Sport and scholastic factors in relation to smoking and smoking initiation in older adolescents: a prospective cohort study in Bosnia and Herzegovina

The Impact of Scholastic Factors on Physical Activity Levels during the COVID-19 Lockdown: A Prospective Study on Adolescents from Bosnia and Herzegovina

Scholastic factors (academic achievement) are hypothesized to be important determinants of health-related behaviors in adolescents, but there is a lack of knowledge on their influence on physical activity levels (PAL), especially considering the COVID-19 pandemic and the imposed lockdown. This study aimed to investigate the associations between scholastic factors and PAL before and during the pandemic lockdown. The participants were adolescents form Bosnia and Herzegovina (n = 525, 46% females), who were observed prospectively at the baseline (before the pandemic lockdown) and during the lockdown in 2020 (follow-up). The scholastic factors (grade point average, behavioral grade, school absences, unexcused absences) were evidenced at the baseline (predictors). The outcome (PAL) was evaluated using the Physical Activity Questionnaire for Adolescents at the baseline and the follow-up. Gender, age, parental/familial conflict, and sport participation were observed as confounders. No significant influence of the predictors on PAL were evidenced at the baseline or at the follow-up. The scholastic variables were significantly associated with the changes of PAL which occurred due to pandemic lockdown, with a lower risk for negative changes in PAL among adolescents who were better in school (OR = 0.56, 95%CI: 0.34–0.81, and OR = 0.66, 95%CI: 0.34–0.97, for the grade point average and behavioral grade, respectively). Students who do well in school are probably more aware of the health benefits of proper PAL, and therefore are devoted to the maintenance of their PAL even during the home-confinement of lockdown. Public health authorities should focus more on helping adolescents to understand the importance and benefits of proper PAL throughout the school system.

Analysis of the Relationship between Tobacco Smoking and Physical Activity in Adolescence: A Gender Specific Study

Background and Objective: Although smoking and the physical activity level (PAL) are important determinants of health status in adolescence, there is a lack of information on the relationship between smoking and PAL in early adolescence. The objective of this study was to evaluate the gender-specific relationship between smoking and PAL in 14-to-16-year-old adolescents. Materials and Methods: The sample included 650 adolescents (337 girls, 14.7 ± 0.5 years at first testing wave) from Bosnia and Herzegovina. During the first testing wave, participants were tested using structured questionnaires. Second testing was commenced after approximately 20 months (16.4 ± 0.6 years). The variables were age, gender, socioeconomic status, living environment, cigarette smoking (predictors), and PAL (criterion). Predictors were measured at the first wave, and criterion at the first-wave and second-wave. Results: For girls, smoking was negatively correlated to PAL at the first-wave (OR: 0.75, 95% CI: 0.55-0.95) and at the second-wave (OR: 0.73, 95% CI: 0.71-0.96). No significant association between smoking and PAL was found for boys. Results suggest that adolescent boys and girls do not follow the equal trajectories when it comes to relationships between smoking and PAL. Conclusions: In developing promotional public health actions related to a decrease of smoking and increase of PAL, a gender-specific approach is highly recommended. Further studies analyzing the cause-effect relationship between consumption of other types of psychoactive substances and PAL in this age group are warranted.

Familial and Parental Predictors of Physical Activity in Late Adolescence: Prospective Analysis over a Two-Year Period

Children’s health behaviors are highly influenced by their parents and family. This study aimed to prospectively evaluate the parental/familial factors associated with physical activity levels (PALs) among older adolescents. The participants were 766 adolescents, who were prospectively observed at baseline (when they were 16 years of age), at first follow-up measurement (FU1; 17 years of age), and second follow-up measurement (FU2; 18 years of age). Sociodemographic factors (age, gender, socioeconomic status, and sport participation) and parental/familial variables were evaluated at baseline. PALs (evidenced by the Physical-Activity Questionnaire-for-Adolescents) were prospectively evidenced at baseline, FU1, and FU2. Factorial analysis of variance for repeated measurements showed a significant decrease in PALs during the study course (F = 83.05, p < 0.001). Sport participation and male gender were significant predictors of PALs at baseline, FU1, and FU2. Logistic regression, controlled for sport participation and male gender, evidenced paternal education as a significant predictor of baseline PALs. Parental conflict was a significant predictor of PALs in all three testing waves. The significant influence of paternal education on the children’s PALs existed from younger adolescence until the age of 17 years. The association between parental conflict and PALs developed in older adolescence. These results should be used in the development of specific and targeted interventions aimed at the improvement of PALs and a reduction of sedentarism in youth.

Parental and Familial Factors Influencing Physical Activity Levels in Early Adolescence: A Prospective Study

Parental/familial factors are important determinants of the physical activity level (PAL) in children and adolescents, but studies rarely prospectively evaluate their relationships. This study aimed to evaluate the changes in physical activity levels among adolescents from Bosnia and Herzegovina over a two-year period and to determine parental/familial predictors of PAL in early adolescence. A total of 651 participants (50.3% females) were tested at baseline (beginning of high school education; 14 years old on average) and at follow-up (approximately 20 months later). The predictors included sociodemographic characteristics (age, gender) and parental/familial factors (socioeconomic status of the family, maternal and paternal education, conflict with parents, parental absence from home, parental questioning, and parental monitoring). Physical activity levels were evidenced by the Physical Activity Questionnaire for Adolescents (PAQ-A; criterion). Boys were more active than girls, both at baseline (t-test = 3.09, p < 0.001) and at follow-up (t-test = 3.4, p < 0.001). Physical activity level decreased over the observed two-year period (t-test = 16.89, p < 0.001), especially in boys, which is probably a consequence of drop-out from the sport in this period. Logistic regression evidenced parental education as a positive predictor of physical activity level at baseline (OR [95% CI]; 1.38 [1.15–170], 1.35 [1.10–1.65]), and at follow-up (1.35 [1.11–1.69], 1.29 [1.09–1.59], for maternal and paternal education, respectively). Parents with a higher level of education are probably more informed about the importance of physical activity on health status, and thus transfer this information to their children as well. The age from 14 to 16 years is likely a critical period for maintaining physical activity levels in boys, while further studies of a younger age are necessary to evaluate the dynamics of changes in physical activity levels for girls. For maintaining physical activity levels in adolescence, special attention should be paid to children whose parents are less educated, and to inform them of the benefits of an appropriate physical activity level and its necessity for maintaining proper health and growth.

Does Participation in Sports Influence the Prevalence of and Initiation into Multiple Substance Misuse in Adolescence? A Two-Year Prospective Analysis

Concurrent smoking and harmful drinking (CSHD) in adolescence is an important public health and social problem, while participation in sports is considered as being protective against CSHD. This study aimed to prospectively evaluate the influence of various facets of sports participation on the prevalence of and initiation into CSHD of adolescents. Participants were adolescents from southern Croatia (n = 711, 43.6% females, 16 years of age at study baseline), who were tested at baseline and at follow-up (two years later). Variables included gender, age, sports factors (participation in individual and team sports, sport experience, competitive success, intensity of involvement in sports), and CSHD. The CSHD prevalence did not increase significantly over the course of the study (from 5.6% to 7.5%, p > 0.05). Binomial logistic regression with age and gender as covariates suggested that team sports participation correlated to CSHD prevalence at baseline, and follow-up, with higher risk for CSHD among those adolescents who quit team sports (OR = 9.18 and 2.68, 95%CI = 2.04–22.26 and 1.05–6.83 for baseline and follow-up, respectively), and those never involved in team sports (OR = 9.00 and 3.70, 95%CI = 2.07–39.16 and 1.57–8.72 for baseline and follow-up, respectively). A higher risk of CSHD at baseline was seen among those adolescents who were involved in sports for longer (OR = 1.66, 95%CI = 1.16–2.38). The results are discussed in the context of the fact that the study included adolescents at the age of rigid sports selection (the transition from youth to professional-level sports). Since the majority of participants began CSHD at an earlier age, further studies in subjects of a younger age range are warranted.

[High level of student smokers in Madrid compared with a similar previous study of 2014]

Smoking is a public health problem that affects young people, and influenced by the environment and cultural level.

OBJECTIVES

To determine smoking prevalence among high-level baccalaureate students in the Autonomous Community of Madrid during the 2018-2019 academic year. To assess the influence of the socio-cultural environment on the onset of youth smoking. To compare the results with previous studies conducted on students of baccalaureate of excellence (BE) and the general population.

POPULATION AND METHODS

Cross-sectional study on BE students in the Autonomous Community of Madrid. Using an anonymous questionnaire, they were asked about tobacco, alcohol and drug consumption, as well as the influence of the environment, friends, and family in the beginning. To compare with previous studies.

RESULTS

A total of 740 valid questionnaires were collected, of which 430 (58.1%) were female, an overall mean age of 16.57±0.61 years, and 53 (7.18%) were smokers. The majority 39 (78%) of smokers acknowledged their friends' influence at its onset. Alcohol was consumed by 349 (47.48%) and other drugs by 109 (15.27%). Being a smoker was related to alcohol, other drugs, a smoking mother, smoking siblings and smoking friends.

CONCLUSIONS

Smoking prevalence among students of BE in Autonomous Community of Madrid continues to be lower than the prevalence of adolescents of their age and there are no variations from previous reports. Starting smoking is related to smoking by friends, siblings, and the mother and with the consumption of alcohol and other substances. Education is very important in the beginning and prevention of smoking, and it is necessary to implement prevention programs at early ages in order to promote their effectiveness, and aimed at young people, parents and teachers.

Identifying Predictors of Changes in Physical Activity Level in Adolescence: A Prospective Analysis in Bosnia and Herzegovina

It is known that physical activity levels (PA levels) decline during adolescence, but there is a lack of knowledge on possible predictors of changes in PA levels in this period of life. This study aimed to prospectively investigate the relationship between sociodemographic and behavioral factors (predictors), PA levels and changes in PA levels in older adolescents from Bosnia and Herzegovina. The sample comprised 872 participants (404 females) tested at baseline (16 years of age) and at follow-up (18 years of age). Predictors were sociodemographic characteristics (age, gender, socioeconomic status, urban/rural residence, paternal and maternal education level) and variables of substance misuse (consumption of cigarettes, alcohol and illicit drugs). The PA level, as measured by the Physical Activity Questionnaire for Adolescents (PAQ-A), was observed as a criterion. Boys had higher PAQ-A scores than girls at baseline and follow-up. Paternal education levels were correlated with PAQ-A scores at baseline (Spearman’s R: 0.18, 0.15 and 0.14, p < 0.05, for the total sample, females and males, respectively) and at follow-up (Spearman’s R: 0.12, p < 0.01 for the total sample). Logistic regression, which was used to calculate changes in PA levels between baseline and follow-up as a binomial criterion (PA decline vs. PA incline), evidenced a higher likelihood of PA incline in adolescents whose mothers were more educated (OR: 1.29, 95% CI: 1.05–1.60) and who live in urban communities (OR: 1.56, 95% CI: 1.16–2.10). The consumption of illicit drugs at baseline was evidenced as a factor contributing to the lower likelihood of PA incline (OR: 0.36, 95% CI: 0.14–0.92). The negative relationship between illicit drug consumption and PA decline could be a result of a large number of children who quit competitive sports in this period of life. In achieving appropriate PA-levels, special attention should be placed on children whose mothers are not highly educated, who live in rural communities, and who report the consumption of illicit drugs. The results highlighted the importance of studying correlates of PA levels and changes in PA levels during adolescence.

Are Sports-Related Factors Correlated to the Prevalence and Initiation of Illicit Drug Misuse in Adolescence? Prospective Study in Older Adolescents

Sport participation is considered as a factor of potential influence on illicit drug misuse (IDM) in adolescence, but there is an evident lack of studies which prospectively investigated this problem. This study aimed to prospectively investigate the sports-related factors related to IDM and the initiation of IDM among older adolescents. The participants were 436 adolescents (202 females; 16 years old at study baseline). They were tested at baseline and follow-up (two years later). The predictors included variables associated with different facets of sports participation and success in sports. The criteria were (i) baseline IDM, (ii) follow-up IDM, and (iii) initiation of IDM between baseline and follow-up. Crude and adjusted (controlled for parental conflict, age, socioeconomic status, and gender) logistic regressions were applied to establish correlations between predictors and criteria. There were higher odds for baseline IDM in adolescents who quit individual sports (OR: 4.2, 95% CI: 1.3-13.9), who had better competitive sports achievements (OR: 1.8, 95% CI: 1.0-3.3), and those involved in sports for a longer time (OR: 1.6, 95% CI: 1.0-2.5). The IDM at follow-up was more prevalent in adolescents who were involved in sports for a longer time (OR: 1.7, 95% CI: 1.1-2.6). Initiation of drug use was predicted by longer experience in sports (OR: 1.8, 95% CI: 1.1-3.1). Sports-related factors were more negatively than positively related to illicit drug use. Most probably, the transition from junior to senior level in sports put specific stress on those adolescents who were highly committed to sports until that time, but who then had to question their own sports abilities and future potential in sports. Sport-authorities should be informed on established results and specific public-health efforts aimed at preventing IDM in athletic adolescents are urgently needed.

Educational and sport factors as predictors of harmful alcohol drinking in adolescence: a prospective study in Bosnia and Herzegovina

OBJECTIVES

The cause-effect relationship between educational and sport factors, and alcohol drinking in adolescents is rarely prospectively investigated. This study aimed to establish the possible influence of sport, scholastic and socio-demographic factors on harmful alcohol drinking (HD) and the initiation of HD in adolescents from Bosnia-Herzegovina.

METHODS

Study included 881 adolescents (49% females) and consisted of (1) baseline tests (16 years of age) and (2) follow-up testing (18 years of age). The independent variables were scholastic and sport-related factors. Alcohol Use Disorders Identification Test was used, with the following dependent variables: (1) HD at baseline, (2) HD at follow-up, and (3) HD initiation. Logistic regressions were applied to define the relationships.

RESULTS

Higher likelihood of HD was evidenced in children who performed poorly in school. Sport factors were positively correlated with HD at study baseline. Higher odds for HD initiation were found for adolescents who reported a lower GPA, a lower behavioral grade, more frequent school absences, and more unexcused school absences.

CONCLUSIONS

The results showed scholastic failure as the predictor of HD initiation. The potential influence of sport factors on HD initiation should be studied at an earlier age.

Prospective Analysis of the Influence of Sport and Educational Factors on the Prevalence and Initiation of Smoking in Older Adolescents from Croatia

The prevalence of smoking among Croatian adolescents is alarmingly high, but no previous study has prospectively examined the sport- and academic-factors associated with smoking and smoking initiation. This study aimed to prospectively examine the associations between scholastic (educational) achievement and sport factors and smoking in 16- to 18-year-old adolescents. This two-year prospective cohort study included 644 adolescents who were 16 years of age at baseline (46% females). Baseline testing was implemented at the beginning of the 3rd year of high school (September 2014) when participants were 16 years old. Follow-up testing was completed at the end of the fourth year of high school, which occurred 20 months later. The evaluated predictor variables were educational-achievement- and sport-related-factors. The outcome variables were (i) smoking at baseline; (ii) smoking at follow-up; and (iii) smoking initiation over the course of the study. We assessed the associations between predictors and outcomes using logistic regression models adjusted for age, gender, socioeconomic status, and conflict with parents. The educational variables were consistently associated with smoking, with lower grade-point-average (Baseline: odd ratio (OR): 2.01, 95% confidence interval (CI): 1.61–2.55; Follow-up: 1.59, 1.31–1.94), more frequent absence from school (Baseline: OR: 1.40, 95% CI: 1.19–1.69; Follow-up: 1.30, 1.08–1.58), and lower behavioral grades (Baseline: OR: 1.80, 95% CI: 1.10–2.89; Follow-up: 1.57, 1.03–2.41) in children who smoke. Adolescents who reported quitting sports were at greater odds of being smokers (Baseline: 2.07, 1.31–3.32; Follow-up: 1.66, 1.09–2.56). Sport competitive achievement at baseline was protective against smoking initiation during following two-year period (0.45, 0.21–0.91). While the influence of the educational variables on smoking initiation has been found to be established earlier; sport achievement was identified as a significant protective factor against initiating smoking in older adolescents. Results should be used in development of an anti-smoking preventive campaign in older adolescents.