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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]

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]

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]

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]

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]

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]

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: 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: 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]

Time-varying confounding is a common challenge for causal inference in observational studies with time-varying treatments, long follow-up periods, and participant dropout. Confounder adjustment using traditional approaches can be limited by data sparsity, weight instability, and computational issues. The Nicotine Dependence in Teens Study is a prospective cohort study, and we used data from 21 data collection cycles carried out from 1999 to 2008 among 1294 students recruited from 10 high schools in Montreal, Quebec, Canada, including follow-up into adulthood. Our aim in this study was to estimate associations of timing of alcohol initiation and cumulative duration of alcohol use with depression symptoms in adulthood. Based on the target trials framework, we defined intention-to-treat and as-treated parameters in a marginal structural model with sex as a potential effect-modifier. We then used the observational data to emulate the trials. For estimation, we used pooled longitudinal target maximum likelihood estimation, a plug-in estimator with double-robust and local efficiency properties. We describe strategies for dealing with high-dimensional potential drinking patterns and practical positivity violations due to a long follow-up time, including modifying the effect of interest by removing sparsely observed drinking patterns from the loss function and applying longitudinal modified treatment policies to represent the effect of discouraging drinking. [ABSTRACT FROM AUTHOR]

Introduction. L'offre à long terme d'interventions de promotion de la santé (IPS) en milieu scolaire peut se révéler bénéfique pour la santé des enfants. Toutefois, on en sait peu sur les facteurs associés à cette institutionnalisation dans les écoles. Dans cette étude, nous avons dégagé les corrélats de l'institutionnalisation des IPS offertes dans les écoles primaires du Québec (Canada). Méthodologie. Dans le cadre d'entrevues téléphoniques structurées en deux parties réalisées sur trois années scolaires (2016-2019), des directeurs et directrices d'écoles primaires (ou leurs représentants désignés) du Québec devaient choisir une IPS de référence ayant été offerte au moins une fois dans leur école dans les trois années précédentes. Ils devaient ensuite indiquer si l'IPS avait été institutionnalisée (c.-à-d. si elle figurait explicitement dans le projet éducatif de l'école, par exemple sous la forme d'objectifs éducatifs accompagnés des mesures permettant leur atteinte). Nous avons analysé les associations entre, d'une part, l'institutionnalisation des IPS et, d'autre part, dix caractéristiques liées aux écoles et seize caractéristiques liées aux IPS à l'aide d'analyses de régression logistique univariées et multivariées. Résultats. Les informateurs clés des écoles (n = 163) ont fait état de 147 IPS différentes ayant été offertes dans leur école dans les trois années précédentes et 56 % de ces IPS avaient été institutionnalisées. Trois dimensions de la culture de l'école - soit 1) la participation des parents et de la collectivité à la vie scolaire, 2) l'engagement de l'école et du personnel enseignant à l'égard de la santé des élèves et 3) l'environnement physique de l'école - étaient associées positivement à l'institutionnalisation des IPS. En ce qui a trait aux caractéristiques liées aux IPS, ce sont le nombre de compétences visées par celles-ci, le nombre de stratégies d'enseignement utilisées, les modifications apportées à l'IPS avant ou pendant sa mise en oeuvre et le succès perçu de l'IPS qui ont présenté une association positive avec l'institutionnalisation des IPS. Le fait d'inviter les familles ou les groupes communautaires à participer à l'IPS était inversement associé à l'institutionnalisation. Conclusion. Une meilleure compréhension des facteurs liés à l'institutionnalisation des IPS pourrait éclairer l'élaboration d'IPS présentant un potentiel de durabilité en milieu scolaire. [ABSTRACT FROM AUTHOR]

To assess the association between childhood body fatness and epithelial ovarian cancer (EOC), and whether this association differs by type of EOC. Using data from a population-based case-control study (497 cases and 902 controls) in Montreal, Canada conducted 2011–2016, we examined the association between childhood body fatness and EOC, overall and separately for invasive vs. borderline EOCs. A figure rating scale was used to measure body fatness at ages 5 and 10. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CI). Quantitative bias analyses were conducted to assess the impact of exposure misclassification and non-participation. The aOR (95% CI) of overall EOC for high vs. low body fatness was 1.07 (0.85–1.34) at age 5 and 1.28 (0.98–1.68) at age 10. The associations were stronger for invasive EOC, specifically the endometrioid histological type. For borderline cancers, the aORs were below the null value with wide confidence intervals. Bias analyses did not reveal a strong influence of non-participation. Non-differential exposure misclassification may have biased aORs towards the null for invasive cancers but did not appear to have an appreciable influence on the aORs for borderline cancers. Childhood body fatness may be a risk factor for invasive EOC in later adult life. Our study highlights the potential importance of examining early life factors for a comprehensive understanding of EOC development. • Few studies have examined the link between childhood body fatness and epithelial ovarian cancer (EOC) risk. • High childhood body fatness is positively associated with invasive EOC. • Quantitative bias analyses suggested minimal distortion of the estimates by selection bias or information bias. • The findings support that early-life exposures may influence later-life risk of EOC. [ABSTRACT FROM AUTHOR]

Many nonregulatory interventions targeting children and youth have been implemented at three levels: directed at the individual (e.g., interactive video games), delivered to students at school (e.g., campus bans), and launched in the community (e.g., mass media campaigns). This systematic review aims to synthesize the evidence on the effectiveness of interventions aimed at preventing e-cigarette initiation among children and youth. MEDLINE, CINAHL, Embase, APA PsycINFO, and Web of Science Core Collection were searched for papers published between January 1, 2004 and September 1, 2022 that reported more than one outcome on vaping prevention among individuals aged less than 21-years-old: vaping prevalence/incidence, initiation intentions, knowledge/attitudes, and other tobacco product use prevalence/initiation intentions. Interventions were at the individual, school, or community level. The risk of bias was assessed using ROBINS-I and RoB 1. Thirty-nine publications met the eligibility criteria. Fourteen individually-based (4 parental monitoring, 3 video games, 2 text messages, 3 graphic message themes, 2 healthcare), 19 school-based (14 educational and skill interventions, 5 vape-free policies/bans), and 6 community-based (3 social media, 3 mass media campaigns) interventions were reported. E-cigarette initiation prevention was observed with high perceived parental monitoring; however, the cross-sectional study designs precluded causal claims. There was promising but limited evidence that social-emotional skills curricula and peer leader programming prevented vaping initiation. Some individual- and school-based interventions showed promise for preventing e-cigarette initiation among children and youth. [ABSTRACT FROM AUTHOR]

Many jurisdictions have implemented different regulatory strategies to reduce vaping among youth. The objective of this systematic review is to synthesize the evidence of the effectiveness of different regulatory strategies for preventing and reducing nicotine vaping among youth. Five electronic databases were searched from January 1, 2004 to July 17, 2022 for primary studies examining state/provincial or national regulations targeting vaping among youth (aged 12–21 years) in high-income countries. The primary outcome was vaping prevalence. Included studies were qualitatively synthesized through systematic review. The systematic review included 30 studies. There was insufficient evidence to recommend age restrictions (n =16), restrictions on location of use (n =1), and mixed/combined regulations (n =3). Flavor bans (n =4), sales licenses (n =2), and taxation (n =2) were generally shown to be associated with decreased rates of youth vaping. Warning labels (n =2) were associated with a decreased desire to initiate vaping. Included studies had moderate-to-serious risks of bias. Although several regulatory interventions have been shown to be effective at reducing vaping among youth, evidence is insufficient to recommend a specific type of regulation. Regulatory authorities could implement various regulations targeting the price, accessibility, and desirability (i.e., flavors and packaging) of E-cigarettes. [ABSTRACT FROM AUTHOR]

Adolescents often report low moderate-to-vigorous physical activity (MVPA) and high screen time. We modeled sex-specific MVPA and screen time trajectories during adolescence and identified contemporaneous patterns of evolution. Data were drawn from 2 longitudinal investigations. The Nicotine Dependence in Teens (NDIT) study included 1294 adolescents recruited at age 12–13 years who completed questionnaires every 3 months for 5 years. The Monitoring Activities of Teenagers to Comprehend their Habits (MATCH) study included 937 participants recruited at age 9–12 years who completed questionnaires every 4 months for 7 years. MVPA was measured as the number of days per week of being active for at least 5 min (NDIT) or 60 min (MATCH). In both studies, screen time was measured as the number of hours spent weekly in screen activities. In each study, sex-specific group-based trajectories were modeled separately for MVPA and screen time from grade 7 to 11. Contemporaneous patterns of evolution were examined in mosaic plots. In both studies, 5 MVPA trajectories were identified in both sexes, and 4 and 5 screen time trajectories were identified in boys and girls, respectively. All combinations of MVPA and screen time trajectories were observed. However, the contemporaneous patterns of evolution were favourable in 14%–31% of participants (i.e., they were members of the stable high MVPA and the lower screen time trajectories). Novelty: MVPA and screen time trajectories during adolescence and their combinations showed wide variability in 2 Canadian studies. Up to 31% of participants showed favourable contemporaneous patterns of evolution in MVPA and screen time. Using uniform methods for trajectory modeling may increase the potential for replication across studies. [ABSTRACT FROM AUTHOR]

Background: Movement behaviors (i.e., physical activity [PA], sedentary behaviors [SB], sleep) relate to mental health. Although movement behaviors are often analyzed as distinct entities, they are in fact highly inter‐dependent (e.g., if an individual increases sleep, then PA and/or SB must be reduced) and these dependencies should be accounted for in the analysis. We tested whether perceptions of time spent in movement behaviors (i.e., moderate‐to‐vigorous intensity PA [MVPA], light physical activity [LPA], SB, and sleep) related to depressive symptoms and self‐report mental health in young adults using a compositional analysis. We then estimated change in depressive symptoms with reallocation of time across movement behaviors using compositional time‐reallocation models. Methods: Data were drawn from the longitudinal NDIT dataset. Complete data were available for 770 young adults (Mage = 20.3, 55% females). Results: The proportion of time spent in MVPA relative to other movement behaviors related to depressive symptoms non‐significantly and to mental health significantly. Reallocating 15 min from MVPA to SB resulted in a significant (0.46 unit) increase in depressive symptoms, and reallocating 15 min of MVPA to LPA was associated with a (0.57) increase in depressive symptoms. Conclusion: These results indicate the importance of relative time spent in each movement behavior to mental health. Further research should examine these associations over time. [ABSTRACT FROM AUTHOR]

Objective: Physical activity levels decline from adolescence to adulthood, but participation in a variety of sports during childhood and adolescence (i.e., sampling) may increase physical activity behaviour during adulthood. We examined the association between sampling sports during adolescence and moderate-vigorous exercise behaviour in adulthood, and we assessed whether this relationship is mediated by perceived variety in exercise. Design: Study 1- prospective longitudinal; Study 2- cross-sectional. Our main outcome was exercise behaviour. Results: In study 1 (n = 775), sampling more sports during adolescence (b =.25, p <.01; 95% CI [.12,.39]) predicted increased frequency of exercise behaviour in young adulthood. In study 2 (n = 108), sampling more sports in adolescence (β =.08, p =.03; 95% CI [.03,.17]) was indirectly associated with exercise behaviour in adulthood through perceived variety in exercise. Conclusion: These findings add to the evidence that sampling sports during adolescence is positively associated with moderate-vigorous exercise during adulthood, and the experience of variety may, in part, explain this relationship. This research generates new hypotheses regarding a potential psycho-social mediator (perceived variety in exercise) of the sampling-exercise behaviour relationship. [ABSTRACT FROM AUTHOR]

Background: Data are lacking on type of e-liquid vaped among e-cigarette users. Further, few studies assess all sources of nicotine used by e-cigarette users to assess whether poly-nicotine use relates to nicotine dependence (ND). The objectives were to describe young adult e-cigarette users by: (i) type of e-liquid vaped; (ii) poly-nicotine use; (iii) ND symptoms; and (iv) attempts to quit conventional cigarettes.Methods: Data were available in cycle 23 of a longitudinal investigation on the natural course of cigarette smoking and ND. A total of 775 young adults (44% male; mean (SD) age 30.5(1.0)) completed mailed self-report questionnaires in 2017-20.Results: Of 775 participants, 149 (19.2%) reported past-year e-cigarette use. Overall, 55.0% of e-cigarette users had used cannabis-containing e-liquid (31.5% vaped cannabis e-liquid exclusively); 50.4% used nicotine-containing e-liquid (23.5% vaped nicotine e-liquid exclusively); and 39.9% used e-liquid without nicotine (8.7% vaped e-liquid without nicotine exclusively). Most e-cigarette users (82.6%) used other nicotine-containing products including conventional cigarettes (72.5%); 60.8% reported ND symptoms, rising to 79.4% among those who vaped nicotine-containing e-liquid. Finally, 29.0% tried to quit conventional cigarettes using e-cigarettes in the past-year, but only 16.7% found them helpful.Conclusions: E-cigarettes now appear to appeal to a broader market than smokers who want to quit. More than half of young adult e-cigarette users vaped cannabis-containing e-liquid in the past year while only one-quarter had used e-cigarettes to assist with cessation. Most e-cigarette users used multiple nicotine-containing substances (including combustible cigarettes) which were associated with reports of ND symptoms. [ABSTRACT FROM AUTHOR]

Background: The context in which school‐based health‐promoting interventions are implemented is key for the delivery and success of these interventions. However, little is known about whether school culture differs by school deprivation. Methods: Using data from PromeSS, a cross‐sectional study of 161 elementary schools in Québec, Canada, we drew from the Health Promoting Schools theoretical framework to develop four measures of health‐promoting school culture (i.e., school physical environment, school/teacher commitment to student health, parent/community engagement with the school, ease of principal leadership) using exploratory factor analysis. One‐way ANOVA with post‐hoc Tukey‐Kramer analyses was used to examine associations between each measure and social and material deprivation in the school neighborhood. Results: Factor loadings supported the content of the school culture measures and Cronbach's alpha indicated good reliability (range: 0.68‐0.77). As social deprivation in the school neighborhood increased, scores for both school/teacher commitment to student health and parent/community engagement with the school decreased. Implications for School Health Policy, Practice, and Equity: Implementation of health‐promoting interventions in schools located in socially deprived neighborhoods may require adapted strategies to address challenges related to staff commitment and parental and community involvement. Conclusion: The measures developed herein can be used to investigate school culture and interventions for health equity. [ABSTRACT FROM AUTHOR]

Introduction. Les interventions de promotion de la santé en milieu scolaire favorisent la santé et le bienêtre des adolescents. Leur présence peut varier en fonction du milieu socioéconomique des écoles (défavorisation scolaire). Nous avons évalué l'importance accordée à certains problèmes de santé ainsi que la disponibilité des interventions de promotion de la santé et la disponibilité de certaines activités parascolaires en fonction du niveau de défavorisation d'écoles secondaires du Québec (Canada). Méthodologie. En 2016-2017, 2017-2018 et 2018-2019, nous avons interviewé les directeurs et directrices (ou leurs représentants) de 48 écoles secondaires publiques classées soit comme défavorisées (33 %), soit comme favorisées (67 %). Les écoles ont été appelées à évaluer l'importance de 13 problèmes courants liés à la santé (nécessitant une intervention) chez leurs élèves et à indiquer si des interventions de promotion de la santé portant sur ces problèmes ou d'autres problèmes de santé ainsi que sur des activités parascolaires de sport ou d'intérêt particulier avaient été offertes dans l'année. Résultats. Quatrevingtquatre pour cent (84 %) des écoles défavorisées avaient offert une ou plusieurs interventions de promotion de la santé dans l'année, contre 73 % des écoles favorisées. Les écoles défavorisées ont été plus nombreuses en proportion que les écoles favorisées à percevoir comme importants la plupart des 13 problèmes liés à la santé. Des interventions de promotion de la santé visant l'intimidation et l'exclusion, l'éducation sexuelle et l'activité physique (problèmes faisant l'objet de mandats gouvernementaux) étaient offertes dans la plupart des écoles. Les écoles défavorisées étaient plus nombreuses en proportion que les écoles favorisées à offrir des interventions de promotion de la santé non liées à un mandat (alimentation saine, santé mentale et bienêtre, consommation de substances, etc.). En revanche, les écoles favorisées étaient plus nombreuses à offrir des activités parascolaires dans les domaines autres que les sports non compétitifs, ces derniers étant offerts en proportions égales par les écoles favorisées et par les écoles défavorisées. Conclusion. Les mandats gouvernementaux semblent favoriser la présence universelle des interventions de promotion de la santé dans les écoles et sont susceptibles d'améliorer l'équité de la promotion de la santé en milieu scolaire. Des études approfondies sont nécessaires sur les différences possibles en matière de contenu et de mise en oeuvre et à propos des effets des interventions de promotion de la santé en fonction de la défavorisation des écoles. [ABSTRACT FROM AUTHOR]

Introduction: Although body weight has been positioned as a strong predictor of physical and mental health, positive and negative body-related psychosocial factors may also be important. Further, both theoretical tenets and empirical evidence suggest that these associations may differ by gender. Our objectives were to examine the associations between body-related self-conscious emotions (body shame, body authentic pride) and physical and mental health in young adults, and to identify potential differences in these associations by gender. Methods: Data for this cross-sectional study were drawn from the Nicotine Dependence in Teens (NDIT) study for 799 young adults (M [SD] age = 33.6 y [0.5]; 43.9% male). We estimated the associations between each of body shame and body authentic pride (i.e. the exposures) and both self-rated physical and self-rated mental health (i.e. the outcomes) in linear regression models that controlled for age, education and body mass index, and we examined potential gender differences in these associations by conducting gender-stratified analyses. Results: In females, self-rated health and mental health decreased by 0.37 and 0.38, respectively, with each unit increase in body shame. Self-rated health and mental health increased by 0.25 and 0.23, respectively, for each unit increase in body authentic pride. In males, self-rated health and mental health decreased by 0.35 and 0.45, respectively, with each unit increase in body shame, and increased by 0.32 and 0.21, respectively, with each unit increase in body authentic pride. Conclusion: Interventions that focus on body weight to the exclusion of body-related self-conscious emotions may side-step a key contributor to self-rated health. [ABSTRACT FROM AUTHOR]

Introduction: The objective was to determine if there is effect modification by home smoking bans in the association between parental smoking and cigarette smoking onset in children. Methods: Data on smoking onset, number of parents who smoke, and home smoking rules were collected from children who had never smoked in self-report questionnaires in Grades 5, 7, 9, and 11. The association between number of parents who smoke and smoking onset in children was tested in pooled logistic regression in 2 groups defined by the presence or absence of a complete home smoking ban. Results: In homes without a complete ban and relative to participants with no parents who smoke, the odds ratio (95% confidence interval [OR (95% CI]) for smoking onset was 1.5 (1.1–1.9) when one parent smoked and 1.4 (1.0–2.1) when both parents smoked. In homes with a complete ban, the OR (95% CI) was 1.6 (1.1–2.3) if one parent smoked, but 4.9 (2.4–9.9) if both parents smoked. Conclusion: The association between number of parents who smoke and smoking onset in children was modified by the presence of a complete home smoking ban. In homes with a complete smoking ban in which both parent smoke, it may be prudent that parents communicate clearly with their children about their reasons for implementing the ban, as well as about their reasons for continuing to smoke. [ABSTRACT FROM PUBLISHER]

Introduction: We investigated whether established risk factors for initiating cigarette smoking during adolescence (parents, siblings, friends smoke; home smoking rules, smokers at home, exposure to smoking in cars, academic performance, susceptibility to smoking, depressive symptoms, self-esteem, school connectedness, use of other tobacco products) are associated with initiation in preadolescents, and whether the effects of these factors differ by gender.Methods: In spring 2005, baseline data were collected in self-report questionnaires from 1801 5th grade students including 1553 never-smokers (mean age=10.7years), in the longitudinal AdoQuest I Study in Montréal, Canada. Follow-up data were collected in the fall and spring of 6th grade (2005-2006). Poisson regression analyses with robust variance estimated the effects of each risk factor on initiation and additive interactions with gender were computed to assess the excess risk of each risk factor in girls compared to boys.Results: 101 of 1399 participants in the analytic sample (6.7% of boys; 7.7% of girls) initiated smoking during follow-up. After adjustment for age, gender and maternal education, all risk factors except academic performance and school connectedness were statistically significantly associated with initiation. Paternal and sibling smoking were associated with initiation in girls only, and girls with lower self-esteem had a significant excess risk of initiating smoking in 6th grade.Conclusions: Risk factors for smoking initiation in preadolescents mirror those in adolescents; their effects do not differ markedly by gender. Preventive programs targeting children should focus on reducing smoking in the social environment and the dangers of poly-tobacco use. [ABSTRACT FROM AUTHOR]

Introduction: We examined whether factors identified as associated with cannabis use at age 14 to 16 years are also associated with ever use at age 12. Methods: Participants in the AdoQuest study (n = 1852) were recruited in 2005 from among Grade 5 students in 29 French-language elementary schools in Montréal, Canada. Self-report data were collected from participants in Grade 5 (spring 2005) and 6 (fall 2005 and spring 2006) and from parents/guardians in 2006/07. Inclusion in the analytic sample (n = 1076; mean age [SD] = 10.7 [0.5]) required data from participant and parental questionnaires and data on cannabis use in Grade 6 (mean age [SD] = 11.7 [0.4]). We estimated associations between ever use at age 12 with 33 potential correlates, separately in unadjusted and adjusted logistic regression models. Results: Fifty-three participants (4.9%) reported ever use at age 12. Factors associated with higher odds of ever use included older age, identifying as male, lower household income, more weekly spending money, ever tried cigarettes or other tobacco products, ever drank alcohol or binge drank, ever gambled, friends or siblings smoke cigarettes, greater nicotine dependence, higher depressive symptoms and greater impulsivity. Protective factors included higher levels of parental/guardian monitoring and greater self-esteem and school connectedness. Conclusions: Factors associated with cannabis use at later ages are also associated with ever use at age 12. Our findings suggest that surveillance for and interventions to prevent cannabis use are warranted before age 12. [ABSTRACT FROM AUTHOR]

Context: The onset of cigarette smoking typically occurs during childhood or early adolescence. Nicotine dependence symptoms can manifest soon after onset, contributing to sustained, long-term smoking. Previous reviews have not clarified the determinants of onset.Evidence Acquisition: In 2015, a systematic review of the literature in PubMed and EMBASE was undertaken to identify peer-reviewed prospective longitudinal studies published between January 1984 and August 2015 that investigated predictors of cigarette smoking onset among youth aged <18 years who had never smoked.Evidence Synthesis: Ninety-eight conceptually different potential predictors were identified in 53 studies. An increased risk of smoking onset was consistently (i.e., in four or more studies) associated with increased age/grade, lower SES, poor academic performance, sensation seeking or rebelliousness, intention to smoke in the future, receptivity to tobacco promotion efforts, susceptibility to smoking, family members' smoking, having friends who smoke, and exposure to films, whereas higher self-esteem and high parental monitoring/supervision of the child appeared to protect against smoking onset. Methodologic weaknesses were identified in numerous studies, including failure to account for attrition or for clustering in samples, and misidentification of potential confounders, which may have led to biased estimates of associations.Conclusions: Predictors of smoking onset for which there is robust evidence should be considered in the design of interventions to prevent first puff in order to optimize their effectiveness. Future research should seek to define onset clearly as the transition from never use to first use (e.g., first few puffs). [ABSTRACT FROM AUTHOR]

Purpose: The association between stressful life events and depressive symptoms is well-established, but the role of coping style in this association is less clear. We examined whether problem-focused, emotion-focused or avoidant coping style mediated and/or moderated the association in young adults. Methods: Data were drawn from a 20-year longitudinal study that included 1294 students' age 12–13 years recruited in 1999–2000 from ten high schools in Montreal, Canada. Herein we report an analysis that included 782 participants aged 24 years on average with data on covariates collected at age 20. Using VanderWeele's four-way decomposition approach, the total effect of stressful life events on depressive symptoms considering coping styles was decomposed into four components: moderation only, mediation only, mediated interaction, no mediation or moderation. Results: We observed mediation only by emotion-focused coping ( β ^ (95%CI) = 0.15(0.04, 0.24)) suggestive that individuals who experienced more stressful life events also reported greater use of emotion-focused coping and higher levels of depressive symptoms. We found moderation only by problem-focused coping ( β ^ (95%CI) = − 1.51(− 2.40, − 0.53)) and by emotion-focused coping ( β ^ (95%CI) = 1.16(0.57, 1.69). These results suggest that individuals reporting more problem-focused coping experienced fewer depressive symptoms after exposure to stressful life events; those reporting more emotion-focused coping experienced more depressive symptoms. Avoidant coping did not mediate or moderate the association between stressful life events and depressive symptoms. Conclusion: Interventions that aim to reduce depressive symptoms in young adults who experience stressful life events may need to reinforce problem-focused coping and minimize emotion-focused coping strategies. [ABSTRACT FROM AUTHOR]

We documented changes in depressive and anxiety symptoms from before to during the COVID-19 pandemic among young adults and investigated whether changes differed across participant characteristics. Data were available in an investigation of 1294 grade 7 students recruited in 1999–2000. For this analysis, we used data collected pre-pandemically in 2017–20 (mean (SD) age = 30.6 (1.0)) and during the pandemic in 2020–21 (mean (SD) age = 33.6 (0.6)). 673 participants with data in both cycles were retained for analysis. Symptoms were measured using the Major Depression Inventory (MDI) and the Generalized Anxiety Disorder-7 (GAD-7) scale. Standardized mean differences (SMD) of changes in MDI and GAD-7 values between cycles were calculated across participant characteristics. On average, MDI scores increased by 2.1 (95%CI 1.4, 2.8) points during the pandemic from mean 10.5; GAD-7 scores increased by 1.2 (0.8, 1.5) points from mean 4.7. The SMD was 0.24 (0.14, 0.33) for MDI, and 0.24 (0.13, 0.34) for GAD-7. No differences in MDI change scores were observed across participant characteristics. Differences in GAD-7 change scores were observed by mood/anxiety disorder (SMD − 0.31 (− 0.58, − 0.05)), household income (0.24 (0.02, 48)), living with young children (− 0.56 (− 1.23,− 0.05)), and adherence to public health recommendations 0.58 (0.19, 1.03)). Increases in depressive and anxiety symptoms were observed 10–16 months into the COVID-19 pandemic among adults age 32–36. [ABSTRACT FROM AUTHOR]

Introduction: School-based health-promoting interventions (HPIs) aim to support youth development and positively influence modifiable lifestyle behaviours. Identifying factors that contribute to or hinder the perceived success of HPIs could facilitate their adaptation, improve implementation and contribute to HPI sustainability. The objective of this study was to identify factors in three domains (school characteristics, characteristics of the HPI and factors related to planning and implementing the HPI) associated with perceived success of HPIs among school principals in elementary schools. Methods: Data were drawn from Project PromeSS, a cross-sectional survey of school principals and/or nominated staff members in a convenience sample of 171 public elementary schools in Quebec, Canada. School board and school recruitment spanned three academic school years (2016-2019). Data on school and participant characteristics, HPI characteristics, variables related to HPI planning and implementation and perceived success of the HPI were collected in two-part, structured telephone interviews. Descriptive statistics were used to characterize schools and study participants. Twentyeight potential correlates of perceived HPI success were investigated separately in multivariable linear regression modelling. Results: Participants generally perceived HPIs as highly successful. After controlling for number of students, language of instruction, school neighbourhood and school deprivation, we identified five correlates of perceived success, including lower teacher turnover, higher scores for school physical environment, school/teacher commitment to student health, principal leadership and school being a developer (vs. adopter) of the HPI. Conclusion: If replicated, these factors should be considered by HPI developers and school personnel when planning and implementing HPIs in elementary schools. [ABSTRACT FROM AUTHOR]

Physical activity (PA) motives are associated with both moderate‐to‐vigorous intensity PA (MVPA) and mental health. Studies examining whether PA motives relate directly to mental health or indirectly through MVPA are lacking. This study examined the direct effect of five PA motives (i.e., enjoyment, competence, fitness, social, appearance) on mental health and their indirect effects through MVPA in adolescents. A total of 424 participants (57.1% females) ages 14–15 years from the longitudinal MATCH study were included. Mediation analyses, based on the counterfactual framework, assessed the natural direct effect of PA motives on mental health, and the natural indirect effects through MVPA. Separate models were conducted for each PA motive. Natural direct effects were observed for enjoyment (β̂[95%CI] = 2.12 [0.34, 3.90]), competence (β̂[95%CI] = 1.58[0.28, 2.88]), fitness (β̂[95%CI] = 1.42[0.04, 2.80]), and social (β̂[95%CI] = 2.32[1.03, 3.60]) motives. No natural direct effects were observed for appearance motives. A natural indirect effect through MVPA was observed for fitness motives, and no other natural indirect effects were found. Interventions and public health strategies in adolescents need to acknowledge the importance of enjoyment, competence social and fitness motives in PA to promote mental health, and integrate specific recommendations on the importance of the reasons why adolescents participate in PA. [ABSTRACT FROM AUTHOR]

Whether physical activity (PA) tracking devices are associated with PA motivation in young adults is largely unknown. We compared total PA minutes per week, total minutes walking/week, meeting moderate-to vigorous PA guidelines, and past-year activity tracking across motivation cluster profiles among 799 young adults. Participants with "self-determined" profiles reported the highest total PA minutes/week followed by participants with "low intrinsic," "controlled self-determined," and "high external" profiles. A behavior regulation profile X activity tracking frequency interaction was not significant. Behavior regulation profiles may need to be considered in PA interventions using activity trackers. [ABSTRACT FROM AUTHOR]

Background and aims: Variation in the TAS2R38 taste receptor gene alters the ability to taste bitter compounds. We tested whether TAS2R38 variation influences early smoking behaviours in adolescence, a critical period of acquisition when taste may influence the natural course of tobacco use. Design and participants: Observational study (Nicotine Dependence in Teens [NDIT]). Cox proportional hazards models were conducted using data from European ancestry adolescent participants who initiated smoking during follow‐up (n = 219, i.e. incident smokers). In young adulthood, cross‐sectional analyses were restricted to European ancestry self‐reported current smokers at age 24 (n = 148). Setting: Montréal, Canada. Measurements: In adolescents, the rates of attaining early smoking milestones were estimated for tasters {PAV diplotypes (i.e. PAV/PAV or PAV/AVI)} versus non‐tasters {AVI diplotype (i.e. AVI/AVI)}. In young adults, associations between tasting status and a nicotine intake biomarker (cotinine + 3'hydroxycotinine) and past‐week cigarette consumption were assessed. Findings Among incident smokers, similar rates to first whole cigarette were found between the diplotype groups (hazard ratio [HR], 1.05; 95% confidence interval (CI), 0.75–1.48; P = 0.765). However, smokers with the PAV (vs AVI) diplotypes attained monthly smoking more rapidly (HR, 1.55; 95% CI, 1.04–2.32; P = 0.033) and had faster conversion to three different measures of tobacco dependence (International Classification of Diseases: HR, 2.29; 95% CI, 0.99–5.28; P = 0.052; modified Fagerström Tolerance Questionnaire: HR, 3.02, 95% CI, 1.04–8.79; P = 0.043; Hooked on Nicotine Checklist: HR, 1.87; 95% CI, 0.98–3.60; P = 0.059). At age 24, those with PAV (vs AVI) diplotypes had higher mean cotinine + 3'hydroxycotinine (197 vs 143 ng/mL; P = 0.053). Conclusions: Adolescents with a genetic variation increasing their ability to taste bitter compounds appear to escalate more quickly to monthly smoking and tobacco dependence during adolescence and have higher nicotine intake in young adulthood versus those without that genetic variation. [ABSTRACT FROM AUTHOR]

Background: Smoking is influenced by genetic factors including variation in CYP2A6 and CYP2B6, which encode nicotine-metabolizing enzymes. In early adolescence, CYP2A6 slow nicotine metabolism was associated with higher dependence acquisition, but reduced cigarette consumption. Here we extend this work by examining associations of CYP2A6 and CYP2B6 with tobacco dependence acquisition in a larger sample of smokers followed throughout adolescence.Methods: White participants from the Nicotine Dependence in Teens cohort that had ever inhaled (n=421) were followed frequently from age 12-18 years. Cox's proportional hazards models compared the risk of ICD-10 tobacco dependence acquisition (score 3+) for CYP2A6 and CYP2B6 metabolism groups. Early smoking experiences, as well as amount smoked at end of follow-up, was also computed. At age 24 (N=162), we assessed concordance between self-reported cigarette consumption and salivary cotinine.Results: In those who initiated inhalation during follow-up, CYP2A6 slow (vs. normal) metabolizers were at greater risk of dependence (hazards ratio (HR)=2.3; 95% CI=1.1, 4.8); CYP2B6 slow (vs. normal) metabolizers had non-significantly greater risk (HR=1.5; 95% CI=0.8, 2.6). Variation in CYP2A6 or CYP2B6 was not significantly associated with early smoking symptoms or cigarette consumption at end of follow-up. At age 24, neither gene was significantly associated with dependence status. Self-reported consumption was associated with salivary cotinine, a biomarker of tobacco exposure, acquired at age 24 (B=0.37; P<0.001).Conclusions: Our findings extend previous work indicating that slow nicotine metabolism mediated by CYP2A6, and perhaps CYP2B6, increases risk for tobacco dependence throughout adolescence. [ABSTRACT FROM AUTHOR]

Purpose: To study the effect of maternal psychiatric disorders (depression, anxiety disorder, bipolar disease, schizophrenia, unspecified psychiatric disorder, and comorbid conditions) and odds of preterm birth.Methods: The Consortium on Safe Labor (2002-2008), an observational cohort with 12 centers from across the United States included 223,394 singleton pregnancies with clinical data obtained from electronic medical records and maternal diagnoses of psychiatric disorders from maternal discharge summaries. Length of gestation was based on the best clinical estimate and categorized as birth less than 39, less than 37, less than 34, and less than 28 weeks' gestation. The adjusted odds ratios (ORs) with 95% confidence intervals of birth were estimated by logistic regression with generalized estimating equations.Results: Any maternal psychiatric disorder was associated with odds of birth less than 39 weeks' gestation (odds ratio [OR] = 1.32, 95% confidence interval = 1.28-1.37), less than 37 weeks' gestation (OR = 1.45, 1.38-1.52), less than 34 weeks' gestation (OR = 1.47, 1.35-1.59), and less than 28 weeks' gestation (OR = 1.57, 1.36-1.82). Specifically, odds of birth less than 37 weeks' gestation were associated with maternal depression (OR = 1.31, 1.23-1.40), anxiety disorder (OR = 1.68, 1.41-2.01), depression with anxiety disorder (OR = 2.31, 1.93-2.78), bipolar disease (OR = 1.54, 1.22-1.94), bipolar disease with depression and/or anxiety disorder (OR = 1.70, 1.30-2.22), and unspecified psychiatric disorder (OR = 1.52, 1.41-1.64).Conclusions: Maternal psychiatric disorders, especially comorbid psychiatric conditions, were associated with increased likelihood of preterm birth. [ABSTRACT FROM AUTHOR]

Introduction The Autonomy over Tobacco Scale (AUTOS), a 12-item self-administered questionnaire, was designed to measure autonomy in three correlated lower-order symptom domains: withdrawal, psychological dependence, and cue-induced craving. The factor structure of the AUTOS remains an open question; confirmatory analyses in adolescents supported the hierarchical structure, while exploratory analyses in adolescents and adults yield single-factor solutions. Here we seek to determine whether the hypothesized hierarchical structure is valid in adult smokers. Methods The AUTOS was administered to two independent convenience samples of adult current smokers: a calibration sample recruited in the US for online studies, and a confirmation sample drawn from the prospective Nicotine Dependence in Teens study in Montreal. We tested competing hierarchical and single-factor models using the robust weighted least-squares (WLSMV) estimation method. Results A single-factor model that allowed correlated error variances between theoretically related items fit well in the calibration sample ( n = 434), χ 2 SB (52) = 165.71; χ 2 / df = 3.19; SRMR = 0.03; CFI = 0.96; NNFI = 0.95; RMSEA = 0.07 (95% CI: 0.06, 0.08). Reliability of the single factor was high (ω B = 0.92) and construct validity was adequate. In the confirmation sample ( n = 335), a similar model fit well:χ 2 SB (53) = 126.94; χ 2 /df = 2.44; SRMR = 0.04; CFI = 0.95; NNFI = 0.93; RMSEA = 0.07 (95% CI: 0.05, 0.08). Reliability of the single factor was again high (ω B = 0.92) and construct validity was adequate. Conclusion The AUTOS is unidimensional in adult smokers. [ABSTRACT FROM AUTHOR]

We examined whether changes in social context (i.e., frequency with which youth engage in physical activity [PA] alone, with teammates, with friends, with siblings, or with parents/grandparents) is associated with change in moderate-to-vigorous intensity PA (MVPA) across Grades 5–8 and Grades 8–11 (N = 938). Data were self-reported annually. Across Grades 5–8, the frequency of PA in all social contexts declined over time, and changes in the frequency of PA alone, with teammates, with siblings, and in diversity of PA companion types were positively associated with change in MVPA. Across Grades 8–11, the frequency of PA with siblings, friends, and parents/grandparents declined over time, and changes in the frequency of PA alone, with teammates, with friends, with parents/grandparents, and in diversity of PA companion types were positively associated with change in MVPA. PA social contexts vary in how they associate with change in MVPA in youth over time. • Data were analyzed using piecewise latent growth modeling. • Physical activity (PA) declined over time in most social contexts. • Change in PA alone or with teammates associated with moderate-to-vigorous PA (MVPA). • Associations between change in PA with companions and MVPA varied by school level. • Change in diversity of PA companion types associated with change in MVPA. [ABSTRACT FROM AUTHOR]

Objective: Robust evidence exists for the health-enhancing benefits of social support in adults. Inflammatory processes are thought to be an important mechanism linking social support and health risk. Less is known about the relation between social support and chronic inflammation during childhood and adolescence, or when the association emerges during the lifespan. Method: Data from the population-representative 1999 Quebec Child and Adolescent Health and Social (QCAHS) survey were analyzed. Youth aged 9, 13, and 16 years (N = 3613) and their parents answered questions about social support. A subsample (n = 2186) completed a fasting blood draw that was assayed for C-reactive protein (CRP). Findings: Higher social support was significantly associated with lower hs-CRPlog, after controlling for age, sex, body mass index (BMI Z-score), medication use, puberty, ethnoracial status (French-Canadian), smoking, household income, and parental education (F = 25.88, p = <.001, Total R2adj = 10.2%). The association was largely similar for boys and girls, and strengthened with age. Conclusion: Greater social support was linked to lower chronic low-grade inflammation in a large sample of children and adolescents. Effect sizes were small and consistent with prior findings in the adult literature. Importantly, these findings provide evidence that the relation between social support and inflammation emerges early in the lifespan. Future work should consider broader, more encompassing conceptualizations of social support, the role of social media, and prospective trajectories of social support and inflammatory markers. [ABSTRACT FROM AUTHOR]

Introduction: Most studies modeling adolescent cigarette smoking trajectories use age as the time axis, possibly obscuring depiction of the natural course of cigarette smoking. We used a simulated example and real data to contrast smoking trajectories obtained from models that used time since smoking onset or calendar time (age) as the time axis.Methods: Data were drawn from a longitudinal investigation of 1293 grade 7 students (mean age 12.8 years) recruited from 10 high schools in Montreal, Canada in 1999-2000, who were followed into young adulthood. Cigarette consumption was measured every 3 months during high school, and again at mean ages 20.4 and 24.0. Analyses using time since onset of smoking as the time metric was restricted to 307 incident smokers; analysis using calendar time included 645 prevalent and incident smokers. Smoking status and nicotine dependence (ND) were assessed at mean ages 20.4 and 24.0. Simulated data mimicked the real study during high school.Results: Use of different time metrics resulted in different numbers and shapes of trajectories in the simulated and real datasets. Participants in the calendar time analyses reported more ND in young adulthood, reflecting inclusion of 388 prevalent smokers who had smoked for longer durations.Conclusions: Choosing the right time metric for trajectory analysis should be balanced against research intent. Trajectory analyses using the time since onset metric depict the natural course of smoking in incident smokers. Those using calendar time offer a snapshot of smoking across ages during a given time period.Implications: This study uses simulated and real data to show that trajectory analyses of cigarette smoking that use calendar time (e.g., age) versus time since onset as the time axis metric tell a different story. Trajectory analyses using the time since onset metric depict the natural course of smoking in incident smokers. Those using calendar time offer a snapshot of smoking across ages during a given time period. Choosing the right time metric should be balanced against research intent. [ABSTRACT FROM AUTHOR]

Background The level of physical dependence is a measure of addiction that correlates highly with addiction-associated changes in brain structure. We sought to determine whether age at first inhalation and initial reactions to inhaling nicotine are related to level of physical dependence in early adulthood. Methods Young adults ( n = 312; mean age = 24 years; 51% female) from the Nicotine Dependence in Teens study who had smoked at least once in the preceding three months completed self-report questionnaires in 2011–12. We assessed level of physical dependence with three validated self-report items assessing ‘wanting,’ ‘craving’ and ‘needing’ triggered by nicotine deprivation. Survey items assessed smoking behavior, including age at first inhalation, and recalled first reactions to inhaling nicotine. Results After adjusting for covariates, experiencing relaxation, heart racing/pounding, rush or “buzz” (OR = 1.45; 95% CI: 1.08, 1.94) and dizziness (OR = 1.58; 95% CI: 1.15, 2.18) at first nicotine inhalation were associated with an increased odds of being at a higher level of physical dependence in young adulthood; the association for experiencing relaxation (OR = 1.78; 95% CI: 1.20, 2.64) and heart racing/pounding (OR = 1.51; 95% CI: 1.00, 2.28) persisted after additionally controlling for all other first reactions. Neither age at first inhalation nor unpleasant first reactions predicted level of physical dependence. Conclusions In accordance with prior research, our findings suggest that smokers who are particularly sensitive to the pleasant, “buzz-related” and generally arousing effects of nicotine may be more likely to attain higher levels of physical dependence. [ABSTRACT FROM AUTHOR]

Availability of health-promoting interventions (HPIs) may vary across schools serving students with different socioeconomic backgrounds. Our objectives were to describe social inequalities across elementary schools in: (i) level of importance that school principals attribute to 13 common health-related issues among students in their school; (ii) availability of HPIs within their school addressing eight health topics and (iii) (mis)alignment between perceived importance and HPI availability. Data were collected in telephone interviews with school principals in a convenience sample of 171 elementary schools (59% of 291 schools contacted). Schools were categorized as serving very advantaged, moderately advantaged or disadvantaged students. Principals reported how important 13 health issues were among students in their schools and provided data on HPI availability for 8 health issues, 4 of which required school action under government mandates. Higher proportions of principals in schools serving disadvantaged students (36% of all 171 schools) perceived most health issues as important. The mean number of HPIs in the past year was 12.0, 12.1 and 11.7 in schools serving very advantaged, moderately advantaged and disadvantaged students, respectively. Only availability of mental health HPIs differed by school deprivation (60, 43 and 30% in very, moderately and disadvantaged, respectively). Although most schools offered oral health HPIs, dental problems were not perceived as important. Smoking was perceived as not important and smoking-related HPIs were relatively rare (9%). Given rapid evolution in public health priorities, (mis)alignment between perceived importance of specific health issues and HPI availability in elementary schools warrants ongoing reflection. [ABSTRACT FROM AUTHOR]

Background: There is a need for better alignment between research on sport and physical activity and the needs of those who are in a position to implement the findings. To facilitate advancement and alignment, we identified the top research priorities of sport and physical activity knowledge users from various sectors. Methods: For this priority-setting study, we used an iterative process of data collection and analysis. Sport and physical activity knowledge users from multiple sectors participated in a workshop (September 2019), which included small working group exercises followed by large-group syntheses leading to the identification of issues that required better understanding. We then sent an online questionnaire to participants for content validation and interim prioritization, to reduce the number of priorities (December 2019 to January 2020). A new questionnaire containing a shortened list of research priorities was sent to an expanded group of respondents to further streamline the list of priorities (January–March 2020). Results: The 24 workshop participants identified 68 issues, of which 21 were retained by the 18 participants in the interim priority-setting questionnaire. The final prioritization questionnaire was completed by 33 stakeholder groups; this step produced a final list of 8 top research priorities. The final priorities identified for sport and physical activity research related to financial support, suboptimal promotion, dropout, best interventions, participation among Indigenous populations, volunteer engagement, safe and inclusive experiences, and knowledge exchange. Interpretation: The 8 priorities identified in this study provide guidance to Canadian sport and physical activity researchers. Research efforts on these priorities will reflect pressing issues as identified by representatives of all sport and physical activity sectors. [ABSTRACT FROM AUTHOR]

Introduction: We examined the mediating role of friends smoking in the association between depressive symptoms and daily/weekly cigarette smoking from adolescence into adulthood.Methods: Data were drawn from the Nicotine Dependence In Teens study (NDIT, Canada) and the Avon Longitudinal Study of Parents and Children (ALSPAC, UK) studies. Three age groups were investigated in NDIT: age 13-14 (n = 1189), 15-16 (n = 1107), and 17-18 (n = 1075), and one in ALSPAC (n = 4482, age 18-21). Multivariable mediation models decomposed the total effect (TE) of depressive symptoms on smoking into a natural direct effect (NDE) and natural indirect effect (NIE) through friends smoking.Results: The odds ratios (ORs) for the TE were relatively constant over time with estimates ranging from 1.12 to 1.35. Friends smoking mediated the association between depressive symptoms and smoking in the two youngest samples (OR [95% confidence interval [CI] 1.09 [1.01,1.17] in 13- to 14-year-olds; 1.10 [1.03,1.18] in 15- to 16-year-olds). In the two older samples, NDE of depressive symptoms was close to the TE, suggestive that mediation was absent or too small to detect.Conclusion: Friends smoking mediates the association between depressive symptoms and daily/weekly cigarette smoking in young adolescents.Implications: If young adolescents use cigarettes to self-medicate depressive symptoms, then interventions targeting smoking that ignore depressive symptoms may be ineffective. Our results also underscore the importance of the influence of friends in younger adolescents, suggestive that preventive intervention should target the social environment, including social relationships. [ABSTRACT FROM AUTHOR]

We examined relationships between pattern of team sport participation during the transition from adolescence to young adulthood (ie, non‐participants, initiators, discontinuers, sustainers) and indicators of mental health. Data on team sport participation and mental health from high school to young adulthood were drawn from the longitudinal NDIT study. After controlling for demographics, physical activity, and previous mental health, one‐way MANCOVA and ANCOVAs indicated that pattern of team sport participation was associated with stress, F(2,706) =8.28, p <.01, and coping, F(2,706) = 10.66, p <.01 in young adulthood. Compared to non‐participants (24% of sample) or those who discontinued team sport after adolescence (51%), individuals who sustained team sport participation from adolescence to young adulthood (22%) reported lower stress and better coping levels. Bivariate regression analysis indicated that, compared to non‐participants, team sport sustainers were less likely to experience panic disorder symptoms (OR =0.57, 95% CI [0.34, 0.94], p =.03). There were too few team sport initiators (2%) to be included in analyses. Sustained team sport participation during the transition from adolescence to young adulthood may promote better mental health. Further research is needed to ascertain causality and develop strategies to encourage individuals to join sport teams during adolescence and sustain participation while transitioning to young adulthood. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the longitudinal and unique association between number of years of team sport and individual sport participation during adolescence and depressive symptoms during early adulthood. Adolescents (n = 860) reported team sport and individual sport participation in each year of secondary school for five years. Participants reported depressive symptoms using the Major Depression Inventory three years after secondary school. Multivariate linear regression was performed to model the associations of sport participation with depressive symptoms while controlling for sex, age, parent education, and baseline depressive symptoms. In the final model, adolescents who consistently participated in team sport during high school reported lower depression scores in early adulthood (β = -.09, p = .02). Number of years of individual sport participation was not statistically significantly associated with depressive symptoms in early adulthood. Based on these findings, team sport participation may protect against depressive symptoms in early adulthood. If this finding is replicated, strategies should be implemented to encourage and maintain team sport participation during adolescence. Further research is needed to understand the mechanisms that link team sport participation to lower depression. [ABSTRACT FROM AUTHOR]

Because there are few proven smoking cessation approaches for young adults, it is critical to consider the potential of e-cigarettes as an option. Evidence from 2012 to 2013 in the United States (U.S.) suggested that current e-cigarette use was associated with a higher probability of daily smoking and a lower probability of quitting among young adults. This study examines the associations between e-cigarette use frequency and cigarette smoking in more recent data. Data on e-cigarette use were available for 32,656 current smokers and 9,565 past-year quitters ages 18-34 in the 2016-2018 U.S. Behavioral Risk Factor Surveillance System. Participants were categorized as "daily", "non-daily", "former", or "never" e-cigarette users. Adjusted prevalence ratios were estimated to test the associations between e-cigarette use and each of daily smoking and past-year cessation. With e-cigarette never-users as the reference: 1) daily e-cigarette users were 30% (95%CI 0.61-0.79) less likely to be daily smokers; non-daily and former e-cigarette users were 8% (95%CI 1.02-1.15) and 16% (95%CI 1.11-1.21) more likely to be daily smokers, respectively; 2) daily e-cigarette users were 54% (95%CI 1.38-1.73) more likely to have quit in the past year; non-daily and former e-cigarette users were 50% (95%CI 0.42-0.59) and 21% (95%CI 0.73-0.86) less likely to have quit in the past year, respectively. The findings suggest that non-daily e-cigarette use was associated with greater frequency of smoking and less quitting whereas daily e-cigarette use was associated with a lower frequency of smoking and more quitting among young adults in 2016-18. [ABSTRACT FROM AUTHOR]