Early Tobacco Use Research Articles

Trends and determinants of tobacco use initiation in India: analysis of two rounds of the Global Adult Tobacco Survey

ObjectivesEarly initiation of tobacco use can lead to lifelong addiction and increases tobacco-attributable morbidity and mortality. This study assesses trends in tobacco use initiation and factors associated with tobacco use...

Alcohol trajectories and subsequent risk for opioid misuse in a cohort of urban adolescents

Background: The opioid epidemic is a public health emergency in the US. Alcohol is the most widely used addictive substance among all age groups; however, the contribution of different alcohol use trajectories throughout adolescence and young adulthood to the development of opioid misuse in young adulthood among urban minority youth has not been investigated. Methods: Data are from a study of 580 youth (85% African American, 67% low SES) residing in Baltimore City followed from ages 6–26. Alcohol trajectories were identified between ages 14 and 26 using group-based trajectory modeling. Opioid misuse was defined as using opioid painkillers without a prescription or using heroin between ages 19 and 26. Opioid misuse outcomes were also investigated separately. Logistic regression examined associations of alcohol trajectories with opioid misuse in young adulthood adjusting for socio-demographics, early use of tobacco and cannabis, neighborhood, and peer factors. Results: Six alcohol use trajectories were identified: Young adult increasing (21.4%), adult increasing (19.1%), abstaining (19.1%), experimenting (15.3%), adolescent increasing (14.8%), and adolescent limited (10.2%). In models fully adjusted for covariates, relative to the abstaining trajectory, the adolescent increasing trajectory was associated with an elevated risk of opioid misuse (aOR = 3.3, 95%CI = 1.4, 7.8) and prescription opioid misuse (aOR = 3.9, 95%CI = 1.4, 10.8) in young adulthood. Conclusions: Escalating alcohol use in adolescence and young adulthood is associated with an elevated risk of opioid misuse in young adulthood in a cohort of predominantly African American and socio-economically disadvantaged young people. Tailored interventions should target high levels of alcohol use during these developmental periods to reduce risk for opioid misuse among disadvantaged youth.

Profile and predictors of adolescent tobacco use in Ghana: evidence from the 2017 Global Youth Tobacco Survey (GYTS).

Understanding the predictive factors for tobacco use, and initiation among the youth is critical for effective intervention and prevention. We, therefore, aimed to determine the profile, associated factors, the regional disparities in the use of tobacco products among the youth in Ghana. The study used the 2017 Ghana Global Youth Tobacco Survey (GYTS) to obtain tobacco-related information among the youth in Junior High Schools across the country. The survey used a two-stage cluster randomized sampling technique to obtain nationally representative data. Weighted univariate and multivariate logistic regression analyses were used to assess the association of participant's characteristics and use of tobacco. Out of the 6039 targeted respondents, 5,664 (93.8%) participated, 2,707 males, 2,929 females, and 28 of the participants had missing gender data. The use of any tobacco product (cigarette, smokeless tobacco, electronic cigarette, or waterpipe tobacco) was 28.3, 7.0, and 4.8% in the Savanna/northern zone, middle/forest zone, and Coastal zone respectively. From the univariate analysis, age (p = 0.005), pocket money (p < 0.001), and exposure to secondhand smoke (SHS) at home (p < 0.001) were significantly associated with tobacco use. In the multivariate analysis, age (p = 0.002), pocket money (p < 0.001), exposure to SHS at home (p < 0.001), and being taught about the dangers of tobacco use (p = 0.043) were significantly associated with tobacco use. Multiple factors including age, pocket money, exposure to SHS were identified to be associated with tobacco use among the youth in Ghana. Promoting anti-smoking campaigns in early adolescence, as well as programmes targeting early tobacco use can guard the youth against initiating tobacco use.

Concurrent Childhood Experiences Impact Underage Substance Use.

Adverse and advantageous childhood experiences (ACEs and counter-ACEs) during adolescence are understudied. This study examined how childhood experiences affect youth tobacco/alcohol use. Participants included 489 U.S. adolescents (baseline 10-13 years; 51% female) from the first five waves of the Flourishing Families Project. Results of the cross-lagged model showed ACEs were predictive of early tobacco use only. Counter-ACEs in wave two and wave three predicted, respectively, decreased tobacco and decreased alcohol use in the following wave. Counter-ACEs were also correlated with reduced alcohol and tobacco use in later waves. These findings indicate the salience of counter-ACEs over ACEs in persistent and late adolescent substance use, though ACEs may be important to consider to prevent very early initiation of tobacco.

JUVENILE ONSET TOBACCO DEPENDENCE-A RARE CASE REPORT

Increasing tobacco use by children in developing nations is a signicant threat to their physical and mental health. Cigarette smoking is often 1 considered as gateway to a more serious drug abuse. In most studies the average age of first-time smokers ranged from 12-14 years. Several risk factors-neurobiological, family, peer inuences, sociocultural and psychiatric comorbidity increase vulnerability to development of substance use disorders. Early tobacco use needs timely intervention to protect a vulnerable child from becoming addicted. Here we present a case of early onset of tobacco smoking in a 9 year male child from Kolkata. The child was brought by his mother with chief complaints of cigarette smoking, headache, easy irritability, decreased academic performance and stealing money since 2 years, which were increased in the last 6 months. The child showed a complete remission on Oral Risperidone 0.5 mg and supportive psychoeducation for 12 months.

Family and School Predictors of Tobacco Use in Chilean Adolescents Aged 13 - 14: A National Study

Objectives: Adolescent smoking is a major health care concern which calls for a more in-depth study of the factors affecting this pediatric disease. We aimed to determine the prevalence of tobacco use among Chilean adolescents aged 13 - 14 and its association with family and school factors. Methods: This was a cross-sectional analytical study. Data from the Eleventh Chilean National Study of Drugs in the School Population 2015 were used (n = 11,791). School and family variables of parental control were evaluated and analyzed by the chi-Square test and a multivariate logistic regression model. Data were processed with the STATA V. 14.0 software at the α = 0.05 level of significance. Results: The prevalence of tobacco use at some time during life was 36% with onset age of 11.4 ± 3.6 years. Girls smoke proportionally more than boys (40.5% and 31.5%, respectively). Parental monitoring decreased use and acted as a protective factor (OR: 0.41, 95%CI: 0.375 - 0.468); likewise for good school performance (OR: 0.52, 95%CI: 0.475 - 0.584). In turn, running away from school raises the risk of smoking (OR: 2.34, 95%CI: 2.03 - 2.72). Conclusions: There is a feminization of cigarette use, and the risk of cigarette smoking increases considerably among adolescents who run away from school. However, parental control and school performance are powerful protective factors against early tobacco use.

Prenatal exposures to tobacco and cannabis: Associations with adult electronic cigarette use

IntroductionPrenatal exposures to tobacco and cannabis are associated with combustible cigarette use. This study evaluated pathways from these prenatal exposures to adult electronic cigarette use. We tested whether there were indirect effects of these prenatal exposures via childhood behavior dysregulation, early tobacco use, and adolescent tobacco dependence. MethodsTelephone interviews were conducted with 427 adult offspring (22–33 years old) from 3 prenatal cohorts with trimester-specific data on exposures to tobacco, alcohol, and cannabis. The offspring were 59% Black and 41% White (61% female). Prenatal exposures included quantity/frequency of tobacco, alcohol, and cannabis use by mothers during the first trimester. Using logistic regression and structural equation modeling, we examined the effects of gestational exposures on adult electronic cigarette use via early cigarette use (prior to age 14), controlling for covariates of combustible and electronic cigarette use. ResultsThere were no effects of childhood behavioral dysregulation on electronic cigarette use. However, there was a significant indirect effect of prenatal exposures to tobacco and cannabis on electronic cigarette use via early adolescent combustible cigarette use and adolescent risk for tobacco dependence. ConclusionsOne implication of these findings is that the inter-generational risk for tobacco use conferred via gestational exposures to tobacco and cannabis generalizes to novel products such as electronic cigarettes. These results have implications for public health, as more women use cannabis and co-use cigarettes and cannabis during pregnancy.

O Programa Nacional de Controle do Tabagismo (PNCT) na perspectiva social: a análise de redes, capital e apoio social

Resumo Em 1986, o Ministério da Saúde lançou o Programa Nacional de Controle do Tabagismo (PNCT). Teve como objetivo prevenir o início da utilização de derivados do tabaco entre crianças e adolescentes, assim como estimular o abandono do fumo entre os já dependentes. Apesar da contínua queda dessa prevalência desde então, vem se observando sinais de retomada desses números. Visto ser o tabagismo uma doença de “contágio social” e não infeccioso-biológico, busca-se refletir sobre a atuação do PNCT perante as recidivas. Toma-se como amparo de diálogo pressupostos advindos da teoria de análise de redes sociais (ARS) e do capital social no contexto do apoio social, com suporte de alguns exemplos fictícios. Conclui-se que o investimento do PNCT em redes de apoio e na inserção do indivíduo nelas, estimulando-os ao estabelecimento de suas próprias redes pessoais, são condições fundamentais para o aumento do capital social do tabagista e, consequentemente, para a prevenção de recidivas.

Black–white disparities in risk for cannabis use and problems in women: The role of early tobacco use, trauma type and psychiatric pathology

Black–white disparities in risk for cannabis use and problems in women: The role of early tobacco use, trauma type and psychiatric pathology

Age at first tobacco use and risk of subsequent psychosis-related outcomes: A birth cohort study.

Compared to the substantial body of research examining links between cannabis use and psychosis, there has been relatively little attention to the role of tobacco as a potential risk factor for psychosis. This study explored the association between age at first tobacco use and psychosis-related outcomes in a birth cohort. This study is based on a large birth cohort (the Mater-University Study of Pregnancy). At approximately 21 years of age, cohort members (N = 3752) were assessed for three psychosis-related outcomes (International Classification of Diseases non-affective psychosis, the presence of any hallucination and total count of delusional-like experiences) with the Composite International Diagnostic Interview and the Peters Delusional Inventory. Associations between age at first tobacco use and psychosis-related outcomes were examined using logistic regression in a model (a) adjusted for sex and age and (b) in a second model excluding all respondents who had a history of past problematic and current cannabis use. When adjusted for age and sex, those who commenced tobacco at 15 years of age or younger were significantly more likely to (a) have non-affective psychosis, (b) be in the highest quartile of total score of the Peters Delusional Inventory and (c) report hallucinations. After excluding all those with a history of a cannabis use disorder, or who were current (last month) cannabis users, a significant association between age at first tobacco use and the presence of hallucinations persisted. There is an association between age at first tobacco use and subsequent psychosis-related outcomes in young adults. While the findings cannot be used to deduce causality, it adds weight to the hypothesis that early tobacco use may contribute to the risk of developing psychosis-related outcomes.

Tobacco Use Among Southwestern Alaska Native People

We examined the characteristics, attitudes, beliefs, and exposure to tobacco products in a cohort of rural dwelling Alaska Native (AN) people. We conducted a study of 400 of AN adult tobacco users and nonusers living in Southwestern Alaska. Questionnaires covered variables such as demographics, tobacco-use history, current tobacco use and dependence scales, general health status, attitudes and beliefs about tobacco, and quitting history. The study population smoked 7.8 cigarettes per day compared with 16.8 on average for the U.S. population: a significant proportion of the population engaged in dual use of cigarettes and smokeless tobacco products. Over one third (40.9%), first tried tobacco at age 11 or younger. The mean measures of tobacco addiction (e.g., Fagerstrom Test for Nicotine Dependence, Severson Scale of Smokeless Tobacco Dependence) scores were lower compared with other U.S. populations. Very high tobacco-use prevalence, dual product use, and early tobacco use are observed in Southwestern AN people. Unexpectedly these did not appear to be correlated with heavier individual tobacco use or higher levels of addiction in this population.

Determinants for the Experimental Consumption and Early Tobacco Use Among School-age Adolescents (Salvador - Bahia-Brazil)

Determinants for the Experimental Consumption and Early Tobacco Use Among School-age Adolescents (Salvador - Bahia-Brazil)

Consumo precoz de tabaco y alcohol como factores modificadores del riesgo de uso de marihuana

To assess the relationship between early tobacco and alcohol use and the risk of marijuana consumption among schoolchildren. A cross-sectional study comprising data from the Fourth National Study on Drug Use in the Chilean School Population (2001). There were studied 54,001 schoolchildren aged between eight and 20 years. Predictors were self-reported tobacco and alcohol use (ever users), age at initiation of tobacco and/or alcohol use, and intensity of tobacco use. The study outcome was self-reported marijuana use (ever users versus never users) and age at initiation of marijuana use. Poisson regression and Weibull regression were used for data analysis. Lifetime prevalence of tobacco use was high: 77%, alcohol 79%, and marijuana 23%. Tobacco consumption increased the likelihood of marijuana use (PR=10.4; 95% CI: 8.9;12.2). Later initiation of tobacco (HR=0.85; 95% CI: 0.84;0.86) and alcohol (HR=0.90; 95% CI: 0.89;0.91) decreased the risk of marijuana use. Marijuana use was higher in heavy smokers compared to light smokers (PR=3.11; 95% CI: 2.96;3.26 versus PR=1.70; 95% CI: 1.58;1.83). Tobacco use is strongly associated with marijuana use, which is significantly associated with the age at initiation of tobacco use, intensity of tobacco use and concurrent use of alcohol. Prevention strategies should target prevention of adolescent early tobacco use.

Smoking and inflammatory bowel disease

Ulcerative colitis (UC) and Crohn's disease (CD) result from genetic and environmental factors. Never smoking and formerly smoking increase the risk of UC, whereas smoking exacerbates the course of CD. We sought to define the age-dependent effects of smoking on the development of UC and CD in familial and sporadic cohorts. University of Chicago patients diagnosed with UC or CD between 1990 and 2002 were surveyed about their tobacco use relative to their diagnosis. Smoking trends were used to estimate age-dependent odds ratios and the attributable risks of smoking in the IBD cohort compared to in the general population. One thousands and thirteen patients were included in the study: 245 with sporadic UC; 216 with sporadic CD; 249 with familial UC; and 303 with familial CD. Being an ex-smoker conferred an increased risk for UC in the 25-44 age group in both the sporadic and familial cohorts, but not in the 45-64 age group in the familial UC cohort. Furthermore, there was no difference in tobacco use between patients with sporadic CD and the general population, although there was a significant increase in smoking in younger patients with familial CD. Ex-smokers make up an increasing percentage of older patients diagnosed with UC, accounting for more than 35% of the attributable risk of late onset (>45 years) UC and a large component of the second peak in diagnosis. Current smokers account for a large percentage of patients diagnosed at a younger age with familial CD but not with sporadic CD. Families with IBD should be counseled that early tobacco use significantly increases the risk of developing CD or, if an ex-smoker, UC at a young age.

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A study from India reports that the prevalence of smoking among primary school students (aged 10-16) in two cities, Delhi and Chennai, is two to four times as high in...

Soziale und individuelle Determinanten des Tabakkonsums im frühen Jugendalter

We examined the structure of individual and social determinants of tobacco consumption in early adolescence. Participants were drawn from a longitudinal study of a birth cohort of originally 384 children at risk for psychopathology. At the age of 15 years, adolescents completed self-report questionnaires measuring their tobacco consumption, smoking-related attitudes (self-efficacy and outcome expectancies), and the smoking behaviour of their friends and parents. About 60% of the 15-year olds reported ever having used tobacco, while nearly 16% reported that they smoked daily. Both smoking-related self-efficacy and peer smoking were most strongly related to early use of tobacco by males and females. Adolescents with a low level of self-efficacy and a large number of friends who smoke were at the greatest risk. While peer smoking influenced both, adolescent smoking and smoking-related attitudes, parental smoking exerted only a minor direct effect on tobacco use among 15-year olds. The smoking level and smoking-related attitudes during early adolescence are strongly influenced by the smoking habits of one's peers.

Revisiting drug progression: long‐range effects of early tobacco use

Drug progression models have been a cornerstone of scientific and public policy discussions for decades. These models have been criticized for their lack of causal mechanisms leading to drug dependence. Future research should focus on identification of pathways and covariates. This study re-examines tobacco use onset and progression to drug dependence in a multi-ethnic sample followed longitudinally from early to late adolescence (1990 to 1998-2000). Data were collected in schools (n = 1208) during early adolescence (mean age 11.07), and subsequently face-to-face interviews were conducted at late adolescence (mean age 20.01). Results indicated ethnic differences in rates and progression of tobacco use, with African Americans and foreign-born Latinos having larger proportions of abstainers and lower rates of persistent use. Most early adolescent smokers progressed to regular use. The odds of progression to marijuana abuse or dependence by later adolescence were highest (O.R. = 4.9) among persistent smokers, but not significant for foreign-born Latinos. The odds of progression to drug abuse or dependence were also highest (O.R. = 6.4) for persistent smokers, but not significant for African Americans. Implications for research on pathways and mechanisms of progression are discussed. Prevention programs may interrupt drug progression if they delay onset of tobacco use until mid-adolescence. Preventing targeted marketing efforts by the tobacco industry, regulating and enforcing tobacco control laws and pricing cigarettes at cost levels that adolescents find prohibitive are effective supplements to traditional behavior change interventions.

The development of suicide ideation and attempts: an epidemiologic study of first graders followed into young adulthood

Studying community residing youths originally recruited for an intervention trial upon entry into first grade, this project sought to estimate risk of suicide ideation and attempts to young adulthood, with focus on those who used drugs before age 16, as compared to youths who used later in development or not at all. Standardized interview assessments in 1989–1994 were completed with 2311 youths age 8–15. Roughly 15 years after recruitment, our study team reassessed 1695, nearly 75% of the survivors (mean age = 21), finding 155 to have made suicide attempts (SA) and 218 with onset of depression-related suicide ideation (SI). We estimate relative risk (RR), from survival analysis and logistic regression models, to study early use of tobacco, alcohol, cannabis, and inhalants, with covariate adjustments for age, sex, race-ethnicity, and other pertinent covariates. Early-onset of cannabis use and inhalant use for females, but not for males, signaled modestly excess risk of suicide attempt (cannabis-associated RR = 1.9; p = 0.04; inhalant-associated RR = 2.2; p = 0.05). Early-onset of cannabis use by females (but not for males) signaled excess risk for suicide ideation (RR = 2.9; p = 0.006). Early-onset alcohol and tobacco use were not associated with later risk of SA or SI. In light of the relatively modest strength of association, the evidence may well reflect an underlying common diathesis or unmeasured prior confounding influences that link early-onset illegal drug use with later risk of these suicide-related events, rather than an influence of early-onset drug use per se.

The early use of alcohol and tobacco: its relation to children's competence and parents' behavior.

Use of tobacco and alcohol during childhood predicts heavy use of these substances and use of illicit drugs during adolescence. This study aims to identify developmental correlates of tobacco and alcohol use among elementary-school children. Cross-sectional surveys were used to measure tobacco and alcohol use, multiple indicators of child competence, parenting behaviors, and parental modeling of tobacco and alcohol use in a sample of 1470 third- and fifth-grade children. Both self-report and teacher-rated assessments were obtained, which allowed collateral testing of study hypotheses. Children's tobacco and alcohol use was strongly related to low scores on several measures of child competence, both self-reported and teacher rated. Children's tobacco and alcohol use was also associated with less effective parenting behaviors and with parental use of tobacco and alcohol. Children's early experience with tobacco and alcohol is associated with weak competence development and exposure to socialization factors that promote risk taking. Interventions to prevent early use of tobacco and alcohol are needed.