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Introduction: We compared smoking initiation and cessation in Quebec versus the rest of Canada as possible underpinnings of the continued higher cigarette smoking prevalence in Quebec. Methods: Data were drawn from the Canadian Community Health Survey (CCHS). We compared average and sex-stratified prevalence estimates of (1) current cigarette smoking in persons aged 15 years and older; (2) past-year initiation of cigarette smoking in those aged 12 to 17 and 18 to 24 years; and (3) past-year cessation in adults aged 25 years and older in Quebec versus the other nine Canadian provinces in each two-year CCHS cycle from 2007/08 to 2017/18. Results: The prevalence of current smoking decreased from 25% to 18% among adults aged 15 years and older in Quebec from 2007/08 to 2017/18, and from 22% to 16% in the rest of Canada. Initiation among those aged 12 to 17 years decreased from 9% to 5% in Quebec, and from 7% to 3% in the rest of Canada. Neither initiation among people aged 18 to 24 (at 6% and 7%, respectively) nor cessation among adults aged 25 and older (approximately 8%) changed over time in Quebec or in the rest of Canada. In each two-year CCHS cycle, past-year initiation among those 12 to 17 years of age was consistently higher in Quebec than in the rest of Canada, but there were no substantial or sustained differences in initiation among people aged 18 to 24 or in past-year cessation. Findings were similar when stratified by sex. Conclusion: Higher levels of smoking initiation among youth aged 12 to 17 years could be a proximal underpinning of the continuing higher prevalence of smoking in Quebec versus the rest of Canada. [ABSTRACT FROM AUTHOR]

There is growing interest in physical activity (PA) to prevent mental disorders in youth. However, few studies examine the association between PA and mental health. Further, how PA volume and context relate to mental health and mental disorders remains unclear, especially among youth in transition to adulthood. This study examined the cross-sectional associations among PA volume and context, mental health, and symptoms of anxiety and depression in post-secondary students. A total of 1527 post-secondary students (97.4% were age 16-24years) recruited in a CEGEP in Quebec, Canada completed a self-report questionnaire during class-time in October 2013. Multivariate linear regression was used to model the associations between PA volume and context and mental health, anxiety and depression controlling for sex, age and perceived socioeconomic status. Volume of moderate-to-vigorous leisure time PA (MVPA) was positively associated with mental health (β (95% CI)=0.072 (0.045, 0.099)) and inversely associated with symptoms of anxiety (-0.011 (-0.020, -0.001)) and depression (-0.010 (-0.017, -0.003)). Volume including all PA intensities was associated with mental health (0.052 (0.028, 0.076)). After controlling for PA volume, active youth involved in team sports had better mental health than those who engaged in PA individually. PA volume and the social context of PA are independently associated with mental health among youth. MVPA is inversely associated with anxiety and depressive symptoms. [ABSTRACT FROM AUTHOR]

Objective To summarize findings from qualitative studies on factors associated with smoking cessation among adolescents and young adults. Data sources We searched Pubmed, Psychinfo, CINAHL, Embase, Web of Science, and SCOPUS databases, as well as reference lists, for peer-reviewed articles published in English or French between January 1, 2000, and November 18, 2020. We used keywords such as adolescents, determinants, cessation, smoking, and qualitative methods. Study selection Of 1724 records identified, we included 39 articles that used qualitative or mixed methods, targeted adolescents and young adults aged 10–24, and aimed to identify factors associated with smoking cessation or smoking reduction. Data extraction Two authors independently extracted the data using a standardized form. We assessed study quality using the National Institute for Health and Care Excellence checklist for qualitative studies. Data synthesis We used an aggregative meta-synthesis approach and identified 39 conceptually distinct factors associated with smoking cessation. We grouped them into two categories: (1) environmental factors [tobacco control policies, pro-smoking norms, smoking cessation services and interventions, influence of friends and family], and (2) individual attributes (psychological characteristics, attitudes, pre-quitting smoking behavior, nicotine dependence symptoms, and other substances use). We developed a synthetic framework that captured the factors identified, the links that connect them, and their associations with smoking cessation. Conclusions This qualitative synthesis offers new insights on factors related to smoking cessation services, interventions, and attitudes about cessation (embarrassment when using cessation services) not reported in quantitative reviews, supplementing limited evidence for developing cessation programs for young persons who smoke. Implications Using an aggregative meta-synthesis approach, this study identified 39 conceptually distinct factors grouped into two categories: Environmental factors and individual attributes. These findings highlight the importance of considering both environmental and individual factors when developing smoking cessation programs for young persons who smoke. The study also sheds light on self-conscious emotions towards cessation, such as embarrassment when using cessation services, which are often overlooked in quantitative reviews. Overall, this study has important implications for developing effective smoking cessation interventions and policies that address the complex factors influencing smoking behavior among young persons. [ABSTRACT FROM AUTHOR]

Using a genetic risk score (GRS) to predict a phenotype in a target sample can be complicated by missing data on the single nucleotide polymorphisms (SNPs) that comprise the GRS. This is usually addressed by imputation, omission of the SNPs or by replacing the missing SNPs with proxy SNPs. To assess the impact of the omission and proxy approaches on effect size estimation and predictive ability of weighted and unweighted GRS with small numbers of SNPs, we simulated a dichotomous phenotype conditional on real genotype data. We considered scenarios in which the proportion of missing SNPs ranged from 20–70%. We assessed the impact of omitting or replacing missing SNPs on the association between the GRS and phenotype, the corresponding statistical power and the area under the receiver operating curve. Omission resulted in a larger bias towards the null value of the effect size, a smaller predictive ability and greater loss of statistical power than proxy approaches. The predictive ability of a weighted GRS that includes SNPs with large weights depends of the availability of these large-weight SNPs. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We aimed to increase understanding of the link between sport specialization during childhood and adolescent physical activity (PA). The objectives were as follows: (1) describe the natural course of sport participation over 5 years among children who are early sport samplers or early sport specializers and (2) determine if a sport participation profile in childhood predicts the sport profile in adolescence. METHODS: Participants (n = 756, ages 10-11 years at study inception) reported their participation in organized and unorganized PA during in-class questionnaires administered every 4 months over 5 years. They were categorized as early sport samplers, early sport specializers, or nonparticipants in year 1 and as recreational sport participants, performance sport participants, or nonparticipants in years 2 to 5. The likelihood that a childhood sport profile would predict the adolescent profile was computed as relative risks. Polynomial logistic regression was used to identify predictors of an adolescent sport profile. RESULTS: Compared with early sport specialization and nonparticipation, early sport sampling in childhood was associated with a higher likelihood of recreational participation (relative risk, 95% confidence interval: 1.55, 1.18-2.03) and a lower likelihood of nonparticipation (0.69, 0.51-0.93) in adolescence. Early sport specialization was associated with a higher likelihood of performance participation (1.65, 1.19-2.28) but not of nonparticipation (1.01, 0.70-1.47) in adolescence. Nonparticipation in childhood was associated with nearly doubling the likelihood of nonparticipation in adolescence (1.88, 1.36-2.62). CONCLUSIONS: Sport sampling should be promoted in childhood because it may be linked to higher PA levels during adolescence. [ABSTRACT FROM AUTHOR]

Objective: To examine the factor structure, internal consistency, reliability, sex invariance, and discriminant validity of the French Canadian version of the Mental Health Continuum-Short Form (MHC-SF).Method: A total of 1485 French-speaking postsecondary students in Quebec, Canada (58% female; mean age = 18.4, SD = 2.4), completed the MHC-SF. Confirmatory factor analysis (CFA) was used to assess the factorial structure of the MHC-SF. Internal consistency was assessed with Cronbach's alpha, and reliability was assessed with the rho reliability coefficient. Invariance testing across sex was conducted using multigroup CFA comparing 4 increasingly restrictive models, and discriminant validity was examined against the Hospital Anxiety and Depression Scale (HADS) using Pearson correlation coefficients and CFA.Results: CFA supported the correlated 3-factor structure of the MHC-SF, with emotional, social, and psychological well-being subscales. The scale and each subscale items had internal consistency coefficients (Cronbach's alphas) above .70 and reliability coefficients (Jöreskog's rho) ranging from .79 to .90. Based on the multigroup CFA, configural, metric, scalar, and error variance invariance of the MHC-SF was observed across sex. Finally, the 2-continua model, suggesting that mental health and mental illness are distinct but related dimensions, was supported by both moderate inverse correlations between MHC-SF and HADS subscale scores and the 2-factor structure in CFA.Conclusions: These data support the multidimensional structure of the MHC-SF and provide evidence of internal consistency, reliability, and invariance across sex. The MHC-SF is a valid and reliable measure of mental health that is distinct from mental illness among French Canadian young adults. [ABSTRACT FROM AUTHOR]

Background: Alarming secular declines in physical activity (PA) have been observed among youth over the last decade. A better understanding of the predictors of these declines is crucial to identifying those children most at risk and to developing interventions that target youth before the onset of decline. This report identifies 1- and 2-year predictors of decline in PA among fourth- and fifth-grade students from inner-city neighborhoods in Montreal, Canada.Methods: Data for this study were collected in classroom questionnaires each May/June from 1993 to 1997. Analyses for this paper were completed in 2001. The cohort included active (at least one PA per day) children with baseline and 1-year (n =1873) or 2-year (n =509) follow-up data.Results: In boys, 1-year predictors of decline to an inactive status identified in generalized estimating equations analysis included moderate (vs high) baseline PA (odds ratio [OR]=1.66, 95% confidence interval [CI]=0.91–3.05); low PA self-efficacy (OR=1.67, 95% CI=1.03–2.71); born outside Canada (OR=2.13; 95% CI=1.31–3.46); Asian origin (OR=1.81; 95% CI=1.03–3.16) and no participation in school teams (OR=1.81, 95% CI=0.93–3.55). In girls, these 1-year predictors included moderate PA (OR=1.91, 95% CI=1.10–3.32); low PA self-efficacy (OR=1.70, 95% CI=1.15–2.49); watching four or more TV programs per day (OR=1.40, 95% CI=0.97–2.02); mother unemployed (OR=1.54, 95% CI=1.07–2.23); and grade five (vs grade four) (OR=1.35, 95% CI=0.94–1.93). Two-year predictors in boys included moderate baseline PA (OR=2.52, 95% CI=0.84–7.50), and born outside Canada (OR=1.96, 95% CI=0.91–4.20). In girls, these 2-year predictors included moderate baseline PA (OR=2.75, 95% CI=1.01–7.49); no participation in school teams (OR=2.14, 95% CI=0.92–5.00); watching four or more TV programs per day (OR=1.93, 95% CI=0.99–3.74); and born outside Canada (OR=1.85, 95% CI=0.96–3.55).Conclusions: Reduced TV viewing among girls and increased participation in school sports teams in boys and girls may prevent declines in PA among pre-adolescents from inner-city neighborhoods. [Copyright &y& Elsevier]

Introduction The few population-based studies that investigate the association between cannabis use and adiposity are inconclusive possibly because nicotine moderates the effect of cannabis on adiposity. The objective was to test the hypotheses that the association between cannabis use and adiposity in young men and women is modified by cigarette smoking. Methods Data were drawn from the Nicotine Dependence in Teens (NDIT) study, a 13-year prospective cohort investigation of the natural course of nicotine dependence. A total of 271 males and 319 females aged 12–13 years at cohort inception provided data on past-year cannabis use and number of cigarettes smoked per day in the past three months, at age 20 years. Outcomes included change in body mass index (BMI) and in waist circumference (WC) from ages 17 to 24 years. The hypothesis was tested in multiple linear regression models that included interaction terms for cannabis use and cigarette smoking and controlled for physical activity, sedentary behavior, alcohol use, and level of the outcome at baseline. Results The association between cannabis use and change in adiposity was U-shaped in male non-smokers and in females, and an inverted U-shape in male smokers. In males, the interaction between cannabis use and cigarette smoking was significant in both the models for change in BMI (p = 0.004; n = 271) and change in WC (p = 0.04; n = 250). In females, the interaction between cannabis use and cigarette smoking was not significant. Conclusion Smoking cigarettes appears to modify the association between cannabis use and adiposity in young men. [ABSTRACT FROM AUTHOR]

Background: While the heritability of cigarette smoking and nicotine dependence (ND) is well-documented, the contribution of specific genetic variants to specific phenotypes has not been closely examined. The objectives of this study were to test the associations between 321 tagging single-nucleotide polymorphisms (SNPs) that capture common genetic variation in 24 genes, and early smoking and ND phenotypes in novice adolescent smokers, and to assess if genetic predictors differ across these phenotypes. Methods: In a prospective study of 1294 adolescents aged 12–13 years recruited from ten Montreal-area secondary schools, 544 participants who had smoked at least once during the 7–8 year follow-up provided DNA. 321 single-nucleotide polymorphisms (SNPs) in 24 candidate genes were tested for an association with number of cigarettes smoked in the past 3 months, and with five ND phenotypes (a modified version of the Fagerstrom Tolerance Questionnaire, the ICD-10 and three clusters of ND symptoms representing withdrawal symptoms, use of nicotine for self-medication, and a general ND/craving symptom indicator). Results: The pattern of SNP-gene associations differed across phenotypes. Sixteen SNPs in seven genes (ANKK1, CHRNA7, DDC, DRD2, COMT, OPRM1, SLC6A3 (also known as DAT1)) were associated with at least one phenotype with a p-value <0.01 using linear mixed models. After permutation and FDR adjustment, none of the associations remained statistically significant, although the p-values for the association between rs557748 in OPRM1 and the ND/craving and self-medication phenotypes were both 0.076. Conclusions: Because the genetic predictors differ, specific cigarette smoking and ND phenotypes should be distinguished in genetic studies in adolescents. Fifteen of the 16 top-ranked SNPs identified in this study were from loci involved in dopaminergic pathways (ANKK1/DRD2, DDC, COMT, OPRM1, and SLC6A3). Impact: Dopaminergic pathways may be salient during early smoking and the development of ND. [ABSTRACT FROM AUTHOR]

Introduction: In adults, chronic exposure to air pollution is associated with elevated blood pressure, but few studies have examined this relationship in youth. We investigated the association between annual ambient concentrations of air pollutants (fine particulate matter [PM2.5] and nitrogen dioxide [NO2]) and systolic blood pressure (SBP) among adolescents in Montréal, Canada. Methods: Participants were students aged 15 to 17 years who provided SBP and residential postal code data in 2004/05 through their enrolment in the Nicotine Dependence in Teens study. Annual estimates for 2004 of residential exposure to NO2 and PM2.5 were provided by the Canadian Urban Environmental Health Research Consortium and linked to participants' residential postal code. Elevated SBP was defined as SBP = 90th percentile adjusted for age, sex and height. Logistic regression was used to estimate odds ratios and 95% confidence intervals (CIs) for each pollutant with respect to elevated SBP, adjusted for relevant confounders. Results: The sample consisted of 508 adolescents (mean age: 16.9, 46% male); 4% had elevated SBP. Although estimates were not statistically significant, there were generally modest positive associations between pollutant levels and SBP. The adjusted prevalence odds ratio of elevated SBP was 1.33 (95% CI: 0.64, 3.05) for every interquartile range (IQR) increase in residential PM2.5 levels (2.1µg/m³). Similarly, the adjusted prevalence odds ratio of elevated SBP was 1.17 (95% CI: 0.47, 2.70) for every IQR increase in residential NO2 levels (10.2 ppb). Conclusion: Findings support a possible relationship between exposure to air pollutants and increased SBP in adolescents, warranting further investigation for this important public health concern. [ABSTRACT FROM AUTHOR]

Identifying food patterns related to obesity can provide information for health promotion in nutrition. Food patterns and their relation with obesity among Canadian children have not been reported to date. Our aim was to identify and describe food patterns associated with obesity in children at risk of overweight. Caucasian children ( n = 630) with at least 1 obese biological parent recruited into the Quebec Adiposity and Lifestyle Investigation in Youth (QUALITY) cohort were studied in cross-sectional analyses. Measures of adiposity (body mass index (BMI), waist circumference, body fat mass percentage measured by dual-energy X-ray absorptiometry), screen time, physical activity (accelerometer over 7 days), and dietary intake (three 24-h food recalls) were collected. Factor analysis was used to identify food patterns. The relationships between food patterns and overweight were investigated in logistic and multiple linear regression models. Three food patterns were retained for analysis: traditional food (red meats, main dishes-soups, high-fat dairy products, tomato products, dressings, etc.); healthy food (low-fat dairy products, whole grains, legumes-nuts-seeds, fruits, vegetables); and fast food (sugar-sweetened beverages, fried potatoes, fried chicken, hamburgers-hot dogs-pizza, salty snacks). Higher scores on the fast food pattern were associated with overweight (BMI ≥ 85th percentile), and other measures of adiposity (BMI, waist circumference, body fat mass percentage) after adjustment for age, sex, physical activity, screen time, sleep time, family income, and mother's obesity ( p < 0.05). Controlling for energy intake did not change these relationships. Our results provide further evidence of a link between fast food intake and obesity in children. [ABSTRACT FROM AUTHOR]

The article discusses research investigating interest of an individualized score among children using a maximal cycling test, called the OMNI cycle scale. Researchers studied the differences between perceived exertion and actual effort, measured by peak oxygen consumption, at various stages of the test to determine whether perceived exertion and actual effort differed according to body mass status or physical activity level. The study's experimental design and methodology, a discussion of the results, and researchers' conclusions regarding the relationship between the effort performed, the OMNI cycle scale score, body mass status, and physical activity level are presented.

Variation in the CYP2A6 gene, which decreases the rate of nicotine metabolic inactivation, is associated with higher adult smoking cessation rates during clinical trials. We hypothesized that slow metabolism is associated with increased quitting during adolescence. White adolescent smokers (N=308, aged 12-17, 36.3% male) from a cohort study were genotyped for CYP2A6, resulting in 7.8% slow, 14.0% intermediate and 78.2% normal metabolizers. Overall, 144 smokers quit smoking, as indicated by being abstinent for at least 12 months. In logistic regression analyses, the odds ratio for quitting was 2.25 (95% confidence interval 1.05, 4.80; P=0.037) for slow metabolizers relative to normal metabolizers. A linear trend toward increased quitting with decreasing CYP2A6 activity was also observed (odds ratio=1.44, 95% confidence interval 1.02, 2.01; P=0.034). Thus, CYP2A6 slow metabolism is associated with increased adolescent smoking cessation, indicating that even early in the smoking history, genetic variation is influencing smoking cessation. [ABSTRACT FROM AUTHOR]

Introduction: In addition to individual-level characteristics, the social and physical environment may influence the initiation of cigarette smoking in adolescents. The objective of this paper is to describe the association between smoking intolerance in schools, and in restaurants and corner stores located near schools, and initiation of cigarette smoking among adolescents. Methods: Data on cigarette smoking were collected in self-report questionnaires every 3 months from 1999 to 2005 in a sample of 1,293 Grade 7 students in 10 secondary schools in Montreal, Canada. Baseline never-smokers (n = 868) were retained for analysis. School administrators completed questionnaires on tobacco control policies and activities within schools. Data on access to tobacco products and smoking restrictions in restaurants and corner stores located in school neighborhoods were collected through direct observation. Schools, restaurants, and corner stores were classified as smoking tolerant or intolerant. Time to initiation of cigarette smoking was modeled as a function of smoking intolerance in schools, restaurants, and corner stores in survival analyses (Cox proportional hazards modeling). Results: Students in smoking-intolerant schools were less likely to initiate smoking than students in smoking-tolerant schools (hazard ratio [HR; 95% CI] = 0.83 [0.68, 1.01]). Students attending schools located in neighborhoods with smoking-intolerant restaurants were less likely to initiate smoking (HR [95% CI] = 0.85 [0.68, 1.07]). There was no association between corner store smoking intolerance and initiation. Conclusions: Smoking intolerance in schools and restaurants may protect against initiation of cigarette smoking and could be useful targets for more intense tobacco control efforts. [ABSTRACT FROM AUTHOR]

Objective To describe the determinants of self-initiated smoking cessation of duration of at least 6 months as identified in longitudinal population-based studies of adolescent and young adult smokers. Methods A systematic search of the PubMed and EMBASE databases using smoking, tobacco, cessation, quit and stop as keywords was performed. Limits included articles related to humans, in English, published between January 1984 and August 2010, and study population aged 10-29 years. A total of 4502 titles and 871 abstracts were reviewed independently by 2 and 3 reviewers, respectively. Nine articles were retained for data abstraction. Data on study location, timeframe, duration of follow-up, number of data collection points, sample size, age/grade of participants, number of quitters, smoking status at baseline, definition of cessation, covariates and analytic method were abstracted from each article. The number of studies that reported a statistically significant association between each determinant investigated and cessation were tabulated, from among all studies that assessed the determinant. Results Despite heterogeneity in methods across studies, five factors robustly predicted quitting across studies in which the factor was investigated: not having friends who smoke, not having intentions to smoke in the future, resisting peer pressure to smoke, being older at first use of cigarette and having negative beliefs about smoking. Conclusions The literature on longitudinal predictors of cessation in adolescent and young adult smokers is not well developed. Cessation interventions for this population will remain less than optimally effective until there is a solid evidence base on which to develop interventions. [ABSTRACT FROM AUTHOR]

Background: We sought to determine if the rate of increase in body mass index (BMI) differs between first generation immigrant children (child and both parents born outside Canada); second generation immigrant children (child born in Canada with at least one parent born outside Canada); and native-born children (child and both parents born in Canada), and if the rate of increase varies across ethnic groups. Methods: Data were available from the evaluation of a 5-year heart health promotion program targeted to elementary school children from 24 schools in multi-ethnic, disadvantaged, inner-city neighborhoods in Montreal, Canada. Participants were 6392 children aged 9–12 years born in and outside of Canada. Height and weight were measured annually according to a standardized protocol. BMI increases with age were examined using individual growth models stratified by immigrant status grouping (first generation immigrant, second generation immigrant, native-born). Results: On average, BMI increased by 0.59, 0.73, and 0.82 kg/m2 with each year of age among first generation immigrant, second generation immigrant, and native-born children, respectively. These differences held across four family origin grouping (Europe, Asia, Central/South America, and Other). Conclusion: The protective effect of immigrant status on BMI increases with age dissipated in second generation immigrant children, whose rate of increase was similar to that of native-born children. Because immigrants constitute the fastest growing segment of the Canadian population, it is important to understand the causes of the higher BMI increases with successive generations. [ABSTRACT FROM AUTHOR]

One potential mechanism to explain the association of depression and cardiovascular mortality is through increased inflammation. Adolescents typically have high levels of depressive symptoms, but the association of depression and levels of inflammation has not been examined within this age group. The objective was to study the association between high-sensitivity C-reactive protein (hs-CRP) concentrations and depressive symptoms in youth. Data were available for 1,535 adolescents aged 13 and 16 years obtained in a province-wide survey of a representative sample of youth in Quebec, Canada in 1999. Data on depressive symptoms were collected in self-report questionnaires. Participants provided a fasting blood sample, and anthropometric measures were undertaken by trained technicians. For each unit increase in the depression score, the odds ratio for elevated hs-CRP (i.e., ≥90th percentile value of the age- and sex-specific CRP distribution) was 1.06 (95% confidence interval 0.79, 1.42) after adjustment for age, sex, ever smoked, language, body mass index, physical inactivity, use of medication, total cholesterol concentration, triglycerides concentration, and systolic blood pressure. These data do not support an association between depressive symptoms and elevated CRP in adolescents. [ABSTRACT FROM AUTHOR]

The effect of screen time during secondary school on percent body fat was examined in a cohort of 744 Canadian adolescents aged 12–13 years at baseline. Participants completed self-reported questionnaires on television viewing and computer use in 19 survey cycles over 57 months from 1999 to 2005. Triceps skinfold thickness and subscapular skinfold thickness were measured in survey cycles 1 and 19. Four screen-time trajectory groups identified in growth mixture modeling included steady-low screen time (73% of the sample), steady-high (10%), increasers (9%), and decreasers (8%). The effect of screen-time trajectory on percent body fat at survey cycle 19 was modeled in boys and girls separately by using linear regression, adjusting for baseline percent body fat and physical activity. Relative to that of steady-low screen-time trajectory group boys, percent body fat was 2.9 (95% confidence interval: 0.7, 5.0) and 2.4 (95% confidence interval: 0.5, 4.2) percentage units higher on average among “increasers” and “steady-high” trajectory group boys, respectively. There was no evidence that screen time has an effect on percent body fat in girls overall, although physical activity modified the association between screen time and percent body fat in both sexes. Efforts to prevent obesity in youth should emphasize reducing screen time. [ABSTRACT FROM PUBLISHER]

Background: There are no national data on levels of organizational capacity within the Canadian public health system to reduce the burden of chronic disease. Methods: Cross-sectional data were collected in a national survey (October 2004 to April 2005) of all 216 national, provincial and regional-level organizations engaged in chronic disease prevention through primary prevention or healthy lifestyle promotion. Levels of organizational capacity (defined as skills and resources to implement chronic disease prevention programmes), potential determinants of organizational capacity and involvement in chronic disease prevention programming were compared in western, central and eastern Canada and across three types of organizations (formal public health organizations, non-governmental organizations and grouped organizations). Results: Forty percent of organizations were located in Central Canada. Approximately 50% were formal public health organizations. Levels of skill and involvement were highest for activities that addressed tobacco control and healthy eating; lowest for stress management, social determinants of health and programme evaluation. The few notable differences in skill levels by provincial grouping favoured Central Canada. Resource adequacy was rated low across the country; but was lowest in eastern Canada and among formal public health organizations. Determinants of organizational capacity (organizational supports and partnerships) were highest in central Canada and among grouped organizations. Conclusion: These data provide an evidence base to identify strengths and gaps in organizational capacity and involvement in chronic disease prevention programming in the organizations that comprise the Canadian public health system. [ABSTRACT FROM AUTHOR]

The authors examined the potential association between changes in the number of moderate-to-vigorous physical activity (MVPA) sessions per week, adiposity, and systolic blood pressure (SBP) during adolescence. SBP and anthropometric factors were assessed biannually (1999/2000, 2002, and 2004) in a cohort of 1,293 Canadian adolescents aged 12–13 years in 1999. Self-reported 7-day recall data on MVPA sessions ≥5 minutes in duration were collected every 3 months over the 5-year period. Estimates of initial level and rate of decline in number of MVPA sessions per week from individual growth models were used as predictors of SBP in linear regression models. A decline of 1 MVPA session per week with each year of age was associated with 0.29-mm Hg and 0.19-mm Hg higher SBPs in girls and boys, respectively, in early adolescence (ages 12.8–15.1 years) and 0.40-mm Hg and 0.18-mm Hg higher SBPs, respectively, in late adolescence (ages 15.2–17.0 years). The associations were not attenuated by changes in body mass index, waist circumference, or skinfold thickness in girls during late adolescence. Although weaker, associations were evident in boys during late adolescence, as well as in both girls and boys during early adolescence. These results support prevention of declines in MVPA during adolescence to prevent higher blood pressure in youth. [ABSTRACT FROM PUBLISHER]

Few prospective studies of smoking initiation have investigated a wide range of time-varying and invariant predictor variables at the individual and contextual levels concurrently. In this study (1999–2005), 877 Canadian students (mean age = 12.7 years) who had never smoked at baseline completed self-report questionnaires on cigarette smoking and 32 predictor variables in 20 survey cycles during secondary school. Height and weight were measured in survey cycles 1, 12, and 19. School administrators completed questionnaires on school tobacco control policies/activities, and trained observers collected data on access to tobacco products in commercial establishments near schools. Younger age, single-parent family status, smoking by parents, siblings, friends, and school staff, stress, impulsivity, lower self-esteem, feeling a need to smoke, not doing well at school, susceptibility to tobacco advertising, alcohol use, use of other tobacco products, and attending a smoking-tolerant school were independent determinants of smoking initiation. Independent determinants of daily smoking onset among initiators of nondaily smoking included smoking by siblings and friends, feeling a need to smoke, susceptibility to tobacco advertising, use of other tobacco products, and self-perceived mental and physical addiction. Adolescent tobacco control programs should address multiple individual and contextual-level risk factors. Strategies that address nicotine dependence symptoms are also needed for adolescents who have already initiated smoking. [ABSTRACT FROM PUBLISHER]

Objectives. We sought to document the sequence and timing of milestones in the process of smoking cessation by prospectively studied cessation milestones among novice adolescent smokers. Methods. Participants, aged 12 to 13 years in 1999 (n=1293), completed self-report questionnaires every 3 months during the school year over 5 years. We ascertained time after first puff to attain 5 cessation milestones among 319 participants who initiated cigarette smoking during follow-up. Results. The cumulative probability of first reports of a serious desire to quit and perceived permanent cessation was 25% at 1.5 months (95% confidence interval [CI]=1.5, 2.5) after the first puff. The first serious quit attempt occurred at 2.5 months (95% C1=2.5, 5.4), lack of confidence about quitting followed at 18.4 months (95% CI=18.4, 26.8), and awareness of the difficulty of quitting occurred at 32.2 months (95% CI=19.2, 38.4). Conclusions. Desire and attempts to quit began soon after smoking onset. Novice smokers progressed through several stages in their perception of the difficulty of quitting. Increased understanding of the cessation process may help in developing effective tobacco control interventions for novice smokers. [ABSTRACT FROM AUTHOR]

Abstract: Background: To extend previous observations that secondhand tobacco smoke (SHS) is associated with nicotine markers in children, we investigated if SHS exposure is associated with self-reports of nicotine dependence (ND) symptoms among young never-smokers. Method: Data on number of persons who smoke inside the home, number of days exposed to SHS in a motor vehicle in the past week, number of parents, siblings, and friends who smoke, and ND symptoms, were collected from 10–12 year-old students in self-report questionnaires. The association between SHS and ND symptoms among young never-smokers was assessed in logistic regression models. Results: Sixty-nine of 1488 never-smokers (5%) reported one or more ND symptom. After controlling for sibling and peer smoking, and susceptibility to initiating smoking, exposure to SHS in a motor vehicle was independently associated with ND symptoms (OR, 95% CI=1.2, 1.0–1.4). The OR for number of persons who smoke inside the home was 1.1 (0.9–1.4). Conclusion: SHS exposure in motor vehicles may be associated with ND symptoms among young never-smokers. If replicated, this finding provides support for interventions that promote non-smoking in motor vehicles. [Copyright &y& Elsevier]

Purpose: To study the effect of cigarette use on height and adiposity in adolescents. Methods: Data on cigarette use were collected every 3 months for 5 years from adolescents initially 12–13 years of age. Height, weight, and triceps skinfold thickness were measured in survey cycles 1, 12, and 19. Multivariate linear regression models were fitted to estimate the association between cigarette use and the anthropometric measures in a dataset that pooled data over two time periods, from survey cycles 1–12 and from survey cycles 12–19. Results: Data were available for 451 boys and 478 girls. Seven percent of boys and 14% of girls smoked ≥30 cigarettes per month on average during the first time period; 9% of boys and 18% of girls smoked ≥30 cigarettes per month on average during the second time period. In boys, a 100-cigarette per month increment in cigarette use over the preceding 2.5 years was independently associated with lower body mass index (−0.4 kg/m2) and shorter height (−0.7 cm). In girls, cigarette use was not associated with height or adiposity. Conclusions: While there was no relation in girls, cigarette use appears to decrease body mass index and height in boys. Young girls may be less likely to take up cigarette smoking if tobacco control messages emphasize that cigarette use may not be associated with reduced weight in adolescent females. [Copyright &y& Elsevier]

Although related to inflammatory markers in adults, little is known about the association between cigarette smoking and C-reactive protein (CRP) in adolescent smokers. We examined the association between high-sensitivity CRP (hs-CRP) concentrations and smoking in youth. We used data from a cross-sectional, province-wide survey of a representative sample of youth conducted in Quebec, Canada, in 1999. Data were collected in self-report questionnaires completed by participants and their parents. Participants provided a fasting blood sample, and anthropometric measures were undertaken by trained technicians. The present analysis pertains to 1,501 adolescents aged 13 and 16 years who completed questionnaires and for whom blood samples were available. The independent association between a six-category indicator of smoking status and elevated hs-CRP, defined as a value at least in the 90th percentile of the age- and sex-specific CRP distribution, was assessed in multiple logistic regression analyses controlling for potential confounders. Relative to never-smokers, the odds ratios (95% confidence intervals) for puffers (i.e., never smoked a whole cigarette), those who smoked but not in the past month, light past-month smokers, moderate past-month smokers, and heavy past-month smokers were 1.04 (0.55-1.98), 1.76 (1.06-2.94), 1.39 (0.70-2.76), 2.07 (0.96-4.42), and 2.40 (1.18-4.88), respectively. Our data suggest a positive association between smoking status and elevated CRP in adolescents, and in particular among heavier past-month smokers. Damage related to cigarette smoking may begin soon after tobacco use initiation, reinforcing the preventive message that no level of smoking is safe in youth. [ABSTRACT FROM AUTHOR]

Background : Research to investigate levels of organisational capacity in public health systems to reduce the burden of chronic disease is challenged by the need for an integrative conceptual model and valid quantitative organisational level measures. Objective: To develop measures of organisational capacity for chronic disease prevention/healthy lifestyle promotion (CDP/HLP), its determinants, and its outcomes, based on a new integrative conceptual model. Methods: Items measuring each component of the model were developed or adapted from existing instruments, tested for content validity, and pilot tested. Cross sectional data were collected in a national telephone survey of all 216 national, provincial, and regional organisations that implement CDP/HLP programmes in Canada. Psychometric properties of the measures were tested using principal components analysis (PCA) and by examining inter-rater reliability. Results: PCA based scales showed generally excellent internal consistency (Cronbach's α = 0.70 to 0.88). Reliability coefficients for selected measures were variable (weighted κ(κw) = 0.11 to 0.77). Indicators of organisational determinants were generally positively correlated with organisational capacity (rs = 0.14–0.45, p<0.05). Conclusions: This study developed psychometrically sound measures of organisational capacity for CDP/HLP, its determinants, and its outcomes based on an integrative conceptual model. Such measures are needed to support evidence based decision making and investment in preventive health care systems. [ABSTRACT FROM AUTHOR]

Abstract: Objectives. : To describe gender differences in smoking cessation counseling practices among general practitioners (GPs), and to investigate the association between training for cessation counseling and counseling practices according to gender. Methods. : Data were collected in two cross-sectional mail surveys conducted in independent random samples of GPs in Montreal, the first in 1998, and the second in 2000. Results. : Respondents included 653 GPs (71% of 916 eligible). All indicators of smoking cessation counseling practices were more favorable among female GPs. Higher proportions of female GPs had received training (28% vs. 17%, p =0.002), and were aware of mailed print educational materials related to cessation counseling (81% vs. 57%, p <0.0001). Training among male GPs was associated with higher scores for ascertainment of smoking status (odds ratio (OR) (95% confidence interval)=1.69 (0.97, 2.96)), provision of advice (OR=2.20 (1.23, 3.95)), and provision of adjunct support (OR=2.86 (1.58, 5.16)). Training was not associated with counseling practices among female GPs. Conclusions. : Female GPs may not benefit from formal cessation counseling training to the same extent as male GPs, possibly because they read and integrate the content of (easily available) print educational materials into their clinical practice to a greater extent than male GPs. The gender-specific impact of print educational material and formal training on cessation counseling should be evaluated among GPs. [Copyright &y& Elsevier]

Abstract: Objective: To describe the delivery of smoking preventive counseling to preadolescent, adolescent, and young adult patients in an Arab population, and to examine counseling behavior according to physician demographic characteristics and perceived barriers to counseling. Methods: A cross-sectional mail survey was carried out among general practitioners (GPs) in private practice in the Emirates of Sharjah, Dubai and Abu Dhabi. Results: Of 391 eligible GPs, 218 (56%) completed the questionnaire. Overall 29, 50 and 65% of GPs offered preventive advice to preadolescents (9–12 years), adolescents (13–19 years) and young adults (20–24 years), respectively. Lack of patient educational materials was cited by 71.8% of GPs as a very important barrier to offering smoking prevention counseling, followed by lack of community resources (66.5%) and lack of time (62.2%). Older age, male gender, and having knowledge of the stages of change were positively associated with offering preventive advice. Conclusion: Physician self-reports of their smoking prevention counseling practices suggest there is opportunity for improvement. More training and support is needed to improve and encourage physician adherence to current smoking prevention counseling guidelines. Practice implication: More research is needed to determine the most effective method to improve delivery of preventive care by GPs, and to communicate appropriate preventive or cessation messages. [Copyright &y& Elsevier]

Background: Obesity in North America is now endemic, and increased understanding of the determinants of physical inactivity is critical. This analysis identified predictors of declines in physical activity over 5 years among adults in low-income, inner-city neighbourhoods. Methods: Data on leisure time physical activity were collected in telephone interviews in 1992 and 1997 from 765 adults (47% of baseline respondents), as part of the evaluation of a community-based cardiovascular disease risk reduction program. Results: One-third of 527 participants who were physically active at baseline, were inactive in 1997. Predictors of becoming inactive included female sex (OR = 1.63 95% CI (1.09, 2.43)), older age (1.02 (1.01, 1.04)), higher BMI (1.57 (1.03, 2.40)), poor self-rated health (1.39 (1.05, 1.84)), lower self-efficacy for physical activity (1.46 (1.00, 2.14)), and not using a neighborhood facility for physical activity (1.61 (1.02, 2.14)). Conclusion: These results highlight the fact that a variety of variables play a role in determining activity level, from demographic variables such as age and sex, to psychosocial and environmental variables. In addition, these results highlight the important role that other health-related variables may play in predicting physical activity level, in particular the observed association between baseline BMI and the increased risk of becoming inactive over time. Lastly, these results demonstrate the need for multi-component interventions in low-income communities, which target a range of issues, from psychosocial factors, to features of the physical environment. [ABSTRACT FROM AUTHOR]

Background: Through the AMI-QUEBEC Study we sought to describe delays to reperfusion therapy for ST-segment elevation myocardial infarction (STEMI) and to identify factors associated with prolonged delays. Methods: We reviewed the charts of all consecutive patients with STEMI admitted to 17 hospitals in the province of Quebec in 2003 to obtain data on the time from presentation to reperfusion therapy. Data were available for 1189 (83.0%) of 1432 patients. Results: The median delay to reperfusion therapy was 32 minutes (first and third quartile [Q1, Q3] 20, 49) for 535 patients who received fibrinolytic therapy, 109 minutes (Q1, Q3 79, 150) for 455 patients who underwent primary percutaneous coronary intervention (PCI) at the initial hospital of presentation and 142 minutes (Q1, Q3 115, 194) for 199 patients who underwent primary PCI after an interhospital transfer. Patients who presented outside daytime working hours, those who received primary PCI and those who required interhospital transfer for primary PCI were less likely to receive reperfusion therapy within current recommended times (odds ratios [ORs] 0.49, 0.56 and 0.15, respectively). Increased age was associated with prolonged delays only among patients who received fibrinolytic therapy (OR for each 10-year increase in age 0.95, 95% credible interval [CrI] 0.93-0.99 for fibrinolytic therapy and 0.99, 95% CrI 0.95-1.05, for primary PCI). Interpretation: In 2003, many patients with STEMI in Quebec were not treated within the recommended times. Delays may be reduced by reorganizing pre- and in-hospital care for patients with STEMI to expedite delivery of reperfusion therapy. [ABSTRACT FROM AUTHOR]

Abstract: This analysis reports the 3-month test–retest reliability of self-reports of cigarette use in novice smokers, and identifies factors associated with adequate recall. Participants included 63 novice smokers (mean age 14.1 years) from the McGill University Study on the Natural History of Nicotine Dependence in Teens. We compared data for three cigarette use indicators obtained in a 1-month recall of smoking, to data obtained for that same month, 3 months later. Forty-three participants (68.3%) smoked infrequently; 12.7%, 6.4%, and 12.7% were monthly, weekly, and daily smokers, respectively. Test–retest reliability for the cigarette use frequency and intensity indicators was good (κ =0.78 and 0.75, respectively); it was lower for total number of cigarettes smoked per month (ICC=0.64). Older age was independently associated with adequate recall for all three indicators. These data suggest that novice smokers recall the frequency and intensity of their cigarette use reliably after 3 months, and that older adolescents have better recall than younger adolescents. [Copyright &y& Elsevier]

Background: The natural course of onset of cigarette use has been conceptualized as progressing sequentially through 5 stages (preparation, trying, irregular use, regular use, nicotine-dependent smoking). However, recent studies suggest that symptoms of nicotine dependence can occur early in the onset process, raising questions about the validity of this model. The objective of our study was to describe the sequence and timing of 12 milestones (6 related to cigarette use and 6 to symptoms of nicotine dependence) during onset of cigarette use. Methods: Grade 7 students in 10 secondary schools in Montréal (n= 1293) were followed prospectively every 3-4 months for 5 years. Using Kaplan--Meier analysis, we computed the number of months after first puff at which the cumulative probability of attaining each milestone was 25%, among 311 participants who initiated cigarette use during follow-up. Results: Inhalation rapidly followed first puff. The cumulative probability of inhalation was 25% at 1.5 months (95% confidence interval [CI] 1.5-2.5). The cumulative probability (and 95% CI) was 2.5 months (1.5-2.5) for mental addiction, 2.5 (1.0-3.0) for smoking a whole cigarette, 4.5 (2.5-8.8) for cravings, 5.4 (3.8-9.7) for physical addiction, 8.8 (7.0-11.9) for monthly smoking, 11.0 (6.4-16.8) for withdrawal symptoms, 13.0 (10.3-20.5) for tolerance, 19.4 (14.5-31.7) for weekly smoking, 19.5 (14.0-23.9) for lifetime total of 100 cigarettes, 23.1 (19.7-37.6) for daily smoking and 40.6 (35.1-56.0) for conversion to tobacco dependence. Interpretation: Symptoms of nicotine dependence develop soon after first puff and can precede monthly, weekly and daily smoking. Cessation interventions that manage dependence symptoms may be needed soon after first puff. [ABSTRACT FROM AUTHOR]

Purpose: To describe longitudinal trajectories of smoking intensity in adolescent novice smokers and to identify predictors of trajectory class membership. Methods: Cigarette consumption among 369 novice smokers (mean age 13 years) was measured over a mean 24 months of follow-up after smoking onset. Classes of smoking intensity trajectories were identified using latent class growth modeling. Predictors of trajectory class membership were identified in polytomous logistic regression. Results: There was considerable between-subject heterogeneity in individual trajectories over time. Four classes of smoking intensity trajectories were identified: low-intensity, non-progressing smokers (72.4% of subjects), and slow, moderate, and rapid escalators (11.1%, 10.8%, and 5.7% of subjects, respectively). Gender, poor academic performance, and having more than half of friends who smoke at smoking onset independently predicted development of trajectory pattern. Escalating trajectory patterns were associated with earlier development of nicotine dependence and tolerance. Conclusions: Cigarette consumption will not escalate rapidly among three-quarters of adolescent novice smokers. Novice smokers who do escalate rapidly should be targeted for early tobacco control intervention to prevent development of nicotine dependence and sustained smoking. [Copyright &y& Elsevier]

Objective. To determine the usefulness of parent history of hypercholesterolemia and cardiovas-cular disease as a screening criterion for hypercholester-olemia in youths. Methods. Data were available from a population-based survey of 3665 Quebec youths aged 9, 13, and 16 years (81.2% of eligible subjects). Blood specimens were collected from 2475 subjects (54.8% of those eligible), and questionnaire data were obtained from 3048 parents (67.5% of those eligible). Lipids were measured in a Centers for Disease Control and Prevention standardized laboratory. Usefulness of parent history in identifying borderline/high low-density lipoprotein cholesterol (LDL-C) (≥2.8 mmol/L [≥110 mg/dL]) and high LDL-C (≥3.4 mmol/L ≥130 mg/dL]) was assessed according to test performance statistics (sensitivity, specificity, posi-tive predictive value, and negative predictive value). Results. The prevalence of a positive parent history was 25.6%; 18.3% of subjects had borderline/high LDL-C, and 4.8% had high LDL-C. Sensitivity, specificity, posi-tive predictive value, and negative predictive value of parent history were 33.1%, 76.0%, 23.7%, and 83.5%, re-spectively, for identifying borderline/high LDL-C; they were 40.7%, 75.1%, 7.7%, and 96.1% for identifying high LDL-C. Test performance statistics were not improved in... [ABSTRACT FROM AUTHOR]

: BackgroundAlthough many sociodemographic and psychosocial factors have been identified as related to adolescent smoking, few studies have examined the role of nicotine-dependence (ND) symptoms. The objective was to study the association between ND symptoms and smoking status among adolescents in the early stages of the smoking onset process.: MethodsThe McGill University Study on the Natural History of Nicotine Dependence is an ongoing 6-year prospective investigation of the natural history of ND among 1267 grade 7 students in ten Montreal high schools. The baseline response was 55.4%. Subjects for this cross-sectional analysis of baseline data, collected in 1999, included 241 past 3-month smokers (mean age [SD]=13.0±0.7 years at baseline). ND symptoms were measured in five indicators, including a measure based on the criteria for tobacco dependence in the International Classification of Diseases-10th Revision (ICD-10), the Hooked on Nicotine Checklist, and three symptom clusters (withdrawal, self-medication, and ND/cravings symptoms). The association between ND symptom indicators and each of sporadic, monthly, weekly, and daily smoking relative to less frequent smoking was investigated in multiple logistic regression analysis.: ResultsDespite low cigarette exposure, 16.6% (95% confidence interval [CI], 11.9%–21.3%) of past 3-month smokers were tobacco dependent. The proportion increased from 0%, 3.1% (95% CI, 0.0%–9.2%), and 4.6% (95% CI, 0.2%–9.0%) among triers, sporadic smokers, and monthly smokers, respectively, to 19.4% (95% CI, 5.5%–33.3%) and 65.9% (95% CI, 51.9%–79.9%) among weekly and daily smokers, respectively. ND/cravings consistently distinguished each smoking category from less frequent smokers; the odds ratios (95% CI) for ND/cravings symptoms were 1.16 (0.99–1.35) in sporadic smokers; 1.17 (1.06–1.29) in monthly smokers; 1.34 (1.19–1.50) in weekly smokers; and 1.39 (1.22–1.59) in daily smokers.: ConclusionsThese data challenge current smoking onset models, which suggest that ND develops only after several years of heavy or daily smoking. ND symptoms are associated, at least cross-sectionally, with increased smoking in adolescents. To increase the likelihood of being effective, tobacco-control programs for children and adolescents will need to take early ND symptoms into account. [Copyright &y& Elsevier]

PURPOSE: To examine the test retest reliability, internal consistency, and convergent construct validity of selected measures of nicotine dependence (ND) among adolescents.METHODS: Self-reports of sociodemographic characteristics and smoking behavior were collected in a convenience sample of 238 high school students aged 13 to 19 years. ND was measured in the Hooked on Nicotine Checklist (HONC), the Stanford Dependence Index (SDI) and in 45 new items identified in consultation with experts and focus group interviews with adolescent smokers.RESULTS: Test retest reliability among past 3-month smokers indicated good to excellent reliability coefficients for HONC items (κ 0.61 to 0.93), except one item that tapped feelings of depression on withdrawal (κ = 0.34). Intraclass correlation coefficients for SDI items ranged from 0.71 to 0.77. Test retest reliability coefficients for the 45 new items ranged from 0.20 to 0.90. The HONC and SDI demonstrated good internal consistency (Cronbach''s α = 0.90 and 0.78, respectively). Convergent construct validity against cigarette exposure was demonstrated for the HONC, SDI, and most of the 45 new items.CONCLUSIONS: The HONC and SDI demonstrated excellent and good psychometric properties, respectively. Most of the 45 new items hold promise as indicators of ND in youth, and should be further investigated. [Copyright &y& Elsevier]

The aims were to explore adolescent smokers' understanding and their physiological and psychological experience of addiction to nicotine and to assess the content validity of the Hooked on Nicotine Checklist (HONC), a 10-item measure of nicotine dependence in youth. Six focus group interviews were conducted with male and female smokers recruited by school staff from among known smokers at one English and two French high schools in Montreal. Participants were 64 high-school students aged 14–17 years. Measurements were focus group discussion of smoking patterns and levels for self and others; feelings and sensations while smoking; physical and mental experiences of urges, feelings and sensations when smoking is prohibited; the physical, psychological, and social meanings of being hooked, dependent, or addicted; levels of dependence, desire to quit, and quit attempts. Participants readily identified nicotine dependence as relevant to their smoking experience. Dependence was described as the need to smoke, sometimes experienced as sensations of emptiness in the chest or blood and sometimes as a feeling in the mind. Smoking urges were often situationally determined and associated with hunger. With the exception of feeling sad, blue, or depressed on smoking withdrawal, participants endorsed almost all the symptoms in the HONC as relevant to their experience of dependence and identified several other symptoms as well. Adolescents are able to provide self-reports of symptoms of dependence that are consistent with a theoretically driven conceptualization of nicotine dependence. The HONC demonstrates content validity among adolescents but could be improved through removal of the item related to depression on withdrawal and possibly addition of items related to stress and appetite. [ABSTRACT FROM AUTHOR]

Discusses the rapid solid-state synthesis of tantalum, chromium and molybdenum nitrides. Solid-state metathesis reactions under static pressures of up to 50 kbar; Alternative route to synthesizing the materials.

Introduction: Youth initiation may drive differences in smoking prevalence across Canadian provinces. Provincial differences in initiation relate to tobacco control strategies and public health funding, but have also been attributed to population characteristics. We test this hypothesis by examining the extent to which seven characteristics--immigration, language, family structure, education, income, home ownership and at-school status--explain differences in initiation across provinces. Methods: We used data from 16 897 youth aged 12 to 17 years in the Canadian Community Health Survey collected from 2015 to 2018. To examine the proportion of provincial differences explained by population characteristics, we compared average marginal effects (AMEs) from partially and fully adjusted models regressing "having ever initiated" on province and other characteristics. We also tested interactions to examine differences in the association between population characteristics and initiation across provinces. Results: Initiation varied from 4% in British Columbia to 10% in Quebec. Being born in Canada, speaking French, not living in a two-parent household, being in the lowest household income quintile, having parents without postsecondary education, living in rented accommodation and not being in school were each associated with initiation. Taking these results into consideration, the AME of residing in another province compared with Quebec was attenuated by between 3% and 9%. Family structure and household income were more strongly associated with initiation in the Atlantic region and Manitoba, but not in Quebec. Conclusion: Differences in initiation between Quebec and other provinces are unlikely to be substantially explained by their demographic or socioeconomic composition. Reprioritizing tobacco control and public health funding are likely key in attaining the "tobacco endgame" across provinces. [ABSTRACT FROM AUTHOR]

Background: Young adults face unique vulnerabilities during major life disruptions like the COVID-19 pandemic. The pandemic contributed to increases in mental health challenges and substance use among young adults. This study explores the experiences of young adults who increased their cannabis use during the pandemic. Methods: Participants were recruited from the Nicotine Dependence in Teens (NDIT) study, and qualitative data were collected through semi-structured interviews conducted via Zoom. A total of 25 participants (ages 33–34) reporting increased cannabis use during the pandemic were included. Thematic analysis and gender-based analysis was employed to extract key themes. Results: Five themes emerged: (1) No disruption in cannabis use; (2) Cannabis use to manage declines in mental health; (3) Cannabis use to break up pandemic boredom; (4) Cannabis use as an expression of freedom; (5) Cannabis use as "another way to chill out." Conclusions: This research provides valuable perspectives on how major life disruptions, like the COVID-19 pandemic, influence cannabis use among young adults. The findings offer guidance for public health initiatives and highlight avenues for further investigation. [ABSTRACT FROM AUTHOR]

To investigate the association between the neighborhood built environment and trajectories of body mass index (BMI) in youth. Data were collected in a prospective study of 1293 adolescents in Montreal. Built environment variables were obtained from public databases for road networks, land use, and the Canadian Census. Anthropometric data were collected when participants were ages 12.5, 15 and 17 years. We undertook hierarchical cluster analysis to identify contrasting neighborhood types based on features of the built environment (e.g., vegetation, population density, walkability). Associations between neighborhood type and trajectories of BMI z-score (BMIz) were estimated using multivariable linear mixed regression analyses, stratified by sex. We identified three neighborhood types: Urban , Suburban , and Village. In contrast to the Urban type, the Suburban type was characterized by more vegetation, few services and low population density. Village and Suburban types were similar, but the former had greater land use diversity, population density with more parks and a denser food environment. Among girls, living in Urban types was associated with decreasing BMIz trajectories. Living in Village types was associated with increasing BMIz trajectories. No associations were observed among boys. Neighborhoods characterized by greater opportunities for active living appear to be less obesogenic, particularly among girls. • Three neighborhood types were identified based on features of the built environment. • Neighborhoods had varying levels of vegetation, services and walkability. • Greater walkability and variety of services led to decreasing BMI in girls. [ABSTRACT FROM AUTHOR]

Objectives. This study evaluated the impact of a 4-year, community-based cardiovascular disease prevention program among adults aged 18 to 65 years living in St-Henri, a low-income, inner-city neighborhood in Montreal, Quebec. Methods. Awareness of and participation in the program were monitored in 3 independent sample telephone surveys. Self-reported behaviors were compared in St-Henri and a nearby comparison community before and after program implementation in both a 3-year repeat independent sample survey and a 5-year longitudinal cohort telephone survey. Results. Awareness of the program reached 37.4%, but participation was low (2%-3%). There were no secular declines in smoking or high-fat diet; physical inactivity increased in both communities. There were no statistically significant program effects detected in the independent sample surveys, although physical inactivity increased more in the comparison community than in St-Henri. In the longitudinal cohort sample, there was a small, statistically significant increase favoring St-Henri in frequency of cholesterol checkups. Conclusions. Despite careful adaptation of the program to the local social context, there were few community-wide program effects. However, several component interventions showed promise in terms of community penetration and impact. (Am d Public Health. 1999;89: 1819-1826) [ABSTRACT FROM AUTHOR]

Evaluates the feasibility of an intervention aimed at offering healthy menu options in fast-food restaurant and family-style restaurants in a low-income neighborhood. Frequency of ordering of healthy menu options; Demand for healthy menu options; Characteristics of restaurant customers more likely to order healthy menu options; Implications for nutrition education.

The objective of the study was to assess the prevalence of obesity and/or undernutrition and evaluate diet and activity patterns among schoolchildren from an ethnically diverse low income urban population. A cross-sectional survey of 498 children aged 9-12 y from 24 schools in low income multiethnic neighborhoods in Montreal, Canada was undertaken. Height, weight, dietary intake, physical activity record, and lifestyle and demographic characteristics were measured. There was no evidence of undernutrition because linear growth was appropriate for age, but 39.4% of children were overweight (>85th percentile NHANES II). Dietary fat intake was higher in children from single-parent families (P < 0.001) and those with mothers born in Canada. Intake of vitamins A, C, iron and folate was directly related to income sufficiency. Children who did more physical activity had significantly higher intakes of energy, calcium, iron, zinc and fiber but were not heavier. Dietary intake was systematically underreported among overweight children, i.e., their reported intakes did not meet calculated energy needs. This underreporting makes it difficult to attribute the accumulated energy imbalance to either energy intake or expenditure. [ABSTRACT FROM AUTHOR]

Presents a study which was conducted to evaluate the impact of `Yes, I Quit,' a smoking cessation course designed for women in a low income, low education community. Methods used to conduct the study; Reasons for continued high prevalence of smoking by social class; Data on sociodemographic characteristics.

Describes the synthesis and characterization of the first 6,6-substituted isomer of nido-B10H14, 6,6-(C5H5N)2B10H12 and application of 11B-11B double quantum nuclear magnetic resonance (NMR) spectroscopy. Reactivity of decaborane(14) with pyridine; Reaction of (pyridine)xSmI2 with B10H14; Spectroscopic characterization.

Background: Group-based trajectory modelling (GBTM) is increasingly used to identify subgroups of individuals with similar patterns. In this paper, we use simulated and real-life data to illustrate that GBTM is susceptible to generating spurious findings in some circumstances.Methods: Six plausible scenarios, two of which mimicked published analyses, were simulated. Models with 1 to 10 trajectory subgroups were estimated and the model that minimized the Bayes criterion was selected. For each scenario, we assessed whether the method identified the correct number of trajectories, the correct shapes of the trajectories, and the mean number of participants of each trajectory subgroup. The performance of the average posterior probabilities, relative entropy and mismatch criteria to assess classification adequacy were compared.Results: Among the six scenarios, the correct number of trajectories was identified in two, the correct shapes in four and the mean number of participants of each trajectory subgroup in only one. Relative entropy and mismatch outperformed the average posterior probability in detecting spurious trajectories.Conclusion: Researchers should be aware that GBTM can generate spurious findings, especially when the average posterior probability is used as the sole criterion to evaluate model fit. Several model adequacy criteria should be used to assess classification adequacy. [ABSTRACT FROM AUTHOR]