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Introduction: Youth initiation may drive differences in smoking prevalence across Canadian provinces. Provincial differences in initiation relate to tobacco control strategies and public health funding, but have also been attributed to population characteristics. We test this hypothesis by examining the extent to which seven characteristics—immigration, language, family structure, education, income, home ownership and at-school status—explain differences in initiation across provinces. Methods: We used data from 16 897 youth aged 12 to 17 years in the Canadian Community Health Survey collected from 2015 to 2018. To examine the proportion of provincial differences explained by population characteristics, we compared average marginal effects (AMEs) from partially and fully adjusted models regressing “having ever initiated” on province and other characteristics. We also tested interactions to examine differences in the association between population characteristics and initiation across provinces. Results: Initiation varied from 4% in British Columbia to 10% in Quebec. Being born in Canada, speaking French, not living in a two-parent household, being in the lowest household income quintile, having parents without postsecondary education, living in rented accommodation and not being in school were each associated with initiation. Taking these results into consideration, the AME of residing in another province compared with Quebec was attenuated by between 3% and 9%. Family structure and household income were more strongly associated with initiation in the Atlantic region and Manitoba, but not in Quebec. Conclusion: Differences in initiation between Quebec and other provinces are unlikely to be substantially explained by their demographic or socioeconomic composition. Reprioritizing tobacco control and public health funding are likely key in attaining the “tobacco endgame” across provinces. [ABSTRACT FROM AUTHOR]

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

This study examines the association between objectively-measured physical activity (PA) intensities and sedentary behavior (SED) in a cohort of 532 children aged 8-10 y. PA and SED were assessed by accelerometer over 7-days. Television and computer/video-game use were self-reported. Associations between PA intensities and SED variables were assessed by Spearman correlations and adjusted multiple linear regression. Higher mean daily moderate-to-vigorous and vigorous PA (MVPA, VPA) were negatively associated with mean daily SED (r = -0.47 and -0.37; p< .001), and positively associated with mean daily total PA (r = .58 and 0.46; p< .001). MVPA was also positively associated with light PA (LPA; r = .26, p < .001 ). MVPA and VPA were not significantly associated with TV, computer/video or total screen time; accelerometer SED was only weakly associated with specific SED behaviors. On average, for each additional 10 min daily MVPA, children accumulated >14 min less SED, and for each additional 5 min VPA, 11 min less SED. Thus, over the course of a week, higher mean daily MVPA may displace SED time and is associated with higher total PA over and above the additional MVPA, due to concomitant higher levels of LPA. Public health strategies should target both MVPA and SED to improve overall PA and health in children. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of mortality in women. In fact, CVD is responsible for a third of all deaths of women worldwide and half of all deaths of women over 50 years of age in developing countries. The prevalence of CVD risk factor precursors is increasing in children. Retrospective analyses suggest that there are some clinically relevant differences between women and men in terms of prevalence, presentation, management and outcomes of the disease, but little is known about why CVD affects women and men differently. For instance, women with diabetes have a significantly higher CVD mortality rate than men with diabetes. Similarly, women with atrial fibrillation are at greater risk of stroke than men with atrial fibrillation. Historically, women have been underrepresented in clinical trials. The lack of good trial evidence concerning sex-specific outcomes has led to assumptions about CVD treatment in women, which in turn may have resulted in inadequate diagnoses and suboptimal management, greatly affecting outcomes. This knowledge gap may also explain why cardiovascular health in women is not improving as fast as that of men. Over the last decades, mortality rates in men have steadily declined, while those in women remained stable. It is also becoming increasingly evident that gender differences in cultural, behavioural, psychosocial and socioeconomic status are responsible, to various degrees, for the observed differences between women and men. However, the interaction between sex- and gender-related factors and CVD outcomes in women remains largely unknown. [ABSTRACT FROM AUTHOR]

This study describes student perceptions of school staff smoking before and after implementation of legislation prohibiting smoking on school grounds. Students completed self-report questionnaires before (grade 6) and after (grade 7, 9 and 11) the law. The percentage of students reporting that school staff smoked in areas where smoking is forbidden was 19%, 32% and 33% in grade 7, 9 and 11, respectively. The mean(SD) score for the frequency with which students saw school staff smoking decreased after the ban but increased thereafter [2.5(1.1), 1.9(1.0), 2.4(1.1) and 2.3(1.1)] in grade 6, 7, 9 and 11, respectively [F(2.861,1662.229) = 45.350, P < 0.001]. These data suggest that the effect of the law dissipated over time. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To describe the development of a prognostic tool to identify adolescents at risk for transitioning from never to ever smoking in the next year. METHODS: Data were drawn from the Nicotine Dependence in Teens study, a longitudinal investigation of adolescents (1999 to present). A total of 1294 students initially age 12 to 13 years were recruited from seventh-grade classes in 10 high schools in Montreal. Self-report questionnaire data were collected every 3 months during the 10-month school year over 5 years (1999-2005) until participants completed high school (n = 20 cycles). Prognostic variables for inclusion in the multivariable analyses were selected from 58 candidate predictors describing sociodemographic characteristics, smoking habits of family and friends, lifestyle factors, personality traits, and mental health. Cigarette smoking initiation was defined as taking even 1 puff on a cigarette for the first time, as measured in a 3-month recall of cigarette use completed in each cycle. RESULTS: The cumulative incidence of cigarette smoking initiation was 16.3%. Data were partitioned into a training set for model-building and a testing set to evaluate the performance of the model. The final model included 12 variables (age, 4 worry or stress- related items, 1 depression-related item, 2 self-esteem items, and 4 alcohol- or tobacco- related variables). The model yielded a c-statistic of 0.77 and had good calibration. CONCLUSIONS: This short prognostic tool, which can be incorporated into busy clinical practice, was used to accurately identify adolescents at risk for cigarette smoking initiation. [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]