Adolescent Consumption Research Articles

Trends in and risk factors for nicotine consumption in childhood and adolescence

Trends in and risk factors for nicotine consumption in childhood and adolescence

Influence of consuming coffee and other beverages in adolescence on risk of type 2 diabetes in adulthood.

Dietary strategies for type 2 diabetes (T2DM) prevention have mainly focused on solid foods and nutrients. Emanating evidence suggests that beverage consumption in adulthood may also influence T2DM development, whereas the role of beverages during adolescence remains unknow. To examine adolescent beverages consumption, and their changes from adolescence to adulthood in relation to T2DM risk in adulthood. This prospective cohort study, conducted within the Nurses' Health Study II (NHS II), enrolled 41,317 women who completed a food-frequency questionnaire (FFQ) regarding their diet in high school and had no diabetes, cardiovascular disease, or cancer at baseline (1997). Beverage consumption including coffee, tea, regular or diet soda, fruit juice or milk, was assessed using the FFQ. Cox proportional hazards models were utilized to estimate hazard ratios (HRs) for the association between beverage consumption in adolescence and risk of incident type 2 diabetes (T2DM) in adulthood, adjusting for potential confounders. During 725,650 person-years of follow-up, 2,844 participants developed T2DM. After adjustment for demographic, lifestyle and dietary risk factors, comparing ≥ 1 serving/day with non-consumers, adolescent coffee [HR, 0.86 (95% confidence interval: 0.75 to 0.98); P-trend = 0.02)] and orange juice [HR, 0.83 (0.71 to 0.96); P-trend = 0.0008)] consumption was associated with lower T2DM risk, whereas, regular soda [HR, 1.37 (1.20 to 1.57); P-trend < 0.0001)] and iced tea [HR, 1.41 (1.21 to 1.65); P-trend < 0.0001)] intake was associated with higher T2DM risk. Increased coffee intake from adolescence to adulthood in 1991 was associated with a lower T2DM risk [HR, 0.70 (0.61 to 0.80); P-trend < 0.0001), comparing ≥ + 3 servings/day with no change], whereas the opposite was observed for increased regular soda [HR, 1.20 (1.06 to 1.35); P-trend = 0.004), comparing ≥ + 1 or more servings/week with no change)] and diet soda consumption [HR, 1.59 (1.41 to 1.80); P-trend = 0.0002), comparing ≥ + 2 servings/day with no change]. Adolescent consumption of coffee or orange juice intake was associated with a lower risk of T2DM, whereas the opposite was observed for intake of regular soda or iced tea. In addition, increased coffee intake was associated with a lower diabetes risk, whereas the opposite was observed for regular or diet soda intake. These data highlight a potentially important role of beverage intake at early life in the etiology of diabetes during adulthood.

Alcohol consumption and dyslipidemia in children and adolescents: A review

Consumption of low-alcohol products by young people is due to the erroneous opinion that they are safe for health. However, against the background of taking low-alcohol drinks, addiction quickly forms and complications develop, including lipid metabolism disorders. Studies show that consumption of low-concentration ethanol-containing drinks changes the structure and ratio of serum lipoproteins. Changes in serum lipids provoked by alcohol intake are involved in the pathogenesis of a number of chronic non-infectious diseases, including alcoholic fatty liver disease and atherosclerotic cardiovascular diseases. According to the data of an anonymous online survey, which involved 155 young people aged 17–20 (18±0.76) years, 17.4% of them consume low-concentration alcohol more than once a week, and 5.8% consume both low-alcohol drinks and strong alcohol daily. Comprehensive efforts are needed to prevent the spread of alcohol addiction among children and young people: raising the age at which it is possible to purchase alcoholic beverages, increasing penalties in the area of illegal alcohol trafficking, and working in the area of anti-alcohol propaganda.

Evaluation of beverage consumption patterns and oral health in Korean adolescents and young adults

Objectives: This study aimed to investigate the beverage consumption patterns and analyze the relationship between the frequency of beverage consumption and oral health in Korean adolescents and young adults who consumed large amounts of sugar from beverages. Methods: Data from the 8th Korea National Health and Nutrition Examination Survey (2019–2021) were analyzed, and 2,787 individuals aged 12-29 years were selected as the study subjects. A complex sample general linear model was used to assess the associations of subject general characteristics and oral health with the frequency of beverage consumption. Results: Both adolescents and young adults frequently consumed carbonated beverages 2.04 and 2.12 times per week, respectively. The most commonly consumed volume per drink was 200 cc. In both groups, the lower the average number of times teeth were brushed daily, the higher was the frequency of fizzy drink consumption. When teeth were brushed less than once daily, the frequency of carbonated drink consumption was 2.63 in adolescents and 2.22 in young adults. Conclusions: This study highlights the need for oral health education of adolescents and young adults on diet and beverage intake. Additionally, information should be provided on oral diseases associated with beverage consumption, such as dental caries and erosion.

Sociodemographic and lifestyle correlates of energy drinks consumption in Serbian adolescents

Abstract Background and aim Energy drinks (EDs) are non-alcoholic beverages that typically contain high levels of caffeine and sugar in combination with other ingredients known to have stimulant properties. Although there is growing evidence of the harmful physiological and psychological effects of energy drinks their popularity has increased during the past decade. While researchers point out variety of health consequences, data on prevalence and correlates of EDs consumption are scarce. Aim of the study was to determine prevalence of EDs consumption and to investigate sociodemographic and lifestyle correlates of EDs consumption among adolescents in Serbia. Study design Secondary analysis of data obtained from 2022 Health Behaviour in School-aged Children Study (HBSC) in Serbia. Study included 3962 students aged 11, 13 and 15 years. Students with missing values for one or more study variables were excluded from the analyses. Methods Multiple logistic analyses stratified by age and sex were performed to estimate the associations between consuming EDs and sociodemographic and lifestyle characteristics. Results Overall, 15.6% of students consumed EDs more than once a week (16.2% of boys and 15.5% of girls) with highest percentage among 15-year-old students (20.3%). For both genders, the percentage of adolescents consuming ED more than once a week was higher among adolescents with lowest family affluence (21.9%), those consuming soft drinks daily (39.5%) and alcohol weekly (47.6%). In boys only, consuming ED several times a week was more frequent among adolescents having at least 60 min moderate-to-vigorous physical activity (MVPA) daily than among those with lower levels of MVPA. Conclusions Different patterns of ED consumption were identified suggesting need for tailored interventions aimed at reducing ED consumption in adolescents. Key messages • Every fifth h 15-year-old student in Serbia consume EDs more than once a week. • Higher EDs consumption among physically active boys indicate need for targeting interventions that will address this issue.

Supply of Alcohol in Early Childhood Leads to Higher Rates of Drinking in Adolescence

Abstract Background Adolescents often experience their first encounter with alcohol at home, provided by parents who perceive it as a means of safeguarding their children against later alcohol-related issues. However, research shows that parental supply of alcohol is a risk factor for adolescent drinking. Notably, existing studies solely focused on parental supply during adolescence, neglecting the prospective evaluation of parental alcohol provision during early childhood on later alcohol use. Methods The data came from the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC), a longitudinal birth cohort study (N = 5,777). Mothers reported on the frequency of offering alcohol to children when children were 3, 5, 7, and 11 years old. The outcome was adolescent alcohol use at ages 15 and 18, reported by adolescents, mothers, and pediatricians. Control variables included sex, maternal education, family structure, and parental alcohol consumption. Results Three classes of children were identified based on parental alcohol supply: abstainers (75.5% of sample), infrequent sippers (16.2%), and frequent sippers (8.3%). Parental drinking increased the risk of both infrequent and frequent sipping. These classes were entered into two structural models (age 15 and age 18 alcohol use modeled as latent factors), alongside covariates. Compared to abstainer class, infrequent and frequent childhood sippers exhibited significantly higher alcohol consumption at age 15 (β = .21, p &amp;lt; .001; β = .25, p &amp;lt; .001, respectively) and age 18 (β = .11, p &amp;lt; .05; β = .24, p &amp;lt; .001, respectively). Conclusions This study represents the first prospective investigation quantifying early childhood alcohol exposure and its subsequent association with adolescent alcohol consumption. Findings emphasize the influence of family dynamics on alcohol behaviors, underscoring the necessity for targeted preventive measures, particularly within families with higher parental alcohol consumption. Key messages • Offering alcohol to children at ages 3-11, even infrequently, significantly increases the risk of more frequent drinking at ages 15 and 18, compared to those with no early exposure. • Parents who drink are more likely to have children who sip alcohol early, leading to higher alcohol consumption in adolescence. Prevention efforts should focus on family habits and early education.

Association of Dairy Foods in Acne Vulgaris

Background: Acne vulgaris is one of the most commonly found skin problems affecting teenagers and adolescents. Dietary foods particularly dairy products consist of milk or any of its food made from milk are frequently regarded by patients and clinicians as a cause or aggravator of acne. As there are very limited studies found on this regard, this study was aimed to find the association of dairy foods in acne vulgaris. Methods: This wasa cross-sectional analytical study and was carried out in the Dermatology and Venereology department of Shaheed Suhrawardy Medical College Hospital. Total 260 patients were selected by appropriate inclusion criteria equally into two groups: Group A (diagnosed with acne vulgaris, n=130) and group B (patients not having acne vulgaris, n=130). A thorough history of every patient and face to face interview was taken by a predesigned questionnaire after getting the written informed consent of the patient. Data were collected in predetermined data collection form. Result were subjected to standard statistical evaluation and were analyzed by SPSS-24. Results: According to the age group, majority of the acne patients were between 10-20 years (75.4% in group A and 63.8% in group B, p&lt;0.05), though mean age in both groups were statistically similar (18.53±5.78 and 17.29±4.59 years, respectively). Also, female respondents were predominant in both groups (80.8% and 72.3%). The risk was increased in those with a family history of acne in siblings (OR2.449, p=0.021;95% CI,1.145-5.238) and the risk was reduced in subjects doing physical exercise. Papules (35.4%) and comedones (27.7%) were most common lesion and mostly found in forehead (74.6%) and left (68.5%) and right (63.1%) cheeks. According to global acne severity grading, majority had mild form of acne (83.1%) and use of cosmetics (43.8% vs. 30%), topical steroid (34.6% vs. 16.9%), taking fastfood (24.6% vs. 14.6%) and less water intake (36.9% vs. 18.5%) also significantly higher among acne patients. Multivariate regression analysis showed, dairy products such as whole milk (OR 1.984, p=0.022), chocolate (2.490, p=0.004), chips (OR 3.207, p&lt;0.001), Pizza (OR 2.388, p=0.021) and red meat (OR 3.055, p=0.009) were significant risk for developing acne vulgaris. Also, whole milk (3.050, p=0.01), chocolate (3.817, p=0.004) and pizza (3.822, p=0.005) were independent risk factors for moderate to severe acne. Conclusion: This study found an association between high dairy product consumption and acne in adolescents, indicating that dairy consumption may be a contributing factor for developing acne vulgaris. J Shaheed Suhrawardy Med Coll 2022; 14(2): 25-33

Association Between Ultraprocessed Food Consumption and Metabolic Disorders in Children and Adolescents with Obesity.

We investigated the effects of ultraprocessed food (UPF) consumption on metabolic disorders (e.g., adiposity, metabolic associated steatotic liver disease [MASLD], and insulin resistance) in children and adolescents with obesity to improve dietary guidelines and public health strategies. The dietary intake of 149 participants (aged 8-17 years) was assessed with food diaries. The NOVA classification system was used to classify food according to the degree of processing. Metabolic outcomes, including the fat mass index (FMI), hepatic fat percentage, and insulin resistance, were measured via dual-energy X-ray absorptiometry (DXA), magnetic resonance imaging proton density fat fraction (MRI-PDFF), and biochemical analysis, respectively. Greater UPF consumption from baseline to the 6-month follow-up was significantly associated with increased insulin and decreased total cholesterol and LDL-cholesterol. UPF consumption was positively associated with the prevalence of MASLD (liver MRI-PDFF ≥ 5%; odds ratio T3 vs. T1 = 1.75; 95% confidence interval [CI] 1.03, 3.00), moderate-to-severe MASLD (liver MRI-PDFF ≥ 10%; OR T3 vs. T1 = 4.19; 95% CI 1.72, 10.22), and insulin resistance (OR T3 vs. T1 = 2.44; 95% CI 1.33, 4.48), after adjusting for covariates. A linear dose-response relationship was observed between UPF consumption and the odds of moderate-to-severe MASLD and insulin resistance. Greater UPF consumption was strongly associated with MASLD and insulin resistance in children and adolescents with obesity, underscoring the importance of reducing UPF consumption through dietary guidelines and public health interventions to mitigate the risk of obesity-related metabolic conditions in young populations.

Food Consumption and Mental Health in Children and Adolescents: A Systematic Review Protocol

Mental illnesses are prevalent among children and adolescents worldwide and may be associated with food consumption and unhealthy lifestyles. This study aims to evaluate the association between food consumption and mental health in children and adolescents through a systematic review and meta-analysis. The electronic search will include keywords related to childhood, adolescence, mental health issues (e.g., anxiety, stress, depression), and eating behaviors (e.g., eating patterns, ultra-processed foods), verified using MeSH terms. The systematic review will follow the PRISMA 2020 guidelines, employing the PECOS strategy, and will include quantitative observational and mixed-methods studies. A search will be conducted in the following databases: Scopus, CINAHL, SPORTDiscus, LILACS, Web of Science, APA-PhysioNET, PubMed (Medline) and EMBASE. Identifying the association between mental health and food consumption will contribute to the development of preventive and intervention strategies aimed at improving the health and well-being of children and adolescents. The analysis of the data will provide results on how psychological factors are linked to the consumption of various food groups, implying the formulation and updating of public policies. These guidelines can assist managers and researchers in creating effective interventions to promote mental health and healthy eating behaviors, ultimately leading to long-term positive impacts on public health..

Mapping Age Differences in Brain Energy Metabolites and Metabolic Markers of Cellular Membrane Production and Degradation With 31P Magnetic Resonance Spectroscopy.

Using Phosphorus Magnetic Resonance Spectroscopy (31P MRS), we examined five metabolites associated with brain energy cycle, and cellular membrane production and degradation in 11 brain regions of 48 children (age 6-15), and 80 middle-aged and older adults (age 52-87). Levels of phosphomonoesters (PMEs) and phosphodiesters (PDEs), gamma plus alpha adenosine triphosphate (γαATP), phosphocreatine (PCr) and inorganic phosphate (Pi), were residualized on the total amplitude value. PMEs were greater in children compared to adults, whereas PDEs showed the opposite age difference. Higher γαATP and lower Pi were found in children compared to adults. The age group differences were particularly salient in the association cortices and anterior white matter. Among children, age correlated negatively with PMEs and positively with PDEs in association cortices. Compared to children, adults had lower intracellular pH. The results suggest reduction in membrane synthesis and increase in membrane degradation in adolescents and to a greater degree in adults compared to younger children. Concomitant reduction in γαATP and increase in Pi are consistent with reduced energy consumption in adolescents and further drop in middle-aged and older adults, although it is impossible to distinguish declines in energy supply from reduced demand due to shrinking neuropil, without longitudinal studies.

Food consumption and glycemic control in children and adolescents with type 1 diabetes mellitus

Food consumption and glycemic control in children and adolescents with type 1 diabetes mellitus

The Mediating Role of Digital Financial Literacy : Examining How Problem Based Learning Influences Consumption Decision Making Among Adolescents

This study aims to analyze the role of digital financial literacy in mediating problem-based learning in adolescents' consumption decision-making. The research method used a survey with a quantitative approach. The population consists of tenth-grade high school students, sampled using purposive sampling from classes that had undergone problem-based learning in economics subjects covering (1) consumption and (2) financial literacy and prioritizing scales, resulting in 142 respondents. The instrument in this study was a questionnaire on Google Forms, which was distributed via QR code. The data was analyzed using SPSS 25. The results obtained by digital financial literacy can significantly mediate problem-based learning in adolescent consumption decision-making with a Z value of 3.003 &gt; 1.96 and sig 0.002 &lt; 0.05. Integrating digital financial literacy in problem-based learning can synergize to improve students' critical thinking, which gives them the ability to make smart consumption decisions regarding their consumption activities.

Alcohol abuse among adolescents and suicide risk - is there a correlation?

Introduction: Adolescent alcohol abuse is a critical public health issue with far-reaching consequences for individual development and societal well-being. Adolescent alcohol consumption poses significant health risks, particularly due to its effects on brain development and its association with increased suicide risk. Purpose of the work: This study aims to investigate the relationship between alcohol abuse and suicide risk in adolescents. Materials and methods: A comprehensive analysis of research papers available on PubMed and Google Scholar was undertaken using the search terms including the following keywords: alcohol abuse/ alcohol abuse in adolescence/ alcohol consumption in adolescence/ alcohol abuse and suicide risk in adolescence/ suicide risk factors in adolescence/ suicidal tendencies among teenagers. Conclusions:Adolescent alcohol abuse has profound implications for brain development and mental health, significantly increasing the risk of suicide. Effective public health strategies, including early intervention, education, and strong support systems, are essential to mitigate these risks and promote healthier environments for young individuals. Addressing the underlying causes of alcohol abuse and providing targeted support can reduce its long-term consequences and improve adolescent well-being.

Association of alcohol consumption with hypertension or prehypertension in Chinese adolescent: A cohort study of the China Health and Nutrition Survey.

This study was conducted to investigate the association between alcohol consumption in adolescence and the risk of hypertension or prehypertension development in early adulthood. This cohort study included adolescent participants aged 12-18 years from the 2000-2011 China Health and Nutrition Survey. Cox proportional risk regression models were used to analyze the associations of the frequency of alcohol consumption, alcohol intake, and type of alcohol with the risk of developing hypertension or prehypertension. Restricted cubic spline analysis was used to assess the dose-response relationships for alcohol intake and their hazard ratios (HRs). A total of 1556 participants were included in the final analysis. Among the overall population, 448 (30.81%) and 35 (34.31%) participants developed hypertension or prehypertension, respectively. Compared with no alcohol consumption, alcohol consumption ≥ 2 times/week and consumption of ≥2 types of alcohol were associated with an increased risk of hypertension and prehypertension, with HRs of 1.97 (95% confidence interval [CI] 1.17-3.34; p=0.011) and 1.77 (95% CI 1.01-3.09; p=0.046), respectively. Alcohol intake of>96mL/week was associated with an increased risk of hypertension and prehypertension, with HRs of 2.09 (95% CI 1.12-3.90; p=0.020) and 2.07 (95% CI 1.11-3.84; p=0.021), respectively. The restricted cubic spline analysis showed that the risk of developing high blood pressure or prehypertension tends to increase with increasing alcohol consumption. Heavy alcohol consumption in adolescence increased the risk of developing hypertension and prehypertension in early adulthood.

Alcohol and brain structure across the lifespan: A systematic review of large-scale neuroimaging studies.

Alcohol exposure affects brain structure, but the extent to which its effects differ across development remains unclear. Several countries are considering changes to recommended guidelines for alcohol consumption, so high-quality evidence is needed. Many studies have been conducted among small samples, but recent efforts have been made to acquire large samples to characterize alcohol's effects on the brain on a population level. Several large-scale consortia have acquired such samples, but this evidence has not been synthesized across the lifespan. We conducted a systematic review of large-scale neuroimaging studies examining effects of alcohol exposure on brain structure at multiple developmental stages. We included studies with an alcohol-exposed sample of at least N = 100 from the following consortia: ABCD, ENIGMA, NCANDA, IMAGEN, Framingham Offspring Study, HCP and UK BioBank. Twenty-seven studies were included, examining prenatal (N = 1), adolescent (N = 9), low-to-moderate-level adult (N = 11) and heavy adult (N = 7) exposure. Prenatal exposure was associated with greater brain volume at ages 9-10, but contemporaneous alcohol consumption during adolescence and adulthood was associated with smaller volume/thickness. Both low-to-moderate consumption and heavy consumption were characterized by smaller volume and thickness in frontal, temporal and parietal regions, and reductions in insula, cingulate and subcortical structures. Adolescent consumption had similar effects, with less consistent evidence for smaller cingulate, insula and subcortical volume. In sum, prenatal exposure was associated with larger volume, while adolescent and adult alcohol exposure was associated with smaller volume and thickness, suggesting that regional patterns of effects of alcohol are similar in adolescence and adulthood.

High dietary antioxidant index associated with reduced insulin resistance in female Mexican children and adolescents

Antioxidant intake is inversely associated with different health outcomes; however, its association with insulin resistance (IR) has not been well documented. We hypothesized that the Dietary Antioxidant Index (DAI) is inversely associated with IR in Mexican children and adolescents. A cross-sectional analysis was performed using data from the Health Workers Cohort Study. A total of 830 children and adolescents aged 7 to 18 years were enrolled. The DAI was evaluated in three categories defined by tertiles using a semiquantitative food frequency questionnaire. IR was defined using previously reported cutoff points in the homeostasis model assessment. This association was evaluated using a multiple logistic regression model. Stratified analysis was performed using body mass index and sex. The prevalence of IR based on the DAI categories (low, medium, high) was 23.8%, 24.2%, and 15.3%, respectively. The IR odds ratio (OR) for participants in the highest DAI category was 0.49 (95% confidence interval [CI]: 0.30-0.80). Notably, female Children and Adolescents in the highest DAI category had significantly lower odds of developing IR than those in the lowest DAI category (OR 0.54, 95% CI 0.29-0.98). Participants with overweight/obesity showed a similar association (OR 0.37, 95% CI 0.18-0.76). These results suggest that the DAI is inversely associated with IR, particularly in females, highlighting the potential role of antioxidants in preventing IR. This underscores the need to establish recommendations for antioxidant consumption in female children and adolescents.

The association between junk foods consumption and attention deficit hyperactivity disorder in children and adolescents: a systematic review and meta-analysis of observational studies.

The adverse effects of junk foods on the risk of attention deficit hyperactivity disorder(ADHD) symptoms were reported in several studies. In this meta-analysis, the association between junk food consumption and the risk of ADHD was investigated in children and adolescents. A comprehensive systematic search was conducted to find all relevant literature via four databases, including PubMed, Web of Science, Scopus, and Google scholar, up to September 2022. Two independent authors screened all documents based on inclusion criteria. The overall effect sizes and related 95% confidence interval (CI) were pooled with the random effect approach. Subgroup analysis was done to measure potential sources of heterogeneity between studies. The quality of the included studies was evaluated with The Newcastle-Ottawa scale (NOS). Nine observational studies with 58,296 children /adolescents were eligible to be include in the meta-analysis. According to the random effect model, there was a positive relation between the consumption of junk foods and ADHD symptoms (odds ratio (OR): 1.24, 95%CI 1.15-1.34, P < 0.001, I2: 37.4%, P = 0.085). A similar significant positive association was shown in the subgroups analysis by different junk foods (sweetened beverages/soft drinks, sweets/candies, and other types of junk foods). This meta-analysis finding demonstrated that consuming junk foods, especially sweetened beverages/soft drinks, and sweets/candies is associated with ADHD symptoms.

Physiological Impacts of Energy Drink Consumption: A Clinical Analysis in Adolescents.

Energy drink (ED) consumption among Israeli-Arab adolescents is widespread. This study aimed to investigate the acute glycemic and insulin effects of EDs in healthy adolescents. Seventy-one Israeli-Arab adolescents (56% girls, average age 16.04 ± 1.03 years) participated in a non-randomized, case-controlled, open-label study. Participants consumed ED (n = 36) or a volume- and carbohydrate-matched non-caffeinated soft drink (SD, n = 35), followed by a 2 h glucose tolerance test. Blood glucose was measured at baseline and 15, 30, 60, and 120 min post-consumption (T0, T15, T30, T60 and T120, respectively). Serum insulin concentration and caffeine relative intensity were determined 45 min post-consumption (T45). Blood glucose levels peaked significantly at T15 and remained significantly higher at T30 in the ED group compared to the SD group (p = 0.005, p = 0.017, respectively). Insulin concentrations were substantially higher at T45 in the ED group (t [64] = 2.794, p = 0.001). This pattern was especially prominent in heavy ED consumers. A positive correlation emerged between the amount of caffeine consumed (mg/kg), blood glucose levels at T15 and T30, and insulin concentration at T45. This study is the first to demonstrate the glycemic and insulin responses to ED consumption in adolescents, suggesting that regulatory measures limiting ED sales to adolescents could improve their health.

Identifying the challenges of policy content related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in adolescents

BackgroundThis study aims to identify policy content challenges related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in Iranian adolescents.MethodsThis qualitative study analyzed high-level and national documents pertaining to adolescent health, high-risk sexual behaviors, stimulant, and alcohol consumption in adolescents. The documents, which were published by public organizations between January 1979 and February 2023 and publicly available, were complemented by interviews with policymakers and executives. The study involved reviewing 51 papers and conducting interviews with 49 policymakers and executives at the national, provincial, and local levels who were involved in addressing adolescent behaviors related to high-risk sexual behaviors, stimulant, and alcohol consumption. The data collected was analyzed using conventional content analysis.ResultsThe study’s results involved examining policy content and identifying challenges related to policy content. The analysis revealed that from the beginning of the Iranian revolution in 1979 until the late 1990s, the dominant approach in Iran was to deny the existence of high-risk behaviors among adolescents. However, in the early 2000s, the country began to adopt a new approach that acknowledged the social harms and ineffectiveness of previous strategies. As a result, a new policy framework was introduced to address high-risk behaviors among adolescents. The study’s interviews with policymakers and executives identified 12 challenges related to policy content, including parallel programs, lack of institutional mapping, lack of evidence-based policymaking, lack of integrated approach regarding training, late parent training, lack of consideration of all occurrence reasons in adolescents’ high-risk behaviors policymaking, and the existence of many abstinence policies regarding high-risk behaviors.ConclusionsThe study’s findings suggest that high-risk behaviors among adolescents in Iran are primarily a health issue, rather than a social or ideological one. Unfortunately, ideological approaches, stigma, and policymaking based on anecdotes rather than evidence have had a significant impact on this area. To improve policymaking in this domain, it is crucial to address these challenges by tackling stigma, adopting an integrated and holistic approach, and implementing evidence-based policies that consider all relevant aspects, including adolescents’ subcultures and policy audiences. Such an approach can also be useful for other countries facing similar conditions.

The prevalence of kratom use and association with co-occurring substance use among adolescents: a 2022 Bangkok behavioral surveillance survey, Thailand

Thailand removed kratom from the list of prohibited substances in 2021, possession and consumption of Kratom is now legal. It is prohibited from selling Kratom to anyone under the age of 18 and/or who is pregnant or breastfeeding. While there are benefits from kratom use with few reported adverse effects, escalating dose and increased use frequency raise the risk for toxic events in the setting of polysubstance use or development of a use disorder. We utilized data from the Behavior Surveillance Survey in Bangkok (n = 5,740) to examine the use of kratom with other substances use in the 12 months before the survey. The prevalence of past-year kratom use among students was 9.3% (95%CI = 8.7–9.9), with higher proportions of males (12.4 versus 6.1%, p < 0.001). The factors associated with past 12-month kratom use were academic performance (Medium GPA; AOR = 2.41, 95% CI = 1.76–3.29; Low GPA; AOR = 4.15, 95% CI = 2.94–5.87), close friend use substance (AOR = 1.94, 95% CI = 1.44–2.59), cannabis use (AOR = 6.84, 95% CI = 4.61–10.15), consumed alcohol (AOR = 2.32, 95% CI = 1.77–3.02), smoked conventional cigarettes (AOR = 4.20, 95% CI = 3.16–5.58), used e-cigarettes (AOR = 4.37, 95% CI = 3.30-5.79) used illicit opioids (AOR = 8.13, 95% CI = 4.35–15.18), and other illicit drug use (AOR = 9.15, 95% CI = 3.78–22.14). These findings may be useful for the initial targeting of efforts to reduce adolescent consumption of kratom. Future studies should examine the effect of regulatory policies or other Thai FDA-related policies use of illicit drugs and e-cigarettes on kratom use.