Association of adolescent cigar use with other high-risk behaviors

Emerging Adulthood, Emergent Health Lifestyles: Sociodemographic Determinants of Trajectories of Smoking, Binge Drinking, Obesity, and Sedentary Behavior

During the transition to adulthood, many unhealthy behaviors are developed that in turn shape behaviors, health, and mortality in later life. However, research on unhealthy behaviors and risky transitions has mostly focused on one health problem at a time. In this article, we examine variation in health behavior trajectories, how trajectories cluster together, and how the likelihood of experiencing different behavior trajectories varies by sociodemographic characteristics. We use the National Longitudinal Study of Adolescent Health (Add Health) Waves I to IV to chart the most common health behavior trajectories over the transition to adulthood for cigarette smoking, alcohol consumption, obesity, and sedentary behavior. We find that health behavior trajectories cluster together in seven joint classes and that sociodemographic factors (including gender, parental education, and race-ethnicity) significantly predict membership in these joint trajectories.

Relationship between Healthy Lifestyle and Sociodemographic Factors in Adolescents in Catalonia: Application of VISA-TEEN Questionnaire

Introduction

There is a clear relationship between the way of life and the health of individuals, and therefore, we can speak of healthy and unhealthy lifestyles. There are different surveys and questionnaires that evaluate the lifestyles of adolescents, but none of them offers a final score that can quantify the healthfulness of an adolescent’s lifestyle. It was with this goal that the VISA-TEEN questionnaire is developed and validated. The objective of this study is to apply the questionnaire to a sample of adolescents who attend school in Catalonia to evaluate the healthfulness of their lifestyles and to relate the scores obtained to different sociodemographic variables.

Methods

Cross-sectional study. A total of 2,832 students from 25 schools in Catalonia responded to the questionnaire. A descriptive analysis was performed, calculating the mean (Standard deviation), median (p₂₅, p₇₅), and confidence interval. The results were calculated for the total population, factoring according to gender, age, urban/rural population, origin (native/immigrant), and family wealth, which was based on the Family Affluence Scale (FAS II). The significance of the difference was calculated for each factor with the appropriate statistical test.

Results

For the total score of healthy lifestyle, the youngest students and those with the highest family wealth obtained higher scores. With respect to eating habits, girls scored higher than boys, and higher scores were observed in natives and those with high family wealth. For physical activity, boys scored higher, as well as younger individuals, natives, and those from rural areas. With respect to substance abuse, the worst scores were found in older individuals, students from rural areas, and natives. The rational use of leisure technology was only associated with age (worsening scores with older age). Lastly, hygiene was better with girls, decreased with age, and was worse with natives than immigrants.

Characterizing substance use and mental health profiles of cigar, blunt, and non-blunt marijuana users from the National Survey of Drug Use and Health

BACKGROUND

Smoking marijuana in a cigar (blunt use) is gaining popularity in the U.S. Research suggests that blunt users differ from exclusive cigar or marijuana users on a variety of demographic and substance use factors. Misreporting of blunts and cigars is also common, particularly among young people, and may lead to inaccurate prevalence estimates. To determine subtype differences, this study investigated the prevalence and demographic, mental health, and substance use correlates of four mutually-exclusive groups of blunt, cigar, and marijuana past 30-day users (cigar-only, blunt-only, non-blunt marijuana, or dual cigar-blunt).

METHOD

Data were analyzed from the 2013 National Survey of Drug Use and Health.

RESULTS

In weighted multinomial logistic regression models, respondents who were younger, Black, and who had used tobacco, alcohol, or other drugs in the past 30-days had the highest odds of reporting blunt-only or dual cigar-blunt use. Those reporting blunt-only and dual cigar-blunt use also endorsed a greater number of marijuana and alcohol use disorder symptoms compared to those reporting cigar-only and non-blunt marijuana use. Lower marijuana risk perceptions were associated with increased odds of marijuana use with or without blunts. Major depressive episode was uniquely associated with non-blunt marijuana use. With respect to misclassifiers, respondents who reported past 30-day blunt use but not past 30-day marijuana use were younger, Black, female, and had lower education and income.

DISCUSSION

Those who report blunt-only and dual cigar-blunt use showed the most severe risk profiles. Communicating health consequences and risks of blunt use should be directed toward specific subgroups.

Reporting of cigar use among adolescent tobacco smokers

INTRODUCTION

With the changing landscape of tobacco products, the divide between cigarettes and cigars is obscured, so understanding adolescent reporting of cigar use is needed to improve best practices for surveillance, screening, and prevention/intervention. This study examined adolescents' reported cigar use and correlates of use.

METHODS

Participants (N=186) were 13-17year old tobacco users participating in a prospective study of adolescent smoking behaviors. Measurement occurred at baseline and 24-months, and included demographics, nicotine dependence, tobacco use, and quit attempts. Cigar use was assessed as, "have you smoked a cigar in the last 30days" and by brand specific use in the past 30days.

FINDINGS

Cigar use was reported by 51 adolescents (27%), and increased to 76 (41%) when identifying by brand name. African Americans (32%) were more likely to smoke cigars than whites (10%, p<.01), Asian/Pacific Islanders (3%, p=.04), and multiracial participants (24%, p=.05). Cigarette-only users smoked more per day (p=.04) and had higher cotinine levels (p=.05) than cigar users. Number of prior quit attempts (p=.84) did not differ by group. Group differences in addiction were found between cigar users and cigarette only users (p<.01). At 24months, more baseline cigar users were tobacco abstinent than cigarette only users (16% versus 7%, p<0.01, respectively).

CONCLUSIONS

Assessment of brand-specific cigars nearly doubled the reporting among adolescent users. Cigar users differed from cigarette-only users in consumption and likelihood of abstinence at 24-months. For more accurate surveillance and to inform treatment considerations, surveys of adolescent tobacco use should include cigars, including brand names, in the assessment strategy.

Development and psychometric validation of a scoring questionnaire to assess healthy lifestyles among adolescents in Catalonia

Background

Lifestyle is intimately related to health. A questionnaire that specifically scores the healthiness of lifestyle of Catalan adolescents is needed. The objective of this study was to develop and validate a scoring questionnaire called VISA-TEEN to assess the healthy lifestyle of young Catalans that can be answered quickly and user-friendly.

Methods

A lifestyle questionnaire was developed based on the analysis of contributions from two focus groups, one with adolescents and the other with people who work with them (teachers and doctors). A panel of experts validated the content of items that were ultimately selected for the VISA-TEEN questionnaire. Three hundred ninety-six adolescents (215 boys and 181 girls, age = 13–19 years) completed the VISA-TEEN. Internal consistency was assessed using Cronbach's alpha (α) reliability coefficient. Test-retest reliability, using an intraclass correlation coefficient (ICC), was calculated based on scores attained two weeks apart. Construct validity was assessed by the extraction of components with an exploratory factor analysis. The relationship between the scores was measured using the health-related quality of life (HRQoL) KIDSCREEN-10 Index (the relationship was assessed by calculating Pearson’s r correlation coefficient). The association of scores in the VISA-TEEN for self-rated health (SRH) was also examined by executing an analysis of variance (ANOVA) between the different categories of this variable. We also calculated the index of fit for factor scales (IFFS) for each component, as well as the discriminatory power of the instrument using Ferguson’s δ (delta) coefficient.

Results

The VISA-TEEN questionnaire showed acceptable reliability (α = 0.66, α_est = 0.77) and a very good test-retest agreement (ICC = 0.860). It could be broken down into the following five components, all with an acceptable or very good IFFS (0.7–0.96): diet, substance abuse, physical activity, Rational Use of Technological Leisure (RUTL), and hygiene. Scores on the VISA-TEEN showed significant correlation with the KIDSCREEN index (r = 0.21, p < 0.001) and were associated with SRH (p < 0.001). The discriminatory power was found to be δ = 0.97.

Conclusions

The VISA-TEEN questionnaire developed to study the lifestyle of Catalan adolescents is a valid instrument to apply in this population as it is shown in the present psychometric tests to understand the role of lifestyle in the health of teenagers or to test the efficacy of health campaigns intended to improve teenagers' lifestyle.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-2778-6) contains supplementary material, which is available to authorized users.

A multiple indicators and multiple causes model of alternative tobacco use

OBJECTIVE

To examine the relationship between adolescents' cigarette smoking experiences and alternative tobacco product (ATP) use.

METHODS

Multiple indicators and multiple causes (MIMIC) models estimated simultaneously the relationship between cigarette smoking experiences and ATP use among high school students (N=1827) completing the 2009 Virginia Youth Tobacco Survey.

RESULTS

Overall, ATP use was associated with adolescents' ever use of cigarettes, early onset of cigarette smoking, cigarettes smoked per day, and peer smoking; however, important model differences between racial/ethnic groups were observed.

CONCLUSIONS

Prevention and cessation programs might reduce adolescent ATP use by targeting specific characteristics of cigarette smoking.

The Differential Heritability of Regular Tobacco Use Based on Method of Administration

Several large studies have demonstrated that the liability to smoke cigarettes is strongly genetically influenced. However, the role of genetic and environmental risk factors in the use of other common forms of tobacco use has yet to be studied. Data on the regular use of cigarettes, cigars, pipes, dip (moist snuff), and chewing tobacco from 2634 male twins were analyzed with ACE structural equation models. Twin similarity for regular cigarette and dip use was largely genetic in origin. However, twin resemblance for chewing tobacco was just about equally the result of genes and shared environment, and twin similarity for use of pipes and cigars was entirely the result of shared environmental factors. Thus, the genetic influences on the liability for regular tobacco use appear to vary based on tobacco type. The causes for the use of different forms of tobacco are complex and worthy of further study.

Predictors of Narghile (Water-Pipe) Smoking in a Sample of American Arab Yemeni Adolescents

To explore the predictors of water-pipe smoking among American Arab Yemeni adolescents, a descriptive correlational design was used, and regression models representing the proposed relationships in the study were tested from a convenience sample of 297 adolescents who attended a teen health clinic and two high schools. The participants completed five measures. Fourteen hypotheses were tested. Experimentation with tobacco was found to be significant in predicting narghile smoking. Tobacco use prevention and cessation interventions for this population can be focused on targeting the family and peer units, from which their identity is likely derived.

Associations between individual and contextual factors and smoking in 13,293 Mexican students

OBJECTIVE

Factors correlated with cigarette smoking in young people have yet to be documented in most developing countries. This study assesses the correlates of smoking in Mexican young people.

METHODS

School-based, cross-sectional study in the central Mexican state of Morelos during the 1998-1999 school year of 13,293 public school students aged 11 to 24 years. Multinomial logistic regression models were constructed with smoking as the dependent variable.

RESULTS

Regular smoking (one or more cigarettes daily) prevalence was 13.1% (95% confidence interval [CI]=12.2-13.9) in males, and 6.1% (95% CI=5.6-6.6) in females. Frequent alcohol intoxication was strongly associated with regular smoking (females, odds ratio [OR]=68.5, 95% CI=37.6-125.2; males, OR=34.5, 95% CI=22.6-52.7). Regular smoking was associated with illegal drug use and smoking by both parents in females, and with illegal drug use in males (males, OR=4.9, 95% CI=3.7-6.5). Also associated with tobacco smoking were high socioeconomic status, low academic achievement, illegal drug use by peers, marijuana use by parents, and depression in adolescents.

CONCLUSIONS

This study documents a strong correlation between tobacco smoking and other health risk behaviors, especially alcohol and drug abuse. In young women especially, the risk of tobacco use increased with alcohol abuse and higher socioeconomic status. School-based interventions are needed that focus on preventing smoking and also take into account other unhealthy behaviors.

Characteristics of users of cigars, bidis, and kreteks and the relationship to cigarette use

BACKGROUND

In the 1990s, youth use of alternative tobacco products including cigars, bidis, and kreteks increased. This article discusses the prevalence of youth use of cigars, bidis, and kreteks, and characteristics of users.

METHODS

The Cigar Use Reasons Evaluation (CURE)-a questionnaire assessing alternative tobacco use and associated attitudes and behaviors-was administered to middle and high school students from 12 school districts across Massachusetts.

RESULTS

Males were more likely to use all forms of alternative tobacco and females more likely to smoke cigarettes. Hispanics were less likely to smoke kreteks or use smokeless tobacco. Urban students were more likely to smoke bidis or use smokeless tobacco than suburban or rural youth. Most smokeless and alternative tobacco users were lifetime cigarette smokers. There was, however, a significant group of cigar smokers, associated with higher parental education, who were not current cigarette smokers.

CONCLUSIONS

Use of alternative tobacco poses a risk to the success of tobacco control efforts. While many alternative tobacco users smoke cigarettes, some alternative tobacco users are current cigarette smokers. Cigar use thus constitutes a potential serious risk for youth who otherwise might not be exposed to tobacco.

Use of sunscreen, sunburning rates, and tanning bed use among more than 10 000 US children and adolescents

OBJECTIVES

To describe the association of sunscreen use, sunburning, and tanning bed use by age, sex, residence, and psychosocial variables associated with tan-seeking behaviors, and to compare these findings with sun protection recommendations from federal agencies and cancer organizations.

METHODS

A cross-sectional study, from all 50 states, of 10 079 boys and girls 12 to 18 years of age in 1999. Data were collected from self-report questionnaires with the children of the participants from the Nurses Health Study (Growing Up Today Study).

RESULTS

The prevalence of sunscreen use was 34.4% with girls more likely to use sunscreen than boys (40.0 vs 26.4, odds ratio: 1.86; 95% confidence interval: 1.70-2.03). Eighty-three percent of respondents had at least 1 sunburn during the previous summer, and 36% had 3 or more sunburns. Nearly 10% of respondents used a tanning bed during the previous year. Girls were far more likely than boys to report tanning bed use (14.4 vs 2.4), and older girls (ages 15-18) were far more likely than younger girls (ages 12-14) to report tanning bed use (24.6% vs 4.7). Tanning bed use increased from 7% among 14-year-old girls to 16% by age 15, and more than doubled again by age 17 (35%; N = 244). Multivariate analysis demonstrated that attitudes associated with tanning, such as the preference for tanned skin, having many friends who were tanned, and belief in the worth of burning to get a tan, were generally associated with sporadic sunscreen use, more frequent sunburns, and increased use of tanning beds.

CONCLUSIONS

Our findings suggest that many children are at subsequent risk of skin cancer because of suboptimal sunscreen use, high rates of sunburning, and tanning bed use. Recommendations in the United States for improved sun protection and avoidance of tanning beds and sunburning, which began in the early 1990s, have been primarily unheeded. Nationally coordinated campaigns with strong policy components must be developed and sustained to prevent skin cancer in a new generation of children and adolescents.