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Background Exposure to violence in youth may be associated with substance use and other adverse health effects. This study examined cigarette smoking in two middle-income areas with different levels and types of exposure to violence. Methods Association of exposure to verbal and physical violence with cigarette smoking in the West Bank oPt (2008) and in Jujuy Argentina (2006) was examined using cross-sectional surveys of 14 to 17-year old youth in 7th to 10th grade using probabilistic sampling. Results Violence exposure rates were more than double for Palestinian girls (99.6% vs. 41.2%) and boys (98.7% vs. 41.1%) compared with Argentinians. The rate of current cigarette smoking was significantly higher among Argentinian girls compared with Palestinian girls (33.1% vs. 7.1%, p Conclusion Findings highlight the importance of producing context and gender specific evidence from exposure to violence, to inform and increase the impact of targeted smoking prevention strategies.

OBJECTIVES:This study evaluated the effect of factors reflecting appreciation of Indigenous culture and racial insults on alcohol and drug use initiation among multi-ethnic youth in Jujuy, Argentina.METHODS:Students were surveyed from 27 secondary schools that were randomly selected to represent the province. A total of 3040 eligible students in 10th grade, age 14 to 18years were surveyed in 2006 and 2660 of these same students completed surveys in 11th grade in 2007. Multivariate logistic regression models assessed the effect of appreciation for Indigenous cultures and reported exposure to racial insults in 10th grade on incident current alcohol drinking in previous 30days, binge drinking (≥5 drinks at one sitting), and lifetime drug use (marijuana, inhalants or cocaine) in 11th grade among students not reporting these behaviors in 2006.RESULTS:In 2006, 63% of respondents reported high appreciation for Indigenous cultures and 39% had ever experienced racial insults. In 2007, incident current drinking was 24.4%, binge drinking 14.8%, and any drug use initiation was 4.1%. Exposure to racial insults increased the likelihood of binge drinking (OR=1.6; 95% CI 1.2-2.1) but was not significant for any drug use. Appreciation for Indigenous cultures reduced the risk of any drug use initiation (OR=0.5, 95% CI 0.3-0.7) but had no effect for alcohol drinking outcomes. These effects were independent of Indigenous ethnicity.CONCLUSIONS:Enhancing appreciation for Indigenous cultures and decreasing racial insults are achievable goals that can be incorporated into programs to prevent youth substance use. Fil: Alderete, Ethel del Carmen. Instituto de Ciencia y Tecnología Regional; Argentina. Universidad Nacional de Jujuy; Argentina Fil: Grerorich, Steven. University of California; Estados Unidos Fil: Monteban, Madalena. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. University of Georgia; Estados Unidos Fil: Kaplan, Celia. University of California; Estados Unidos. Helen Diller Family Comprehensive Cancer Center; Estados Unidos Fil: Mejia, Raul Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudio de Estado y Sociedad; Argentina. Universidad de Buenos Aires; Argentina Fil: Jennifer Livaudais, Toman. University of California; Estados Unidos Fil: Pérez Stable, Eliseo. University of California; Estados Unidos. Centro de Estudio de Estado y Sociedad; Argentina

Introduction: We evaluated an intervention to teach physicians how to help their smoking patients quit compared to usual care in Argentina. Methods: Physicians were recruited from six clinical systems and randomized to intervention (didactic curriculum in two 3-hour sessions) or usual care. Smoking patients who saw participating physicians within 30 days of the intervention (index clinical visit) were randomly sampled and interviewed by telephone with follow-up surveys at months 6 and 12 after the index clinical visit. Outcomes were tobacco abstinence (main), quit attempt in the past month, use of medications to quit smoking, and cigarettes per day. Repeated measures on the same participants were accommodated via generalized linear mixed models. Results: Two hundred fifty-four physicians were randomized; average age 44.5 years, 53% women and 12% smoked. Of 1378 smoking patients surveyed, 81% were women and 45% had more than 12 years of education. At 1 month, most patients (77%) reported daily smoking, 20% smoked some days and 3% had quit. Mean cigarettes smoked per day was 12.9 (SD = 8.8) and 49% were ready to quit within the year. Intention-to-treat analyses did not show significant group differences in quit rates at 12 months when assuming outcome response was missing at random (23% vs. 24.1%, P = .435). Using missing=smoking imputation rule, quit rates were not different at 12 months (15.6% vs. 16.4% P = .729). Motivated smokers were more likely to quit at 6 months (17.7% vs. 9.6%, P = .03). Conclusions: Training in tobacco cessation for physicians did not improve abstinence among their unselected smoking patients. Fil: Mejia, Raul Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina. Universidad de Buenos Aires; Argentina Fil: Stable, Eliseo J. Pérez. Universidad de California en San Francisco; Estados Unidos Fil: Kaplan, Celia P.. Universidad de California en San Francisco; Estados Unidos Fil: Gregorich, Steven E.. Universidad de California en San Francisco; Estados Unidos Fil: Livaudais Toman, Jennifer. Universidad de California en San Francisco; Estados Unidos Fil: Peña, Lorena. Centro de Estudios de Estado y Sociedad; Argentina Fil: Alderete, Mariela del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundacion Interamericana del Corazón Argentina; Argentina Fil: Schoj, Veronica. Fundacion Interamericana del Corazón Argentina; Argentina Fil: Alderete, Ethel del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

Se examinaron patrones de consumo de alcohol y alcoholemia en sala de emergencia del hospital público de referencia para traumatismos en la provincia de Jujuy aplicando el Instrumento de Evaluación para los Trastornos Debidos al Consumo de Alcohol, versión corta (AUDIT-C). Se entrevistaron pacientes durante las 24 horas de 4 días (N=500) y se obtuvieron muestras para prueba de alcoholemia en el 84%. El 37% presentaba consumo de riesgo (hombres 50% vs. mujeres 23%) y el 29% tenía síntomas de dependencia (hombres 48% vs. mujeres 11%). El 17% de los hombres y el 3% de las mujeres tenían un nivel de alcoholemia igual o mayor a 50 mg/dl. En modelos de regresión logística multivariados la razón de posibilidades para los hombres de ser consumidores de riesgo (OR ajustado 3.2; IC 95% 2.1-5.0), tener síntomas de dependencia (OR ajustado 7.5; IC 95% 4.4-12.7) o niveles elevados de alcoholemia (OR ajustado 8.0; IC 95% 2.2-28.8), fue mayor que para las mujeres. Para ingresos por accidentes, situaciones de violencia o uso de drogas, la razón de posibilidades de ser consumidores de riesgo (OR ajustado 2.4; IC 95% 1.5-3.9), presentar síntomas de dependencia (OR ajustado 2.0; IC 95% 1.2-3.3), o alcoholemia (OR ajustado 7.7; IC 95% 3.0-19.8) fue mayor comparados con ingresos por otras causas. El alcoholismo tiene un impacto significativo en la ocurrencia de lesiones e influye sobre la demanda de atención médica. La implementación de programas de prevención podría ser una herramienta efectiva para reducir el impacto negativo del alcoholismo.We examined patterns of alcohol consumption and blood alcohol levels in emergency room patients. The study was conducted in a public hospital of the province of Jujuy, Argentina. A survey was conducted among all patients during the 24 hours of 4 consecutive days (N=500) using the Alcohol Use Disorders Identification Test, short version (AUDIT-C). Blood samples were collected in 84% of participants. Results showed that 37% were hazardous drinkers (men 50% vs. women 23%), 29% had symptoms of dependence (men 48% vs. women 11%); 17% of men and 3% of women had high blood alcohol levels, equal or greater than 50 mg/dl. In multivariate logistic regression models men had increased likelihood of hazardous drinking (Adjusted OR 3.2; 95% CI 2.1-5.0), symptoms of dependence (Adjusted OR 7.5; 95% CI 4.4-12.7) and increased blood alcohol levels (Adjusted OR 8.0; 95% CI 2.2-28.8), compared with women. Patients admitted due to accidents, violence, or drug use, had increased likelihood of hazardous drinking (Adjusted OR 2.4; 95% CI 1.5-3.9), dependence symptoms (Adjusted OR 2.0; 95% CI 1.2-3.3) and increased blood alcohol levels (Adjusted OR 7.7; 95% CI 3.0-19.8), compared with those admitted for other reasons. Alcoholism has a significant impact on the occurrence of injuries and on the demand imposed on health services. Prevention programs can potentially reduce the negative health and social impact of alcoholism.

This study examines alternative tobacco use among Latin American youth. A self-administered survey in a random sample of 27 schools was administered in 2004 in Jujuy, Argentina (N = 3218). Prevalence of alternative tobacco product use was 24.1; 15.3 of youth used hand-rolled cigarettes, 7.8 smoked cigars, 2.3 chewed tobacco leaf and 1.6% smoked pipe. Among youth who never smoked manufactured cigarettes, alternative product use was rare (2.9), except for chewing tobacco (22). In multivariate logistic regression boys were more likely than girls to smoke pipe (OR=3.1; 95 CI 1.1-8.7); indigenous language was associated with smoking hand-rolled cigarettes (OR=1.4; 95 CI-1.1-1.9) and pipe (OR=2.2; 95 CI 1.5-3.4). Working in tobacco sales was a risk factor for chewing tobacco (OR=2.9; 95 CI: 1.7-4.9) and smoking hand-rolled cigarettes (OR=1.4; 95 CI 1.1-1.8). Having friends who smoked was associated with chewing tobacco (OR=1.8; 95 CI 1.0-3.2) and with smoking cigars (OR=2.1; 95 CI 1.5-2.9). Current drinking and thrill-seeking orientation were associated with cigars and pipe smoking. Findings highlight the importance of surveillance of alternative tobacco products use and availability among youth and for addressing identified risk factors. Copyright © 2010 Ethel Alderete et al. Fil: Alderete, Ethel del Carmen. Instituto de Ciencia y Tecnología Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Kaplan, Celia Patricia. University of California; Estados Unidos Fil: Gregorich, Steven E.. University of California; Estados Unidos Fil: Pérez Stable, Eliseo J.. University of California; Estados Unidos