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A limited number of findings from empirical studies show that biracial adolescents are at a heightened risk of peer victimization. Black/White biracial adolescents are frequent targets of peer victimization due to racism and systematic oppression that are inherent in U.S. schools. Similar to adolescents of other racial and ethnic groups, biracial adolescents who are victimized by their peers are likely to exhibit psychosocial and behavioral issues. However, little is known about protective factors that might buffer the link between peer victimization and adverse outcomes of these youth. The study examines whether perceived ease of talking with parents and siblings moderates the association between peer victimization and psychosocial problems among Black/White biracial early adolescents. Data were derived from the Health Behavior in School-Aged Children (HBSC) study. Participants were 158 early adolescents, ages 10-14, who self-reported as both Black and White. Adolescents who perceived their fathers as easy to talk to were less likely to bully others or carry a weapon when victimized by their peers. Adolescents who perceived their mothers to be easy to talk to were less likely to carry a weapon. There were also lower rates of psychosomatic symptoms for youth who reported perceived ease talking with siblings.

School bullying and cyberbullying are serious public health problems that negatively affect the lives of school-aged children. We examined the correlation between risk behaviors and lack of resiliency factors with bullying and cyberbullying across seven Mediterranean countries. The sample consisted of 33,399 adolescents (51.1% girls) aged 11, 13, and 15 years who participated in the Health Behavior in School-aged Children (HBSC) survey in 2018 in Greece, Israel, Italy, Macedonia, Malta, Portugal, and Spain. Bivariate logistic regressions were conducted to test the relationship between risk behaviors, resilience, and bullying. All risk behaviors and lack of resiliency factors examined were related to involvement in bullying as a victim, perpetrator, or bully-victim, both in school and cyberbullying. Moreover, the odds of involvement in school bullying and cyberbullying increased as the number of risk behaviors and the lack of resiliency factors grew. Our results may contribute to the development and implementation of anti-bullying programs.

The workplace has been highlighted as a potential setting to deliver health promotion programs to target modifiable health behaviors that contribute to chronic disease. This review evaluated the effectiveness of interventions implemented within the workplace that targeted either smoking, nutrition, alcohol, physical activity, and/or overweight and obesity in men. A review protocol was prospectively registered through PROSPERO (CRD42021293398). Five electronic bibliographic databases were searched for randomized controlled trials conducted in the workplace assessing chronic disease risk factors in men from January 2010 to August 2021. Eleven studies were included, reporting on overweight and obesity n = 8, physical activity n = 7, nutrition n = 4, alcohol n = 3, smoking n = 3, with eight studies assessing multiple outcomes. Results were mixed. Narrative synthesis highlighted studies reporting improvements to snacking frequency, sugar sweetened beverage consumption, and physical activity (METs and Vo2 max). Meta-analysis highlighted pooled mean decrease in body weight of -0.28 kg up to 3 months; -1.38 kg for >3 months, and pooled mean decrease in body mass index 0.06 kg/m2 up to 3 months; -0.27 kg/m2 for >3 months. Despite the encouraging direction of the relationship, results were not statistically significant (p > 0.05). Findings underscore the potential of workplace health promotion programs targeting certain chronic disease risk factors in men; however, future research should consider long-term study designs to assess the efficacy of workplace health programs as a solution to the growing burden of global disease.

Objective: Adverse childhood experiences (ACEs), which refer to childhood traumatic events, have been identified as risk factors for tobacco use in adulthood. However, studies are limited on the effect of sex on the association of ACEs with e-cigarettes and dual use of e-cigarettes and cigarettes. This study explored sex differences in the association of ACEs with e-cigarettes, cigarettes, and dual use of e-cigarettes and cigarettes among adults in the United States. Methods: This was a cross-sectional analysis of data from adults aged [greater than or equal to]18 years in the 2020 Behavioral Risk Factor Surveillance System (N = 62,768). ACEs, the independent variable, was a composite score assessed from 11 questions (with responses yes-1 or no/never-0) related to childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction and categorized as 0 (reference), 1, 2, 3, or [greater than or equal to] 4. The dependent variable, tobacco use patterns, included nonuse (reference), e-cigarette only, cigarette only, and dual use of e-cigarettes and cigarettes. Multinomial logistic regression was performed to test the interaction between sex and ACEs while controlling for potential confounders. Results: Although we found no statistically significant interaction by sex, a greater number of ACEs were associated with higher odds of the different tobacco use patterns among females and males, with varying strengths of associations. Specifically, females who reported [greater than or equal to] 4 ACEs compared with none had higher odds of e-cigarette (aOR [95% CI]: 3.58 [1.49-8.63]), cigarette (2.57 [1.72-3.83]) and dual use (3.25 [1.79-5.91]) relative to nonuse. Males with [greater than or equal to] 4 ACEs had higher odds of cigarette (1.75 [1.15-2.65]) and dual use (7.64 [3.95-14.79]). Conclusion: Our findings underscore the importance of developing appropriate, tailored trauma-informed intervention strategies for females and males. It is also important to consider ACEs in designing tobacco-specific preventive programs to curb initiation and promote cessation among U.S. adults.

Telephone-based services are a practical and effective behavioral support for smoking cessation, yet no in-depth analyses of this counseling have been conducted. Understanding the general content of Quitline conversations can help to improve current practices and may inform future interventions. Therefore, we aimed to independently explore conversation themes, topics, and client questions during Quitline counseling sessions with Quitline clients in Queensland, Australia. A purposive sample of 30 recorded counseling sessions, completed between January and March 2019, were de-identified, transcribed, and thematically analyzed. Seven themes, encompassing 35 topics, were derived from 26 initial calls and four follow-up calls: (1) Client details and building rapport; (2) Client history and motivation to quit; (3) Pharmacotherapy; (4) Behavioral aspects of quitting and relationship with smoking; (5) Understanding nicotine dependence and other important considerations; (6) Additional support and smoking cessation resources; and (7) Planning, goal setting and follow-up. Three themes emerged from 18 client questions including: (1) Pharmacotherapy safety and contraindications; (2) Pharmacotherapy instructions and mechanism of action; and (3) Physiology of nicotine dependence. This is the first qualitative analysis of the content of Quitline counseling sessions in Australia. Counselors collect and deliver a breadth of information to provide tailored, evidence-based health care, while building rapport and trust. Findings may be translatable into personalized self-help interventions that are more accessible or appealing to people reluctant to contact Quitline. Harnessing educational opportunities regarding pharmacotherapy adherence and misconceptions can improve client confidence in the product and smoking cessation outcomes. Further research will map conversations to motivational interviewing and behavior change techniques.

Background: Social factors play an important role in adolescents' behaviors. This study aims to understand percentages of health risk behaviors across country in Europe, North America, and China; explore the associations between friendly school and family contexts and involvement for several health risk behaviors among adolescents. Methods: Data derived from health behavior in school-aged children cross-sectional surveys and China Education Panel Survey in 2014-2015. Hierarchical generalized linear modeling was used to analyze data. Results: The highest percentages of health risk behaviors including unhealthy diet, smoking or alcohol, screen-based sedentary behaviors, and violent behaviors across country ranged from 28.62% to 65.24%. National classmate friendliness was negatively associated with 5 out of 9 health risk behaviors prevalence rates in 41 countries (p < 0.05). Adolescents' perceived peer friendly and helpful were common protective factor for engaging in several health risk behaviors (p < 0.01). Individual family contexts were associated with 3 types of health risk behaviors involvement (p < 0.001). School health policy implications: Health risk behaviors among adolescents reducing was associated with the implementation of friendly school and family contexts, emphasizing the significance of the goals of embedding friendly adolescents, along with the home-school collaboration. Conclusions: Public health strategies should promote national climate of friendship and individual perceived friendly school contexts to reduce health risk behaviors.

Objective: In Denmark, more students smoke in vocational schools than in upper secondary schools. Smoking-prevention initiatives may reduce the prevalence of smoking but may also introduce unforeseen challenges. This study examined the significance of smoking and dilemmas related to smokefree school hours (SFSH) among established smokers in Danish vocational schools. Design: Qualitative research design. Setting: Data collection took place in a vocational education and training (VET) school in Denmark. The subject area was care, health and pedagogy (CHP). Method: Participant observation and focus groups were conducted with students and teachers. Two classes were observed for 2 weeks in total. The data analysed consisted of participant observation field notes (n = 10 school days), transcripts from student focus groups (n = 6; aged 18--56) and transcripts from teacher focus groups (n = 11). Results: Two dilemmas were described as faced by established smokers in relation to the implementation of smokefree school hours: (1) The school is entitled to make rules versus the right to decide for oneself; and (2) life and schoolwork are challenging and demanding versus school work is more important than smoking. Conclusion: The findings illustrate how smoking, as an ingrained everyday practice for established smokers, represents a means of coping with difficult school demands and everyday challenges, particularly for vulnerable students, and how regulations such as SFSH create dilemmas for those students. These dilemmas are important to consider when designing and implementing smoking-prevention initiatives to prevent potential negative side effects and an unintended increase in social inequality in smoking.

Objective: To investigate the impact of generalized joint hypermobility (GJH) on eating behavior. Participants: Physical therapy and rehabilitation students. Methods: The Beighton evaluation (a cutoff of 5/9) for defining GJH. The Eating Attitudes Test (EAT-40) was used for eating disorders. Smoking habits and alcohol use were also questioned. Results: Compared with 51 non-GJH students (mean age 20.5 years, 73% female), 46 students with asymptomatic GJH (20.6 years, 89% female) were more likely to have greater median EAT-40 scores (9 vs. 6, p = 0.002). There was no statistically significant difference between the groups in terms of the susceptibility to eating behavior disorders (6.5% vs. 2.0%), smoking habits (6.5% vs. 9.8%), and alcohol use (15.2% vs. 11.8%) (p > 0.05). Positive correlation (r = 0.221, p = 0.029) and positive effect (R = 0.221, R[superscript 2] = 0.049; p < 0.05) between Beighton scores and EAT-40 scores were found. Conclusion: The more joint hypermobility the greater the risk for eating disorders.

Objective: This study investigated the sex-specific prevalence of smoking (past 30 days) and the associations with height among university/college students. Participants: 25,405 (11,579/14,826 males/females) college students in Xi'an China. Methods: A cross-sectional, self-administered survey. Results: The male and female prevalence of smoking (past 30 days) was 32.9% and 7.4%, respectively. The prevalence of smoking of the male height groups ranged from 29.8% to 36.9%; only the [greater than or equal to]188 cm height group showed significantly higher prevalence than the reference group (i.e., 173-177cm; 33.0%). The female prevalence of smoking was 4.0-8.2% in the [less than or equal to]170cm groups and increased to 12.3% in the 171-175 cm group and 36.1% in the [greater than or equal to]176 cm group, while it was 6.5% for the reference group (161-165 cm). Conclusions: This exploratory study firstly revealed the significantly higher prevalence of smoking among the "tallest" height groups, especially among females. Future studies are warranted to confirm such findings and explore related mechanisms.

Objective: The present study aims to examine whether secondhand smoke exposure (SHSE) in university students can affect three indices of self-satisfaction related to depression as indiced by appearance, weight, and freedom of life choice. Participants: We collected data from 740 nonsmoking students in the summer of 2018, of which 57.84% were exposed to secondhand smoke. Methods: Depressive symptoms, SHSE, smoking status, weight satisfaction, appearance satisfaction, and freedom of life choice were self-reported via a questionnaire. Results: The generalized linear analyses revealed that SHSE was linked to lower scores of perceived freedom of life choice but not significantly associated with weight nor appearance satisfaction. The mediation analyses indicated that perceived freedom of life choice fully mediated the association between SHSE and depressive symptoms. Conclusions: These findings shed light on the importance of SHSE and its effects on mental health in university students. Preventive strategies should therefore locally target university campuses.

Research has linked pre- and perinatal complications (PPCs) with increased risk for autism spectrum disorder (ASD). However, PPCs are also known risk factors for other mental health disorders. This study explored which PPCs are specific risk factors for ASD, as opposed to other forms of psychopathology, among a large sample of clinically-referred youth. Archival data were used from 1177 youth who were evaluated at a hospital-based autism clinic. Results from logistic regressions indicated that use of tobacco, alcohol, or drugs, or experiencing amniocentesis predicted inclusion in the non-ASD group, while physical difficulties with delivery predicted inclusion in the ASD group. Possible explanations and implications for these findings are discussed.

Lifestyle risk behaviours--physical inactivity, poor diet, poor sleep, recreational screen time, and alcohol and tobacco use--collectively known as the "Big 6" emerge during adolescence and significantly contribute to chronic disease development into adulthood. To address this issue, the Health4Life program targeted the Big 6 risk behaviours simultaneously via a co-designed eHealth school-based multiple health behaviour change (MHBC) intervention. This study used multiple causal mediation analysis to investigate some potential mediators of Health4Life's effects on the Big 6 primary outcomes from a cluster randomised controlled trial of Health4Life among Australian school children. Mediators of knowledge, behavioural intentions, self-efficacy, and self-control were assessed. The results revealed a complex pattern of mediation effects across different outcomes. Whilst there was a direct effect of the intervention on reducing moderate-to-vigorous physical activity risk, the impact on sleep duration appeared to occur indirectly through the hypothesised mediators. Conversely, for alcohol and tobacco use, both direct and indirect effects were observed in opposite directions cancelling out the total effect (competitive partial mediation). The intervention's effects on alcohol and tobacco use highlighted complexities, suggesting the involvement of additional undetected mediators. However, little evidence supported mediation for screen time and sugar-sweetened beverage intake risk. These findings emphasise the need for tailored approaches when addressing different risk behaviours and designing effective interventions to target multiple health risk behaviours. The trial was pre-registered with the Australian and New Zealand Clinical Trials Registry: ACTRN12619000431123.

Background: Despite recent declines, youth nicotine vaping remains seen by experts as a national public health epidemic. Few, if any, researchers have examined how related high-profile and school-based prevention programs such as LifeSkills Training (LST) are further disseminated with cooperation from research-to-practice entities as well as the tobacco industry. Purpose: Provides a systems-driven documentary analysis of efforts pertaining to prevention entities at the University of Colorado, Boulder, as well as LST, and the tobacco industry. Methods: Employs focused synthesis data collection with constant comparative analyses. Results: Likely previously unseen and related to LST, is the degree to which prevention entities with a public mission appear to cooperate among themselves and with the tobacco industry as part of a longstanding, if not elaborate, school-based drug prevention social system characterized by patterned evidence of opaque or furtive representations and/or activities. Discussion: Along with limitations, summarizes a research-to-practice social system likely compromising school-based prevention and, in turn, the health of the young people they serve. Theorizes a symbolic politics explanatory mechanism while providing recommendations toward transparency for more informed school-based prevention decision-making. Translation to Health Education Practice: Emphasizes the National Commission for Health Education Credentialing Inc. (NCHEC) critical thinking and program evaluation competencies.

Background: Tobacco use and dependence alongside environmental tobacco exposure collectively form a leading cause of morbidity and mortality for the global population. Several clinical and public health interventions have sought to address this growing epidemic on both micro and macro levels. One national campaign, "Tips From Former Smokers" was prominent across the tobacco cessation landscape. Implemented by the U.S. Centers for Disease Control and Prevention, this campaign garnered coverage and engagement across the national population and also on virtual spaces via social media platforms in our digital era. Purpose: This study is the first of its kind to critically examine sources and formats as well as assess the nature of content covered across the widely viewed videos pertaining to this campaign on YouTube. Prior studies have analyzed this campaign's content on Facebook and Twitter. Method: This study was cross-sectional, descriptive, and observational in design and involved conducting a content analysis of the most popular videos covered on the campaign across YouTube. Results: Videos pertaining to health and aesthetic effects stemming from the sequelae of smoking, environmental tobacco exposure, and comorbidities with smoking attracted the most views. The majority of the widely viewed videos on the campaign were in the form of testimonials. There was scant coverage on tips and strategies for cessation across the videos. Discussion: We present several clinical, campaign and systemic implications from these findings. We also propose recommendations for further considerations in future campaign development and implementation that build off the limitations and draw on the strengths of the "Tips From Former Smokers" campaign in addressing tobacco use and dependence as well as environmental tobacco exposure as targets for future cessation interventions. Translation to Health Education Practice: In addition, we further delineate recommendations that account for health equity, diversity, and inclusivity considerations in coverage of content that could heighten engagement, relatability, connectivity, and acceptability of content by viewers worldwide. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars. http://portal.shapeamerica.org/trn-Webinars

This study investigated the extent to which adolescent social network positions are associated with the risk of lifetime daily smoking and nicotine dependence (ND), and whether these associations differ by gender. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 6,267), this study estimated multinomial logistic regression models. An increase in in-degree nominations, out-degree nominations, and Bonacich centrality was associated with a lower relative risk of never smoking daily versus ever smoking daily. By contrast, adolescents with greater in-degree nominations, out-degree nominations, Bonacich centrality, and network reach in three steps were at decreased risk for lifetime ND. Gender-stratified models indicate that the negative association between network position and never smoking daily was driven largely by women, whereas the positive association between network position and lifetime ND was driven largely by men. Incorporating social network structural approaches into adolescent smoking prevention efforts may be beneficial.

Public health campaigns have the potential to correct vaping misperceptions. However, campaigns highlighting vaping harms to youth may increase misperceptions that vaping is equally/more harmful than smoking. Vaping campaigns have been implemented in the United States and Canada since 2018 and in England since 2017 but with differing focus: youth vaping prevention (United States/Canada) and smoking cessation (England). We therefore examined country differences and trends in noticing vaping campaigns among youth and, using 2022 data only, perceived valence of campaigns and associations with harm perceptions. Seven repeated cross-sectional surveys of 16-19 year-olds in United States, Canada and England (2018-2022, n = 92 339). Over half of youth reported noticing vaping campaigns, and noticing increased from August 2018 to February 2020 (United States: 55.2% to 74.6%, AOR = 1.21, 95% CI = 1.18-1.24; Canada: 52.6% to 64.5%, AOR = 1.13, 1.11-1.16; England: 48.0% to 53.0%, AOR = 1.05, 1.02-1.08) before decreasing (Canada) or plateauing (England/United States) to August 2022. Increases were most pronounced in the United States, then Canada. Noticing was most common on websites/social media, school and television/radio. In 2022 only, most campaigns were perceived to negatively portray vaping and this was associated with accurately perceiving vaping as less harmful than smoking among youth who exclusively vaped (AOR = 1.46, 1.09-1.97). Consistent with implementation of youth vaping prevention campaigns in the United States and Canada, most youth reported noticing vaping campaigns/messages, and most were perceived to negatively portray vaping.

Objective: Despite community colleges accounting for 34% of all undergraduate enrollment, research on substance-use patterns among community college students is limited. Community college students may engage in substance use differently than their 4-year university counterparts due to differences in psychosocial factors and decreased availability of mental health services. The current study aimed to elucidate risk factors underlying non-medical use of prescription simulants (NMUS) and nicotine use by community college students. Methods: A web-based survey was administered to 10 of 13 community colleges within a southeastern state's Board of Regents school system. The survey included questions related to NMUS, nicotine use, alcohol use, mental health diagnosis, and demographics. Results: Overall, 9% of the participants reported NMUS, and 24.6% used nicotine. Multivariate analysis of variance and ?[subscript 2] tests revealed group differences among individuals using only nicotine, only NMUS, both nicotine and NMUS, and neither nicotine nor NMUS. Post-hoc 2 × 2 ?[subscript 2] tests indicated that individuals using both nicotine and NMUS had higher incidence of mental health diagnoses, were more likely to live in urban areas, reported higher weekly alcohol consumption, and were more likely to be male as compared to individuals using neither substance. Attention-deficit hyperactivity disorder (ADHD) symptoms were higher in individuals using only NMUS and both NMUS and nicotine as compared to those using only nicotine or neither substance. Conclusions: These findings provide insight into demographic and psychological variables associated with NMUS and nicotine use among community college students that could be benefitted by greater access to affordable mental health services.

This is part II of a two-part series on integrating a physical activity component in delivering health lessons to elementary and middle school students. The purpose of this series is to illustrate how health content can be implemented with hands-on activities, physical experiments, visual illustrations that are associated with a specific lesson focus, or physical tasks that require students to repeatedly practice memory recall. Two physical activities in the following five health education topics are provided in this article: (1) alcohol, tobacco and other drugs; (2) communicable and chronic diseases; (3) consumer and community health; (4) environmental health; and (5) injury prevention and safety. Corresponding National Health Education Standards and twenty-first-century skills for each activity are also provided. Similar to part I of the series, a few of the designs can be implemented with a different lesson focus or health topic. Examples are discussed at the end of the article.

In the summer of 2020, SARS-CoV-2 infection rates among the U.S. population aged 20-39 years exceeded other age groups, with the largest increases occurring in the southern US. As many colleges reopened for in-person instruction in August and September, these trends continued among campuses across the country. Our study aimed to identify risk factors (demographic and behavioral) associated with SARS-CoV-2 infection among college students. We used data from a survey administered to students at a southern university in the US. The survey had a total of 765 respondents and this study included the 679 (88.8%) who responded about their SARS-CoV-2 infection status. We examined associations between population characteristics and reported SARS-CoV-2 infection and calculated prevalence ratios along with 95% confidence intervals. SARS-CoV-2 infection was 2.5 times more likely among current users of electronic nicotine delivery systems (ENDS) compared to those who do not use ENDS (95% confidence interval [CI]: (1.76-3.4)) and 2.8 times more likely among those who reported a high frequency of binge drinking compared to those who did not report binge drinking (95% CI: (1.81-4.36)). Current high frequency ENDS users were 2.76 (1.79-4.25) more likely to report SARS-CoV-2 infection than non-users. Current low frequency users of ENDS were 2.27 (1.53-3.37) times more likely to report SARS-CoV-2 infection than nonusers. A trend analysis among ENDS use frequency and SARS-CoV-2 infection was statistically significant, showing a significant dose response with increasing ENDS use. The results of this analysis may assist in providing guidance on policies as well as may serve as a steppingstone for future research concerning SAR-CoV-2 infection among university populations.

The school-to-prison pipeline (STPP) describes in shorthand the problematic relationship between some students' school experiences and their subsequent incarceration. One summer, in response to vocal concerned parents, a suburban school board adopted a zero-tolerance policy for smoking and vaping. Through the combined effects of the zero-tolerance approach, exclusionary punishments, the presence of SROs (school resource officers), racially disproportionate disciplinary practices, and a culturally nonresponsive school setting, 90 students were introduced to the criminal justice system in one school year. This case helps school leaders examine the elements of the STPP and how they work together to damaging effect. The questions and activities will guide readers to develop multiple ways to forestall and/or repair STPP supporting policies and practices.

Objective: This study aimed to understand COVID-19 pandemic impacts on anxiety, depression, and addictive/excessive behaviors, with exploration of intolerance of uncertainty (IU) and social connectedness as potential moderators. Participants: Adult college students participated. Method: Our online survey assessed symptoms and behaviors prior to COVID-19, during the initial outbreak (Wave 1), and during early 2021 (Wave 2). Results: Significant increases were found in anxiety, depression, binge eating, sexual behaviors, video game playing, internet/social media usage, and compulsive exercise in both waves. IU moderated the relationship between both depression/anxiety and certain excessive behaviors; social connectedness moderated the relationship between anxiety and smoking. Conclusions: This study replicated prior work and highlights new impacts on addictive/excessive behaviors, as well as moderating effects from social connectedness and IU. Future research is warranted to evaluate the efficacy of treatments targeting IU and social connectedness as the pandemic continues to unfold.

Objective: This longitudinal study tested the relationship between cigarette and e-cigarette use and SARS-CoV-2 seroconversion among US college students. Participants: Undergraduate students (n = 764), drawn from a randomly selected invitation-only pool from a large Midwestern university, that were initially negative for SARS-CoV-2 antibodies and were re-tested in November were included in this study conducted in Fall 2020. Methods: Demographics and cigarette and e-cigarette use behaviors (nicotine use) were collected in a baseline survey. SARS-CoV-2 antibody tests were administered in September (baseline) and November (endline) of 2020. Log-binomial regression analyses were conducted to test the association between nicotine use and SARS-CoV-2 seroconversion. Results: SARS-CoV-2 seroconversion was 5.2%. No statistically significant associations were found between nicotine use and SARS-CoV-2 seroconversion. Conclusions: Contrary to prior results, we found no association between nicotine use and SARS-CoV-2 seroconversion. Nicotine use may not be a key risk factor for COVID-19 acquisition in predominantly healthy college-aged populations.

Objective: To examine the association between vaping and health behaviors (physical activity, fruit and vegetable consumption, sleep, cigarette use, alcohol consumption) and mental health among college students. Methods: Socio-demographic characteristics, vaping, health behaviors, perceived stress, and depressive symptoms of undergraduates enrolled at a large university located in the Northeast of the United States were assessed via an online survey. Results: Of all participants (n = 1775), less than a fifth (n = 314, 17.7%) reported any vaping in the past month. More men reported vaping than women (23.2% vs. 14.5%). Those who vaped reported fewer nights of restful sleep and greater alcohol consumption. Those who smoked and binge drank were more likely to report vaping. Perceived stress was greater among women who vaped, and depressive symptoms were greater among those who vaped regardless of gender. Conclusions: Vaping was associated with smoking, alcohol consumption, and poorer mental health among young adults.

Objective: Problem-drinking among university students is common and poses serious health-related risks. Therefore, identifying and addressing associated factors is important. Participants and methods: A large cross-sectional online-survey with 12,914 university students from Berlin was conducted from November 2016 to August 2017. Relative-risk- and correlation-analysis was used to identify factors associated with problem-drinking and regular heavy-drinking. Independent t-tests compared impulsivity and personality traits, chi-square-tests compared drinking motives between risk- and non-risk-drinkers. Results: Male gender, tobacco-smoking, illegal substance use, impulsivity and various sociodemographic and psychosocial variables were significantly related to problem/heavy-drinking. Extraversion was a risk, conscientiousness and agreeableness were protective factors. Drinking-motives did not differ significantly between risk- and non-risk-drinkers. Generally, the main drinking-motives were to feel elated, relax and social purposes. Conclusion: The identified markers and related problem behaviors may serve as a tool to enhance the identification of student subgroups at risk for problem/heavy-drinking, and hence improve targeted health-intervention-programs.

Background: The key to controlling tobacco use lies in preventing new smokers. Graphic health warnings (GHW) discourage smoking initiation, but their effectiveness depends, in part, on their design. Purpose: To measure the effect of varying the design and location of GHW, which occupy 30% of the package, to discourage smoking initiation. Methods: Non-smokers young adults aged 18-21 years (n = 358) were recruited online and randomized to one of four experimental conditions, in a 2 (Color, yellow vs white) × 2 (Location, top vs. bottom) between subjects experimental design. Results: GHWs located on top increase perceived message effectiveness, reduce pack appeal, and decrease purchase intention. Yellow color increases perceived message effectiveness and white color reduces pack appeal. Yellow warnings on top grabbed more attention. Discussion: Results suggest that the yellow warning on top is the best combination for GHWs covering 30% of the pack. This combination increases perceived message effectiveness, decreases pack appeal, and is the most attention-grabbing. Translation to Health Education Practice: Health communication strategies that address these key considerations can contribute to the prevention of cigarette smoking-associated noncommunicable diseases. Competencies and sub-competencies in one area of responsibility, (V) Advocacy, were addressed.

There is a public health epidemic in adolescents' use of Electronic Nicotine Delivery Systems (ENDSs), also known as electronic cigarettes, vaping products, or JUULs. However, little is known about the level of knowledge school staff have about ENDS. The purpose of this study is to examine outcomes of a nurse-led educational intervention designed to increase school staff knowledge about ENDS. A descriptive, nonrandomly selected pre-test/post-test design was used with 125 Wisconsin school staff. Results revealed further educational needs of school staff in content areas including advertising to youth and flavoring of ENDS. Following the educational intervention, post-test results showed a significant overall improvement in participant knowledge scores. Recommendations include implementing nurse-led education about ENDS to a more diverse population of school staff. Providing nurse-led ENDS education to school staff offers an upstream, proactive approach for school nurses to help address this public health epidemic.

The influences of information exposure on youth and young adults' (YYA) support for smoking/vaping regulations have been understudied. This study examines (i) the relationships between routine exposure to (i.e. scanning) anti-smoking/pro-vaping information and YYA support for anti-smoking/vaping regulations and (ii) whether these relationships differ across YYA users and non-users of tobacco products. We analyzed the data from a nationally representative two-wave rolling cross-sectional survey of YYA in the United States, collected from 2014 to 2017 (baseline n = 10 642; follow-up n = 4001). Less than 5% of the participants ever scanned pro-smoking and anti-vaping information. Scanning anti-smoking information had significant positive relationships with support for all anti-smoking policies cross-sectionally, and this pattern was longitudinally significant in two anti-smoking policy contexts. Scanning pro-vaping information had significant negative associations with support for anti-vaping policies cross-sectionally, but not longitudinally. The lagged positive relationships between scanning anti-smoking information and support for anti-smoking regulations were stronger among YYA smokers than among YYA non-smokers, whereas evidence from adult data suggested the opposite pattern. The findings suggest that scanning information can affect YYA support for tobacco regulations. Future efforts are required to investigate mechanisms underlying the influences of scanned information on YYA support for tobacco regulations.

Globally, COVID-19 has been a major societal stressor and disrupted social and physical environments for many. Elucidating mechanisms through which societal disruptions influence smoking behavior has implications for future tobacco control efforts. Qualitative interviews were conducted among 38 adults who smoked combustible cigarettes in 2020 and 2021. The majority were women (75.7%), identified as Black (56.8%), were employed (61.3%), had a smoke-free home (66.7%) and lived in a small metro or rural (79.0%) county, primarily in rural southwest Georgia. Participants reported more time at home, increased isolation and less socializing, changed work and financial situations and altered household and family contexts. The vast majority of participants smoked more at some point during the pandemic with about half of these continuing to smoke more at the time of the interview. More time at home, multiple sources of stress and boredom were the main reasons for increased smoking. Decreases in smoking were attributed to financial strain, smoke-free home rules and nonsmoking family members, concerns about COVID-19 and less socializing with friends who smoke. Future tobacco control efforts during societal stressors such as pandemics should take into account specific psychosocial and environmental influences in attempts to minimize negative changes to smoking patterns.

Background: In April 2016, the City of Chicago implemented an ordinance restricting the sale of all flavored (including menthol) tobacco products (FTPs), including electronic cigarettes, at retailers located within 500 feet of any public, private, or alternative elementary, middle ("primary"), or high ("secondary") school. We examined changes in retail availability of FTPs from before to after policy implementation among policy-affected retailers compared with retailers not subject to the policy. Method: Observational data were collected in June to September 2015 (Wave 1; pre-policy) and November to December 2016 (Wave 2; post-policy) from a panel of 194 randomly selected policy-area stores (located within 500 feet of a school), and a panel of 199 randomly selected comparison-area stores (located more than 500 feet from a school). Using generalized estimation equation regression, we assessed differences in FTP availability changes across study areas. Results: We observed a statistically significant policy effect on FTP availability (Area × Wave interaction, p<0.05); however, more than half of policy-area retailers continued to display at least one FTP after policy implementation (87.11% at Wave 1, 57.73% at Wave 2, p<0.05). Similar reductions were seen for the availability of flavored cigarillos/little cigars and menthol cigarettes, while policy effects varied across store types. Discussion: FTP availability reductions appear to be associated with policy implementation, but FTPs remained readily available at retailers subject to the policy. This study contributes to the evidence base indicating that policies with exclusions or exemptions for certain flavors, products, store types, or retailer locations have a limited effect on retail availability of FTPs.

Background: E-cigarette companies use YouTube to foster brand awareness, market their products, and interact with current and future tobacco users. However, research on the official YouTube channels of e-cigarette companies is limited. This study determined the themes of, and degree of user engagement with, videos posted to the official channels of e-cigarette companies on YouTube. Methods: Data were collected from the official YouTube channels of seven e-cigarette companies by scraping (i.e., electronically copying) the videos. The earliest video was posted on October 10, 2013, and the most recent video was posted on April 22, 2021 (n = 260). An inductive approach was used to identify themes in the data. User engagement with posts including number of likes, dislikes, and comments were also collected. Results: Prevalent themes included branding (n = 250 of 260 videos, 96%), youth use (n = 222, 85%), and tobacco use (n = 210, 81%), while less common themes included misleading health statements (n = 4, 2%), personal choice (n = 4, 2%), and antitobacco (n = 2, 1%). Videos that contained the themes testimonial, product design features, and instructional received the highest mean number of likes. Videos that contained the themes antitobacco, cessation, and testimonial received the highest mean number of dislikes. The 260 videos in this study were collectively viewed 6,619,700 times as of May 5, 2021. Conclusions: Videos from the official YouTube channels of seven e-cigarette companies often focused on branding and user experience but rarely mentioned cessation. While videos about cessation were rare, they received the second highest mean number of dislikes. Future research should assess the impact of exposure to e-cigarette-related content on YouTube and e-cigarette-related attitudes and behaviors.

Electronic cigarettes are the most widely used tobacco product among youth in the United States. Although rapidly growing, research on effective message strategies for e-cigarette use prevention is still limited. This study examined the relative effectiveness of gain framing versus loss framing in youth-targeting prevention text messages delivered either as individual expository texts or simulated text exchanges between a youth patient and a pediatrician. A national sample of 1,084 youth susceptible to future e-cigarette use was randomized to condition in an online message testing experiment featuring a 2 (framing: gain vs. loss) × 2 (format: individual texts vs. simulated exchange) factorial design. Results revealed a consistent interaction between framing and messaging format in message liking, positive affect, attitude toward e-cigarette use, and future e-cigarette use intentions. The gain frame outperformed the loss frame in the simulated exchange conditions while the reverse trend was true for the individual text conditions. Furthermore, the main effect of messaging format was significant on multiple outcomes in favor of simulated text exchanges. The main effect of framing was only significant on negative affective response with the loss frame eliciting stronger responses. These findings suggest that the relative effectiveness of gain framing versus loss framing depends on how messages are presented in youth-targeting text messaging interventions. When messages are likely to be delivered in a discrete manner, the loss frame should be preferred. When greater interactivity and narrative development are possible, the gain frame should be favored. E-cigarette prevention efforts should leverage these insights to enhance message effectiveness.

We examined the prevalence and correlates of anticipated responses to hypothetical cigar price increases. Data are from a 2021 representative sample of U.S. adults who reported past-30-day cigar use (n = 454; mean age = 39.8 years). Weighted multivariable logistic regressions assessed the correlates of behavior change responses. If cigar price increased, 77.2% intend to pay more, 44.7% intend to reduce use, and 39.9%, 37.7%, and 17.1% intend to use other tobacco, cannabis, and cheaper cigars, respectively. Those who smoked cigarillos (vs. other cigars) had higher odds of intending to pay more (adjusted odds ratio [AOR] = 2.73; 95% confidence interval [CI] = [1.41, 5.29]) and use other tobacco (AOR = 2.35; 95%CI = [1.26, 4.36]). Those who smoked within 5 min of waking (vs. > 60 min) had higher odds of intending to use cheaper cigars (AOR = 5.19, 95%CI = [1.38, 19.46]). Almost half of U.S. adults who report past-30-day cigar use may reduce cigar smoking in response to price increases, though behavioral response may depend on cigar type smoked and tobacco dependence.

Today, countries implement policies and programs for childhood obesity. However, the effect of classroom teachers in preventing obesity is in a position to be a role model for students. Therefore, the awareness of the pre-service classroom teachers about nutrition and their nutritional behaviors have an important place on the students. On the other hand, a regular and correct nutrition behavior that the teacher candidates who are trained in the primary school teaching program will receive can gain this behavior to the students they will teach. In addition, there is a balanced and regular eating habit in the physical activity and nutrition section of the Physical Education and Play Lesson Curriculum in primary schools. In this study, it was aimed to examine the dietary habits of primary school teacher candidates. For this purpose, the questionnaire revealing the eating habits was applied to the primary school teacher candidates. In the analysis of the data, percentage and frequency tests were performed with the SPSS program. In the research results; it was discovered that most of the primary school teacher candidates did not receive nutrition education, did not have alcohol and smoking habits, and did not engage in any sports activities. It has been stated that almost all of the primary school teacher candidates have the habit of breakfast, but they skip meals, and the most skipped meal is lunch. They stated that the reason for skipping meals was that they did not have the opportunity. It was seen that the majority of the participants consume less than two liters of water per day and less than five cups of tea/coffee per day. As a result of the study, it was determined that the primary school teacher candidates' nutritional habits and knowledge levels were deficient.

This study aimed to examine the relationship between the caffeine consumption status of students in sports sciences and their happiness levels. The study was quantitative and was conducted with the participation of 228 volunteer students studying in sports sciences from various universities (Artvin Coruh, Trabzon, Bayburt, Igdir, Agri Ibrahim Çeçen, Gazi, Atatürk). The Oxford Happiness Scale (OHS) developed by (Hills & Argyle, 2002) and this questionnaire were used to collect the data. Statistical analysis of the data was performed with independent groups T-test, one-way analysis of variance (ANOVA) and Pearson correlation analysis. As a result of the analysis, while a positive and low-level significant relationship was found between the students' happiness scores and the age variable (p < 0.05); no significant difference was found in the variables of gender, body mass index (BMI), department of education (p > 0.05). When looking at the variable of doing sports, statistically significant differences were found, and it was concluded that the mean score of those who did sports as licensed-national was significantly higher than the mean score of those who did sports as hobbyists and amateurs (p < 0.05). Again, a statistically significant difference was found in happiness scores according to chronic disease states; (p < 0.05) no difference was found according to smoking status (p > 0.05). At the same time, a statistically positive and low-level significant relationship was found between happiness scores and the amount of coffee consumed daily (p < 0.05); No statistically significant relationship was found between happiness and the amount of black tea and chocolate consumed daily (p > 0.05).

Teacher students' tobacco-purchasing behaviors have been a problem among teacher students in Thailand. Life patterns and coping with stress levels have been perceived as the main contributors to these behaviors. Life pattern is based on the concepts of the lifestyles of a person. People tend to share similar lifestyle orientations when they are in similar social groups or have similar interests. This includes teachers students and their learning environment. Additionally, coping with stress is referred to as teacher students' coping skills when they feel pressure in life. Therefore, this research article aimed to study how life patterns and coping with stress influence teacher students' tobacco-purchasing behavior in Bangkok. The research questionnaire was a five-level Likert scale questionnaire. Data was collected through a survey with 900 teacher students from three universities in Bangkok. The data were analyzed using descriptive statistics, frequency, percentage, mean, standard deviation, and Multiple Linear Regression by Enter technique. The data analysis indicated that life pattern positively influences the tobacco-purchasing behavior of teacher students in the Bangkok area with a coefficient of influence at 0.470 with significant at 0.01 level (P-Value <0.001); while coping with stress had a negative influence over the purchasing behavior with a coefficient of influence at -0.104 with statistical significant at 0.01 level (P-Value <0.001). This suggested that when coping with stress increases by 1 unit, the level of tobacco purchasing behavior decreases by 0.104 units. The two variables were able to predict tobacco-purchasing behavior at 20.5 percent.

The aim of this study is to determine whether the level of aggression of the students of Physical Education and Sports School at Istanbul Ayvansaray University differs according to some demographic variables. For this purpose, 180 students from the Physical Education and Sport School participated voluntarily who got trainings from Istanbul Ayvansaray University's Coaching Education Department, Sports Management Department, Recreation and Exercise and Sports Sciences Department. Survey data were obtained from the "personal information form" and the "Aggression Scale" developed by Buss-Perry, adapted to Turkish by Madran (2013). SPSS 21 package program was used to analyze the obtained data. In the analysis of the data, T-Test and One Way analysis of variance analysis were used. The difference between the variables was interpreted on the basis of p < 0.05 significance level. As a result of the study, although there were significant differences between the aggression levels of the students according to age and sex, the differences between the sections they studied and the level of aggression according to the field they were doing were meaningless. Students with alcohol and cigarette addictions were found to have higher levels of aggression. It was found that the mean score of male students was higher than that of female students.

This study developed an online health education program by applying the Health Belief Model with social support to prevent tobacco use by student teachers and evaluated the effectiveness of the program during the COVID-19 pandemic in Thailand. This involved mixed method research divided into 2 phases, with phase 1 combining an online focus group discussion (n=8) and a literature review to develop an online health education program to prevent tobacco use, while phase 2 involved evaluating the effectiveness of the program. Phase 2 used a randomized pretest-posttest control group design consisting of an intervention group (n=30) and a control group (n=30) selected by simple random sampling for both groups from student teachers in academic years 1-5 in the Faculty of Education, Kasetsart University, Bangkok, Thailand. The result from phase 1 for the proposed program for the intervention group involved 8 weeks of online activities, including exercise, meditation, music, games and lectures by experts in public health, health education, and experiences shared by ex-smokers. Leaflets were provided to all participants in both the intervention and control groups. The results from phase 2 showed significant differences in knowledge (p < 0.000; p < 0.007), attitude (p < 0.000; p < 0.034) and risk behavior to tobacco use (p < 0.004; p < 0.025) for both the intervention and control groups at 8 weeks post-intervention compared to pre-intervention, respectively. The program could support, guidance, and contributions of the many individuals and organizations that have been involved in the online process.

The study aimed to examine pre-service physical education and science education teachers' health-promoting lifestyle profiles, nutrition habits, knowledge of nutrition levels, and their relationships with some demographic variables (gender, department, smoking, physical activity level). The study is a descriptive study conducted in a government university in Türkiye. The samples consisted of fourth-year pre-service physical teachers (N=37) and pre-service science teachers (N=32). Nutrition Habits Assessment Form, Health Promoting Lifestyle Profile II instrument (HPLP II), and Nutrition Knowledge Level for Adults Scale, which consisted of two parts, "Basic Nutrition Scale" and "Food Preference Scale," were used as data collection tools. Descriptive statistics and parametric tests analyzed data. Considering differences in the physical activity subscale between different departments, a significantly higher score was recorded among pre-service physical education teachers compared to pre-service science teachers. A significantly higher score was observed in the subscales on interpersonal relations and stress management and Basic Nutrition Scale Score among pre-service science teachers compared to pre-service physical education teachers. A significantly higher score was observed in the subscales on physical activity and interpersonal relations among male compared to female students. The HPLP II scores of the preservice teachers, which exercised three times more than three times a week, were higher than those who exercise once a week and didn't exercise.

The present study was aimed at investigating to what extent self compassion of university students was predicted by their risk taking behavior sub-dimensions. The sample of study included 658 undergraduate students from different faculties of a public university during the 2018-2019 academic year. In order to collect the data in the study, Self Compassion Scale, Risk Behaviors Scale and Personal Information Form are used. Pearson product-moment correlation coefficient and multiple regression analysis were used in the analysis. The results of the study revealed the highest correlation between self compassion scores and suicidal tendency, which is one of the subdimensions of risk-taking behavior. In addition, it was found that together with the sub-dimensions of risk taking behavior, it explained 38.2% of the variance in self-compassion scores and It was found that the variable that most predicted self-compassion was suicidal tendency. Findings were discussed and interpreted in the light of literature.

Although the rate of sexual intercourse among adolescents has increased in Asian countries, including Korea, many sexually active adolescents still do not use contraception. The aim of this study was to identify the risk factors for contraceptive nonuse among adolescents using decision tree analysis of the 2018 Korea Youth Risk Behavior Survey data from 2,460 high school students who had an experience of sexual intercourse. The findings indicated that the highest risk group who did not use contraception during sexual intercourse did not receive sexual health education in school and was involved in habitual or purposeful drug use. The experience of ever receiving treatment due to violence and the experience of sexual intercourse after drinking were also identified as risk factors for contraceptive nonuse. To encourage contraceptive use, development of standard sexual health education, counseling, and educational intervention intended to prevent risky behaviors is needed.

The present study examined (1) intraindividual changes in the frequency of electronic nicotine delivery systems (ENDS) use across young adulthood, 18 to 30 years old, and (2) if depressive symptoms and sensation-seeking tendencies, independently and in interaction with one another, were associated with these changes. Data were from a longitudinal study of students recruited from 24 Texas colleges and followed across six waves from fall 2015 to spring 2019. Participants (n = 1298; 36.3% non-Hispanic white, 56.3% women) were 18 to 26 years old in fall 2015 and all reported past 30-day ENDS use on at least one wave. We used growth curve modeling for an accelerated longitudinal design to examine if ENDS use frequency changed with increasing age and if depressive symptoms and sensation seeking, independently and in interaction with one another, were associated with these changes. Results showed that ENDS use frequency increased with increasing age. Depressive symptoms and sensation seeking were not independently associated with more frequent ENDS use or an accelerated increase in ENDS use frequency across increasing age. However, a significant two-way interaction indicated that young adults with elevated depressive symptoms used ENDS more frequently, but only when they had higher levels of sensation seeking. Findings indicate that young adults with depressive symptoms are a heterogeneous population and that those with high levels of sensation-seeking tendencies are at elevated risk for more frequent ENDS use. Interventions for young adults high in both sensation-seeking and depressive symptoms may help prevent and decrease ENDS use.