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

Introduction. Les produits de tabac chauffé sont de nouveaux produits du tabac susceptibles d'attirer les jeunes. Cette étude visait à explorer, dans quatre provinces canadiennes, si la proximité et la densité des détaillants de produits de tabac chauffé autour des écoles secondaires étaient associées à une utilisation de ces produits chez les adolescents. Méthodologie. Une recherche menée en ligne entre novembre 2020 et mars 2021 a permis de repérer les détaillants qui vendaient des dispositifs IQOS et des bâtonnets HEETS (conçus pour les dispositifs IQOS) dans des zones tampons circulaires de 500 m, 1 000 m et 1 500 m autour de 120 écoles secondaires ayant participé à l'étude COMPASS 2020-2021. Les données sur la proximité et la densité des détaillants ont été liées à des données transversales sur les élèves (N = 40 636), et des modèles de régression multiniveaux ont été utilisés pour explorer l'association entre, d'une part, la proximité et la densité des détaillants de produits de tabac chauffé et, d'autre part, l'utilisation de produits de tabac chauffé, après ajustement pour les covariables pertinentes. Résultats. Si seulement 10,0 % des écoles étaient situées à moins de 1 000 m d'au moins un détaillant vendant des dispositifs IQOS, 65,0 % d'entre elles étaient situées à proximité d'au moins un détaillant vendant des bâtonnets HEETS. L'école fréquentée par l'élève était responsable de 23,7 % de la variabilité de la probabilité d'utilisation de produits de tabac chauffé. Toutefois, la proximité et la densité des détaillants de produits de tabac chauffé autour des écoles n'ont présenté aucune association significative avec la probabilité d'utilisation de ces produits chez les élèves. Conclusion. Bien que l'école fréquentée par l'élève soit responsable d'une part importante de la variabilité de l'utilisation de produits de tabac chauffé, ces résultats laissent penser que les élèves pourraient obtenir des produits de tabac chauffé par des sources autres que les commerces de détail. Il faut continuer de surveiller la situation, car l'utilisation des produits de tabac chauffé chez les adolescents est susceptible d'évoluer. [ABSTRACT FROM AUTHOR]

Background Adolescence is a critical period for vaping onset. The purpose of this article was to examine the effect of the early stages of the COVID-19 pandemic period on youth vaping. Methods We used 3-year linked data from the COMPASS study, including 7585 Canadian (Quebec, Ontario) adolescents from which 1949 completed all three survey waves (pre-COVID-19 [2018, 2019] and online [2020] during the early pandemic period [May–July 2020]) and provided vaping data. Structural equation modeling (SEM) and difference-in-difference (DD) models were used to estimate pre-COVID-19 to initial COVID-19 pandemic period change (2019–2020) in vaping (monthly, weekly, daily) compared with 2018–2019 change to adjust for age-related effects. Models were adjusted for age of entry into the cohort and sociodemographic characteristics. Results In the SEM and DD models, the proportion of youth who were monthly and weekly vaping increased from 2018 to 2019 but decreased from 2019 to 2020; daily vaping increased across all waves. However, for all vaping outcomes modeled, the expected increases from the pre-COVID-19 wave (2019) to the initial COVID-19 period wave (2020) were lesser relative to the changes seen across the 2018 to 2019 waves. Conclusion The early stages of the COVID-19 pandemic period appear to be associated with a reduction in the proportion of youth who were monthly and weekly vapers in our adjusted longitudinal models. While daily vaping increased over this same period of time, the magnitude of the increase in our adjusted longitudinal models appears attenuated by the early stages of the pandemic. Implications This large prospective study of youth that included pre-pandemic data is unique in that we were able to identify that the early stages of the COVID-19 pandemic period was associated with a reduction in the proportion of youth who were monthly and weekly vapers in our adjusted longitudinal models. Conversely, the proportion of youth who were daily vaping increased over this same period of time, but the magnitude of the increase appears smaller than expected during the early stages of the pandemic in our adjusted longitudinal models. This study provides novel robust evidence that the patterns of vaping most aligned with onset and progression (i.e. monthly and weekly use) appear attenuated during the initial pandemic period. [ABSTRACT FROM AUTHOR]

Background: In the school year immediately following cannabis legalization in Canada, this paper investigated youth perceptions of school support for the prevention and cessation of substance use. Scant research has examined student perceptions in relation to school disciplinary approaches. This study was the first to classify school discipline approach styles using school-level measures. Objective: The objective of this study was to examine whether different school cannabis use-related disciplinary approaches are associated with student cannabis use and perceptions of school supportiveness for the prevention and cessation of substance use. Results: School- and student-level survey data from Year 7 (the 2018/2019 school year) of the COMPASS study were used, including 68,037 grade 9–12 (Secondary I–V in Quebec) students attending 131 Canadian secondary schools. Schools were classified as using different cannabis use-related disciplinary styles based on school-administrator reported approaches to student first-offense violations of school cannabis policies. We identified that although none of the cannabis use-related disciplinary approach styles examined were associated with cannabis use, they were associated with student perceptions. Students attending schools classified as using a Permissive/Supportive approach had a higher likelihood of perceiving their school as supportive for substance use prevention/cessation than their peers at Authoritarian schools. Students who perceived their school as supportive for substance use prevention/cessation were less likely to report current cannabis use than their peers who perceived their school as unsupportive. Conclusions: Unlike previous studies using school classification styles that are based on student perceptions, results do not support direct associations between school cannabis use-related disciplinary styles and student cannabis use. Future prospective research should examine whether supportive disciplinary approaches (e.g., counseling referrals, educational programs) promote student perceptions of school supportiveness, and in turn, deter student substance use. [ABSTRACT FROM AUTHOR]

Background: Given the high rates of cannabis use among Canadian youth and that adolescence is a critical period for cannabis use trajectories, the purpose of this paper was to examine the effect of the early stages of the COVID-19 pandemic period on youth cannabis use in the context of a natural experiment. We used 3-year linked data from the COMPASS study, including 7653 Canadian (Quebec, Ontario) adolescents from which 1937 completed all 3 survey waves (pre-COVID-19 [2018, 2019] and online [2020] during the early pandemic period [May-July 2020]). Structural equation modeling (SEM) and double difference (DD) models were used to estimate pre-COVID-19 to initial COVID-19 pandemic period change (2019-2020) in cannabis use (monthly, weekly, daily) compared to 2018 to 2019 change to adjust for age-related effects. Models were adjusted for age of entry into the cohort and sociodemographic characteristics.Results: In the SEM and DD models, monthly, weekly, and daily cannabis use increased across all waves; however, the expected increases from the pre-COVID-19 wave (2019) to the initial COVID-19 period wave (2020) were lesser relative to the changes seen across the 2018 to 2019 waves. The cross-sectional data from May to July 2020 identified that the majority of youth who use cannabis did not report increased cannabis use due to COVID-19 or using cannabis to cope with COVID-19.Conclusion: During the early stages of the COVID-19 pandemic period, there does not appear to be a detrimental effect on youth cannabis use, when adjusted for age-related changes. Further prospective research is needed to explore the impact of the ongoing pandemic response on youth cannabis use onset and progression. [ABSTRACT FROM AUTHOR]

Exercise has significant benefits for brain health and this may have downstream learning benefits for youth. However existing studies looking at links between physical activity and academic achievement are limited by relatively small sample sizes and/or cross-sectional designs. The objective of this study is to determine the direction and magnitude of the association between physical activity and academic achievement in a large prospective sample of adolescents. Linear mixed models with random intercepts and multinomial ordinal generalized estimating equations were employed to analyze the prospective relationship between measures of physical activity and academic achievement from the COMPASS study (N = 9,898 linked participant data cases from year 2 (2013–2014) to year 4 (2015–2016)). The linear relationships between minutes of moderate to vigorous physical activity and academic achievement (English: r = -.047, p <.000; Math: r = -.026, p =.008) as well as meeting the national physical activity guidelines and academic achievement (English: est = -.052, p =.004; Math: est = -.052, p =.028) were negative and trivial in magnitude. Organized sport participation showed slight positive associations with academic achievement indices, but these were also of trivial magnitude. In conclusion, the relationship between physical activity and academic achievement was effectively null in this population sample. Advocacy for physical activity programming for adolescent populations may best be undertaken with reference to lack of net academic achievement cost, rather than presence of benefit, or simply with reference to the many other physical and mental health benefits for youth. [ABSTRACT FROM AUTHOR]

Background: Youth who go hungry have poorer mental health than their counterparts - there are gender differences in this relationship. This study investigated the role of social support in the association between hunger and mental health among a nationally representative sample of youth in Canada in gender-specific analyses.Methods: We used a probability-based sample of 21,750 youth in grades 6-10 who participated in the 2017-2018 Canadian Health Behaviour in School-aged Children. Self-report data were gathered on hunger, mental health (measured via the World Health Organization-5 well-being index) and five sources of support - peer, family and teacher support as well as the school climate and neighborhood support. We conducted adjusted, gender-specific, multilevel regression analyses assessing the association between mental health, social support and hunger.Results: We found that youth who reported lower support were more likely to experience going to bed hungry (relative to never hungry) across all support factors. As for the social support factors, all the social support factors were associated with a higher mental health score, even after controlling for hunger. Despite these results our final set of models showed that our measures of social support did not alleviate the negative association between hunger and mental health. As for gender-specific findings, the negative association between hunger and a mental health was more pronounced among females relative to their male counterparts. We also found that certain social support factors (i.e., family, teacher and neighborhood support) were associated with a higher mental health score among females relative to males while controlling for hunger status.Conclusions: We find that five social support factors are associated with a higher mental health score among ever hungry youth; however, social support did not overpower the negative association between hunger and mental health. Food insecurity is a challenge to address holistically; however, hungry youth who have high social support have higher odds of better mental health. [ABSTRACT FROM AUTHOR]

Results A total of 123 participants registered for the study and received nicotine patches (117 of these provided a unique ID, indicating that they responded to the invitation letter). Offering nicotine patches to all households in a community with high smoking rates: Pilot test of a population-based approach to promote tobacco cessation. Rates of cigarette smoking can vary greatly between geographic regions.[[1], [3]] This pilot study examined whether there was benefit to the concentrated distribution of tobacco cessation resources - in this case the distribution of nicotine patches - to a region with higher-than-average smoking rates. [Extracted from the article]

Background: Evidence whether individuals with attention-deficit hyperactivity disorder (ADHD) are at increased risk for traffic violations/collisions is mixed. This study investigated the association between ADHD and traffic violations among youth and young adults; examined whether this association differed by age, sex, or comorbid mental or physical problems; and modelled factors associated with traffic violations among individuals with ADHD.Methods: Data come from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH), a cross-sectional epidemiological study. The sample was restricted to youth and young adults aged 15 to 39 years and categorized into 3 groups: 15 to 19 years (n = 1886), 20 to 29 years (n = 3679), and 30 to 39 years (n = 3659). Lifetime ADHD and past-year contact with police for traffic violations were self-reported. Logistic regression models quantified the association between ADHD and traffic violations, stratified by age. Interactions were included to examine moderating effects.Results: No evidence suggested an association between ADHD and past-year traffic violations (odds ratio [OR], 1.07; 95% confidence interval (CI), 0.64 to 1.79), age-specific estimates did not differ across age groups (P = 0.696), and no factors moderated the association. Three factors were found to increase odds for past-year traffic violations among individuals with ADHD: aged 20 to 29 years (OR, 3.84; 95% CI, 1.47 to 10.06), male sex (OR, 3.48; 95% CI, 1.39 to 8.59), and white ethnicity (OR, 5.62; 95% CI, 1.24 to 25.51).Conclusions: Individuals with ADHD are not an at-risk group for traffic violations but instead share similar risk factors with individuals in the general population without ADHD-information useful for health professionals. Replication studies are needed to examine the robustness of these findings. [ABSTRACT FROM AUTHOR]

In particular research domains, the randomized control trial (RCT) is considered to be the only means for obtaining reliable estimates of the true impact of an intervention. However, an RCT design would often not be considered ethical, politically feasible, or appropriate for evaluating the impact of many policy, programme, or structural changes common in public health research. As such, researchers must use alternative yet robust research methods for determining the impact of such interventions. The evaluation of natural experiments (i.e. an intervention not controlled or manipulated by researchers), using various experimental and non-experimental design options can provide an alternative to the RCT. The following review highlights (a) the importance of evaluating natural experiments; (b) design considerations associated with evaluating natural experiments; (c) methods for reducing bias in natural experimental studies; and (d) the potential benefits of targeted systems to enable natural experiments in emerging priority domains moving forward. [ABSTRACT FROM AUTHOR]

ABSTRACT: BACKGROUND: Sedentary behavior is linked to many adverse health outcomes; however, its relationship with academic achievement is less understood. We examined sedentary behavior's impact on academic achievement over 3 years in 4408 adolescents from the COMPASS study. METHODS: Sedentary behavior (screen‐based: watching/streaming television shows/movies, video/computer games, surfing the internet; communication‐based: texting/messaging/emailing, talking on the phone; and doing homework) and academic achievement (overall math and English marks) were self‐reported. RESULTS: Holding time fixed, moving from the lowest quartile (Q1) to Q2, Q3, or Q4 of watching/streaming television shows/movies (Q2: OR = 0.90; 95%CI: 0.84‐0.97, Q3: OR = 0.85; 95%CI: 0.74‐0.98, Q4: OR = 0.74; 95%CI: 0.64‐0.85) or to Q2 of surfing the internet (Q2: OR = 0.87; 95%CI: 0.78‐0.97) decreased the likelihood of surpassing English standards. Moving from Q1 to Q2 of communication‐based sedentary behavior (OR = 0.90; 95%CI: 0.82‐0.99) decreased the likelihood of surpassing math standards. Moving from Q1 to Q4 (OR = 1.31; 95%CI: 1.15‐1.50) of watching/streaming television shows/movies increased the likelihood of surpassing math standards. Moving from Q1 to Q4 of doing homework (OR = 1.16; 95%CI: 1.02‐1.31) increased the likelihood of surpassing English standards. CONCLUSIONS: Predicting academic achievement from total sedentary behavior is challenging. Targeting specific types of sedentary behavior should be considered for improving math and English achievement. [ABSTRACT FROM AUTHOR]

Background:With the development of new gambling technology, and increased internet accessibility, online gambling has rapidly emerged as a new gambling market. Governments in numerous jurisdictions have moved to legalize online gambling, yet little is known about the impact of online gambling availability particularly for adolescents. To date, few studies have identified the characteristics of adolescent online gamblers and even fewer have looked at whether these characteristics differ from land-based adolescent gamblers. This study examined socio-demographic and factors associated with online gambling for adolescents and compared this to land-based gamblers to examine whether the profile of online gamblers are unique. Method:Data for the current study comes from the 2012–2013 Youth Gambling Survey (YGS) (n = 10 035) and consists of students in Grades 9 to 12 from three Canadian provinces: Newfoundland and Labrador, Ontario, and Saskatchewan. Results:Compared to adolescents who did not have a gambling problem, those who had low to moderate (OR = 2.21,p < .001) or high problem gambling severity (OR = 13.60,p < .001) were significantly more likely to gamble online. Adolescents who played free games were also significantly more likely to gamble online (OR = 2.75,p < .001). Females were significantly less likely to gamble online compared to males (OR = 0.31,p < .001). Other than gender, problem gambling severity and playing free games, when compared to land-based adolescent gamblers, the profile of online gamblers are not that different. Conclusions:Current prevention efforts for adolescents should focus on gambling across modalities. [ABSTRACT FROM PUBLISHER]

Introduction: Youth obesity rates in Canada continue to rise. In this study, we produced conservative estimates of the potential excess calories from alcohol use across different alcohol consumption patterns common among Canadian youth to assess whether alcohol use should be considered in future obesity prevention strategies. Methods: Using data from 10 144 Grade 12 students participating in the COMPASS study (2013/14), we estimated the number of calories consumed per year from alcohol consumption. Our estimates were based on three different generic types of alcoholic beverages, which were grouped according to average calorie content (vodka coolers; beer [5%]; and beer [4%], wine and liquor) across different frequencies of alcohol use and binge drinking. Results: Results indicated high potential caloric intake for students who binge drank, as well as high variability in the estimates for calories consumed based on common consumption patterns for the different beverage types. For instance, 27.2% of students binge drank once per month, meaning they consumed between 6000 and 13 200 calories in one year (equivalent to 0.78 - 1.71 kg of fat). For the 4.9% of students who binge drank twice per week, the total calories in one year would range from 52 000 to 114 400 (equivalent to 6.74 - 14.83 kg of fat). Conclusion: Current recommendations for preventing youth obesity do not generally include any consideration of alcohol use. The high prevalence of frequent alcohol consumption and binge drinking by youth in this study and the substantial number of calories contained in alcoholic beverages suggest alcohol use among youth may warrant consideration in relation to youth obesity prevention. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite the importance of breakfast consumption, breakfast skipping is common among Canadian youth. This study examines how changes to school-based breakfast programs are associated with breakfast-skipping behavior. METHODS: Using school-level longitudinal data from Year 1 (Y1: 2012-2013) and Year 2 (Y2: 2013-2014) of the COMPASS study, quasi-experimental methods evaluated the impact over time that changes to school-based breakfast programs had on breakfast skipping or participating in school-based breakfast program. RESULTS: Between Y1 and Y2, the school-level prevalence of breakfast skipping (54.5%-54.9%) and breakfast program participation (12.3%-13.6%) increased. Of the 43 participating schools, 5 implemented a new school breakfast program. Among the intervention schools, 1 school (School 4) observed a significant, and 1 school (School 3) observed a significant increase in the school-level prevalence of skipping breakfast; there was no significant change in the other 3 intervention schools. CONCLUSIONS: Despite the availability of free school breakfast programs, the majority of youth skipped breakfast at least once a school week. Owing to the variation in the types of programs implemented, additional evaluation evidence is necessary to determine which students bene?ted the most from these programs. [ABSTRACT FROM AUTHOR]

Background: Adolescence is characterized by low moderate- to vigorous- intensity physical activity (MVPA) levels. Targeting the school setting can increase MVPA among a large proportion of adolescents. However, school-based physical activity interventions for adolescents remain largely ineffective. Therefore, the purpose of this study was to examine how naturally-occurring changes to school physical activity policy, recreational programming, public health resources, and the physical environment, impact adolescent MVPA over a 1-year period. Methods: Quasi-experimental longitudinal data from 18,777 grade 9-12 students (mean age = 15.1 ± 0.02 years), and 86 principals from 86 schools, participating in year 2 (2013-2014) and year 3 (2014-2015) of the COMPASS study (Ontario and Alberta, Canada) was used. Total MVPA over the previous week was self-reported at both time points using the COMPASS Student Questionnaire and average daily MVPA was calculated. Changes to physical activity policies, recreational programming, public health resources, and the physical environment were self-reported by school principals. Changes to the number and condition of physical activity facilities were objectively measured during school audits using the COMPASS School Environment Application. Multi-level modeling was used to examine change in student MVPA between schools that made changes and schools that did not. Models were adjusted for several student and school level confounders. Results: Over the 1-year period, 61 of 86 schools made physical activity related changes. Of these, 9 significantly changed student MVPA. However, only 4 of 9 schools' changes increased student MVPA, including opening the fitness centre at lunch (β = 17.2, 95 % CI: 2.6-31.7), starting an outdoor club (β = 17.8, 95 % CI:7.4-28.1), adding a bike rack (β-14.9, 95 % CI: 0.7-29.1), and adding weightlifting and run/walk clubs, archery, figure skating, increased access to the sports field, and improved condition of the outdoor basketball court (β = 15.5, 95 % CI: 5.2-25.7). Conclusions: Changes such as adding or increasing access to facilities, and adding multiple recreational programs, seemed to be effective for increasing student MVPA over the 1-year period. However, given the specificity of results, a one-size fits all approach may not be effective for increasing MVPA. Instead, school principals need to consider the resources within and surrounding their school, and the interests of the students. [ABSTRACT FROM AUTHOR]

Using nationally representative data from the Canadian Community Health Survey, we explored if the Vancouver 2010 Winter Olympics were associated with leisure-time physical activity rates among youth in Canada. No statistically significant changes were observed in the rate of moderately active/active youth in Canada or the province of British Columbia (BC) over the two-year time periods under investigation. At the regional level however, a significant increase in the rate of moderately active/active females from 2007–2008 (pre-event) to 2009–2010 (the year prior to the event and the year the event was staged) was observed in the Richmond, BC, health region (z = 2.05,p = .04). Previous conclusions that trickle-down effects do not occur are not supported by our data. Instead, we conclude that trickle-down effects may in fact occur, but may tend to be localised within certain communities (i.e. close to where Olympic events are staged) and among particular segments of a population. [ABSTRACT FROM AUTHOR]

Background: With the rapid proliferation of new gambling technology and online gambling opportunities, there is a concern that online gambling could have a significant impact on public health, particularly for adolescents. The aim of this study is to examine online and land-based gambling behaviour among adolescents in 3 Canadian provinces (Ontario, Newfoundland and Labrador, Saskatchewan) prior to the implementation of legalized online gambling.Methods: Data are from 10,035 students in grades 9 to 12 who responded to the 2012-2013 Youth Gambling Survey (YGS) supplement, a questionnaire administered as part of the Canadian Youth Smoking Survey (YSS, 2012) in 3 provinces: Newfoundland and Labrador (n = 2,588), Ontario (n = 3,892), and Saskatchewan (n = 3,555).Results: Overall, 41.6% of adolescents (35.9% of females and 47.4% of males) had gambled in the past 3 months. 9.4% of adolescents had gambled online in the past 3 months alone (3.7% of females and 15.3% of males). The most popular form of online gambling was online sports betting. Adolescents also engaged in online simulated gambling including internet poker (9.1%) and simulated gambling on Facebook (9.0%). Few adolescents participated in online gambling exclusively and online gamblers were more likely than land-based gamblers to engage in multiple forms of gambling. A higher proportion of adolescent online gamblers scored "high" or "low to moderate" in problem gambling severity compared to land-based only gamblers.Conclusions: Despite restrictions on online gambling at the time of the study, adolescents were engaging in online gambling at a significantly higher rate than has been previously found. Adolescents were also using technology such as video games to gamble and free online gambling simulations. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to examine the correlates of current smoking among off-reserve First Nations and Métis adults, two Aboriginal Canadian groups that are at higher risk to smoke and more likely to suffer from chronic health conditions relative to their non-Aboriginal counterparts. A particular focus was on culturally specific factors and their associations with current smoking.Methods: We used data from Statistics Canada's, 2012 Aboriginal Peoples Survey to investigate the correlates of smoking among 12,720 First Nations and Métis adults. Sequential binary logistic regression models were estimated to examine associations between smoking and culturally specific, demographic, geographic, socioeconomic and health-related variables.Results: Overall, 39.4% were current smokers. Multivariate results found that those who had hunted, fished or trapped within the last year were more likely to be smokers. In addition, respondents who were exposed to an Aboriginal language at home or outside the home were more likely to be smokers. Current smoking was significantly associated with being aged 35 to 49 years, living in a small population center, low income, low education, unemployment, being unmarried, low ratings of self-perceived health, heavy drinking and low body mass index. Respondents aged 65 years and older and those living in British Columbia were less likely to smoke.Discussion: The results of this study suggest that it may be useful to consider cultural characteristics, particularly language in efforts to reduce the prevalence of manufactured tobacco use among First Nations and Métis adults. Interventions should also consider demographic, geographic and socioeconomic variables, in addition to co-occurring health-risk behaviors. [ABSTRACT FROM AUTHOR]

The article discusses a study that examined associations between smoking and obesity among youth and explored whether associations are mediated by weight loss attempts or bullying experiences. Study highlights include a table that outlines sample characteristics of grades 9 to 12 in Ontario from 2012 to 2013, calculation of measures of self-reported height and weight and body mass index, and exclusion of students from models on a case-wide basis if data were missing for outcomes or covariates.

Objective To examine youth exposure to smoking in cars following 7 provincial bans on smoking in cars with children in Canada. Method Repeated cross-sectional data from the 2004–2012 Youth Smoking Survey ( n = 91,800) were examined. Using a quasi-experimental design, contrasts of the interaction of survey year and province included in the logistic regression analyses were used to test whether exposure significantly declined pre-post implementation of a ban on smoking in cars relative to control provinces not implementing a ban. Results Exposure across all provinces declined from 26.5% in 2004 to 18.2% of youth in 2012. Exposure declined significantly from pre to post implementation of a ban on smoking in cars with children in Ontario at time 1 post ban (Pre-Ban = 20.4% T1post = 10.3%, OR = 0.45), time 2 post ban (12.1%, OR = 0.61) and time 3 post ban (11.6%, OR = 0.58) relative to control provinces that did not implement a ban. In British Columbia exposure to smoking in cars declined significantly at pre-post ban time 3 compared to the control group (Pre-Ban = 21.2%, T3post = 9.6%, OR = 0.51). No other provinces had a significant change in exposure pre-post ban relative to the control provinces. Interpretation Although rates declined, significant differences were only found in Ontario relative to control provinces in the immediate and long term. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the prevalence of different communication- and media-based sedentary behaviors and examine how they are associated with modifiable risk behaviors and key demographic correlates among a large sample of youth. METHODS: Data from 23,031 grade 9 to grade 12 students in Year 1 (2012-2013) of the COMPASS study (Canada) were used to examine the prevalence of sedentary behaviors by gender and by grade. The between-school variance in sedentary behaviors was calculated and models were developed to examine how modifiable risk factors and demographic correlates were associated with sedentary behaviors. RESULTS: Youth averaged 494 (±313) min/day of sedentary behavior and 96.7% of the sample exceeded the sedentary behavior guidelines of no more than 2h per day. Significant between-school random variation in the sedentary behaviors was identified. Substance use, weight status, ethnicity, and gender were the main predictors of the sedentary behaviors examined. CONCLUSIONS: The vast majority of youth in the COMPASS sample are considered highly sedentary. The evidence clearly suggests we need to develop more effective methods of intervening, that school-based programming is warranted, and that gender-specific programming may be required. [ABSTRACT FROM AUTHOR]

Background: School-based prevention activities continue to be an important tobacco control resource, however there is little guidance for school-based tobacco control programming within Ontario. The objective of this study is to identify real-world changes in school-based tobacco control programs or policies in the COMPASS study and examine of those interventions (natural experiments) had any impact on the school-level prevalence of smoking susceptibility and current smoking over time. Methods: This paper uses longitudinal school-level smoking behaviour data from Year 1 (Y1: 2012-13) and Year 2 (Y2: 2013-14) of the COMPASS study. Changes to school-level tobacco control programs and policies were measured using the COMPASS School Programs and Policies Questionnaire and knowledge broker follow-up interviews. Quasi-experimental tests of proportion and difference-in-difference models were used to evaluate the impact of the interventions identified between Y1 and Y2 on school-level prevalence of smoking susceptibility among never smokers and current smoking. Results: Between Y1 and Y2, 17 schools reported a change in their tobacco control programming or policies. In four of the intervention schools, the increase in the within-school prevalence of susceptible never smokers between Y1 and Y2 was significantly greater than the natural change observed in the control schools. In five of the intervention schools, the decrease in the within-school prevalence of current smokers between Y1 and Y2 was significantly greater than the natural change observed in the control schools. Only two of the new interventions evaluated (both focused on policies of progressive punishment for students caught smoking on school property), were associated with significant desirable changes in both smoking susceptibility and current smoking between Y1 and Y2. Discussion: Interventions specific to effective and enforced tobacco control were the most common and consistently had the desired impact on the school-level prevalence of smoking susceptibility and current smoking. Due to the variation in the types of interventions implemented and their effectiveness, additional evaluation evidence is necessary to determine the most successful activities and contexts among individual students. The results presented here highlight which of these real-world promising interventions should be further evaluated using the longitudinal individual-level data in COMPASS over time. [ABSTRACT FROM AUTHOR]

Background The use of alternative tobacco products (ATPs) has grown in popularity among Canadian youth. This study examined the association between a school-level characteristic (the senior student tobacco use rate) and the current use of manufactured cigarettes, little cigars or cigarillos, cigars, roll-your-own cigarettes, smokeless tobacco (SLT), and a hookah among junior students. Methods This study used nationally representative Canadian data from 29,495 students in grades 9 to 12 as part of the 2010/2011 Youth Smoking Survey. For each ATP, we described rates of senior and junior tobacco use, calculated the variance attributed to school-level factors, and examined the association between the senior student (grades 11 and 12) tobacco use rate and the current use of each ATP among junior students (grades 9 and 10) while accounting for relevant student-level characteristics. SAS 9.3 was used for all analyses. Results Over half of schools sampled had senior students that reported using each ATP. School-level differences accounted for between 14.1% and 29.7% of the variability in ATP current use among junior students. Each one percent increase in the number of senior students at a school that currently use manufactured cigarettes, SLT, or a hookah was significantly independently associated with an increased likelihood that a junior student at that school currently used manufactured cigarettes (OR 1.04, 95% CI 1.01 to 1.06), SLT (OR 1.14, 95% CI 1.06 to 1.24), or a hookah (OR 1.09, 95% CI 1.03 to 1.14). Conclusions Characteristics of the school environment a junior student attends appear to play an important role in ATP use, and tobacco control programs and policies should be designed to ensure that they include strategies to curb the use of all tobacco products. Additional evidence is needed for the impact of comprehensive school-based tobacco control approaches. [ABSTRACT FROM AUTHOR]

Background Few researchers have the data required to adequately understand how the school environment impacts youth health behaviour development over time. Methods/Design COMPASS is a prospective cohort study designed to annually collect hierarchical longitudinal data from a sample of 90 secondary schools and the 50,000+ grade 9 to 12 students attending those schools. COMPASS uses a rigorous quasi-experimental design to evaluate how changes in school programs, policies, and/or built environment (BE) characteristics are related to changes in multiple youth health behaviours and outcomes over time. These data will allow for the quasi-experimental evaluation of natural experiments that will occur within schools over the course of COMPASS, providing a means for generating "practice based evidence" in school-based prevention programming. Discussion COMPASS is the first study with the infrastructure to robustly evaluate the impact that changes in multiple school-level programs, policies, and BE characteristics within or surrounding a school might have on multiple youth health behaviours or outcomes over time. COMPASS will provide valuable new insight for planning, tailoring and targeting of schoolbased prevention initiatives where they are most likely to have impact. [ABSTRACT FROM AUTHOR]

Highlights: [•] Co-SEA as a app supported by all major mobile device platforms. [•] Archives photos of the built environment features being measured in the audit. [•] Can collect and store information without an internet connection. [•] Audit data can be uploaded to a secure server via a Wi-Fi connection. [•] Co-SEA can be easily shared and used with other researchers. [ABSTRACT FROM AUTHOR]

Objectives: To examine school and student characteristics associated with physical activity in grade 1 to 4 students. Methods: Multi-level logistic regression examined factors associated with being moderately and highly active. Results: A student was more likely to be moderately or highly active if he/she attended a school that provides student access to facilities and equipment outside of school hours. Male students were more likely to be moderately or highly active and overweight or obese students were less likely to be moderately or highly active. Conclusions: Research should evaluate if implementing a school policy that provides student access to facilities and equipment outside of school hours is effective in promoting physical activity in grade 1 to 4 students. [ABSTRACT FROM AUTHOR]

Background Excessive weight gain among youth is an ongoing public health concern. Despite evidence linking both policies and the built environment to adolescent and adult overweight, the association between health policies or the built environment and overweight are often overlooked in research with children. The purpose of this study was to examine if school-based physical activity policies and the built environment surrounding a school are associated with weight status among children. Methods Objectively measured height and weight data were available for 2,331 grade 1 to 4 students (aged 6 to 9 years) attending 30 elementary schools in Ontario, Canada. Student-level data were collected using parent reports and the PLAY-On questionnaire administered to students by study nurses. School-level policy data were collected from school administrators using the Physical Activity Module of the Healthy School Planner tool, and built environment data were provided by the Enhanced Points of Interest data resource. Multi-level logistic regression models were used to examine the school- and student-level characteristics associated with the odds of a student being overweight or obese. Results There was significant between-school random variation in the odds of a student being overweight [σ² µ0 = 0.274(0.106), p < 0.001], but not for being obese [σ² µ0 = 0.115(0.089)]. If a student attended a school that provided student access to a variety of facilities on and off school grounds during school hours or supported active transportation to and from school, he/she was less likely to overweight than a similar student attending a school without these policies. Characteristics of the built environment were not associated with overweight or obesity among this large cross-sectional sample of children. Conclusions This new evidence suggests that it may be wise to target obesity prevention efforts to schools that do not provide student access to recreation facilities during school hours or schools that do not support active transportation for students. Future research should evaluate if school-based overweight and obesity prevention programming might be improved if interventions selectively targeted the school characteristics that are putting students at the greatest risk. [ABSTRACT FROM AUTHOR]

Background: Substance use and weight gain among youth increase the risk for future disease. As such, the purpose of this study is to examine how many Canadian youth are currently failing to meet substance use and weight gain related public health guidelines. Methods: Data from the 2010–11 Youth Smoking Survey were used to examine grade 9 to 12 students meeting seven different guidelines by sex and by grade. Results: Among Canadian youth, 8.8% were current smokers, 18.8% were current marijuana users, 25.5% were current binge drinkers, 22.5% were considered overweight or obese, 31.2% did not meet physical activity guidelines, 89.4% exceeded sedentary behaviour guidelines, and 93.6% reported inadequate fruit and vegetable intake. The mean number of risk factors per student was 2.9 (±1.2); only 0.5% of youth reported having none of the risk factors. Conclusion: Students rarely met all seven public health guideline examined, and the vast majority of actually reported having two or more modifiable risk factors for disease. [ABSTRACT FROM AUTHOR]

Abstract: Objective: In order to understand the factors that differentiate adolescents who have tried smoking from those who have become established smokers, this study examined which student- and school-level factors differentiated current smokers from experimental smokers among a nationally representative sample of Canadian secondary school students. Method: Student-level secondary data from the 2008–2009 Canadian Youth Smoking Survey was linked with school-level data from the 2006 Census and one built environment characteristic, and examined using multilevel logistic regression analyses. Results: The current smoking rates varied (P <0.001) across schools. The number of tobacco retailers surrounding the schools was associated with current smoking when adjusting for student characteristics. Additionally, students were more likely to be current smokers if they were: male, in higher grades, believed that smoking can help when they are bored, reported low school connectedness, used marijuana, had a sibling or close friend who smoked, and had no smoking bans at home. Conclusions: These study findings suggest that school anti-smoking strategies need to target males, increase students' attachment to their school, address tobacco-related beliefs, and include interventions targeting smoking siblings and friends. The government should consider zoning restrictions to limit sales of tobacco products near schools. [Copyright &y& Elsevier]

The correct sentence should read: Furthermore, at least one additional small-scale study does appear to support the notion that brain health benefits of physical activity are realized in adolescents, despite unclear translation of such brain health benefits into overt academic achievement benefits [19]. Reference 1 Papasideris M, Leatherdale ST, Battista K, Hall PA (2021) An examination of the prospective association between physical activity and academic achievement in youth at the population level. The correct sentence should read: While the current results do not support the assumed academic benefits of physical activity, these results are consistent with another longitudinal investigation into the topic using COMPASS data [28]. [Extracted from the article]

Abstract: Patterns of smoking can vary among youth smokers. The purpose of this study was to examine three different patterns of smoking among youth (daily smoking, smoking sporadically on weekdays and weekends, and smoking during weekdays only), and to examine the sociodemographic characteristics that are associated with each smoking pattern in a representative sample of Canadian youth smokers. Data were collected as part of the 2010/2011 Youth Smoking Survey (YSS) from 31,396 students in grades 9 to 12 from secondary schools in 9 Canadian provinces. Data from the YSS were used to assess smoking behaviors and sociodemographic factors that are associated with smoking patterns among youth. We used logistic regression models to examine factors associated with week day only and some day smoking patterns relative to daily smoking patterns. Results indicate that among current youth smokers, the majority are daily smokers (62.0%), followed by some day (23.5%) and week day only (13.5%) smokers. Students who smoke some days were more likely than daily smokers to share cigarettes with others; however, they were less likely than daily smokers to have a parent, step-parent or guardian who smokes cigarettes and less likely to have close friends who smoke cigarettes. Conversely, students who smoke week days only were less likely than daily smokers to have a sibling who smokes cigarettes. These data suggest that the school environment continues to play an important role in reducing youth smoking rates in Canada, especially among youth who only smoke week days. The high percentage of week day only smokers suggests that current school-level tobacco control initiatives may be insufficient for preventing youth smoking onset. [Copyright &y& Elsevier]

Introduction: The objective of the study was to determine the brand distribution of premium, discount, and native cigarette brands and to identify the factors associated with smoking these brands among a nationally representative sample of Canadian youth smokers. Methods: Data from 3,137 current smokers in Grades 9–12 participating in the 2008–2009 Youth Smoking Survey (YSS) were used to examine the prevalence and factors associated with different cigarette brand preferences. Results: The most prevalent brand of cigarette smoked was premium cigarettes (44.7%), followed by discount cigarettes (33.7%), and to be native cigarettes (7.3%). There was significant variability in brand preference by province with the majority of youth in Atlantic Canada and Quebec smoking a discount brand of cigarettes and higher prevalence rates of native cigarette use in Ontario and Quebec. Respondents were more likely to smoke discount cigarettes if they were female, daily smokers, or if they only had $1–20 a week in spending money. Respondents were more likely to smoke native cigarettes if they were Aboriginal, heavier smokers, or if they reported having no weekly spending money. Conclusions: A significant proportion of students from Grade 9 to 12 in Canada smoke cigarettes that are more affordable than premium brands and it appears that the market share for these more affordable cigarette options has increased in recent years. Given that the price of cigarettes is an important determinant in youth smoking behavior, it is critical to develop and continue to enforce tobacco control strategies designed to eliminate access to cheaper sources of cigarettes among youth populations. [ABSTRACT FROM AUTHOR]

Background: The COMPASS study is designed to follow a cohort of ~30,000 grade 9 to 12 students attending ~60 secondary schools for four years to understand how changes in school characteristics (policies, programs, built environment) are associated with changes in youth health behaviours. Since the student-level questionnaire for COMPASS (Cq) is designed to facilitate multiple large-scale school-based data collections using passive consent procedures, the Cq is only comprised of self-reported measures. The present study assesses the 1-week (1wk) test-retest reliability and the concurrent validity of the Cq measures for weight status and dietary intake. Methods: Validation study data were collected from 178 grade 9 students in Ontario (Canada). At time 1 (T1), participants completed the Cq and daily recoding of their dietary intake using the web-based eaTracker tool. After one week, (T2), students completed the Cq again, participants submitted their daily eaTracker logs and staff measured their height and weight. Test-retest reliability of the self-reported (SR) weight status and dietary intake measures at T1 and T2, and the concurrent validity of the objectively measured and SR weight status and dietary intake measures at T2 were examined using intraclass correlation coefficients (ICC). Results: Test-retest reliability for SR height (ICC 0.96), weight (ICC 0.99), and BMI (ICC 0.95) are considered substantial. The concurrent validity for SR height (ICC 0.88), weight (ICC 0.95), and BMI (ICC 0.84) are also considered substantial. The test-retest reliability for SR dietary intake for fruits and vegetables (ICC 0.68) and milk and alternatives (ICC 0.69) are considered moderate, whereas meat and alternatives (ICC 0.41), and grain products (ICC 0.56) are considered fair. The concurrent validity for SR dietary intake identified that fruits and vegetables (ICC 0.53), milk and alternatives (ICC 0.60), and grain products (ICC 0.41) are considered fair, whereas meat and alternatives (ICC 0.34) was considered slight. Conclusions: While the test-retest reliability of the measures used in this study were all high, the concurrent validity of the measures was considered acceptable. The results support the use of the self-reported COMPASS weight status and dietary intake measures for use in research where objective measures are not possible. [ABSTRACT FROM AUTHOR]

Abstract: Background: Research indicates that it is common for youths to use nicotine replacement therapy (NRT) despite limited empirical evidence for its effectiveness within this population. Since very little is known about the characteristics associated with NRT use by youth, the current study examined the association between ever and current use of NRT as a function of student characteristics and the characteristics of the schools they attend. Methods: This study used nationally representative student-level data from 29,296 grade 9 to 12 students who participated in the 2008–2009 Canadian Youth Smoking Survey (YSS). School-level data on the built environment surrounding schools were provided by DMTI-Spatial, and data on school location were provided by the Canadian Census. Two multilevel logistic regression models were used to predict ever use of NRT and current use of NRT as a function of student and school characteristics among current smokers. Results: Overall, 21.1% of youth smokers in Canada had ever used NRT and 5.1% were currently using NRT. Odds of ever and current NRT use were highest among daily smokers and boys, while youths who had made multiple quit attempts or participated in a quit and win contest were more likely to be ever NRT users. Attending a school located within an urban area increased youths'' odds of ever and current NRT use, whereas higher density of pharmacies surrounding a school was inversely associated with current NRT use. Conclusions: Characteristics of students and the schools they attend were associated with the likelihood of youth smokers using NRT. Significant between-school differences in NRT use exist, however further research is needed to identify which school characteristics account for these differences and understand how youth are accessing NRT. [Copyright &y& Elsevier]

The current study examined the prevalence of alcohol, tobacco and drug use and comorbid use of these substances among 45,425 students in grades 7 to 12 as part of the 2008–09 Canadian Youth Smoking Survey. The results of this paper suggest that alcohol, tobacco, marijuana and illicit drugs are currently used by a substantial number of youth in Canada, and that comorbid use is also very widespread among users. Alcohol was the most prevalent substance used by youth and it was rare to find youth who had used tobacco or drugs without also currently using alcohol. By grade 12, the majority of students were current users of alcohol, tobacco or drugs. Future research should consider developing a better understanding of how to prevent substance use among this population. [Copyright &y& Elsevier]

Background: Despite the apparent decline in the popularity of roll-your-own (RYO) cigarettes over the past few decades, RYO tobacco products are widely available and used by a substantial number of adult smokers. Considering research has yet to examine the prevalence of RYO tobacco use among youth populations, this manuscript examines the prevalence of RYO tobacco use and factors associated with RYO use in a nationally representative sample of youth smokers from Canada. Methods: This study used data collected from 3,630 current smokers in grades 9 to 12 as part of the 2008-09 Canadian Youth Smoking Survey (YSS). Descriptive analyses of the sample demographic characteristics, smoking status, cigarettes per day, weekly spending money, and frequency of marijuana use were examined by RYO tobacco ever use and RYO tobacco current use. Two logistic regression models were used to examine factors associated with RYO tobacco ever use and RYO tobacco current use. Results: We identified that 51.2% of current smokers were RYO ever users and 24.2% were RYO current users. The prevalence of RYO current users was highest in Atlantic Canada (40.1%) and lowest in Quebec (12.3%). RYO current users were more likely to be male (OR 1.27), to be daily smokers (OR 1.75), to use marijuana once a month or more (OR 2.74), and to smoke 11 or more cigarettes per day (OR 6.52). RYO current users were less likely to be in grade 11 (OR 0.65) or grade 12 (OR 0.40) and less likely to have between $20 to $100 (OR 0.44) or more than $100 (OR 0.45) of disposable income. Conclusions: Developing a better understanding of RYO tobacco use among youth is important for advancing population-level tobacco control prevention strategies and cessation programs. We identified that RYO tobacco use is not a negligible problem among Canadian youth. Ongoing research is needed to continue monitoring the prevalence of RYO use among youth and the factors associated with its use, but to also monitor if this more affordable tobacco product is being targeted to price sensitive youth smokers. [ABSTRACT FROM AUTHOR]

Abstract: Understanding factors associated with youth cigarette access behaviours can provide insight into the development of more effective means of preventing youth from accessing cigarettes. This cross-sectional study used self-reported data collected from 41,886 students in grades 9 to 12 who participated in the 2006–07 Youth Smoking Survey to examine the student- and school-level characteristics that differentiate youth smokers who usually access cigarettes from a social source versus buying their own from retailers. Multi-level regression analyses revealed significant between-school variability in the odds of a smoking student reporting that they usually buy their own cigarettes. Important student-level characteristics associated with how youth usually access their cigarettes included binge drinking and being asked for age or photo identification when purchasing cigarettes from a retailer. Future studies should further explore the school- and student-level characteristics associated with youth cigarette access behaviour. [Copyright &y& Elsevier]

Introduction: In Canada, nicotine replacement therapy (NRT) is a best practice for adult smoking cessation, but it is not recommended for use among youth smokers. The purpose of this study was to determine the prevalence of NRT use among youth smokers in Canada and examine factors associated with its use. Methods: Data from 41,886, Grade 9–12 students who participated in the 2006–2007 Youth Smoking Survey were used to determine prevalence of NRT use. Logistic regression models were conducted to examine the association between NRT use by smoking status, demographic characteristics, and exposure to tobacco control programs. Results: In 2006–2007, 20.4% of current and former youth smokers in Canada had ever used NRT and 7.4% were currently using NRT. Among ever and current NRT users, 17.7% and 23.7%, respectively, had never tried to quit smoking. Odds of NRT use were highest among current smokers, older youths, boys, youths who had made multiple quit attempts, and youths with no disposable income. Participation in cessation counseling was significantly associated with increased NRT use, whereas attending antismoking classes in school was inversely associated with using NRT. Conclusions: A substantial number of Canadian youth use NRT, despite restrictions on its sale to this population. This study identifies characteristics associated with youths using NRT. Research is needed to elucidate mechanisms by which characteristics identified in this study affect NRT use. For example, it may be important to understand whether attending smoking cessation counseling induces NRT use in youths or vice versa. [ABSTRACT FROM AUTHOR]

BACKGROUND: Schools can be an efficient venue for promoting physical activity (PA) among adolescents. Physical education (PE) requires investigation because it is a variable associated with adolescent PA levels and its existence in schools represents a significant opportunity for strategies to combat declining PA levels among this population. This article examines the between-school variability in student rates of PE enrollment among a large sample of high schools in Ontario, Canada, and identifies the school- and student-level characteristics associated with PE enrollment. METHODS: This cross-sectional study utilized self-reported school- and student-level data from administrators and students at 73 high schools. Students' enrollment in PE, demographic, behavioral, and psychosocial variables was linked to school environment data comprising of school demographics and administrator assessed quality of policies, facilities, and programs related to PA. Analysis involved multilevel modeling. RESULTS: The mean rate of PE enrollment among the 73 high schools was 62.4%, with rates by school ranging from 28.9% to 81.1%. When student demographics, behavioral, and psychosocial factors were controlled for, there was still a school effect for student PE enrollment. The school effect was explained by the provision of daily PE and school median household income. CONCLUSIONS: This is the first study to examine the extent to which PE enrollment varies between schools and to identify school factors associated with school variability in rates of PE enrollment. Although most variation in PE enrollment lies between students within schools, there is sufficient between-school variation to be of interest to practitioners and policy makers. [ABSTRACT FROM AUTHOR]

Objective. Increasing our understanding of the differences between obesity and overweight status across various geographical areas may have important public health implications. We aimed to explore prevalence and factors (i.e., demographic and lifestyle) associated with overweight and obesity among youth across urban, suburban and rural settings. Methods. A cross-sectional study used self-reported data collected from students (grades 9–12) attending 76 high schools in Ontario, Canada, as part of the SHAPES-Ontario study (2005–2006). Of the 34 578 eligible students selected to complete the Physical Activity Module in the 76 participating schools, 73.5% (n=25 416; 50.8% males, 49.2% females) completed the survey. Univariate and multivariate analyses were conducted using body mass index for weight measurement and self-reported data on lifestyle factors, and self-perception of body weight. Results. The overall prevalence of overweight and obesity was 14.3% and 6.3%, respectively. The prevalence of overweight in urban, suburban and rural areas was 14.6%, 13.8% and 15.1%, respectively, while the prevalence of obesity was 6.3%, 6.0% and 6.7%, respectively, and the difference was significant (χ2= 16.53, p<0.05). In the multivariate logistic regression analysis, age, TV watching, level of urbanization and perception of body weight were important predictors of overweight and obesity. Conclusion. Our understanding of how overweight and obesity rates vary depending on the level of urbanization may help health professionals to either tailor programs to the needs of the individuals living in these different areas or to target existing programs to the contexts where they are most likely to have an impact. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: There is a need to better understand the prevalence of use of pharmaceutical aids among former smokers, and explore concerns that those former smokers may have had about using such products. This paper examines the use of various cessation aids and strategies as well as reasons for not using cessation aids among a nationally representative sample of former smokers from Canada. Methods: Using data from the 2006 Canadian Tobacco Use Monitoring Survey (CTUMS), univariate analyses were performed to examine the use of different cessation aids, strategies to quit smoking, and reasons for not using cessation aids among former smokers who had quit in the previous two years. Results: In 2006, over one in four Canadians (27.1% or about 7.2million persons) aged 15 and older was a former smoker. Overall, female former smokers were more likely to report that they reduced their consumption of cigarettes as a quitting strategy, whereas male former smokers were more likely to report using a pharmacological aids when quitting. Among reasons given for not using cessation aids, lack of trust that these products would work was the most common (15.4%), following by issue of cost (8.5%), concern about possible side effects (5.8%) and lack of information about products (1.8%). Conclusion: These results suggest that men and women use different approaches to quit smoking. Our findings provide new insight which could be used to target cessation programs to the individuals where they are most likely to be effective. [Copyright &y& Elsevier]

Purpose: To examine energy expenditure (EE) when playing active and inactive videogames (VG). Methods: Predicted EE was measured among 51 undergraduate students while playing active and inactive VG (Ontario, Canada). Results: Predicted EE was significantly higher playing the active VG compared to the inactive VG according to heart rate monitor (97.4 kcal vs 64.7 kcal) and SenseWear® armband (192.4 kcal vs 42.3 kcal) estimates. Conclusion: Active VG may be a viable intervention tool for increasing EE among students who would otherwise be spending time in sedentary screen-based behaviors. [ABSTRACT FROM AUTHOR]

Background: Given the decline in physical activity (PA) levels among youth populations it is vital to understand the factors that are associated with PA in order to inform the development of new prevention programs. Many studies have examined individual characteristics associated with PA among youth yet few have studied the relationship between the school environment and PA despite knowing that there is variability in student PA levels across schools. Methods: Using multi-level logistic regression analyses we explored the school- and student-level characteristics associated with PA using data from 2,379 grade 5 to 8 students attending 30 elementary schools in Ontario, Canada as part of the PLAY-Ontario study. Results: Findings indicate that there was significant between-school random variation for being moderately and highly active; school-level differences accounted for 4.8% of the variability in the odds of being moderately active and 7.3% of the variability in the odds of being highly active. Students were more likely to be moderately active if they attended a school that used PA as a reward and not as discipline, and students were more likely to be highly active if they attended a school with established community partnerships. Important student characteristics included screen time sedentary behaviour, participating in team sports, and having active friends. Conclusion: Future research should evaluate if the optimal population level impact for school-based PA promotion programming might be achieved most economically if intervention selectively targeted the schools that are putting students at the greatest risk for inactivity. [ABSTRACT FROM AUTHOR]

The School Health Action, Planning, and Evaluation System (SHAPES) is a data collection and feedback system designed to support population-based intervention planning, evaluation, and field research related to youth. The Physical Activity Module of SHAPES consists of: (a) a machine readable questionnaire to collect physical activity data from all students (grades 6 to 12) in a school, (b) a school administrator questionnaire to assess school policies, programs, and resources related to physical activity, and (c) a school-specific feedback report documenting student behavior and school programs and policies. This SHAPES module provides schools with feedback that enables them to take stock of patterns of activity and obesity within their school, recognize what is (and what is not) in place to support physical activity, and how to plan and evaluate their own prevention efforts. SHAPES enables researchers and stakeholders to identify what interventions work, in what contexts, with what students. [ABSTRACT FROM AUTHOR]

Background: Even though the use and prevalence of roll-your-own cigarettes (RYO) has been declining over the past decades, RYO remains important. Given the paucity of research examining RYO use, there is a need to better understand the current and potential future context of RYO use. Methods: Data from the 2002 Canadian Tobacco Use Monitoring Survey (CTUMS) were used to examine RYO tobacco use among 23,341 Canadians aged 15 and older. Logistic regression models were conducted to examine factors which differentiate smokers who smoke RYO tobacco all of the time, most of the time or sometimes from smokers who do not smoke RYO tobacco. Results: We found that 17% (n = 925,000) of current smokers in Canada reported smoking RYO. When compared to manufactured cigarette (MC) smokers, RYO users were heavier smokers, more addicted to nicotine, and less likely to consider quitting smoking. Lower income smokers were more likely to smoke RYO tobacco compared to smokers with high income. Conversely, smokers who had completed secondary school or university were less likely to smoke RYO tobacco compared to smokers who had not completed secondary school. Conclusion: This study demonstrates that RYO tobacco use is not a negligible problem within Canada and provides valuable new insight for developing future tobacco control initiatives for this population of smokers. [ABSTRACT FROM AUTHOR]

Objective. Childhood overweight and obesity is a major public health issue. A better understanding of factors associated with sedentary behaviours would provide valuable insight for tailoring interventions to prevent or reduce overweight among youth. Methods. Data were collected from 25 416 grade 9 to 12 students attending 76 secondary schools in Ontario, Canada, using the Physical Activity Module of the School Health Action, Planning and Evaluation System (SHAPES). Sex specific multivariate logistic regression analyses were then used to examine how physical activity, BMI, social influences, and smoking behaviour were associated with screen time, time spent reading, and time spent on homework. Results. The average screen time per day was 2.7 (±1.7) hours, yet 48.1% of students reported spending less than one hour reading per week and 30.2% spent less than an hour of time on homework per week. Among males, being underweight (≤5% percentile BMI, adjusted for age and sex) was associated with more screen time (OR 1.23, 95%CI 1.01-1.50) and time spent reading (OR 1.19, 95%CI 1.00-1.43), whereas being at risk of overweight (≥85% percentile BMI, adjusted for age and sex) was associated with less time spent on homework (OR 0.75, 95%CI 0.65-0.85). Conversely, among females, being at risk of overweight was associated with more screen time (OR 1.24, 95%CI 1.10-1.41), and time spent reading (OR 1.19, 95%CI 1.05-1.35). Aside from BMI, other factors associated with sedentary behaviours included physical activity, parental encouragement and support for physical activity, close friend physical activity behaviour, and smoking status. Discussion. We found that students are highly involved in screen-based sedentary behaviours, but spend a limited time on more productive sedentary behaviours, like reading and homework. Developing a better understanding of sedentary behaviours is critical for preventing and reducing obesity among youth populations. [ABSTRACT FROM AUTHOR]

Research has yet to examine how physical activity, body mass index (BMI) and concerns about weight among youth populations are associated with susceptibility to smoking among never smokers. The Physical Activity Module of the School Health Action, Planning and Evaluation System (SHAPES) was completed by 25,060 students in grades 9 to 12 within 76 secondary schools in Ontario (Canada) to examine how being overweight, weight concerns, and physical activity are associated with susceptibility to smoking in a large sample of youth. Among the 14,795 students who were never smokers, 3,809 (25.8%) were classified as susceptible to future smoking and 10,986 (74.2%) were classified as non-susceptible to future smoking. Smoking susceptibility was negatively associated with being highly active or at risk of overweight and positively associated with perceptions of being slightly overweight or slightly underweight. Students who report 1 or more hours of screen or phone time per day were also more likely to be susceptible. This is the first study to identify that susceptibility to future smoking among never smokers is associated with physical activity, overweight and concerns about weight. This is valuable new insight for tailoring and targeting future school-based tobacco control and/or physical activity programming to youth populations. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To examine how smoking behaviour and beliefs, physical activity and weight, and social influences are associated with intentions to quit smoking among youth. Methods: This cross-sectional study used self-reported data collected from 26,379 grade 9 to 12 students in Ontario, Canada. Results: Intending to quit smoking was positively associated with students believing that they could quit smoking, being moderately active, and having smoking friends. Male smokers were less likely to intend to quit smoking than female smokers. Intending to quit smoking in the next 30 days was positively associated with students believing that they could quit smoking and being highly active, and negatively associated with being overweight and having three or more smoking friends. Conclusion: These findings provide insight for researchers and practitioners interested in understanding the factors which may promote smoking cessation among smoking school-aged populations. [Copyright &y& Elsevier]

Cluster analysis modeling was used to identify distinct smoking taxonomies among 4,473 smokers from 29 secondary schools (2000-2001) in Ontario, Canada. Analyses revealed a two-cluster solution (4,349 [97.2%] situational smokers and 124 [2.8%] ubiquitous smokers). Different psychosocial characteristics influenced the smoking behavior of these unique groups. Our findings are substantially different from the traditional definitions for non-daily and daily smoking used in the literature, which typically impose rules about smoking frequency or volume when defining smoking status. These findings suggest that more robust taxonomies of youth smoking are required in future tobacco control research. The study's limitations are noted. [ABSTRACT FROM AUTHOR]