Search

It is well established that many adolescents who smoke want to quit, but little is known about why adolescents want to quit and if reasons to quit differ across gender. The objective of this study was to determine if reasons to quit smoking differ in boys and girls. Data on the Adolescent Reasons for Quitting (ARFQ) scale were collected in mailed self-report questionnaires in 2010-2011 from 113 female and 83 male smokers aged 14-19 years participating in AdoQuest, a longitudinal cohort study of the natural course of the co-occurrence of health-compromising behaviors in children. Overall, the findings indicate that reasons to quit in boys and girls appear to be generally similar, although this finding may relate to a lack of gender-oriented items in the ARFQ scale. There is a need for continued research to develop and test reasons to quit scales for adolescents that include gender-oriented items.

Background: The purpose of the present study was to examine whether the availability of intramural or extramural sports in secondary schools is associated with physical activity levels in youth throughout secondary school and at age 20. Methods: Eight hundred and eight adolescents from 10 secondary schools in Montreal, Canada, provided physical activity data every 3 months during the school year from ages 13 to 17, and again at age 20. School administrators completed questionnaires on the availability of intramural and extramural sports. Three-level general linear models were used to examine associations among the number of intramural and extramural sports, moderate and vigorous physical activity controlling for age, sex, body mass index, mother's education, and school-level socioeconomic status. Results: Regardless of whether or not they reported participating in intramural sports, adolescents in schools with more intramural sports engaged in 3.6 (p = 0.03) more total, and 1.3 (p = 0.03) more vigorous activities per week than those attending schools with fewer intramural sports. Number of extramural sports was not statistically significantly associated with physical activity, regardless of whether or not individual students participated. Conclusion: Providing more opportunities for intramural sports in secondary schools may be an effective strategy to help adolescents attain physical activity recommendations. (Contains 2 figures and 2 tables.)

To study the effect of a teachers' ban on supervising sports-related extracurricular physical activities (ECAs), levels of physical activity among 979 grade 7 students (mean age = 12.7 [0.5] years at baseline) were compared during and after the ban in seven schools that fully implemented the ban, and three schools that did not implement the ban fully. On average, schools offered 18.0 (SD = 5.1) ECAs during a no-ban school year. Students attending full implementation schools were significantly more likely than students in nonimplementation schools to be active after the ban ended (odds ratio for being active = 1.89 [95%confidence interval: 1.39,2.58]). They also increased the number of physical activities in which they participated (coefficient = 4.04;SE = 1.01). Ending a teachers' ban on sports-related ECAs was associated with increased involvement in physical activity among secondary school students. (Contains 3 tables and 1 figure.)

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]

Copyright of Promotion de la Santé et Prévention des Maladies Chroniques au Canada is the property of Public Health Agency of Canada 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.)

Introduction: School-based health-promoting interventions (HPIs) foster adolescent health and well-being. Access to HPIs may differ by the socioeconomic advantage of students at each school (school deprivation). We assessed the importance of health issues and availability of HPIs and extracurricular activities by school deprivation in high schools in Quebec, Canada. Methods: In 2016/17, 2017/18 and 2018/19, we interviewed school principals or a designee in 48 public high schools classified as disadvantaged (33%) or advantaged (67%). Schools rated whether 13 common health-related issues were important (i.e. warranted intervention) in their student population and reported whether HPIs to address these or other health issues and/or sports or special interest extracurricular activities had been available in the past year. Results: 84% of disadvantaged schools offered one or more HPIs in the past year compared to 73% of advantaged schools. Higher proportions of disadvantaged schools perceived most of 13 health-related issues as important. HPIs for bullying/exclusion, sex education and physical activity (issues subject to government mandates) were available in most schools. Higher proportions of disadvantaged schools offered non-mandated HPIs (i.e. for healthy eating, mental health/well-being and substance use). Higher proportions of advantaged schools offered extracurricular activities in all areas other than non-competitive sports, which was offered by equal proportions of advantaged and disadvantaged schools. Conclusions: Government mandates appear to facilitate universal availability of HPIs in schools, possibly boosting equity in school-based health promotion. Further investigation of possible differences in the content, implementation and/or effects of HPIs based on school deprivation is warranted. [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]

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]

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]

To update a systematic review published in 2012 that identified predictors of cigarette smoking cessation among adolescents. The PubMed and Web of Science databases were searched for relevant articles published between September 2010 and January 2018, using the following keywords: smoking OR tobacco OR cessation; quit OR stop; longitudinal OR prospective OR cohort. Our search identified 3,399 articles. Inclusion criteria included longitudinal studies (intervention and cohort studies) evaluating cigarette smoking cessation in young people (aged 10–24 years). After screening, in total, 34 articles were included in the review. In total, 63 predictors of smoking cessation among adolescents were identified, with 36 new predictors that were not identified in the previous review: nine sociodemographic factors, 13 psychosocial factors, five behavioral factors, 19 social influences factors, eight smoking related variables, six environmental factors, 2 health related variables, and one genetic factor. To increase the probability of successful smoking cessation, strategies targeting young smokers should consider both individual and environmental predictors of cessation. [ABSTRACT FROM AUTHOR]

In young people, alcohol consumption and depressive symptoms are related, but the temporal ordering of the relationship is an open question. Previous studies have not disaggregated influences of interindividual and intraindividual components affecting the relationship. We investigated whether a reciprocal relationship between frequency of alcohol use and depressive symptoms exists in the general population of adolescents after removing interindividual influences. A total of 1,293 Canadian adolescents provided data on depressive symptoms and frequency of alcohol use every 3 months from grade 7 to 11 (1999–2005) for a total of 20 cycles. We used latent curve models with structured residuals, which disaggregate interindividual and intraindividual components to assess the directionality of the relationship. Both drinking frequency and depressive symptoms increased linearly and quadratically over time, with significant interindividual variation around the origin and rate of change. Intercepts and slopes for drinking frequency and depressive symptoms differed by sex and age. After controlling for sex, age, maternal education, sensation seeking, impulsivity and clustering by school, a significant positive association was observed between depressive symptoms and drinking frequency 3 months later (.032 [.004,.060]; p =.024), but no association was observed between drinking frequency and subsequent depressive symptoms (.011 [−.006 to.029]; p =.193). Our data provide longitudinal evidence that changes in depressive symptoms exceeding one's "normal" level predict increases in drinking frequency. This suggests that teaching youth to recognize and cope with mood changes would be worthwhile. [ABSTRACT FROM AUTHOR]

Despite limited evidence on the association between physical activity (PA) and blood pressure (BP) in youth, experts recommend that adolescents engage regularly in moderate-to-vigorous PA. We examined the relationships between PA intensity and frequency and the likelihood of having high BP in a population-based cohort of adolescents from Montréal, Canada. PA was self-reported every 3 months from grade 7 to 11, and BP was measured at ages 12.8, 15.2, and 17.0 years on average. We analyzed data from 993 participants (mean [SD] age = 16.0 [1.0], 51.6% female) with BP data at ages 15.2 and/or 17.0 years, using pooled ordinal logistic regression. BP (normal/elevated/hypertensive range) was the outcome, and past-year PA intensity and frequency were potential predictors. Eight percent of participants had elevated BP (120-129/<80), and 3.2% had BP in the hypertensive range (≥130/≥80). Participants engaged in a median (interquartile range) of 7.0 (4.5, 9.3) and 5.5 (2, 10.8) moderate and vigorous PA sessions/week, respectively. After adjusting for age, sex, mother's education, use of alcohol and cigarette consumption, engaging in PA more intense than light during the previous year was associated with a lower odds of having BP in the hypertensive range (ORs [95% CIs] = 0.93 [0.88, 0.97] to 0.97 [0.94, 0.99]). The relationships were not altered by adjusting for BMI. Our findings support recommendations that adolescents engage in at least moderate PA on a regular basis to prevent development of BP in the hypertensive range. [ABSTRACT FROM AUTHOR]

It is unclear whether changes in physical activity (PA) or sugar consumption during the COVID-19 pandemic relate to mental health among adolescents. This study identified profiles of change in PA and sugar consumption during the COVID-19 pandemic, and estimated associations between these profiles and anxiety, depression and wellbeing among French adolescents. Data were from the cross-sectional school-based EXIST pilot study conducted one year after the end of the first lockdown. Adolescents provided data on lifestyle behavior changes and mental health during the pandemic using self-report questionnaires. We used latent class analysis to identify profiles of change in PA and sugar consumption, and conducted multinomial logistic regression to estimate associations between these profiles, and mental health. Among 380 adolescents (52.5% male; 13.5 ± 0.6 years), we identified four change profiles: 1) "increased PA and decreased sugar consumption" (21.8%), 2) "PA and sugar consumption stable over time" (36.1%), 3) "decreased PA and increased sugar consumption" (28.4%), and 4) "consistently low PA and stable sugar consumption over time" (13.7%). Compared to adolescents in profile 1, odds of depression were higher among adolescents in profile 3 (OR [95%CI] = 2.42[1.17; 4.99]) and profile 4 (OR = 3.16; [1.39; 7.19]). Associations were similar for wellbeing, but profiles were unrelated to anxiety. Unfavorable changes in PA and sugar consumption during the COVID-19 pandemic may have contributed to deteriorating adolescents' mental health. Future studies should assess long-term effects of the pandemic on PA and sugar consumption, and whether any long-term changes are associated with adolescent mental health. • One in three adolescents reduced their moderate to vigorous physical activity level. • One in five adolescents increased consumption of sugary food products. • We identified four lifestyle behavior change profiles among youth during COVID-19. • The least favorable profiles characterized 42% of adolescents. • Youth with the least favorable profiles had poor mental health 1-year post-lockdown. [ABSTRACT FROM AUTHOR]

There may be sex differences in the response to nicotine, according to findings of studies in animals; however, sex differences in the natural course of cigarette smoking and nicotine dependence are documented in few studies. Prevalent (n = 240 girls; n = 184 boys) and incident (n = 231 girls; n = 184 boys) cigarette smokers from the Nicotine Dependence in Teens Study were followed up to 5 years after first puff, from age 12 to 18 years (1999–2005). We used Cox proportional hazards models to compare time to development of 3 cigarette-use (i.e., whole cigarette; 100 cigarettes lifetime; regular smoking), and 3 nicotine-dependence symptom (i.e., “really need a cigarette”; mentally addicted; physically addicted) milestones across sex. Girls were at higher risk than boys of attaining all milestones; hazard ratios (95% confidence intervals) ranged from 1.35 (1.06, 1.72) for 100 cigarettes lifetime to 1.74 (1.44, 2.10) for “really need a cigarette.” Among nonregular smokers, 26% (8%; 43%) and 25% (6%; 44%) more girls than boys reported “really need a cigarette” 1 and 2 years, respectively, after first puff. Preventive interventions may need adjustment to incorporate these findings. Additional research should clarify the relative contribution of biological and social underpinnings of these sex differences. [ABSTRACT FROM AUTHOR]

Background: Efforts to increase physical activity in youth need to consider which activities are most likely to be sustained over time in order to promote lifelong participation in physical activity. The Monitoring Activities of Teenagers to Comprehend their Habits (MATCH) study is a prospective cohort study that uses quantitative and qualitative methods to develop new knowledge on the sustainability of specific physical activities. Methods/design: Eight hundred and forty-three grade 5 and 6 students recruited from 17 elementary schools in New Brunswick, Canada, are followed-up three times per year. At each survey cycle, participants complete self-report questionnaires in their classroom under the supervision of trained data collectors. A sub-sample of 24 physically active students is interviewed annually using a semi-structured interview protocol. Parents (or guardians) complete telephone administered questionnaires every two years, and a health and wellness school audit is completed for each school. Discussion: MATCH will provide a description of the patterns of participation in specific physical activities in youth, and enable identification of the determinants of maintenance, decline, and uptake of participation in each activity. these data will inform the development of interventions that take into account which activities are the most likely to be maintained and why activities are maintained or dropped. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To describe the incidence and identify predictors of smoking initiation in young adults. Methods: Data were collected in self-report questionnaires in 22 cycles over 13 years in a prospective cohort investigation of 1,293 students recruited in 1999–2000 from all grade 7 classes in a convenience sample of 10 high schools in Montreal, Canada. Participants were 12.7 years of age on average at cohort inception and 24.0 years of age in cycle 22. Independent predictors of smoking initiation in young adulthood (post–high school) were identified in multivariable logistic regression analysis using generalized estimating equations. Results: Of 1,293 participants, 75% initiated smoking by cycle 22. Of these, 44%, 43%, and 14% initiated before high school, during high school, and in the 6 years after high school, respectively. The incidence density rate of initiation was .33, .13, .14, .11, and .12 initiation events per person-year in grade 7, 8, 9, 10, and 11, respectively, and .05 post–high school. Independent predictors of smoking initiation in young adults included alcohol use, higher impulsivity, and poor academic performance. Conclusions: A total of 14% of smokers who initiated smoking before age 24 years did so after high school. The predictors of initiation in young adults may provide direction for relevant preventive interventions. [Copyright &y& Elsevier]

Abstract: Smoking to alleviate negative affect or improve physiological functioning (i.e., self-medication) is one explanation for the association between depression and smoking in adolescents. This study tests whether using cigarettes to improve mood or physiological functioning is associated with the onset, and change over time, of elevated depressive symptoms. Data were drawn from the Nicotine Dependence in Teens study which followed 1293 participants initially aged 12–13years in Montreal, Canada every three months for five years. The subsample included 662 adolescents who had been current smokers (reported smoking during the previous three months) at any point during the study. Survival analysis was used to test whether self-medication scores predicted onset of elevated depressive symptoms. Changes over time in depressive symptom scores relative to self-medication scores were modeled in growth curve analyses controlling for sex and number of cigarettes smoked per week. Smokers who reported higher self-medication scores had higher depressive symptom scores. The interaction between self-medication scores and the acceleration rate in depressive symptom scores was significant and negative, suggesting that participants with higher self-medication scores had decelerated rates of change in depression over time compared to participants with lower self-medication scores. Smoking appears to be ineffective at reducing depressive symptoms. These findings are consistent with a version of the Positive Resource Model that suggests that smoking will not lower depressive symptoms, but could slow the rate of change over time. Alternatively, the perceived positive benefits may be the result of alleviation of symptoms of withdrawal and craving resulting from abstinence. The self-medication scale may identify a population at risk of increased levels of depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: The endocannabinoid system is implicated in psychiatric disorders and drug dependence. Within this system, fatty acid amide hydrolase (FAAH) metabolizes endocannabinoids. Individuals with A-group genotypes (C/A or A/A) of a common FAAH variant (rs324420; C > A; Pro129Thr) have slower enzymatic activity compared to C-group individuals (C/C genotype). Slow FAAH activity is differentially associated with alcohol and nicotine use.Methods: Among European-ancestry participants in the NDIT study (n = 249-607), genotype associations with past-year binge drinking in young adults were estimated in logistic regression models. In adolescents, hazard ratios (HR) were estimated from Cox proportional hazards models to assess the FAAH genotype group association with time to drinking initiation and attaining drinking frequency outcomes. HR were also used to assess genotype effect on time to smoking initiation and attaining early smoking milestones (e.g., first inhalation, ICD-10 dependence).Results: Compared to those in the C-group, those in the A-group had higher odds of binge drinking at ages 20 (Odds ratio (OR) = 2.16, 95 % CI 1.36-3.42) and 30 (OR = 1.61, 95 % CI 1.10-2.36). Time to initiation of drinking and daily drinking was faster in adolescents in the A-group (HR = 1.39, 95 % CI 1.09-1.77 and HR = 2.24, 95 % CI 1.05-4.76, respectively). Time to smoking initiation was faster in the A-group (HR = 1.20, 95 % CI 1.04-1.39); however, time to smoking milestones among adolescent smokers was not consistently different for the A- versus C-groups (HR = 0.43 to 1.13).Conclusions: Slow FAAH activity (A-group) was associated with greater risks for binge drinking, drinking initiation and escalation, and cigarette smoking initiation, but had little impact on the escalation in cigarette smoking behaviors. [ABSTRACT FROM AUTHOR]

Our objectives were (i) to systematically review how SNA is used in studies investigating adolescent health behaviours (i.e., the purpose of using SNA, methods used for network data collection and analysis), and (ii) to develop methodological guidelines to help researchers use SNA in studies on adolescent health behaviours. Five databases were searched using keywords related to "social network analysis" and "adolescents". We extracted data from included articles pertaining to the choice of methods for network data collection and analysis. We used these data to develop a 5-step decision tree to help researchers make methodological decisions most appropriate to their research objectives. A total of 201 articles were included. Most investigated tobacco (50%) or alcohol use (48%). SNA was used most often to examine processes related to peer selection or influence (37%) and/or to examine the effect of sociometric position on health behaviours (34%). 181 studies (90%) used a sociocentric approach for SNA, 16 studies (8%) used an egocentric approach, and 4 studies (2%) used both. We identified five decision-making steps in SNA including the choice of: (i) network boundary, (ii) SNA approach, (iii) methods for name generators, (iv) methods for name interpreters, and (iv) SNA indicators. This study provides insights and guidance in a 5-step decision tree on practical and methodological considerations in using SNA to explore adolescent health behaviours. • Social network analysis (SNA) is a powerful method to investigate adolescent health behaviours. • The methods used for network data collection and analysis are highly heterogeneous across studies. • Our 5-step decision tree includes practical considerations to guide researchers in using SNA. • The decision tree will help researchers make methodological decisions most appropriate to their research objectives. [ABSTRACT FROM AUTHOR]

This study describes developmental trajectories of depressive symptoms in adolescents and examines the association between trajectory group and mental health outcomes in young adulthood. Methods: Depressive symptoms were self-reported every three months from grade seven through grade 11 by 1293 adolescents in the Nicotine Dependence in Teens (NDIT) study and followed in young adulthood (average age 20.4, SD=0.7, n=865). Semi-parametric growth modeling was used to identify sex-specific trajectories of depressive symptoms. Results: Three distinct trajectory groups were identified: 50% of boys and 29% of girls exhibited low, decreasing levels of depressive symptoms; 14% of boys and 28% of girls exhibited high and increasing levels; and 36% of boys and 43% of girls exhibited moderate levels with linear increase. Trajectory group was a statistically significant independent predictor of depression, stress, and selfrated mental health in young adulthood in boys and girls. Boys, but not girls, in the high trajectory group had a statistically significant increase in the likelihood of seeking psychiatric care. Conclusions: Substantial heterogeneity in changes in depressive symptoms over time was found. Because early depressive symptoms predict mental health problems in young adulthood, monitoring adolescents for depressive symptoms may help identify those most at risk and in need of intervention. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Less than 15% of children and adolescents participate regularly in physical activity (PA) and, with ever-increasing obesity, strategies to improve PA levels in youth are urgently needed. Exergaming offers a PA alternative that may be especially attractive in our increasingly technophilic society. However, there are no observational studies of exergaming in population-based samples of adolescents. The purpose of this study was to investigate potential sociodemographic, lifestyle, psychosocial, weight-related, and mental health correlates of exergaming as well as describe the type, timing, and intensity of exergaming in a population-based sample of adolescents. METHODS: Data on exergame use and potential sociodemographic, lifestyle, psychosocial, weight-related, and mental health correlates of exergaming were collected in mailed self-report questionnaires completed by 1241 grade 10 and 11 students from the Montreal area with a mean age of 16.8 years (SD = 0.05 years; 43% male) participating in the AdoQuest study. The independent correlates of exergaming were identified in multivariable logistic regression models. RESULTS: Nearly one-quarter (24%) of participants reported exergaming. Exergamers played 2 days per week on average, for ~50 minutes each bout; 73% of exergamers played at a moderate or vigorous intensity. Exergamers were more likely than nonexergamers to be girls, to play nonactive video games, to watch ≥2 hours of television per day, to be stressed about weight, and to be nonsmokers. CONCLUSIONS: Many adolescents exergame at intensity levels that could help them achieve current moderate-to-vigorous PA recommendations. Interventions that encourage exergaming may increase PA and decrease sedentary behavior in select youth subgroups, notably in girls. [ABSTRACT FROM AUTHOR]

Background: Nicotine dependence (ND) symptoms can occur soon after first puff, so that stopping smoking becomes difficult well before 100 cigarettes lifetime is attained. Yet some surveillance systems do not monitor ND symptoms and 100-cigarettes lifetime is used in at least one surveillance system to define current smokers. To assess whether these features limit interpretation of grade-specific data in surveillance, we described smoking and ND symptoms across grade in incident vs. prevalent smokers, and in smokers according to 100-cigarettes lifetime.Methods: Data were available in an investigation of 1294 grade 7 students from 10 Montreal-area high schools followed every 3 months from grade 7 to 11. Analyses described cigarette consumption, 100-cigarette lifetime consumption, cravings, withdrawal symptoms, mFTQ nicotine dependence and ICD-10 tobacco dependence by grade among past 3-month smokers.Results: Despite low cigarette consumption, 21-30% of grade 7 smokers reported ND symptoms. This increased to 27-44% in grade 8 and remained stable thereafter despite increased cigarette consumption. In grade 7, 10% of all smokers had not attained the 100-cigarette milestone but were already dependent. In grade 8, 9, 10 and 11, these proportions were 12%, 8%, 6% and 6%, respectively.Conclusions: ND symptoms should be monitored in youth surveillance systems since they tell a different "story" than cigarettes and their appearance may represent a critical "point-of-no-return." Interventions for incident smokers are needed across grades to stop smoking before ND manifests. Without a shift in focus toward incident rather than established smokers, many children who try cigarettes will become addicted. [ABSTRACT FROM AUTHOR]