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Background: Delinquent behaviours among youth harms health and social trajectories, and public health broadly. Despite evidence that engaging in and being victimized by delinquent behaviours often cluster, most studies have examined the clustering of delinquent behaviours or victimization experiences independently. Information on patterns of co-occurrence is crucial to design appropriate interventions. Objectives: The primary purpose was to identify latent classes of delinquency and victimization among youth from the general population. The secondary purpose of this study was to examine associations of individual, household, and classroom covariates on latent class membership. Method: The sample consisted of 1948 youth aged 4–14 from the 2014 Ontario Child Health Study. Latent class analysis was performed to identify patterns of delinquent behaviours and experiences of victimization, while multinomial regression was conducted to examine how covariates were associated with likelihood of class membership. Results: The analysis identified four classes of youth in the OCHS sample: (1) low delinquency and low victimization (75.4%), (2) moderate victimization and moderate school delinquency (7.8%), (3) high victimization and moderate home delinquency (11.8%), and high victimization and high home and school delinquency (5.0%). Youth sex, household income, ethnicity, parental education, and parental depression were associated with differences in class membership. Conclusions: Approximately one quarter of youth engaged in delinquent behaviours, with patterns of co-occurrence suggesting these youth engage in delinquent behaviours and are victimized by delinquent behaviours across environments. Interventions should approach youth delinquency and victimization as a spectrum of clustered behaviours and experiences in these environments. [ABSTRACT FROM AUTHOR]

Consistent evidence points to the detrimental effects of income inequality on population health. Income inequality may be associated with online gambling, which is of concern since gambling is a risk factor for adverse mental health conditions, such as depression and suicide ideation. Thus, the overall objective of this study is to study the role of income inequality on the odds of participating in online gambling. Data from 74,501 students attending 136 schools participating in the 2018/2019 Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) survey were used. The Gini coefficient was calculated based on school census divisions (CD) using the Canada 2016 Census linked with student data. We used multilevel modeling to explore the association between income inequality and self-reported participation in online gambling in the last 30 days, while controlling for individual- and area-level characteristics. We examined whether mental health (depressive and anxiety symptoms, psychosocial wellbeing), school connectedness, and access to mental health programs mediate this relationship. Adjusted analysis indicated that a standardized deviation (SD) unit increase in Gini coefficient (OR = 1.17, 95% CI 1.05, 1.30) was associated with increased odds of participating in online gambling. When stratified by gender, the association was significant only among males (OR = 1.12, 95% CI 1.03, 1.22). The relationship between higher income inequality and greater odds for online gambling may be mediated by depressive and anxiety symptoms, psychosocial well-being, and school connectedness. Evidence points to further health consequences, such as online gambling participation, stemming from exposure to income inequality. [ABSTRACT FROM AUTHOR]

Purpose: Considerable debate centered on the impact of school closures and shifts to virtual learning on adolescent mental health during the COVID-19 pandemic. We evaluated whether mental health changes differed by school learning modes during the pandemic response among Canadian adolescents and whether associations varied by gender and perceived home life. Methods: We used prospective survey data from 7270 adolescents attending 41 Canadian secondary schools. Conditional change linear mixed effects models were used to examine learning mode (virtual optional, virtual mandated, in-person, and blended) as a predictor of change in mental health scores (depression [Centre for Epidemiologic Studies – Depression], anxiety [Generalized Anxiety Disorder-7], and psychosocial well-being [Flourishing scale]), adjusting for baseline mental health and covariates. Gender and home life happiness were tested as moderators. Least square means were calculated across interaction groups. Results: Students learning in a blended learning mode had greater anxiety increases relative to their peers in other learning modes. Females learning fully in-person and males learning virtually when optional reported less of an increase in depression scores relative to their gender counterparts in other learning modes. Learning virtually when optional was associated with greater declines in psychosocial well-being in students without happy home lives relative to other learning modes. Conclusion: Findings demonstrate the importance of considering gender and home environments as determinants of mental health over the pandemic response and when considering alternative learning modes. Further research is advised before implementing virtual and blended learning modes. Potential risks and benefits must be weighed in the context of a pandemic. [ABSTRACT FROM AUTHOR]

Purpose: We investigated whether social health mitigates the association between weight perception and anxiety and depression 1 year later in a large sample of Canadian youth in a prospective, gender-specific analysis. Methods: We used 2 years of linked survey data from 20,485 grade 9–11 students who participated in wave 6 (2017/18) and 7 (2018/19) of the COMPASS study. Mental health outcomes included the Generalized Anxiety Disorder—7 item (GAD-7) scale and the 10-item Centre for Epidemiological Studies Depression Scale Revised (CESD-10-R). Social health encompassed students' perceived relationships with friends, family, teachers, and within schools. Multilevel, prospective, linear models regressed mental health (at wave 7) on social health (at wave 6) and weight perception (at wave 6) while controlling for weight status, ethnicity, and grade (at wave 6). Interaction terms were used to test social health factors as moderators in the association between weight perception and mental health. Results: Overweight perceptions were associated with higher anxiety and depression scores among youth; this was more pronounced among females. Social health was associated with lower anxiety and depression scores. Among females only, an overweight perception had the highest predicted scores for significant depressive symptoms. Among males only, underweight perceptions were associated with higher anxiety scores. No social health factors had moderating effects in females, and only two interactions were significant among males: feeling safe at school had protective associations with anxiety scores among those with underweight perceptions while those with overweight perceptions had higher depression scores when they reported rewarding social relationships. Conclusion: Overweight perceptions in all youth, and underweight perceptions in males, predicted anxiety and depression symptoms 1 year later. The role of social health should not be discounted as a means of preventing anxiety and depression in youth, although this study suggests it is not sufficient to protect against adverse associations with overweight perceptions for all youth, and underweight perceptions for males. [ABSTRACT FROM AUTHOR]

Understanding risky sexual behaviors among adolescents is key in efforts devoted to reducing the health burden related to sexually transmitted infections and unintended or unplanned pregnancies. The aims of this study were to understand the association between number of lifetime sexual partners and time since sexual debut (TSSD) among adolescents and to determine whether sex modified this association. Data were drawn from the 2018–2019 COMPASS-Quebec study, a cohort study conducted in secondary schools in the province of Quebec, Canada. Of 18,467 respondents aged 14 years and older, 6991 (37.9%; mean age 15.3) reported consensual sexual intercourse and answered questions on their age at sexual initiation and number of lifetime sexual partners. Multilevel Poisson regressions with robust standard errors were estimated to adjust for covariates and produce adjusted group mean differences. The adjusted mean number of lifetime sexual partners ranged from 1.5 for those who had recently begun sexual activity (< 12 months) to 4.0 for those who had been active for > 35 months, an average rise of about 0.6 per year. Females-to-males adjusted mean differences showed that males reported more sexual partners than females at all time points, but the differences were only significant at the shorter (< 12 months) and longer (> 35 months) time spans. This study highlights the importance of taking into account TSSD when using and interpreting the number of lifetime sexual partners as risky sexual behavior among adolescents. Sex did not have a significant modifying effect on the relationship between number of lifetime sexual partners and TSSD. [ABSTRACT FROM AUTHOR]

Canada is in the midst of an ongoing, escalating opioid crisis, with significant impacts on adolescents and young adults. Accordingly, mental health impairment was examined as a risk factor for non-medical prescription opioid use (NMPOU) among high school students. In addition, the moderating effects of the school environment, in terms of the availability of mental health services and substance use policies, were characterized. Self-reported, cross-sectional data were obtained from the COMPASS study, including 61,239 students (grades 9–12) in 121 secondary schools across Canada. Current and lifetime NMPOU were ascertained. Categorical indicators of mental health impairment and school environment were derived. The main analytical strategy encompassed hierarchal multilevel logistic regression, including the addition of interaction terms to characterize the moderation effects. Current and lifetime NMPOU were reported by 5.8% and 7.2% of the students, respectively. After adjusting for confounders, students in the highest quintile of mental health impairment had odds ratios (OR) of 2.60 (95% confidence interval [CI] 2.29–2.95) and 2.96 (95% CI 2.64–3.33) for current and lifetime NMPOU, respectively when compared to students in the lowest quintile of mental health impairment. A significant interaction between mental health impairment and school environment indicated relatively lower risks of NMPOU in students from schools that provide more mental health services and have stricter substance use policies. Mental health impairment increased the risk of NMPOU, but the associations were moderated by the school environment. These findings underscore the importance of mental health services and substance use regulations in schools. [ABSTRACT FROM AUTHOR]

Purpose: Studies have shown consistent associations between youth e-cigarette use and subsequent smoking uptake. However, it remains unclear why, as limited evidence exists regarding the mechanisms underlying these associations. Our study investigated whether having one or more smoking friends mediated the association between e-cigarette use and cigarette smoking onset among a longitudinal sample of Canadian youth who were never smokers at baseline. Methods: A longitudinal sample of youth that participated in three waves of the COMPASS study (2015–2016 to 2017–2018) was identified (N = 5,535). The product of coefficients method was used to assess whether having one or more smoking friends mediated the association between: (1) past 30-day e-cigarette use and cigarette smoking onset and (2) past 30-day e-cigarette use and subsequent dual use of e-cigarettes and cigarettes. Results: Having one or more smoking friends did not mediate the association between (1) past 30-day e-cigarette use and cigarette smoking onset (β = 0.38, 95% CI − 0.12, 0.89) or (2) past 30-day e-cigarette use and subsequent dual use (β = 0.46, 95% CI − 0.16, 1.07). Post hoc tests indicated that smoking friends significantly predicted past 30-day e-cigarette use and cigarette smoking at wave 3 (aOR 1.68 and 2.29, respectively). Conclusion: Having smoking friends did not explain the association between e-cigarette use and smoking uptake despite being a common risk factor for both e-cigarette use and cigarette smoking. Prevention efforts should consider how best to incorporate effective programming to address these social influences. [ABSTRACT FROM AUTHOR]

Purpose: High-frequency cannabis use in adolescents has been associated with adult mental illness. In contrast, physical activity has been demonstrated to benefit mental health status. The purpose of this study was to examine whether, within a 1-year prospective study design, changes in cannabis use frequency are associated with changes in mental health, and whether meeting physical activity guidelines moderates these associations. Methods: COMPASS (2012–2021) is a hierarchical longitudinal health data survey from a rolling cohort of secondary school students across Canada; student-level mental health data linked from Years 5 (2016/17) and 6 (2017/18) were analysed (n = 3173, 12 schools). Multilevel conditional change regression models were used to assess associations between mental health scores change, cannabis use change and physical activity guideline adherence change after adjusting for covariates. Results: Adopting at least weekly cannabis use was associated with increases in depressive and anxiety symptoms and decreases in psychosocial well-being. Maintaining physical activity guidelines across both years improved psychosocial well-being regardless of cannabis use frequency, and offset increases in depressive symptoms among individuals who adopted high frequency cannabis use. Physical activity adherence had no apparent relationship with anxiety symptoms. Conclusion: Regardless of the sequence of events, adopting high frequency cannabis use may be a useful behavioural marker of current or future emotional distress, and the need for interventions to address mental health. Physical activity adherence may be one approach to minimizing potential changes in mental health associated with increasing cannabis use. [ABSTRACT FROM AUTHOR]

Understanding the risk factors that initiate cancer is essential for reducing the future cancer burden. Much of our current cancer control insight is from cohort studies and newer large-scale population laboratories designed to advance the science around precision oncology. Despite their promise for improving diagnosis and treatment outcomes, their current reductionist focus will likely have little impact shifting the cancer burden. However, it is possible that these big data assets can be adapted to have more impact on the future cancer burden through more focus on primary prevention efforts that incorporate artificial intelligence (AI) and machine learning (ML). ML automatically learns patterns and can devise complex models and algorithms that lend themselves to prediction in big data, revealing new unexpected relationships and pathways in a reliable and replicable fashion that otherwise would remain hidden given the complexities of big data. While AI has made big strides in several domains, the potential application in cancer prevention is lacking. As such, this commentary suggests that it may be time to consider the potential of AI within our existing cancer control population laboratories, and provides justification for why some small targeted investments to explore their impact on modelling existing real-time cancer prevention data may be a strategic cancer control opportunity. [ABSTRACT FROM AUTHOR]

Evidence suggests associations between weight management intentions, weight perceptions, and health-compromising behaviours among adolescent girls. Drawing on cross-sectional data for 21,456 girls, we employed multinomial logistic regression to examine whether smoking, binge drinking, and breakfast-skipping were associated with weight management intentions and weight perceptions. According to self-reported heights and weights, 61.4% of girls were in the healthy weight category. However, most reported trying to manage their weight, with 58% trying to lose, 4.5% trying to gain, and 18% trying to maintain their weight. Smokers were more likely than non-smokers to report intentions to lose, gain, or maintain weight versus to do nothing. However, smokers were less likely than non-smokers to perceive themselves as underweight or overweight versus about the right weight. Binge drinkers were more likely than other girls to report an intention to gain and less likely to be trying to maintain their weight versus doing nothing, and breakfast-skippers were more likely to report trying to lose or gain weight but less likely to report trying to maintain weight versus doing nothing. Binge drinkers and breakfast-skippers were more likely than non-binge drinkers and non-breakfast-skippers, respectively, to perceive themselves as underweight, overweight or very overweight versus about the right weight. In sum, the majority of girls reported trying to manage their weight, and those engaging in other health-compromising behaviours were more likely to do so, though the exact nature of the associations differed by behaviour. Recognition of shared underlying risk factors for this clustering of behaviours may inform comprehensive health promotion efforts. [ABSTRACT FROM AUTHOR]

Data from 29,296 students in grades 9-12 as part of the 2008-2009 Youth Smoking Survey were used to examine the prevalence of cigar, cigarillo, and little cigar use and factors associated with their use. Among Canadian youth in grades 9-12, 12.9% reported current use of cigarillos or little cigars, and 8.1% reported current use of cigars. The characteristics of youth most likely to use either cigars or cigarillos and little cigars were being male, being in grade 11 or 12, being a daily or occasional cigarette smoker, having more than $20 of weekly spending money, and having ever tried flavored tobacco. Our findings suggest that cigars, cigarillos, and little cigars are used by a substantial number of Canadian youth, many of whom do not smoke cigarettes. As such, current national prevalence estimates of youth smoking may be underestimated, and existing tobacco control prevention programs and policies may be overlooking a large population of at-risk youth. [ABSTRACT FROM AUTHOR]

Data from the Canadian Youth Smoking Survey ( n = 27,030 in 2006; n = 16,705 in 2004; n = 11,757 in 2002) were used to examine changes in the prevalence and comorbid use of alcohol, tobacco, and marijuana over time and examine if demographic factors and binge drinking are associated with comorbid substance use among youth. Alcohol was the most prevalent substance used, and it was rare to find youth who had used tobacco or marijuana without also having tried alcohol. Youth who reported binge drinking were substantially more likely to also have tried tobacco and/or marijuana. These data suggest that multi-substance prevention programs are required for youth populations. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine how social models for smoking are related to smoking susceptibility among a sample of non-smoking elementary school students. The Tobacco Module of the School Health Action, Planning and Evaluation System (SHAPES) was administered to 6,431 students (grades 6 to 8) in 57 elementary schools in the province of Ontario, Canada. Multi-level logistic regression analysis was used to examine how smoking friends, parents, and the prevalence of smoking among grade 8 students at a school were related to smoking susceptibility among the 2,478 non-smoking grade 6 and 7 students. Findings indicate that non-smoking grade 6 and 7 students are more likely to be susceptible to smoking if they have (a) smoking friends, (b) a mother who smokes, or (c) two or more close friends who smoke and attend a school with a relatively high smoking rate among the grade 8 students. Sub-populations of non-smoking youth may be at increased risk for smoking because of the elementary school they attend. Future school-based smoking prevention programs might benefit from targeting prevention programming activities to the schools that are putting students at the greatest risk for smoking. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Public Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Public Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Understanding polysubstance use (PSU) patterns and their associated factors among youth is crucial for addressing the complex issue of substance use in this population. This study aims to investigate PSU patterns in a large sample of Canadian youth and explore associated factors using data from COMPASS, a longitudinal health survey of Canadian secondary school students. The study sample consisted of 8824 students from grades 9 and 10 at baseline in 2016/17, followed over 3 years until 2018/19. Leveraging machine learning methods, especially the least absolute shrinkage and selection operator (LASSO) and multivariate latent Markov models, we conducted a comprehensive examination of PSU patterns. Our analyses revealed distinct PSU patterns among Canadian youth, including no-use (C1), alcohol-only (C2), concurrent use of e-cigarettes and alcohol (C3), and poly-use (C4). C1 showed the highest prevalence (60.5%) in 2016/17, declining by 2.4 times over 3 years, while C3 became the dominant pattern (32.5%) in 2018/19. The prevalence of C3 and C4 increased by 2.3 and 4.4 times, respectively, indicating a growing trend of dual and multiple substance use. Risk factors associated with PSU patterns included truancy (ORC2 = 1.67, 95 % CI [1.55, 1.79]; ORC3 = 1.92, 95 % CI [1.80, 2.04]; ORC4 = 2.79, 95 % CI [2.64, 2.94]), having more smoking friends, more weekly allowance, elevated BMI, being older, and attending schools unsupportive in quitting drugs/alcohol. In contrast, not gambling online (ORC2 = 0.22, 95 % CI [−0.16, 0.58]; ORC3 = 0.14, 95 % CI [-0.24, 0.52]; ORC4 = 0.08, 95 % CI [−0.47, 0.63]), eating breakfast, residing in urban areas, and having higher school connectedness were protective factors against a higher-use pattern. This study provides insights for policymakers, educators, and health professionals to design targeted and evidence-based interventions, addressing youth substance use challenges through a comprehensive examination of PSU patterns and influential factors impacting substance use behaviors. [ABSTRACT FROM AUTHOR]

Purpose: Adolescent depression is a significant public health concern, and studying its multifaceted factors using traditional methods possess challenges. This study employs random forest (RF) algorithms to determine factors predicting adolescent depression scores.This study utilized self-reported survey data from 56,008 Canadian students (grades 7–12) attending 182 schools during the 2021/22 academic year. RF algorithms were applied to identify the correlates of (i) depression scores (CESD-R-10) and (ii) presence of clinically relevant depression (CESD-R-10 ≥ 10).RF achieved a 71% explained variance, accurately predicting depression scores within a 3.40 unit margin. The top 10 correlates identified by RF included other measures of mental health (anxiety symptoms, flourishing, emotional dysregulation), home life (excessive parental expectations, happy home life, ability to talk to family), school connectedness, sleep duration, and gender. In predicting clinically relevant depression, the algorithm showed 84% accuracy, 0.89 sensitivity, and 0.79 AUROC, aligning closely with the correlates identified for depression score.This study highlights RF’s utility in identifying important correlates of adolescent depressive symptoms. RF’s natural hierarchy offers an advantage over traditional methods. The findings underscore the importance and additional potential of sleep health promotion and school belonging initiatives in preventing adolescent depression.Methods: Adolescent depression is a significant public health concern, and studying its multifaceted factors using traditional methods possess challenges. This study employs random forest (RF) algorithms to determine factors predicting adolescent depression scores.This study utilized self-reported survey data from 56,008 Canadian students (grades 7–12) attending 182 schools during the 2021/22 academic year. RF algorithms were applied to identify the correlates of (i) depression scores (CESD-R-10) and (ii) presence of clinically relevant depression (CESD-R-10 ≥ 10).RF achieved a 71% explained variance, accurately predicting depression scores within a 3.40 unit margin. The top 10 correlates identified by RF included other measures of mental health (anxiety symptoms, flourishing, emotional dysregulation), home life (excessive parental expectations, happy home life, ability to talk to family), school connectedness, sleep duration, and gender. In predicting clinically relevant depression, the algorithm showed 84% accuracy, 0.89 sensitivity, and 0.79 AUROC, aligning closely with the correlates identified for depression score.This study highlights RF’s utility in identifying important correlates of adolescent depressive symptoms. RF’s natural hierarchy offers an advantage over traditional methods. The findings underscore the importance and additional potential of sleep health promotion and school belonging initiatives in preventing adolescent depression.Results: Adolescent depression is a significant public health concern, and studying its multifaceted factors using traditional methods possess challenges. This study employs random forest (RF) algorithms to determine factors predicting adolescent depression scores.This study utilized self-reported survey data from 56,008 Canadian students (grades 7–12) attending 182 schools during the 2021/22 academic year. RF algorithms were applied to identify the correlates of (i) depression scores (CESD-R-10) and (ii) presence of clinically relevant depression (CESD-R-10 ≥ 10).RF achieved a 71% explained variance, accurately predicting depression scores within a 3.40 unit margin. The top 10 correlates identified by RF included other measures of mental health (anxiety symptoms, flourishing, emotional dysregulation), home life (excessive parental expectations, happy home life, ability to talk to family), school connectedness, sleep duration, and gender. In predicting clinically relevant depression, the algorithm showed 84% accuracy, 0.89 sensitivity, and 0.79 AUROC, aligning closely with the correlates identified for depression score.This study highlights RF’s utility in identifying important correlates of adolescent depressive symptoms. RF’s natural hierarchy offers an advantage over traditional methods. The findings underscore the importance and additional potential of sleep health promotion and school belonging initiatives in preventing adolescent depression.Conclusion: Adolescent depression is a significant public health concern, and studying its multifaceted factors using traditional methods possess challenges. This study employs random forest (RF) algorithms to determine factors predicting adolescent depression scores.This study utilized self-reported survey data from 56,008 Canadian students (grades 7–12) attending 182 schools during the 2021/22 academic year. RF algorithms were applied to identify the correlates of (i) depression scores (CESD-R-10) and (ii) presence of clinically relevant depression (CESD-R-10 ≥ 10).RF achieved a 71% explained variance, accurately predicting depression scores within a 3.40 unit margin. The top 10 correlates identified by RF included other measures of mental health (anxiety symptoms, flourishing, emotional dysregulation), home life (excessive parental expectations, happy home life, ability to talk to family), school connectedness, sleep duration, and gender. In predicting clinically relevant depression, the algorithm showed 84% accuracy, 0.89 sensitivity, and 0.79 AUROC, aligning closely with the correlates identified for depression score.This study highlights RF’s utility in identifying important correlates of adolescent depressive symptoms. RF’s natural hierarchy offers an advantage over traditional methods. The findings underscore the importance and additional potential of sleep health promotion and school belonging initiatives in preventing adolescent depression. [ABSTRACT FROM AUTHOR]

Objectives: Youth vaping is a concern in Canada. While school-level policies influence student behaviours, few studies have investigated the association between school vaping policies and student vaping. This study reviewed and scored the comprehensiveness of school vaping policies and investigated the association between school vaping policy scores and student vaping., Methods: Online policy documents from n = 39 schools in Ontario, Alberta, and British Columbia, Canada, participating in the 2021-2022 wave of the COMPASS study were collected, reviewed, and scored for comprehensiveness (/39) using the School Tobacco Policy Index (STPI) rating form. The mean and range of scores for each domain of the STPI were calculated. School policy scores were linked to student vaping data from the COMPASS study. Multilevel logistic regression analyses identified the association between school vaping policy score and student lifetime and current (past 30-day) vaping., Results: The mean total policy score was 10.2/39 (range 0‒24), and 28% of schools scored 0/39. The majority of school policies did not identify enforcement approaches or available preventive or cessation resources. Increasing STPI score was not associated with the odds of student lifetime or current vaping in multilevel logistic regression analyses., Conclusion: The STPI quickly identified components of school vaping policies that were missing. The overall score of most school vaping policies in our sample was low and most school vaping policies lacked many important components. Future studies should explore factors associated with adolescent vaping and identify effective prevention measures., (© 2024. The Author(s).)

Objective: To provide contemporary evidence of how dietary intake and eating behaviours vary by social positions among adolescents., Methods: We used survey data collected during the 2020-2021 school year from 52,138 students attending 133 secondary schools in Alberta, British Columbia, Ontario, and Quebec, Canada. Multiple regression models tested whether self-reported indicators of dietary intake and eating behaviours differed by gender, race/ethnicity, and socioeconomic status (SES)., Results: Females were more likely than males to skip breakfast, restrict eating, and consume fruit, vegetables, and fast food on more days. Gender-diverse/"prefer not to say" students were more likely to restrict eating than males and the least likely to consume breakfast and drink water daily, and fruits and vegetables regularly. Black and Latin American students were more likely to restrict eating and consume purchased snacks and fast food, and less likely to drink water daily than white and Asian adolescents. Daily breakfast consumption was most likely among Latin American students. Black students were the least likely to report eating breakfast daily and fruits and vegetables regularly. Lower SES was associated with lower odds of eating breakfast and drinking water daily and regular fruit and vegetable consumption, and higher odds of restrictive eating and purchased snack consumption. Fast food consumption had a u-shaped association with SES., Conclusion: Results emphasize gender, racial/ethnic, and socioeconomic inequities in the diets and eating behaviours of adolescents. There is a critical need to address the structural factors contributing to inequities and prevent the consequences of dietary disparities., (© 2024. The Author(s).)

Objectives: Income inequality has been linked to high and unhealthy body mass index (BMI), though there is a dearth of evidence in adolescents. Therefore, this study examines the association between income inequality and BMI in a large sample of Canadian adolescents., Methods: A pooled cross-sectional design was used. Participants were adolescents (n = 101,901) from 157 Canadian secondary schools participating in the 2016-2017, 2017-2018, or 2018-2019 waves of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) study. BMI was calculated from self-reported height and weight and converted to World Health Organization (WHO) z-BMI scores. Gini coefficients were calculated at the census division level (n = 49) using data from the 2016 Canadian Census. Multilevel modelling was performed to account for the clustering of students nested within schools, which were nested within census divisions. Interactions were included to determine whether associations were heterogeneous for males and females., Results: Income inequality demonstrated a non-linear association with WHO z-BMI score (z-Gini: β = 0.05, 95%CI: 0.02, 0.08; z-Gini 2 : β = -0.02, 95% CI: -0.04, -0.01) among adolescents after adjusting for student-, school-, and census division-level covariates. This association was more pronounced among females., Conclusion: The association between income inequality and BMI, being overweight, or having obesity appears to be non-linear. Public health units and schools may benefit from incorporating upstream factors such as income inequality into their interventions attempting to promote healthy weights., (© 2023. The Author(s) under exclusive license to The Canadian Public Health Association.)

Objective: This study examined the associations between public health engagement (PHE) in school-based substance use prevention programs and student substance use. For the purposes of this study, PHE refers to any form of collaboration between the local government public health agency and the school to promote the physical and mental health of students., Methods: Data for this study were collected from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour (COMPASS) study during the 2018/2019 data collection year. Multilevel logistic regression was used to analyze the associations between PHE and student substance use., Results: Data from 84 schools and 42,149 students were included; 70% of schools had PHE in substance use prevention programs. PHE in substance use prevention appears to have had no significant impact on student substance use in our models. When PHE was divided into five methods of engagement, it was found that when public health solved problems jointly with schools, the odds of a student using alcohol or cannabis significantly increased. When schools were split into low- and high-use schools for each substance measured, some methods of PHE significantly decreased the odds of cannabis and cigarette use in high-use schools and significantly increased the odds of alcohol and cannabis use in low-use schools., Conclusion: This study highlights the need to develop better partnerships and collaborations between public health and schools, and the importance of ensuring that school-based substance use prevention programs are evidence-based and tailored to the specific needs of schools and students., (© 2022. The Author(s).)

Objectives: In 2015, the Liquor Control Board of Ontario (LCBO) authorized sale of alcohol in some Ontario grocery stores. This research evaluates the impact of the new policy on alcohol use patterns of youth in a quasi-experimental setting with two control groups., Methods: The sample consists of 2267 grade 9 students attending 60 secondary schools across Ontario (n = 56) and Alberta (n = 4), who provided 4-year linked longitudinal data (2013-2014 to 2016-2017) in the COMPASS study. The study used the frequency of drinking and the frequency of binge drinking to characterize alcohol use behaviours., Results: Latent transition analysis found four statuses of alcohol use: abstainer, periodic drinker, low-risk drinker, and high-risk regular drinker. The new policy had no negative impact among periodic and low-risk drinkers, but the risk of transitioning from the abstainer (lowest risk status) to high-risk regular drinker (highest risk status) among the exposed cohort was 1.71 times greater post-policy than pre-policy change, compared with those of Ontario-unexposed (0.50) and Alberta-unexposed cohorts (1.00). The probability of sustaining high-risk drinking among the exposed cohort increased by a factor of 1.76, compared with 1.13-fold and 0.89-fold among the Ontario-unexposed and Alberta-unexposed cohorts, respectively., Conclusion: Youth are more likely to transition from abstinence to high-risk regular drinking, and high-risk regular drinkers are more likely to maintain their behaviours in the jurisdictions exposed to the latest change in LCBO policy authorizing grocery stores to sell alcohol. When formulating policy interventions, youth access to alcohol should be considered in order to reduce their harmful alcohol consumption.

Objectives: E-cigarettes are an increasingly popular product among youth in Canada. However, there is a lack of long-term data presenting trends in use. As such, the objective of this study was to examine trends in e-cigarette and cigarette use across various demographic characteristics between 2013 and 2019 among a large sample of secondary school youth in Canada., Methods: Using repeat cross-sectional data from a non-probability sample of students in grades 9 to 12, this study explored trends in the prevalence of ever and current e-cigarette use and cigarette smoking between 2013-2014 and 2018-2019 in British Columbia, Alberta, Ontario, and Quebec. Trends in ever and current e-cigarette use and cigarette smoking were studied across demographic variables among students in Ontario., Results: The prevalence of e-cigarette ever and current use was variable across province and increased over time, particularly between 2016-2017 and 2018-2019. In contrast, the prevalence of current cigarette smoking was relatively stable over the study period, decreasing significantly in Alberta and Ontario between 2017-2018 and 2018-2019. In Ontario, the prevalence of ever and current e-cigarette use increased among all grades, both genders, and all ethnicities., Conclusion: Consistent with data from the United States, the prevalence of e-cigarette use among our large sample of Canadian youth has increased substantially in a short period of time. Surveillance systems should continue to monitor the prevalence of tobacco use among youth. Additional interventions may be necessary to curb e-cigarette use among Canadian youth.

Priority setting in health research can assist stakeholders to identify research and policies that have the greatest potential for benefits to public health. Priority setting has been utilized by researchers to identify barriers, facilitators, and recommendations for future public health research. This commentary describes how a priority-setting approach was used as part of a workshop activity on the school nutrition environment in Ontario, Canada, to facilitate brainstorming, sorting, and rating of concepts related to the school nutrition environment. This work demonstrates an interesting and concrete case of priority setting, of interest for various planning activities (both programming and research), particularly those around school-based healthy eating programs or a related research agenda.

Objectives: Adolescents involved in bullying are at increased risk for alcohol use; however, much of this research has been cross-sectional. The aim of this work was to therefore examine the longitudinal associations between bullying and future alcohol use., Methods: Data were drawn from the COMPASS study. The current study used a 2-year linked sample of grade 9 and 10 students from 2015 to 2017 (n = 6005). Students were asked to report their involvement with bullying as well as alcohol use and binge drinking behaviours. Generalized estimating equations regression analyses were used to examine the relationship between bullying involvement at baseline and alcohol use and binge drinking at follow-up., Results: Overall, 20% of students in grades 9 and 10 reported involvement in bullying. There was evidence of a modest longitudinal association between bullying and binge drinking. Being a bully or bully-victim at baseline was associated with increased odds of initiating future binge drinking., Conclusions: Being a bully or bully-victim in grade 9 or 10 was associated with initiating binge drinking within the following 2 years. Targeted alcohol use prevention programming may benefit these groups.

Objectives: Female sport participation is a prioritized action area in the 2018 Canadian federal budget for improving health and well-being. This study examined team sport participation prevalence and longitudinal associations with health-related behaviours among Canadian adolescent girls., Methods: We analyzed data from the COMPASS study. Participants included 1978 female secondary-school students who self-reported the following information at all measurement time-points (grades 9, 10, 11, and 12): socio-demographic, team sport participation status (consistent, intermittent and non-participator), moderate-to-vigorous physical activity (MVPA), dietary behaviours, smoking, cannabis use and binge drinking. Linear mixed models and generalized estimating equation models were used to examine team sport participation status in association with changes in health-related behaviours across grades., Results: The prevalence of team sport participation declined by an average of 38.4% between grades 9 and 12. Proportions of participants being categorized as consistent, intermittent and non-participators were 25.7%, 36.4% and 37.9%, respectively. Compared to non-participators, consistent participators reported significantly greater decline in MVPA (β = - 2.77, 95% CI - 5.36, - 0.18), and the increase in odds of becoming more frequent cannabis users (OR 1.11, 95% CI 1.00, 1.26) and binge drinkers (OR 1.13, 95% CI 1.04, 1.23) was significantly greater. Girls' team sport participation had no significant longitudinal association with dietary behaviours and smoking status., Conclusion: Team sport participation outside of school settings is risky for prospective health-related behaviours in adolescent girls. Our findings highlight the need for investing in tailored participation initiatives that also consider how to prevent harmful substance use.

Objectives: The school environment is an ideal setting to introduce policies to prevent smoking behaviour. However, there may be variability in the strength of school board and secondary school tobacco policies, which may affect student smoking behaviours. This study assessed the strength of a sample of school board and secondary school tobacco policies and examined the association with student smoking behaviours., Methods: Tobacco policies from school boards (n = 21/26) and secondary schools (n = 43/81) that participated in the COMPASS study during 2015-2016 were obtained online. A standardized instrument was used to assess the strength of school board and secondary school tobacco policies on four domains. Using the sample of students from schools with identified policies (n = 22,696), separate multilevel regression models examined the association between school policy scores and a student's susceptibility to smoking, ever smoking, current smoking, and perceived support of the school environment., Results: The mean school board tobacco policy score was 13.7/40 and the mean secondary school tobacco policy score was 11.3/40. Students were significantly less likely to report current smoking (OR 0.95, 95% CI 0.91-0.99) and more likely to report a supportive school environment (OR 1.06, 95% CI 1.04-1.08) with each four-unit (i.e., 10%) increase in school tobacco policy score., Conclusions: The vast majority of school board and secondary school tobacco policies were missing components and therefore could not be considered comprehensive. Stronger school tobacco policies may help to reduce student current smoking behaviours.

Objectives: We investigated associations between dieting and other health-compromising behaviours among adolescent girls, both cross-sectionally and longitudinally. The behaviours considered included smoking, binge drinking, and breakfast-skipping, and clusters of these., Methods: Data for 3386 adolescent Ontario girls were drawn from COMPASS, a school-based study, which collects self-reported measures of weight, dieting, and other health-related factors. Multilevel logistic regression models were used to investigate relationships between dieting at baseline and smoking, binge drinking, and breakfast-skipping, as well as clusters of these behaviours at baseline and 2 years later., Results: Baseline dieters were at an elevated risk of smoking and binge drinking (RR = 1.8 and 1.5, respectively) by follow-up compared to non-dieters. Further, dieting was associated with combinations of these behaviours, with the highest risks for smoking/breakfast-skipping (RR = 1.64) and smoking/binge drinking (RR = 1.55). Over one in two (58%) girls reported dieting at baseline and four in five baseline dieters reported dieting 2 years later. Seven in ten girls were dieting at one or both time points. Baseline dieters were more likely to engage in a greater number of risky behaviours, regardless of what the actual behaviours were., Conclusion: Dieting is longitudinally associated with engagement in other risky behaviours among adolescent girls. These findings suggest that dieting may be an early risk factor for engagement in other risky behaviours and highlight the need for comprehensive prevention strategies to target shared underlying drivers. In addition, attention is needed to the potential for well-meaning weight-related initiatives to promote dieting.

Objectives: To examine school- and student-level correlates of physical activity., Methods: Cross-sectional Year 2 data collected from 45 298 grade 9-12 students attending 89 secondary schools in the COMPASS study were examined using multi-level modelling to predict the likelihood of students a) achieving 60 minutes of moderate to vigorous physical activity (MVPA) daily; and b) achieving the Canadian Society for Exercise Physiology (CSEP) activity guideline for youth (60 minutes/MVPA daily, vigorous physical activity at least three days in a week, and resistance training at least three days in a week)., Results: The prevalence of students achieving 60 minutes of MVPA daily and meeting the CSEP guideline was 49.3% and 31.0% respectively. Modest between-school variability was identified (1.1% for 60 minutes MVPA and 0.8% for CSEP guideline). School-level characteristics significantly associated with the outcome measures included location, school size, quality of facilities, and accessibility of facilities. Significant student-level correlates included sex, grade, weekly income, binge drinking, fruit and vegetable consumption, and body mass index., Conclusions: Most youth in this large study reported inadequate physical activity levels. Students were more likely to achieve 60 minutes of MVPA if they attended a larger school or a school in an urban location, whereas students were less likely to meet the CSEP guideline if they attended a school in a small urban location. However, student-level factors, such as binge drinking and inadequate fruit and vegetable consumption, were more strongly associated with the outcomes examined.

Objectives: We investigated the extent to which a sample of Ontario and Alberta secondary schools are being compliant with their respective provincial nutrition policies, in terms of the food and beverages sold in vending machines., Methods: This observational study used objective data on drinks and snacks from vending machines, collected over three years of the COMPASS study (2012/2013-2014/2015 school years). Drink (e.g., sugar-containing carbonated/non-carbonated soft drinks, sports drinks, etc.) and snack (e.g., chips, crackers, etc.) data were coded by number of units available, price, and location of vending machine(s) in the school. Univariate and bivariate analyses were undertaken using R version 3.2.3. In order to assess policy compliancy over time, nutritional information of products in vending machines was compared to nutrition standards set out in P/PM 150 in Ontario, and those set out in the Alberta Nutrition Guidelines for Children and Youth (2012) in Alberta., Results: Results reveal a decline over time in the proportion of schools selling sugar-containing carbonated soft drinks (9% in 2012/2013 vs. 3% in 2014/2015), crackers (26% vs. 17%) and cake products (12% vs. 5%) in vending machines, and inconsistent changes in the proportion selling chips (53%, 67% and 65% over the three school years). Conversely, results highlight increases in the proportion of vending machines selling chocolate bars (7% vs. 13%) and cookies (21% vs. 40%) between the 2012/2013 and 2014/2015 school years., Conclusion: Nutritional standard policies were not adhered to in the majority of schools with respect to vending machines. There is a need for investment in formal monitoring and evaluation of school policies, and the provision of information and tools to support nutrition policy implementation.

Objectives: To measure the food safety knowledge, attitudes and self-reported practices of high school students in Ontario., Methods: We administered a school-wide paper survey to the student body (n = 2,860) of four Ontario high schools. We developed the survey by selecting questions from existing, validated questionnaires, prioritizing questions that aligned with the Canadian Partnership for Consumer Food Safety Education's educational messages and the food safety objectives from the 2013 Ontario High School Curriculum., Results: One in five students reported currently handling food in commercial or public-serving venues; of these, 45.1% had ever taken a course that taught them how to prepare food (e.g., food and nutrition classes, food handler certification). Food safety knowledge among respondents was low. For example, 17.3% knew that the best way to determine whether hamburgers were cooked enough to eat was to measure the temperature with a food thermometer. Despite low knowledge, most respondents (72.7%) reported being confident that they could cook safe, healthy meals for themselves and their families. Safe food handling practices were frequently self-reported. Most students (86.5%) agreed that being able to cook safe, healthy meals was an important life skill, although their interest in learning about safe food handling and concern about foodborne disease were less pronounced., Conclusion: Our findings suggest that food safety knowledge is low, yet confidence in preparing safe, healthy meals is high, among high school students. Because work and volunteer opportunities put students in contact with both the public and food, this group is important to target for increased education about safe food handling.

Objective: To examine the correlates of current smoking among Métis aged 18 years and older, with a particular focus on culturally-specific factors. Cultural factors included spirituality, knowledge of an Aboriginal language, membership in a Métis organization and attendance at Métis cultural events. Demographic, geographic, socio-economic and health-related variables were also considered., Methods: Data from 6,610 adult Métis aged 18 years and older who responded to the 2006 Aboriginal Peoples Survey and Métis supplement were used to examine the correlates of current smoking using sequential binary logistic regression modelling., Results: Overall, 39.9% of adult Métis respondents in the sample were current smokers. Adult Métis who reported a high level of spirituality were less likely to be current smokers. Those who spoke an Aboriginal language, or lived in a house where an Aboriginal language was spoken, were more likely to be current smokers. Being a member of a Métis organization and attending cultural events were not independently associated with current smoking. Métis with higher household income, greater education, higher self-perceived health, and greater physical activity participation were less likely to be current smokers, whereas those who reported heavy alcohol consumption were more likely to be current smokers., Conclusions: The results of this study suggest that interventions aimed at reducing smoking among adult Métis might be more successful if they include some connection to spirituality. It is also evident that co-occurring risk behaviours, in addition to demographic and socio-economic factors, are important considerations when developing interventions to reduce smoking among this population.

Objectives: To explore school and student characteristics associated with the number of physical education (PE) classes that elementary students received and to determine whether these characteristics and amount of PE were associated with the physical activity (PA) levels of elementary students., Methods: Multi-level modeling with school-level (n = 30) and student-level (n = 2,447) questionnaire data from the PLAY-ON study was used to explore the school factors associated with the number of PE classes that students in grades 5 to 8 report receiving, and how these factors were associated with their PA. The Theories of Organizational Change served to operationalize the main school factors measured in this study and included assessments of: organizational climate (school practices related to PE or PA), organizational capacity (school ability to provide students with more PE or PA), and school PA/PE policies., Results: The number of PE classes reported per week was higher in schools that had two PA facilities in addition to a gymnasium (β = 1.13, p = 0.048) and in schools with greater levels of parental involvement in school-based PA decisions and programs (β = 2.06, p = 0.001). However, students in schools that provided more intramural programs reported fewer PE classes than those without (β = -1.97, p &lt; 0.001). The number of PE classes provided in the previous week was associated with greater odds of students being highly active compared to minimally active (OR = 1.14, p = 0.003)., Conclusion: Organizational and structural factors within the school environment are related to the amount of PE that students receive at school. Strategies are required to resolve the resulting inequities.

Objectives: Caffeinated energy drinks have become increasingly popular among young people, raising concern about possible adverse effects, including increased alcohol consumption and related risk behaviours. The current study examined consumption of caffeinated energy drinks and use of energy drinks with alcohol, as well as associations with socio-demographic and behavioural characteristics, among a sample of secondary school students in Ontario., Methods: Survey data from 23,610 grade 9-12 students at 43 purposefully sampled Ontario secondary schools participating in the baseline wave (2012/13) of the COMPASS study were analyzed using generalized linear mixed-effects models. Outcomes were any energy drink use, frequency of use, and use of alcohol mixed with energy drinks; covariates were age, sex, race, spending money, bodymass index (BMI), weight-related efforts and alcohol use. Two-way interactions between sex and other covariates were tested., Results: Nearly one in five students (18.2%) reported consuming energy drinks in a usual week. Use of energy drinks was associated (p &lt; 0.01) with all socio-demographic variables examined and was more common among students who were male, off-reserve Aboriginal, had some spending money, had a BMI outside of "healthy" range, were trying to lose weight, and/or reported a higher intensity of alcohol use. Interactions with sex were observed for age, spending money and weight-related efforts. Use of energy drinks mixed with alcohol in the previous 12 months was reported by 17.3% of the sample, and was associated with race, spending money, and more frequent binge drinking., Conclusion: Regular use of energy drinks was common among this sample of students and strongly linked to alcohol consumption.

Objectives: Given the link between active commuting and physical activity, this study examined factors associated with active commuting among a nationally representative sample of Canadian youth., Methods: Using data from the 2010-11 Youth Smoking Survey, this study examined different forms of commuting (active, inactive, mixed) and factors associated with either mixed or active commuting among grade 6 to 12 students., Results: Among Canadian youth in 2010-11, only 22.1% reported being an active commuter and only 25.7% reported being a mixed commuter. Students were more likely to commute actively if they were male, in younger grades (grades 6-10), a normal weight, a current smoker, or lived in urban areas., Conclusion: There is substantial opportunity to promote active commuting within the Canadian context since most youth were inactive commuters. Future research should explore the underlying facilitators or barriers to active commuting so that we better understand how best to promote active commuting among the subpopulations of youth (e.g., females, overweight youth, non-smokers, youth in rural areas) who are less likely to commute actively.

Objectives: The current study team sought to understand smokeless tobacco (SLT) usage trends among youth, using nationally representative data collected as part of the Canadian Youth Smoking Survey (YSS) between 2004 and 2008., Methods: Descriptive analyses of SLT ever use among respondents in grades 6 to 9 were examined according to year of data collection (2008, n = 31,249; 2006, n = 34,050; and 2004, n = 23,362). Using the 2008 data from respondents in grades 6 to 12 (n = 51,922), logistic regression models were used to examine characteristics associated with SLT ever use and current use., Results: Between 2004 and 2008, the prevalence of youth in grades 6 to 9 reporting they have ever tried SLT significantly decreased by 30.8%. In 2008, male students were more likely than females to have tried SLT (OR 4.87, 95% CI 4.34-5.45) or to currently use SLT (OR 4.96, 95% CI 4.12-5.96). There are regional differences in prevalence of SLT use across Canada, with the highest rates in western provinces and the lowest in Quebec. Current smokers were also more likely to use SLT (OR 11.86, 95% CI 10.22-13.76) compared to non-smokers. Older students are more likely to report ever use or current use of SLT., Conclusion: The findings from this study demonstrate that in Canada, adolescent SLT use is primarily an issue with males and there are significant regional differences. Ongoing monitoring of SLT is encouraged considering the tobacco industry's recent investments and product development and increased use in countries like the United States.

Objectives: The purpose of this study was to explore school and individual characteristics associated with smoking susceptibility among a nationally representative sample of Canadian youth who were never-smokers., Methods: Using data from the 2006-07 Youth Smoking Survey, multi-level logistic regression modeling was used to examine if student-level and school-level characteristics were associated with smoking susceptibility among grade 9 to 12 never-smokers., Results: In 2006, 88.2% of Canadian youth in grades 9 to 12 were considered never-smokers, of whom 28.2% (n=255,840) were considered to be susceptible to future smoking. Significant between-school random variation in smoking susceptibility was identified, although the school-level smoking rate was not significantly associated with the risk of an individual student being susceptible. At the student level, smoking susceptibility was associated with having a sibling who smokes, having 1 or 2 close friends who smoke, having ever used alcohol or marijuana, being female and being in grade 9. Parental smoking and exposure to smoking in a car or in the home were not significantly associated with smoking susceptibility., Conclusion: One way to prevent smoking onset among youth is to interfere with the development of susceptibility to smoking in non-smoking youth population. We found that over 1 in 4 Canadian youth who were never-smokers in 2006 were considered susceptible to smoking in the future. Ongoing tobacco control prevention initiatives are crucial for reducing the prevalence of smoking susceptibility among non-smoking Canadian youth.

Physical activity is a multi-faceted behaviour comprised of several components: frequency, intensity, time and type (FITT). Despite this understanding, there is currently a lack of knowledge regarding how the individual components of FITT influence chronic diseases. This is partly due to the tendency for researchers to focus on intensity via obtaining accurate measurements of energy expenditure. Although energy expenditure is an important consideration in the assessment of physical activity, it is only one component. Accordingly, future studies examining the association between physical activity and disease risk would benefit from examining all the components of FITT. Considering that all the components of FITT are modifiable, knowing their independent or combined influence on risk may provide valuable insight for future prevention interventions.

Objectives: Given that little is known about how youth access contraband cigarettes, the current study seeks to examine factors associated with how underage smoking youth report usually accessing contraband cigarettes., Methods: This study used nationally representative data collected from 41,886 students (grades 9 to 12) as part of the 2006-07 Canadian Youth Smoking Survey (YSS). Using data from current smokers who report that their usual brand of cigarettes is contraband, three logistic regression models were used to examine factors associated with buying cigarettes from a store, getting cigarettes from a family member, or getting cigarettes from friends or strangers., Results: In 2006, 7.9% (n = 1 3,300) of Canadian youth who were current smokers reported that their usual brand of cigarettes was contraband. Among these youth, the majority reported that they usually get their cigarettes from a friend or stranger (54.8%), whereas 26.4% report usually getting them from a family member and 18.8% usually buying their own from a store. Boys were more likely to buy contraband cigarettes from a store, whereas youth with a parent who smokes contraband cigarettes were substantially more likely to get contraband cigarettes from a family member and youth with friends who smoke contraband cigarettes were substantially more likely to get contraband cigarettes from a friend or stranger., Conclusion: Ongoing surveillance of contraband cigarette use among youth and how youth access contraband cigarettes is required for guiding future tobacco control policy and programming activities.

Objectives: Schools represent an important environment for physical activity (PA) promotion among youth. Schools can promote PA through policies and programs but our understanding of how these school characteristics associate with student PA levels is largely unknown. Developing this understanding is critical for implementing new prevention interventions. The aim of this study was to identify the school- and student-related characteristics associated with moderate and high levels of PA in a sample of Ontario elementary schools., Methods: Using multi-level logistic regression analyses, we explored the school- and student-level characteristics associated with being moderately and highly active using data collected from administrators and from students in grades 5 to 8 at 30 elementary schools in Ontario. Students' PA levels, sex, grade, and the number of physical education classes per week were linked to school environment data--specifically, a school's chosen implementation model for daily physical activity and whether it offers intramural and interschool PA programming., Results: Findings indicate that there was significant between-school variation for being moderately and highly active. Students were less likely to be moderately or highly active if they attended a school offering interschool PA programming. An important student characteristic positively associated with student PA levels included participating in at least two physical education classes per week., Conclusion: The residual differences in PA by school suggest that school-level characteristics facilitate higher levels of student PA beyond individual-level factors. Although most variation in student PA lies between students within schools, there is sufficient between-school variation to be of interest to practitioners and policy-makers.

Objective: To examine how social support, participation in intramurals, varsity and community sports are associated with physical activity among Ontario secondary school students, and explore gender differences in the prevalence of physical activity and participation in school- and community-based sports., Methods: Data from 25,416 students (grades 9-12) attending 76 Ontario secondary schools were collected using the School Health Action, Planning, and Evaluation System (SHAPES). Logistic regression analyses examined how social support and school- and community-based sports participation were associated with physical activity., Results: Males and females with low social support for physical activity were less likely to be active than their lower-risk peers (males: OR 0.61; females: OR 0.72). Males and females were more likely to be active if they participated in intramural activities (males: OR 1.92; females: OR 1.55), varsity sports (males: OR 1.93; females: OR 1.77), or community sports (males: OR 2.84; females: OR 2.90)., Conclusion: Since students with low social support for physical activity were less likely to be active, interventions to increase support and engagement in physical activity should be targeted to these students. In addition, considering that participation in school- and community-based sports increases the likelihood that students were active, practitioners should seek to enhance opportunities for participation in and access to these programs in order to increase the level of activity obtained by students.

Objective: Current and emerging public health challenges require a new approach to research training. The purpose of the CIHR-Strategic Training Program in Tobacco Research (STPTR) is to equip the next generation of scientific leaders with the knowledge, skills and experiences that will enhance their ability to conduct tobacco research that will have a positive impact on the health of the population., Participants: Graduate students or post-doctoral fellows from any university in Canada who are working with a STPTR Mentor in the broad area of tobacco control., Setting: Mentors at three universities: University of British Columbia, University of Toronto, and University of Waterloo., Intervention: The STPTR currently has four elements: a video course linking STPTR trainees and mentors across universities; an annual meeting; stipend awards that free CIHR STPTR fellows to concentrate on research; and personal, cross-disciplinary research mentoring., Outcomes: Feedback solicited from current and past trainees at the three-year point of the program suggests that there are four key value-added benefits associated with being a trainee in the STPTR: transdisciplinary connectedness, community building, capacity building, and exposure., Conclusion: Feedback from trainees at different stages in their training experience, different academic institutions, and different academic disciplines will inform the ongoing framing of the STPTR and may inform future training programs in other disciplines of chronic disease prevention, health promotion, and the emerging science of population-level intervention.