-up. Mental distress was assessed with Hopkins Symptom Checklist, version 10. RESULTS There was a statistically significant association between daily smoking at age 15 and mental distress at age 18 for girls, but not for boys (odds ratio [OR]=2.0 [1.5-2.8] and 1.3 [0.7-2.4], respectively). In girls, the association remained statistically significant even after adjustment for sociodemographic variables and several lifestyle factors. In an analysis of 15-years-old "never smokers," a statistically significant association was found between smoking and mental distress for both genders at age 18. Mentally distressed adolescents at age 15 did not show a higher proportion of smoking at age 18 compared with those not distressed. CONCLUSIONS In addition to supporting earlier findings that smoking seems to be causally related to depressive symptoms among adolescent girls, the contribution of this study is that this association only to some extent is confounded by other unhealthy lifestyle habits.
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Abstract
Substance use disorders and sleep disorders are among the most common psychiatric problems in children and adolescents. They often co-occur and have a significant negative effect upon normal development. This article provides a review of the most recent literature on the relationship between these disorders, along with recommendations on how to recognize and clinically address these disorders in children and adolescents.
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Affiliation(s)
- Irina Gromov
- Matrix Alliance Associates, Inc, Department of Psychiatry, The University of Texas Southwestern Medical Center, 8222 Douglas Avenue, Suite 375, Dallas, TX 75225, USA.
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Richter M, Erhart M, Vereecken CA, Zambon A, Boyce W, Gabhainn SN. The role of behavioural factors in explaining socio-economic differences in adolescent health: A multilevel study in 33 countries. Soc Sci Med 2009; 69:396-403. [DOI: 10.1016/j.socscimed.2009.05.023] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2008] [Indexed: 11/25/2022]
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Bricker JB, Otten R, Liu J, Peterson AV. Parents who quit smoking and their adult children's smoking cessation: a 20-year follow-up study. Addiction 2009; 104:1036-42. [PMID: 19392909 PMCID: PMC2720994 DOI: 10.1111/j.1360-0443.2009.02547.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Extending our earlier findings from a longitudinal cohort study, this study examines parents' early and late smoking cessation as predictors of their young adult children's smoking cessation. DESIGN Parents' early smoking cessation status was assessed when their children were aged 8 years; parents' late smoking cessation was assessed when their children were aged 17 years. Young adult children's smoking cessation, of at least 6 months duration, was assessed at age 28 years. SETTING Forty Washington State school districts. PARTICIPANTS AND MEASUREMENTS Participants were 991 at least weekly smokers at age 17 whose parents were ever regular smokers and who also reported their smoking status at age 28. Questionnaire data were gathered on parents and their children (49% female and 91% Caucasian) in a longitudinal cohort (84% retention). FINDINGS Among children who smoked daily at age 17, parents' quitting early (i.e. by the time their children were aged 8) was associated with a 1.7 times higher odds of these children quitting by age 28 compared to those whose parents did not quit [odds ratio (OR) 1.70; 95% confidence interval (CI) 1.23, 2.36]. Results were similar among children who smoked weekly at age 17 (OR 1.91; 95% CI 1.41, 2.58). There was a similar, but non-significant, pattern of results among those whose parents quit late. CONCLUSIONS Supporting our earlier findings, results suggest that parents' early smoking cessation has a long-term influence on their adult children's smoking cessation. Parents who smoke should be encouraged to quit when their children are young.
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Affiliation(s)
- Jonathan B. Bricker
- Cancer Prevention Research Program, Division of Public Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington,Department of Psychology, University of Washington, Seattle, Washington
| | - Roy Otten
- Behavioural Science Institute, Radboud University, Nijmegen, Nijmegen, The Netherlands
| | - Jingmin Liu
- Cancer Prevention Research Program, Division of Public Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Arthur V. Peterson
- Cancer Prevention Research Program, Division of Public Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington,Department of Biostatistics, University of Washington, Seattle, Washington
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Tollefsen E, Langhammer A, Bjermer L, Romundstad P, Holmen TL. Allergy: a systemic disease? The HUNT and Young-HUNT study, Norway. Pediatr Allergy Immunol 2008; 19:730-6. [PMID: 18312534 DOI: 10.1111/j.1399-3038.2008.00732.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A systemic nature of allergic diseases has been hypothesized. As part of this discussion, we studied if adolescent allergic wheeze and increasing combinations of allergic organ involvements (lung, nose and skin) would also increase the reporting of other health problems (headache, muscle pain and abdominal pain). In addition, we studied if parental asthma was associated with adolescent clustering of allergic expressions and if parental asthma with additional health problems (headache or muscle pain) was associated with adolescent reporting allergy in combination with headache, muscle pain and abdominal pain. Adolescents 13-19 yr (n = 8817, 89%) participated in the Young-HUNT study, Norway, 1995-97. Parental data on asthma were eligible in n = 5620. Health and lifestyle were measured by questionnaires and interviews. Associations with additional health problems were significantly strengthened with combinations of wheeze and other allergic expressions. Odds Ratio for associations 'wheeze only', 'wheeze and rhinitis' and 'wheeze, rhinitis and eczema' were for headache 2.1, 3.4 and 3.7; for muscle pain 2.8, 3.2 and 4.9; for abdominal pain 3.6, 4.0 and 4.9. All p for trend were <0.010. Similar results were obtained when studying allergic wheeze; p for trend <0.001. Parental asthma was associated with clustering of adolescent allergic expressions, and parental asthma with headache or muscle pain was significantly associated with reported allergy combined with similar health problems in their offspring. The results indicate that allergy may be expressed beyond organs commonly viewed as part of an allergic disease, and hence may support a hypothesis of a systemic nature of allergic diseases.
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Affiliation(s)
- Elin Tollefsen
- Department of Lung Medicine, St. Olavs Hospital, Trondheim University Hospital, Norwegian University of Science and Technology, Trondheim, Norway.
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Pärna K, Usin J, Ringmets I. Cigarette and waterpipe smoking among adolescents in Estonia: HBSC survey results, 1994-2006. BMC Public Health 2008; 8:392. [PMID: 19032756 PMCID: PMC2613150 DOI: 10.1186/1471-2458-8-392] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Accepted: 11/25/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking is a major single cause of preventable morbidity and premature mortality. Tobacco use among adolescents is a significant public health problem as smoking behaviour is undeniably established in adolescence. While cigarette smoking among adolescents has been a significant public health problem for years, waterpipe smoking is considered to be a new global public health threat. The objectives of this study were to describe trends of cigarette smoking and the prevalence of waterpipe smoking and to study the association between cigarette and waterpipe smoking among adolescents in Estonia. METHODS This study was based on a four-yearly HBSC survey of health behaviour among school-aged children conducted in 1994-2006 in Estonia. It was a school-based survey of a nationally representative sample using standardized methodology. The target group of the survey were 11-, 13-, and 15-year-old schoolchildren (N = 13826), 6656 boys and 7170 girls. Cigarette and waterpipe smoking was determined on a 4-stage scale: every day, at least once a week, less than once a week, not smoking. Logistic regression analysis was applied to examine gender- and age-specific smoking trends and to study the association between cigarette and waterpipe smoking. RESULTS Prevalence of smoking was higher among boys than girls in all age groups during the whole study period. The prevalence of cigarette smoking increased in 1994-2002 and then slightly decreased in both genders. The increase in smoking was larger among girls. Among girls, daily smoking increased during the whole study period. Among 15-year-old schoolchildren one-third of the boys and one quarter of the girls were cigarette smokers, 21% of the boys and 12% of the girls were daily smokers in 2006. One fourth of the boys and one sixth of the girls were waterpipe smokers. A logistic regression analysis revealed a strong association between cigarette and waterpipe smoking among schoolchildren. CONCLUSION The results of this study can significantly enhance the capacity to develop and implement tobacco prevention and control programmes among the youth in Estonia.
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Affiliation(s)
- Kersti Pärna
- Department of Public Health, University of Tartu, Estonia
- Estonian Centre of Excellence in Behavioural and Health Sciences, Tallinn, Tartu, Estonia
| | - Janika Usin
- Department of Public Health, University of Tartu, Estonia
| | - Inge Ringmets
- Department of Public Health, University of Tartu, Estonia
- Estonian Centre of Excellence in Behavioural and Health Sciences, Tallinn, Tartu, Estonia
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Effects of smoke exposure and other lifestyle factors on pain response to electrical stimulation in women. Pain Res Manag 2008; 13:231-5. [PMID: 18592060 DOI: 10.1155/2008/240573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A relationship between smoking and development of pain syndromes has been suggested in the literature. The present study examined associations between smoke exposure and other related variables, and pain response to suprathreshold electrical stimulation. METHODS Subjects were prospectively recruited from a population referred to an electrodiagnostic clinic. Information about age, smoke exposure, caffeine and alcohol consumption was obtained, as well as documented objective signs of stress through physical assessment. One investigator applied two standardized 0.1 ms electrical stimulations (50 mA followed by 100 mA) to asymptomatic extremities at the beginning of each electrodiagnostic session, using consistent technique. Subjects used a visual analogue scale to indicate the level of pain felt after each stimulation. RESULTS Two hundred fifteen women were included. Current smokers and those currently exposed to second-hand smoke had significantly higher pain ratings (P=0.003 for 50 mA, P=0.005 for 100 mA) than those not currently exposed to smoke. Time since exposure was negatively associated with pain ratings. Those with objective signs of stress reported higher levels of pain, which was significant for the 100 mA stimulation (P=0.046). Linear regression modelling indicated that current smoke exposure and alcohol use were associated with higher pain ratings at both 50 mA and 100 mA, while stress was associated with higher pain ratings and older age was associated with lower pain ratings at 100 mA only. INTERPRETATION Exposure to cigarette smoke is significantly related to higher reported levels of pain experienced in response to electrical stimulation in this study population. Exposure to smoke can add 10 points to the 100-point visual analogue scale compared with subjects without exposure, with alcohol use adding another eight points. Reported pain decreases as length of time since previous exposure to smoke increases.
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Waldie KE, McGee R, Reeder AI, Poulton R. Associations Between Frequent Headaches, Persistent Smoking, and Attempts to Quit. Headache 2008; 48:545-52. [DOI: 10.1111/j.1526-4610.2007.01037.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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The Burden and Determinants of Neck Pain in the General Population. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2008. [DOI: 10.1007/s00586-008-0624-y] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976) 2008; 33:S39-51. [PMID: 18204398 DOI: 10.1097/brs.0b013e31816454c8] [Citation(s) in RCA: 490] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Best evidence synthesis. OBJECTIVE To undertake a best evidence synthesis of the published evidence on the burden and determinants of neck pain and its associated disorders in the general population. SUMMARY OF BACKGROUND DATA The evidence on burden and determinants of neck has not previously been summarized. METHODS The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders performed a systematic search and critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Studies meeting criteria for scientific validity were included in a best evidence synthesis. RESULTS We identified 469 studies on burden and determinants of neck pain, and judged 249 to be scientifically admissible; 101 articles related to the burden and determinants of neck pain in the general population. Incidence ranged from 0.055 per 1000 person years (disc herniation with radiculopathy) to 213 per 1000 persons (self-reported neck pain). Incidence of neck injuries during competitive sports ranged from 0.02 to 21 per 1000 exposures. The 12-month prevalence of pain typically ranged between 30% and 50%; the 12-month prevalence of activity-limiting pain was 1.7% to 11.5%. Neck pain was more prevalent among women and prevalence peaked in middle age. Risk factors for neck pain included genetics, poor psychological health, and exposure to tobacco. Disc degeneration was not identified as a risk factor. The use of sporting gear (helmets, face shields) to prevent other types of injury was not associated with increased neck injuries in bicycling, hockey, or skiing. CONCLUSION Neck pain is common. Nonmodifiable risk factors for neck pain included age, gender, and genetics. Modifiable factors included smoking, exposure to tobacco, and psychological health. Disc degeneration was not identified as a risk factor. Future research should concentrate on longitudinal designs exploring preventive strategies and modifiable risk factors for neck pain.
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Abstract
The adolescents with asthma are a distinct group of patients with different problems and needs compared to children and adults. Specific issues of asthma in adolescence are the variability of the clinical spectrum, the presence of particular risk factors for the persistence of symptoms, underdiagnosis and undertreatment of the disease. Refusal of the sick role, denial of symptoms, carelessness about dangerous inhalation exposure, erratic self-medication, overexertion without taking precautions against exercise-induced asthma, and a poor relationship between patients, their families, and often doctors are the main obstacles to successful management of asthma in this critical age. There are also major problems of compliance for these patients. The goal of optimal quality of life will be achieved only if the physician thoroughly understands the adolescent's needs and provides optimal care.
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Saunes M, Smidesang I, Holmen TL, Johnsen R. Atopic dermatitis in adolescent boys is associated with greater psychological morbidity compared with girls of the same age: the Young-HUNT study. Br J Dermatol 2007; 156:283-8. [PMID: 17223868 DOI: 10.1111/j.1365-2133.2006.07688.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Having atopic dermatitis (AD) as well as other chronic diseases is often associated with reduced mental health. Adolescents with AD are thought to be especially vulnerable, but few studies have included an ample number of young people. OBJECTIVES To study self-reported mental distress among boys and girls 13-19 years of age with AD compared with mental distress among healthy adolescents as well as mental distress among adolescents with other chronic diseases or complaints, such as headache, neck or shoulder pain, asthma, allergy and rhinitis. METHODS The Young-HUNT study was conducted as a cross-sectional, population-based survey in 1995-97. All students in Nord-Trondelag County, Norway, aged 13-19 years were invited, and some 89% participated. A questionnaire on mental and somatic health, life-style and social conditions was completed during one school hour. RESULTS A total of 4384 girls and 4433 boys participated. The prevalence of mental distress was higher among older teenagers, and more than every fourth girl aged 17-19 reported mental distress. Although more girls than boys reported mental distress, AD, headache and neck or shoulder pain, the odds for reporting both AD and mental distress were higher for boys [odds ratio (OR) = 2.1 (1.6-2.9)] compared with girls [OR = 1.3 (1.1-1.6)]. A corresponding sex difference in reporting mental distress was also seen for some other chronic diseases or complaints. CONCLUSIONS In adolescents aged 13-19 years there was a strong and significant association between self-reported mental distress and AD as well as headache and neck or shoulder pain for both sexes. Although boys reported fewer complaints as AD, they perceived the complaints a heavier burden than did the girls.
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Affiliation(s)
- M Saunes
- Department of Dermatology, St Olavs Hospital, Trondheim University Hospital, Eirik Jarls gt 12, Trondheim, Norway.
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Richter M, Leppin A. Trends in socio-economic differences in tobacco smoking among German schoolchildren, 1994-2002. Eur J Public Health 2007; 17:565-71. [PMID: 17353201 DOI: 10.1093/eurpub/ckm010] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND While the graded relationship between socio-economic status (SES) and risk behaviour in adulthood has been the subject of intense research, far less is known about socio-economic differences in health-related behaviour among adolescents. The purpose of the present study is to examine socio-economic differences in adolescent tobacco use in Germany as well as changes in the relationship between 1994 and 2002. METHODS Data were obtained from the 'Health Behaviour in School-aged Children' study conducted in the largest federal state of Germany, Northrhine-Westfalia, in 1994, 1998 and 2002. The analysis is based on 11.401 11- to 15-year old students. Socio-economic differences in regular smoking were studied in relation to both parental SES (family affluence) and students own SES (school type). Trends from 1994 to 2002 were analysed for each category of family affluence and school type separately. RESULTS Family affluence only had a weak effect on regular smoking while for type of school a strong social gradient for smoking was found for both the genders. Trend analyses within the different family affluence and school-type categories showed that smoking has generally increased in all socio-economic groups. The level of socio-economic differences remained virtually unchanged in girls and boys in the past 10 years in Germany. CONCLUSIONS The same relationships of family affluence and school type with smoking have persisted for almost a decade in Germany. Students own SES affects adolescent smoking substantially. Prevention programmes should focus on the school setting in order to tackle current as well as future health inequalities.
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Affiliation(s)
- Matthias Richter
- School of Public Health, University of Bielefeld, Bielefeld, Germany.
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Tollefsen E, Langhammer A, Bjermer L, Kurtze N, Holmen TL. Adolescents with wheeze have increased risk of additional health problems. The Young-HUNT study, Norway. Prev Med 2007; 44:178-82. [PMID: 17055041 DOI: 10.1016/j.ypmed.2006.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Revised: 08/30/2006] [Accepted: 09/08/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To explore the hypothesis of an association between current wheeze and other health problems in adolescence and to investigate any sex differences. METHODS N=8817 adolescents aged 13-19 years completed a self-administered questionnaire including questions on health and lifestyle in Norway (1995-1997). RESULTS All subjective health problems were significantly more prevalent in current wheezers compared to non-wheezers (frequent headache: girls 18% vs. 9%, boys 8% vs. 3%; frequent neck and shoulder pain: girls 10% vs. 5%, boys 6% vs. 2%; frequent joint and muscle pain: girls 6% vs. 2%, boys 6% vs. 2%; and frequent abdominal pain: girls 10% vs. 3%, boys 3% vs.1%). In both sexes, adjusted for covariates, current wheezers had statistically significant increased risk of reporting frequent headache (girls OR=2.0, boys OR=2.9), frequent neck and shoulder pain (girls OR=1.9, boys OR=3.3), frequent joint and muscle pain (girls OR=2.7, boys OR=3.5) and frequent abdominal pain (girls OR=2.7, boys OR=2.0). CONCLUSIONS Current adolescent wheezers reported more additional health problems compared to non-wheezers. Even if girls reported more symptoms in general, the associations were stronger in boys. The findings are important for the clinical approach to teenage wheezers and should increase doctors' awareness of coexistence of other health complaints in these patients.
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Affiliation(s)
- Elin Tollefsen
- Trondheim University Hospital, Department of Respiratory Medicine, Trondheim, Norway.
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Aamodt AH, Stovner LJ, Hagen K, Bråthen G, Zwart J. Headache prevalence related to smoking and alcohol use. The Head-HUNT Study. Eur J Neurol 2006; 13:1233-8. [PMID: 17038038 DOI: 10.1111/j.1468-1331.2006.01492.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to examine a possible association between smoking, alcohol and headache in a large population-based cross-sectional study. A total of 51,383 subjects completed a headache questionnaire and constituted the 'Head-HUNT' Study. Questionnaire-based information on smoking was available in 95% and on alcohol in 89% of the individuals. Associations were assessed in multivariate analyses, estimating prevalence odds ratios (ORs) with 95% confidence intervals (CI). Prevalence rates for headache were higher amongst smokers compared with never smokers, most evident for those under 40 years smoking more than 10 cigarettes per day (OR 1.5, 95% CI 1.3-1.6). Passive smoking was also associated with higher headache prevalence. For alcohol use, there was a tendency of decreasing prevalence of migraine with increasing amounts of alcohol consumption compared with alcohol abstinence. Only with regard to symptoms indicating alcohol overuse, a positive association with frequent headache was found. The association between headache and smoking found in the present study raises questions about a causal relationship, e.g. that smoking causes headache or that it allays stress induced by headache. The observed negative association between migraine and alcohol consumption is probably explained by the headache precipitating properties of alcohol.
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Affiliation(s)
- A H Aamodt
- Norwegian National Headache Centre, Trondheim University Hospital, Trondheim, Norway.
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