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INTRODUCTION: Rural residence is a well-established risk factor for risk behaviors and subsequent morbidity and mortality in the United States. Smoking is the primary cause of preventable death and is more prevalent in rural America. As chronic smoking habits typically develop during adolescence, the discrepancy in smoking rates between rural and urban youth likely contributes to a significant geographic disparity in the long-term health of adults. METHODS: Data were extracted from 12th-grader surveys of the U.S. Monitoring the Future study from 1998 to 2018. The historic trends of smoking initiation, ever-regular and current-regular smoking rates of rural and urban adolescents were estimated with intercept-only time-varying effect models. Differences in prevalence between rural and urban youth were calculated for each smoking behavior. RESULTS: Though overall smoking prevalence continues to decline, this trend is significantly attenuated among rural adolescents compared to urban youth. The absolute difference in lifetime smoking prevalence between rural and urban youth has markedly increased from 6.9% in 1998 to 13.5% in 2018, which is among the highest in the past 20 years and is a potentially alarming upward trend. However, the absolute differences in ever-regular and current-regular smoking prevalence have shown an overall net decline, decreasing from 6.4% to 4.8%, and from 5.5% to 3.0%, respectively. CONCLUSIONS: This geographic disparity between rural and urban adolescents represents a potentially modifiable cause of increased morbidity and mortality in rural areas. Interventions and regulatory efforts should be tailored for rural adolescents to reduce the narrowing but persistent disparity in regular smoking.

Objective: This study aimed to explore the individual, familial, and social factors associated with different smoking status in Thai adolescents from the 2017 Cigarette Smoking and Alcohol Drinking Behavior Survey (CSAD) Methods: The nationally representative sample of 6046 adolescents aged 15-19 years who took part in the 2017 CSAD in Thailand. Multinomial logistic regression analysis was conducted to explore the associations between the individual, familial, and social factors and different smoking status. Results: The daily smoking and occasional smoking was 6.4% and 3.3%, respectively. Gender, alcohol use, substance use, attitudes toward smoking, exposure to secondhand smoke at home, anti-smoking social media campaign, and graphic warning labels were related to both daily and occasional smoking. Daily smoking was associated with exposure to secondhand smoke at school, restaurant, and public transport, and exposure to tobacco advertising. Conclusion: These findings suggest that smoking prevention intervention should particularly focus on these factors and also need to develop the anti-smoking policies for smoking prevention among adolescents.

Background: Smoking is currently a trend among youths, with the public emergence of new smokers shifting to this group. Aim:This study aims at analyzing the effect of peer promoters as communicators on the knowledge and smoking attitudes of junior high school adolescents. Methods:The quasi-experimental and non-equivalent control group designs were used. Furthermore, the respondents included 1062 students from two junior high schools in Makassar City, Indonesia, with 473 and 589 males and females, respectively. A total of 801 respondents had paired data (pre and post-test) consisting of 334 in the intervention and 467 in the control school.Paired t-test was used to measure the difference in the pretest and post-test scores of intervention and control schools. Independent t-test was used to determine mean difference between the pretest and post-test scores between intervention and the control schools. Results:The results showed that 18.4% (n = 1062) had smoked, with subtleties of 39.4% male and 1.5% female understudies. the knowledge score increase of 0.82 (p = 0.000) and 0.22 (p = 0.004) was observed in the intervention and control schools, respectively (n = 801). The attitude score also increased by 2.23 (p = 0.080) in the intervention and 2.51 (p = 0.000) in the control school (n = 801). Differences in the knowledge and attitude scores between both schools obtained a value of p = 0.004 and 0.766, respectively. Conclusion: education by peer promoters increase knowledge and change adolescent smoking attitudes indicated the promotion of school-based smoking behavior prevention efforts with intensive peer approach

Background: Reductions in the age at onset of smoking to adolescence is a public health concern. Evidence suggests that cognitive factors(CF)play an important role in adolescent smoking behavior. t...

Background and aims Reports of youth e-cigarette use often do not disaggregate by underlying smoking status. This study compared annual 2014–19 youth estimates of past 30-day e-cigarette use prevalence and frequency by smoking status in the United States. Design Nationally representative, cross-sectional, school-based survey [National Youth Tobacco Surveys (NYTS)]. General linear models accounting for complex survey design compared e-cigarette use prevalence by smoking status by year, overall and stratified by frequency, separately for high school (HS) and middle school (MS) students. The 2019 survey was analyzed separately because of its change in survey methodology. Setting MSs and HSs in the United States. Participants A total of 116 704 students from 1268 schools, ages 9–19. Measurements Students self-reported (paper 2014–18, electronic 2019) ever and past 30-day (current) use of e-cigarettes and cigarettes, as well as frequent use (20–30 days of month). Findings From 2014 to 2018, current e-cigarette use prevalence increased among never, current and former smokers in HS, but only among never and current smokers in MS (each P-value < 0.001). E-cigarette use increases for current HS smokers were primarily among frequent e-cigarette users. In 2018, the absolute number of HS frequent users who were never or former smokers (420 000 combined) surpassed current smokers (370 000). In 2019, current e-cigarette use prevalence for never, former and current smokers was 17.5% [95% confidence interval (CI) = 16.0–19.0], 53.6% (95% CI = 45.2–61.9) and 85.8% (95% CI = 81.6–89.9) for HS students, respectively, and 6.8% (95% CI = 5.9–7.7), 40.8% (95% CI = 34.7–47.0) and 78.0% (95% CI = 71.9–84.2) for MS students. That year, the number of HS never (420 000) and former smokers (570 000) using e-cigarettes frequently eclipsed that of current smokers (390 000). Conclusions E-cigarette use prevalence and frequency among youth vary by smoking status, with highest levels of use among current smokers. However frequent e-cigarette use among never smokers and former smokers has increased.

The present study aimed to examine the effects of primary social factors on the smoking behaviors according to the smoking stages—initiation and continuation—among Korean adolescents. We used the clustered logistic regression method to examine whether the primary social factors significantly influence smoking behaviors among Korean adolescents at two different stages with a cross-sectional study for 9 years. We found that primary social factors significantly influenced adolescent smoking in both stages, and peer effects for adolescent smoking were much clearer in the smoking continuation stage. In addition, adolescents initiating smoking early tend to continue their smoking with high probability. The impacts of primary social factors are robust on adolescent smoking, particularly in the smoking continuation stage.

Objective: The purpose of this study was to compare the effectiveness of two methods to intervene in adolescent smoking in Taiwan and evaluate quitting behavior 6 months later. Methods: A total of ...

Family support has a beneficial impact on protecting health-risk behaviour in adolescents. This study aimed to explore whether family support is associated with risk of smoking during transition from early (11 years) to late (15 years) adolescence across 42 countries. The data from the cross-national Health Behaviour in School-aged Children (HBSC) study in 2017/2018 were employed (N = 195,966). Family support was measured using the four-item Family dimension of the Multidimensional Scale of Perceived Social Support (sum score 20 or more was categorised as high family support). Smoking was defined as a reported cigarette smoking at least 1–2 days in the last 30 days. The association between smoking and family support was assessed using a prevalence ratio (PR) obtained from the multivariate Poisson regression. Over two thirds of adolescents reported high levels of support from their family. Family support was found to significantly decrease with age in most of the countries, with the boys reported high level of family support more often than girls. The adolescents who reported having low family support also were more likely to smoke compared to their peers who reported having high family support (PR = 1.81; 95% CI: 1.71–1.91 in boys, and PR = 2.19; 95% CI: 2.08–2.31 in girls). The countries with a stronger effect of family support in reducing smoking risk indicated lower rates of adolescent smoking as well as lower increases in the cigarette smoking prevalence during the age period from 11 to 15 years. This study reinforces the need for family support, which is an important asset helping adolescents to overcome the risk of smoking during their transition from early to late adolescence.

Background: Pubertal timing refers to the timing of an individual regarding pubertal sexual maturation, both physiologically and psychologically. Existing research shows that pubertal timing is associated with behavioral problems. This study investigated the role of parenting style in the relationship between pubertal timing and Chinese adolescents’ smoking behavior. Methods: The study examined the association of pubertal timing, parenting style and adolescents’ smoking behavior, using the Pubertal Development Scale (Chinese version), Simplified Parenting Style Scale-Chinese version, and three items related to adolescents’ smoking situation. Participants were 1391 Chinese adolescents aged 11–16 years old (53.41% boys). Hierarchical linear regression analyses assessed the moderating role of parenting style on the association between pubertal timing and adolescent smoking behavior. Results: The results indicated that parenting style moderates the relationship between pubertal timing and adolescent smoking behavior. For male adolescents, father rejection moderated the relationship between early pubertal timing and smoking behavior. For female adolescents, father rejection, father emotional warmth, and mother emotional warmth moderated the relationship between pubertal timing and smoking behavior. Conclusions: Findings from the study highlight the importance of parenting style, which may influence the negative outcomes associated with early pubertal timing and can help improve interventions aimed at reducing these negative outcomes.

Introduction The emergence of low-cost smartphone technology has coincided with major declines in adolescent smoking and other risk behaviours. This study explores the relationship between internet use and smoking in adolescents and investigates whether rising internet use contributed to the decline in smoking between 2012 and 2018. Methods Data were drawn from a nationally representative New Zealand survey of students aged 14-15 (N = 11 299), conducted biennially between 2012 and 2018. We used logistic regression to explore the association between internet use and smoking and test whether increasing time on the internet was associated with declining adolescent smoking over the study period. Results The proportion of students spending 5+ hours per day online increased from 15% to 35%. Heavy internet use was not a protective factor for smoking at the individual level. In 2016/2018, some types of past week internet use were associated with decreased risk of smoking (e.g. doing schoolwork, finding out about news), some were associated with increased risk (e.g. social media use) and others appeared to have no association with smoking (e.g. gaming, online shopping). The relative risk of smoking was lower in 2018 relative to 2012 (relative risk 0.68, 95% confidence interval 0.51, 0.90, after adjustment for demographic factors). Adding internet use to the model did not help to account for smoking decline. Discussion and conclusions We found no evidence that increasing time spent on the internet during the 2012-2018 period (during which smartphones became ubiquitous) contributed to the decline in adolescent smoking.

Objectives: Adolescent e-cigarette users are at risk of developing smoking intention, an established predictor of conventional cigarette smoking. In this study, we identify subgroups of adolescent e-cigarette users who are most likely to intend to smoke conventional cigarettes. Methods: Cross-sectional data on 1357 8th and 10th grade e-cigarette users who had never smoked conventional cigarettes were obtained from 2014-2017 Monitoring the Future Surveys. We conducted latent class analysis to identify subgroups of adolescent e-cigarette users; through latent class regression analysis, we examined the association between subgroup membership and smoking intention. Results: We identified 3 subgroups of adolescent e-cigarette users: socially-protected (56.6%), peer-driven (29.8%), and market-vulnerable (13.6%). The peer-driven class reported the highest number of peers who smoke and the lowest proportion of friends who strongly disapproved of daily cigarette smoking. They were significantly more likely than the socially-protected and market-vulnerable classes to have smoking intention (AOR=2.46; 95% CI 1.84-3.28, and AOR=2.29; 95% CI 1.48-3.53, respectively). Conclusion: Our findings provide insights on the constellation of risk and protective factors that contribute to smoking intention among adolescent e-cigarette users. It highlights peer influence as an important area of emphasis for adolescent smoking prevention programs.

Parent–adolescent communication is assumed to be an important factor affecting adolescent smoking behavior. However, the inner mechanism accounting for this association has still not been clarified in research. Our purpose in this study was to examine the relationships between parent–adolescent communication, adolescent smoking behavior, and depression, as well as gender differences in the relationship between depression and adolescent smoking behavior. Participants were 1,134 students at 6 junior high schools in China who completed the Parent-Adolescent Communication Scale, the Epidemiological Studies Depression Scale, and the Smoking Behavior Test. Results showed that parent-adolescent communication had a significant negative effect on adolescent smoking behavior and depression partially mediated the relationship between parent–adolescent communication and adolescent smoking behavior. In addition, gender moderated the relationship between depression and adolescent smoking behavior. Overall, these findings may help to promote better understanding of the relationship between parent–adolescent communication and adolescent smoking behavior.

BackgroundThe prevalence of cigarette smoking among South Korean adolescents has decreased markedly over the past decade, which may indicate a norm shift between generations of adolescents. The present study aims to identify the effect of banning smoking in public places and increasing cigarette prices on current adolescent smoking, and to determine whether these policies additionally resulted in cohort effects.MethodsRepeated cross-sectional survey data, nationally representative of South Korean adolescents, were used. A total of 853 441 adolescents ranging in age from 12 to 18 years (mean age, 15 years) were identified. Models applied were segmented regression model to detect changes in smoking trends and age-period-cohort model to determine the cohort effects on the trends.FindingsBetween 2006 and 2017, smoking decreased from 16% to 9% in boys and from 9% to 3% in girls. After a complete ban on smoking in public places, there were significantly negative trends in the prevalence of smoking for both boys (β=−1.1; 95% CI: −1.9 to −0.2) and girls (β=−0.4; 95% CI: −0.6 to −0.1). Immediate decrease among girls was found after cigarette prices increased (β=−0.8; 95% CI: −1.5 to −0.2). For the cohort effect, the risk of smoking decreased with every consecutive year for boys born after 1998 and girls born after 1997.ConclusionsOur results indicate the presence of cohort effects in the reduction of adolescent smoking. The cohort effect was induced by smoke-free legislation. Research on cohort effects, and methods to denormalise tobacco, will contribute to preventing adolescents from ever trying a cigarette.

The burden of adolescent cigarette smoking is substantial. We assess mothers' and fathers' attitudes and behaviours on adolescent smoking using a cross-sectional study of n = 707 adolescents. Associations between parental attitudes and behaviours in adolescent smoking were assessed using logistic regression separately for boys and girls. Occasional alcohol use by both parents increased odds of smoking once a day (OR = 2.44, 95% CI 1.26, 4.71, OR = 1.51, 95% CI 0.97, 2.35, respectively). Fathers smoking increased odds for girls (OR = 1.59, 95% CI 1.01, 2.52). A democratic mother decreased odds for boys (OR = 0.32, 95% CI 0.10, 0.93) whereas a protective, demanding mother increased the odds for girls (OR = 8.65, 95% CI 1.38, 54.22). Public health smoking prevention programs could support changing parental behaviours and attitudes in early years to address this burden in countries with authoritarian parenting styles. WOS:000638522200001 2-s2.0-85103492921 PubMed: 33918478

Summary The concept of the Health Promoting School (HPS) encourages a holistic approach to promoting health in schools, instead of a more traditional education on health. The aim of this paper was to determine the association between studying in a HPS and smoking and alcohol consumption among adolescents. A cross-sectional study of 3574 adolescents from 44 HPS and 66 non-HPSs was conducted. The association between studying in a HPS and smoking and alcohol consumption among adolescents was analysed using logistic regression models. Pearson’s χ2 test was used to determine the differences between HPS and non-HPS students’ sociodemographic characteristics, and the difference in distribution of students who smoked and consumed alcohol at various rates across different groups. Studying in a HPS setting was not significantly associated with adolescent smoking or attempts to smoke. Compared to HPS students, non-HPS students had a significantly higher chance of attempting to consume alcohol and consumed alcohol once a month or more frequently. In comparing the distribution of HPS and non-HPS students according to the frequency of smoking and alcohol consumption across various groups of respondents, it was determined that some factors were associated with frequency of smoking and alcohol consumption among adolescents. The results of the study showed that studying in a HPS was associated with a reduction in both smoking and alcohol consumption, and therefore it is advisable to further develop the HPS network. However, both the individual and educational characteristics of adolescents must be taken into account when planning prevention measures.

Background:Smoking among Japanese adolescents has decreased noticeably. However, little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016.\nMethods:We conducted a repeated cross-sectional study using data from three surveys of high school students in Okinawa, Japan, in 2008, 2012, and 2016. The study participants consisted of 7902 students in grades 10 through 12 (15–18 years). Smoking was assessed as current cigarette use. SES indicators included familial SES (parental education and family structure) and student’s own SES (school type). To evaluate absolute and relative inequalities, prevalence differences (PDs) and ratios (PRs) between low and high SES groups were estimated. The slope index of inequality (SII) and relative index of inequality (RII) were also calculated.\nResults:Smoking prevalence among boys and girls significantly declined from 11.5% and 6.2% in 2008 to 4.7% and 1.9% in 2016, respectively. Similar decreasing trends in smoking were found among most of the SES groups. The PDs and SII for parental education in boys and family structure in girls decreased over time while those for school type persisted among boys and girls. The PRs and RII for school type in boys increased while those for other SES indicators among both sexes remained stable over time.\nConclusions:Smoking among Japanese adolescents has been declining and time trends of socioeconomic inequalities in smoking varied by absolute and relative measures. Further policies and/or interventions to reduce smoking inequalities should focus on the context of schools, especially in vocational high schools., 論文

Teenage smoking is a growing health issue in the Saudi population, and it could be predicted by some factors. To understand teenage smoking risk factors in our population, we reviewed the literature on related topics. A narrative review of the related literature published in the English language from 2008 to 9th July 2019 using PubMed database was performed to know the prevalence of teenage smoking, important predictors and possible preventive measures. The prevalence of adolescent smoking was ranging from 9.2 to 20%. The main predicting factors were male gender, parental smoking, and education status, smoking peers, having pocket money and watching smoking sceneries in movies. The important preventive strategies were improving awareness, excising tax and increasing legal age of smoking to 21 years. Our study revealed that most of the Saudi youth aged from 15-24 years started smoking at an age younger than 18 years which call for the development and implementation of preventive programs to minimize smoking initiation among teenagers.

Background and aims Exposure to tobacco, alcohol and fast-food use in films is associated with initiation of these behaviours. India is the world’s largest film producer, but the extent of such imagery in Bollywood (Hindi cinema) films is unclear. We therefore aimed to describe the extent of and trends in tobacco, alcohol and fast-food imagery in Bollywood films, between 1994–2013. Methods For the 15 top-grossing films each year between 1994–2013, the number of five-minute intervals containing product images were determined separately for tobacco, alcohol and fast-food. Both the proportion of films containing at least one image occurrence, and occurrences per film, were described overall and by year. Negative binomial regression described associations between film rating and occurrences/film, and estimated time-trends in occurrences/film, adjusted for rating. Results We analysed 93 U-rated (unrestricted), 150 U/A-rated (parental guidance for children aged

Background Despite declining US adolescent smoking prevalence from 40% among 12th graders in 1995 to around 10% in 2018, adolescent smoking is still a significant problem. Using the International Childhood Cardiovascular Cohort (i3C) Consortium, which includes 7 international cohorts recruited in childhood and followed into adulthood, the present study was designed to confirm the important relation between adolescent smoking and daily adult smoking and present new data on adult smoking into the forties and comparison of smoking in the United States, Finland, and Australia. Methods and Results Childhood smoking experience during ages 6 to 19 in the 1970s and 1980s was classifiable in 6687 i3C participants who also provided smoking status in their twenties and forties through 2011–2018. Prevalence of daily smoking in their twenties was directly related to degree of smoking during adolescence and inversely related to the age at which that smoking experience occurred ( P trend, P trend, US , Finnish, and Australian participants. Conclusions These long‐term follow‐up data show that smoking intensity increased throughout adolescence. Prevalence of adult smoking and cessation by the forties were both correlated with levels of childhood smoking intensity. These data lend support to preventive strategies designed to reduce, delay, or eliminate any youth access to cigarettes.

Introduction Susceptibility, or openness to smoking, is a predictor of future smoking. This study examines within-gender racial/ethnic differences in smoking susceptibility over historical time (1999–2018) and developmental age (11–18 years). Methods Data were obtained from 205,056 adolescent never smokers in 14 waves of the National Youth Tobacco Survey. Weighted time-varying effect models were used to estimate nonlinear trends in smoking susceptibility among minority (versus white) adolescents. Analyses were conducted in 2019. Results Compared with whites, Latino/a adolescents were consistently more susceptible to smoking, whereas black and Asian adolescents fluctuated between being less and equally susceptible over time. American Indian, Alaska Native, Native Hawaiian, and Pacific Islander adolescents were more susceptible from 2014 to 2017, with differences being larger for girls. Susceptibility peaked at age 14 years. Compared with whites, Latino/a adolescents were more susceptible throughout adolescence. Black adolescents were more susceptible in early adolescence, whereas Asian adolescents were less or equally susceptible to smoking in early to mid-adolescence. American Indian, Alaska Native, Native Hawaiian, and Pacific Islander girls were more susceptible in early and mid-adolescence, but boys were more susceptible in early adolescence only. American Indian, Alaska Native, Native Hawaiian, and Pacific Islander girls were less susceptible than white girls aged 18 years. Conclusions Twenty-year racial/ethnic differences in smoking susceptibility were evident, particularly among girls, but were mostly equivalent between genders over developmental age. Targeting susceptible adolescents with gender-, race/ethnic-, and age-tailored prevention efforts may prevent or delay adolescents’ transition to tobacco use and reduce tobacco-related disparities.

Adolescent smoking is a persistent public health problem across countries, including the UK (Unger and Rohrback 2002) that appears climbing (Chen et al. 2008; Farrelly et al. 2002). The model used in this study expands the EPPM model to include social factors (parental and peer pressure) and a range of emotions beyond fear. After pre-testing the field study included 1479 non-smoking adolescents 11–13 years old and 358 smokers 11–13 years old from a mix of schools in southern England. All scales proved reliable and the data were submitted to SEM. Among non-smokers parental views of smoking have a strong effect on smoking attitude and intentions to smoke, as does susceptibility to peer pressure. Perceived threat of smoking results in attitudes toward smoking being more negative for social threats only, while perceived efficacy reduces both attitudes and intentions for both social and physical threats.

The prevalence of adolescent smoking in Greenland is relatively high and remains an important topic to study. The present study reports the prevalence of smoking among Greenlandic adolescents in 2018 and the association between smoking and social relations. The study was based on HBSC Greenland 2018, using a theoretical framework proposed by Due and colleagues, which divides social relations into structural and functional relations. The study showed a statistically significant gender difference in smoking, as 11.4% of the girls reported to smoke compared to 7.9% of the boys. The smoking prevalence increased significantly with age, and differences were also found for a place of residence, as the smoking prevalence was higher in towns and settlements compared to Nuuk. The adolescent smoking prevalence was higher when living in a home with one adult or in a foster family, school home or orphanage, versus living in home with at least two adults. No significant associations were found between adolescent smoking and functional relations. The results are beneficial to consider when applying new interventions to prevent adolescent smoking initiation in Greenland.

Introduction We explored the role of rejection of parental smoking in the association between parental smoking and smoking in adolescents. Methods In 2010–11 cross-sectional survey, 61,810 Hong Kong secondary school students (mean age 14.6 years, 50.5% boys) reported their smoking (never, not susceptible; never, susceptible; ever, not current; current), paternal and maternal smoking, and whether they accepted paternal and maternal smoking (acceptance/rejection). We used multinomial logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of students' smoking in relation to acceptance and rejection of parental smoking, compared with no parental smoking. Results The OR (95% CI) of “never, susceptible”, “ever, not current”, and “current”, compared with “never, not susceptible”, in relation to acceptance of paternal smoking was 1.81 (1.67–1.96), 2.46 (2.25–2.69), and 2.79 (2.51–3.10), respectively. The corresponding ORs for rejection were 0.70 (0.64–0.76), 1.23 (1.13–1.35), and 0.47 (0.40–0.56). The OR (95% CI) of “never, susceptible”, “ever, not current”, and “current”, compared with “never, not susceptible”, in relation to acceptance of maternal smoking was 2.05 (1.80–2.33), 2.57 (2.29–2.88), and 6.33 (5.39–7.44), respectively. The corresponding ORs for rejection were 0.85 (0.69–1.05), 1.59 (1.39–1.81), and 2.14 (1.71–2.68). No overlapping was observed between the 95% CIs for acceptance and rejection of paternal or maternal smoking. Conclusions While adolescent smoking was associated with parental smoking, especially in those who accepted parental smoking, the association was attenuated or reversed in those who rejected parental smoking.

Background: Smoking is recognized as a major public health problem in the world.Materials & Methods: The objective of the study was to assess the prevalence and determinant of adolescent smoking in West Kafrul Dhaka. This was a cross sectional study conducted in 2013 among 150 adolescent boys of school and slum.Results: The results showed 35.33% adolescent boys had smoking habit. Most of the adolescent (86.79%) had started smoking when they were 14-17 years old. This study found that peers influence (50.94 %) was the most common causes of smoking. Among the boys who live in slum, 80% were smoker and among the school going boys 15% were smoker.Conclusion: Smoking was very common among middle-class male teenagers and even more prevalent among youths from nearby slums. Awareness program on tobacco will be an effective way to control.Anwer Khan Modern Medical College Journal Vol. 9, No. 1: Jan 2018, P 34-38

The aim of the study was to understand, from the perspective of youth, how and under which circumstances a ban on tobacco sales to minors can be effective in influencing youth smoking behaviour. We searched Medline, Embase, and PsychINFO in February 2016. A systematic search for studies about a ban on sales to minors and smoking behaviour was performed. Only studies that addressed potential mechanisms were included, resulting in thirty-three studies. We extracted evidence from 26 quantitative, 5 qualitative, and 2 mixed-methods studies, explaining how the ban may be effective in reducing smoking behaviour, and contextual factors that may influence these mechanisms. We identified two mechanisms and three contra-mechanisms. First, when direct access to commercial sources is limited, cigarette consumption may be reduced because minors have restricted access to commercial cigarettes. Minors' access to social sources and the various ways in which they continue to buy cigarettes by circumventing the ban, are two contra-mechanisms that undermine this effect. Second, when the ban is strongly enforced, an anti-smoking norm may be created and adolescents may smoke less as a result. One contra-mechanism may possibly undermine this effect: the 'forbidden fruit' effect. Whether these (contra-) mechanisms occur depends on contextual and individual factors such as level of enforcement, the minors' social network, and their dependence on smoking. The ban can be effective if well enforced. However, minors' access to social sources and their ways to circumvent the ban should be addressed to achieve its full potential.

BACKGROUND AND OBJECTIVES: Secondhand smoke (SHS) directly increases exposure to airborne nicotine, tobacco’s main psychoactive substance. When exposed to SHS, nonsmokers inhale 60% to 80% of airborne nicotine, absorb concentrations similar to those absorbed by smokers, and display high levels of nicotine biomarkers. Social modeling, or observing other smokers, is a well-established predictor of smoking during adolescence. Observing smokers also leads to increased pharmacological exposure to airborne nicotine via SHS. The objective of this study is to investigate whether greater exposure to airborne nicotine via SHS increases the risk for smoking initiation precursors among never-smoking adolescents. METHODS: Secondary students (N = 406; never-smokers: n = 338, 53% girls, mean age = 12.9, SD = 0.4) participated in the AdoQuest II longitudinal cohort. They answered questionnaires about social exposure to smoking (parents, siblings, peers) and known smoking precursors (eg, expected benefits and/or costs, SHS aversion, smoking susceptibility, and nicotine dependence symptoms). Saliva and hair samples were collected to derive biomarkers of cotinine and nicotine. Adolescents wore a passive monitor for 1 week to measure airborne nicotine. RESULTS: Higher airborne nicotine was significantly associated with greater expected benefits (R2 = 0.024) and lower expected costs (R2 = 0.014). Higher social exposure was significantly associated with more temptation to try smoking (R2 = 0.025), lower aversion to SHS (R2 = 0.038), and greater smoking susceptibility (R2 = 0.071). Greater social exposure was significantly associated with more nicotine dependence symptoms; this relation worsened with higher nicotine exposure (cotinine R2 = 0.096; airborne nicotine R2 = 0.088). CONCLUSIONS: Airborne nicotine exposure via SHS is a plausible risk factor for smoking initiation during adolescence. Public health implications include limiting airborne nicotine through smoking bans in homes and cars, in addition to stringent restrictions for e-cigarettes.

본 연구는 스코틀랜드의 생태체계적 청소년 금연 프로그램의 전략과 실천을 분석하고, 2017년 서울시에서 진행된 ‘담배없는 세대’ 프로그램을 위한 정책적 제언을 하는데 목적이 있다. 본 논문은 청소년 흡연을 개인적 특성과 사회적인 측면이 내포된 복합적인 문제로 보고, 청소년 금연을 위해서 생태체계적 접근이 필요하다고 본다. 이것은 대부분의 한국의 금연 프로그램이 청소년 개인 문제로 접근하고 있는 것과 차별적이다. 연구결과 ‘담배없는 세대’를 만들기 위해서는 첫째, 사회문화적 환경을 바꾸는 ‘낙수효과 접근방식’의 흡연예방을 실시해야 한다. 둘째, 흡연예방의 방향이 처벌중심에서 건강한 삶의 긍정적 선택의 방향으로 나아가야 한다. 셋째, 흡연문화 재생산 방지를 위한 가족의 교육이 필요하다. 넷째, 또래 지원자 양성을 통한 또래문화를 변화시키는 접근이 필요하다. 마지막으로 이를 위해 지속적이고 안정적인 재정지원이 요구된다. 본 연구는 ‘담배없는 세대’를 먼저 시행하고 있는 스코틀랜드의 사례를 통해 한국의 정책과 프로그램이 어떻게 나아가야 할지 단초를 제공하였다는 점에서 중요한 의미를 지닌다.

Background Promoting smoke-free home policies have been a key public health strategy credited with declining rates of cigarette initiation. Awareness of risk for initiation of new products such as e-cigarettes, nicotine dependence, and serious health consequences has led legislators, clinicians, and parents to discuss how best to protect adolescents from using. Parental monitoring and enforcement of rules has been shown to influence adolescent health behaviors. Methods This is a secondary analysis of the Population Assessment of Tobacco and Health (PATH) Study, a longitudinal household survey …

Introduction Regulations of the sale of tobacco products to minors have been effective at reducing adolescent tobacco use overall. However, these efforts may not be uniformly enforced in all areas, creating uneven protection against adolescent smoking. Knowledge regarding factors associated with tobacco retail outlet (TRO) violations could help inform better enforcement strategies. Methods In this study, we used Bayesian index regression models to determine if tobacco sales to minors violations across Virginia (2012–2021) were related to store characteristics and neighborhood deprivation and identify geographic areas at significantly elevated risk for violations after adjusting for these factors. Results Results show that there were multiple factors associated with a higher likelihood of tobacco sales violations. Store type was an important factor, as grocery stores and pharmacies had significantly lowered likelihood of violations compared with convenience stores. Being located near another TRO was significantly associated with increased risk of sales to a minor. Neighborhood deprivation was also positively associated with TRO sales violations. Further, there were statistically higher likelihood of sales violations occurring in specific areas (e.g., southwest and southeast) of the state that were not explained by neighborhood deprivation and store attributes. Conclusions Together, results highlight the need to better understand where and why TRO sales violations are occurring in order to improve efforts aimed at monitoring and remediating TRO sales violations.

This paper provides new evidence on how tobacco control policies affect adolescent smoking as measured by self-reported measures and serum cotinine levels, a biomarker of nicotine exposure. I use data from the National Health and Nutrition Examination Surveys covering 1988–1994 and 1999–2012. Higher cigarette excise taxes lead to statistically significant decreases in smoking prevalence as measured by both self-reports and serum cotinine levels. Among self-reported smokers, cigarette excise taxes are associated with statistically significant reductions in serum cotinine levels but not in cigarette consumption. Among likely smokers, as defined by serum cotinine levels, I do not find that cigarette excise taxes reduce serum cotinine levels on the intensive margin, but I do find that tobacco control policies, especially policies directed at minors, may increase the incidence of misreported smoking status.

Objective: This systematic review synthesizes factors related to nicotine replacement therapy (NRT) use among adolescents seeking to quit smoking, using the social–ecological model as a guiding framework. Data Source: Searches of PubMED, ProQuest, EBSCOhost, and ERIC were conducted in July 2016. Study Inclusion and Exclusion Criteria: Original studies of cigarette smokers younger than 18 years that discussed NRT were included. Data Extraction: Two reviewers individually extracted study purpose, sample, design, and results. Data Synthesis: Factors were categorized by social–ecological model level and summarized. Results: A total of 103 907 articles were identified during initial search. After narrowing to peer-reviewed articles in English and eliminating reviews and adult-only studies, we reviewed 51 articles. These 51 articles identified factors from studies at each level of the social–ecological model: intrapersonal ( k = 20), interpersonal ( k = 2), organizational ( k = 7), community ( k = 11), and public policy ( k = 14). Conclusion: Findings provide insight into the applicability of NRT for adolescent smoking cessation, and factors by social–ecological model level highlight areas for additional research. Future adolescent NRT studies should assess factors at the interpersonal, organizational, and community levels, as well as the interactions between levels.

Objective The utility of studying substance use during early adolescence depends on how well indicies of lower-level experimentation predict the development of substance use problems. We examined associations between experimental cigarette use at T1, recanting of use 8 months later (T2), and daily smoking at 2 years (T4). Methods Longitudinal telephone survey of 6522 US youth aged 10–14, examining lifetime cigarette smoking (none, just puffing, 1–19, 20–100, >100) and recanting (i.e., reporting lifetime use at T1, denying ever using at T2) as predictors of T4 daily smoking using multivariable logistic regression. Covariates included sociodemographics, friend/family smoking, school performance, and personality characteristics. Results The sample was 51% male, 18% Black, 17% Hispanic, with 70% retained at T2. At T1, 407 (8.9%) adolescents reported some smoking, of whom 85 (20.9%) recanted at T2. At T4, 970 reported any smoking, of whom 88 (9.1%) were daily smokers. Any T1 experimentation identified two-thirds of T4 daily smokers (sensitivity = 66.7%) with a false positive rate of 7.8%. T1 lifetime smoking categories were associated with the following adjusted odds ratios for T4 daily smoking (vs. never smokers): 2.7 for recanters (95% confidence interval 0.82, 8.5), 3.5 for few puffs (1.7, 7.0), 9.6 for 1–19 cigarettes (4.1, 22.3), 3.8 for 20–100 cigarettes (1.0, 14.3), and 30.1 for >100 cigarettes (8.1, 111). Conclusions In this sample experimentation with cigarettes predicted future daily smoking with high utility. The findings provide a rationale for monitoring and reporting any experimentation cigarettes as a tobacco surveillance outcome.

Objective: This article examines gender differences in the transmission of smoking, and the role of parenting, school climate, and negative emotions in the parental smoking–adolescent smoking relationship. Methods: The study used a nationally representative cross-sectional data on 5,290 Filipino secondary students. Results: Results suggest that Filipino adolescents having parents who smoke, tend to smoke cigarettes. Maternal smoking affects both girls' and boys' smoking, but paternal smoking has no effect on both sexes. Further, parenting dimensions (support and knowledge), school climate (bullying victimization and peer support), and negative emotions (loneliness and anxiety) tend to moderate the effects of parental smoking on adolescent smoking. Some of these factors appear to protect adolescents from parental smoking, while others aggravate the effects of parental smoking. Conclusions/Importance: Current findings suggest important theoretical and practical implications on the relationship betwe...

Pasien rumah sakit Dr. Soedarso Pontianak yang mengalami penyakit jantung koroner terbukti perilaku merokok sebagai faktor risiko. Pengetahuan merupakan faktor yang dominan memprediksi perilaku merokok remaja di Pontianak. Peneliti ingin mengetahui efektifitas pendidikan kesehatan melalui booklet berbahasa daerah terhadap pengetahuan rokok pada siswa SMP di Pontianak. Rancangan penelitian ini adalah pre-test post-test with control group design. Penelitian ini mengelompokkan subjek kedalam 2 kelompok, yaitu kelompok perlakuan mendapatkan pendidikan kesehatan melalui booklet berbahasa daerah dan kelompok kontrol tanpa perlakuan. Hasil penelitian menujukkan terdapat perbedaan

Adolescent smoking prevention is an important issue in health care. This literature review describes the theoretical concept of ecological model for adolescent smoking and tobacco retailers and summarizes previous studies on the association between the density and proximity of tobacco retailers and adolescent smoking. We reviewed nine studies on tobacco retailer density and proximity in relation to adolescent smoking, published in peer-reviewed journals between 2004 and 2014. The tobacco retailer density and proximity were correlated with adolescent lifetime smoking, past 12-month smoking, past 30-day smoking, and susceptibility to smoking. School nurses or other school health professionals may need to include the density and proximity of tobacco retailer factors around schools in school-based tobacco-use prevention programs. Health policy makers may need to consider zoning or licensing restrictions of tobacco retailers around schools for adolescent smoking prevention.

Background Most European countries have seen a decrease in the prevalence of adolescent smoking. This decrease has, however, been patterned by gender. Girls’ smoking rates have now overtaken boys’ in many European countries. The two genders may not, however, share the same smoking beliefs and this could explain differences between the genders in smoking prevalence. We describe gender differences in smoking beliefs and investigate variations between countries, along with their gender context. Methods In 2016, we conducted the SILNE R study (Smoking Inequalities Learning from Natural Experiments – Renew) in 55 schools located in seven European countries: Belgium, Italy, The Netherlands, Portugal, Finland, Ireland, and Germany. We surveyed 12,979 students aged 14–16 years (50% were girls). We classified smoking beliefs into four categories: positive individual, positive social, negative individual, and negative social beliefs. We expected girls to score higher on the last three of those categories and we hypothesized that countries with a more gender-equal culture would have less gender difference in beliefs about smoking. Results One out of two smoking beliefs differed significantly between genders. Negative social beliefs were more common in girls, while beliefs about the dating-related aspects of smoking were more common in boys. We identified Germany and Belgium as the only countries with no gender differences in any of the belief scales. No correlation was found, however, between these scales and the Gender Inequality Index. Conclusions In some countries, gender-specific interventions might be implemented; however, two opposing strategies might be used, depending on whether such programs are aimed at boys or girls.

BACKGROUND: The United Kingdom (UK) fully-implemented standardised packaging for cigarettes and rolling tobacco on 20th May 2017. We explore adolescent's awareness of, and responses to, standardised cigarette packaging in the UK after it became mandatory.METHODS: Eight focus groups were conducted in schools in Scotland with 16-17 year-olds (n = 41), between November 2017 and November 2018, to explore awareness of, and responses to, standardised cigarette packaging. Unlike in Australia, where only straight-edged flip-top cigarette packs are permitted, in the UK standardised cigarette packs can have slim designs, and different edge types (straight, rounded or bevelled) and opening styles (flip-top or shoulder box). We explored how each of these pack formats was perceived. We also explored to what extent brand variant name differentiated cigarettes sold in standardised packaging.RESULTS: Most participants were aware of standardised packaging without being shown pack stimuli. Standardised packs were considered embarrassing and off-putting, and the health warnings salient. Among the standardised packs shown, there was a preference for the slimmer pack, viewed as more discrete and the cigarettes potentially less harmful, and the shoulder box, considered cool and different. Participants were interested in some brand variant names on standardised packs (e.g. Legendary Black), particularly those they considered to imply coolness and sophistication.CONCLUSION: Adolescents consider standardised cigarette packs in the UK unappealing, and the warnings salient, two core aims of this measure. However, positive reactions to some of the standardised packs (slimmer pack, shoulder box), and variant names used, has implications for countries developing standardised packaging regulations.

Background Policymakers can adopt and implement various supply-side policies to limit youth access and exposure to tobacco, such as increasing the minimum age of sale, limiting the number or type of tobacco outlets, or banning the display of tobacco products. Many studies have assessed the impact of these policies, while less is known about the preceding policy process. The aim of our review was to assess the available evidence on the preceding process of agenda setting, policy formulation, and policy legitimation. Methods A systematic literature search was conducted using the PubMed and the Social Sciences Citation Index databases. After selection, 200 international peer-reviewed articles were identified and analyzed. Through a process of close reading, evidence based on scientific enquiry and anecdotal evidence on agenda setting, policy formulation and policy legitimation was abstracted from each article. Results Scientific evidence on the policy process is scarce for these policies, as most of the evidence found was anecdotal. Only one study provided evidence based on a scientific analysis of data on the agenda setting and legitimation phases of policy processes that led to the adoption of display bans in two Australian jurisdictions. Conclusion The processes influencing the adoption of youth access and exposure policies have been grossly understudied. A better understanding of the policy process is essential to understand country variations in tobacco control policy. Electronic supplementary material The online version of this article (10.1186/s12889-019-7073-x) contains supplementary material, which is available to authorized users.

Background Studies relating cigarette smoking and body weight yield conflicting results. Weight-lowering effects in women and men have been associated with smoking, however, no effects on weight have been proven. This study examined the association between cigarette smoking and relative weight in adolescent males and females as they age into young adults. Methods Data from the National Longitudinal Survey of Youth—a nationally representative survey conducted annually—was used for this analysis. The sample consists of 4225 males and females observed annually from 1997 at age 12 to 17 through 2011 at age 27 to 31. Hierarchical generalized models (HGM) assess the impact of smoking on the likelihood of having higher BMI controlling for demographic, household and environmental impacts. The second estimation considers the possibility that smoking is endogenous and utilizes a multinomial instrument (IV) for smoking level. Results HGM models reveal a negative association between cigarette smoking and BMI for both males and females. Individuals who smoke more have lower BMI compared to infrequent or non-smokers. General health rating, region of residence and income were used instrument for smoking in a linear two-stage IV specification. The instrument is highly correlated with BMI and results mirror the HGM. Finally, models run on early, middle and advanced adolescents show that the relationship diminishes over time. The relationship between BMI and smoking decreases as females age but increases for males. Conclusions Empirical models confirm an association cigarette consumption and BMI in both males and females. This negative relationship varies with age. It is important to identify health risks—obesity—and modifiable risk factors—smoking—that contribute to health disparities among adolescents. However, the increase in one risky behavior leading to the decrease in the prevalence of the other, complicates the issue. The higher prevalence of frequent cigarette uses among both adolescents and young adults of lower BMI suggest that smoking could be used curb or suppress appetite., Highlights • The weight impact of tobacco use by adolescents, unlike adults, has not been conclusively determined. • This study examines the relationship between cigarette use and the body weight (BMI) of high school aged youth. • Since smoking can be considered endogeneous in weight studies, smoking is instrumented in a two-stage process. • Cigarette use is associated with higher BMI, but magnitudes vary by age. • Models run on early, middle and older adolescents show that the relationship diminishes over time. • The relationship between BMI and smoking decreases as females age but increases for males. • Overweight and obese adolescents were more frequent tobacco users. • Results suggest that electronic and conventional tobacco has similar BMI associations when used independently.

Background: Tobacco use is an important public health issue. Morocco implemented a tobacco control programme, which has been ongoing among students at middle and secondary schools since 2010. Aim: This study aims to compare the trend in smoking among the programme beneficiaries with the results of the initial study conducted prior to the implementation of the programme. Setting: This study was conducted in middle and secondary schools of the Gharb Region in Morocco between 2010 and 2015. Methods: Two cross-sectional studies were conducted in 2010 and 2015 in the middle and secondary schools of the Gharb Region. Multistage cluster sampling was used. The information was collected using a self-administered questionnaire. Results: In the first study in 2010, 5312 students participated, and in the second one in 2015, 4208 students participated. The level of information on smoking and its effects was higher in 2015 (94.0%) than in 2010 (92.5%). In 2010, parents, primary schools and television and radio were more involved in student information on smoking compared to 2015. The proportion of students claiming that tobacco was not a pleasure (86.3%) and that it does not calm nerves (76.5%) was significantly higher in 2015 than in 2010. The prevalence of smoking increased significantly in 2015 (2.9%) against 2010 (1.8%). Conclusion: This study reports the general positive evolution in knowledge about smoking and its effects. Despite that the prevalence of smokers increased in 2015. The results suggest the need to address family influences on adolescent smoking and to investigate participation of schools in education and training students in tobacco dependence prevention.

Purpose Smoking is a significant cause of morbidity and mortality worldwide. In the past decades, the prevalence of adolescent smoking has decreased in industrial countries. However, whether the decreasing trend can be seen across all socioeconomic groups is unknown. The aim of this study was to examine time trends in adolescent smoking according to the socioeconomic status among Finnish adolescents between 2000 and 2015. Methods A population-based school survey was conducted biennially among 14- to 16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for frequent smoking, lifelong nonsmoking, and socioeconomic adversities (low parental education, not living with both parents and parental unemployment during the past year) were calculated. Associations were studied using binomial logistic regression results shown by odds ratios with 95% confidence intervals. Results Frequent smoking was positively associated and lifelong nonsmoking was negatively associated with socioeconomic adversities. Over the study period, the overall prevalence of frequent smoking decreased and lifelong nonsmoking increased. However, no similar changes were observed among adolescents with most socioeconomic adversities. Conclusion Socioeconomic differences in adolescent smoking increased in Finland between 2000 and 2015. Although the overall prevalence of frequent smoking decreased, no similar decrease was observed among adolescents with most socioeconomic adversities. Similarly, although the overall prevalence of lifelong nonsmoking increased, this was not observed among adolescents with most socioeconomic adversities. Socioeconomic adversities should be considered in the prevention of adolescent smoking.

Adolescent smoking is a major public health problem around the world, including Thailand. The current study provides a three-month follow-up evaluation of the Project EX tobacco use cessation program among Thai adolescents. The intervention was tested involving a quasi-experimental trial with 185 smokers, with two program and two control condition schools (within each condition, one school in Bangkok Province and one school in Nakhon Pathom Province). At 3-month follow-up, the intent-to-treat (ITT) quit rate was 23% in the program group and 11% in the standard care control group (p

Background and Aims If socio‐economic disadvantage is associated with more adolescent smoking, but less participation in tertiary education, and smoking and tertiary education are both associated with heavier drinking, these may represent opposing pathways to heavy drinking. This paper examines contextual variation in the magnitude and direction of these associations.