First Use Of Tobacco Research Articles

Relationships between age at first substance use and persistence of cannabis use and cannabis use disorder

BackgroundFrom a secondary prevention perspective, it is useful to know who is at greatest risk of progressing from substance initiation to riskier patterns of future use. Therefore, the aim of this study was to determine relationships between age at first use of alcohol, tobacco and cannabis and patterns of cannabis use, frequency of use and whether age of substance use onset is related to having a cannabis use disorder (CUD).MethodsWe analysed data from Ireland’s 2010/11 and 2014/15 National Drug Prevalence Surveys, which recruited 5134 and 7005 individuals respectively, aged 15 years and over, living in private households. We included only those people who reported lifetime cannabis use. Multinomial, linear and binary logistic regression analyses were used to determine relationships between age of substance use onset and patterns of cannabis use, frequency of use and having a CUD.ResultsWhen compared to former users, the odds of being a current cannabis user were found to be reduced by 11% (OR = 0.89; 95% CI: 0.83, 0.95) and 4% (OR = 0.96; 95% CI: 0.92, 1.00) for each year of delayed alcohol and cannabis use onset, respectively. Among current users, significant inverse linear relationships were noted, with increasing age of first use of tobacco (β = − 0.547; P < .001) and cannabis (β = − 0.634; P < .001) being associated with a decreased frequency of cannabis use within the last 30 days. The odds of having a CUD were found to be reduced by 14% (OR = 0.86; 95% CI: 0.78, 0.94) and 11% (OR = 0.89; 95% CI: 0.82, 0.98) for each year of delayed tobacco and cannabis use onset respectively in analyses which examined survey participants aged 15–34 years.ConclusionsAmong people who report past cannabis use, it is those with a more precocious pattern of early use of substances, including alcohol, and especially tobacco and cannabis, who are more likely to report ongoing, heavy and problematic cannabis use. Secondary prevention initiatives should prioritise people with a pattern of very early onset substance use.

Risky Behaviours among Adolescent Students of Pokhara Valley: A School-Based Cross-sectional Survey.

Adolescence is the period of physical and mental vulnerabilities where health risk behaviours are common due to their experimental nature and decision-making power. A higher prevalence of risky behaviours among adolescents has been reported globally which resulted in adverse effects on health and wellbeing. The present study aims to explore the overall prevalence of health risk behaviours among adolescents. This study was conducted in 2014 using the WHO guideline of a Global School-Based Student Health Survey (GSHS) in the Pokhara valley of Nepal using a stratified clustered sampling technique. A descriptive study was conducted among 1190 adolescent school students of the valley. A self-administered questionnaire was used for data collection. The data were analysed using SPSS for descriptive statistics. The response rate of the participants was 95.35%. The prevalence of the current use of tobacco, alcohol, and drug was 15.9%, 17.1%, and 4.1% respectively. The mean age of first use of tobacco, alcohol, and drug was found14.07±1.82, 14.19±1.78, and 15.52±1.61 years respectively.Two third (66.4%) of the participants reported having sexual intercourse one or two times within the last 12 months. Among them, 21.4 % reported no use of condoms during sexual intercourse. The mean age of first sexual intercourse was 14.69±1.56 years. Similarly, 42.2% reported being injured in the past 12 months of study. The study shows a higher prevalence of health risk behaviours among adolescents. Tobacco, drug, alcohol use, and risky sexual activities were initiated at a younger age.

Knowledge, attitude, and usage pattern of tobacco among high school students in Nay Pyi Taw, Myanmar.

ABSTRACTIn Myanmar, although the law prohibits the sale of tobacco products to and by those aged less than 18 years, the use of smoking and smokeless tobacco among high school students is a social problem. There has been no previous study on tobacco use or knowledge of tobacco law among students in Nay Pyi Taw. A survey was conducted to assess the knowledge, attitude, and usage pattern of tobacco among high school students in Nay Pyi Taw, Myanmar. The data were collected in three high schools, from 300 students of Grade 10 and 11, in September 2015, using anonymous self-administered questionnaires which included characteristics of students, knowledge, attitude, and usage pattern of tobacco. Of the 300 students, 104 (34.7%) were smokers and 85 (28.3%) were users of smokeless tobacco. The average age of first use of tobacco was 14 years. Although most students knew about the ill effects of tobacco, only 25% knew about the Tobacco Product Law. The most common source of tobacco was friends and male family members were main smokers in families. Most students had seen male teachers and headmasters smoking in schools. The usage of tobacco and smokeless tobacco was associated with sex and the students’ attitude towards tobacco. This study indicated that the high school students knew about the ill effects of tobacco, but not about the Tobacco Product Law. Schools need to educate students and teachers about tobacco and the Tobacco Product Law and the enforcement of the law is also needed.

Social Determinants of Alcohol Use and Heaving Episodic Drinking Among Hispanic Young Adults

Background: Although there are numerous preventive measures in the literature, a vast percentage of Hispanic young adults continue to engage in alcohol use and heavy episodic drinking. The purpose of the study was to examine social determinants of recent alcohol use and heavy episodic drinking among Hispanic young adults 18-25 years of age. Methods: In 2016, a secondary analysis (N = 3,452) was performed of 2012 National Survey on Drug Use and Health data. A series of logistic regression analyses were performed to determine whether recent alcohol use and heavy episodic drinking differed based on sex, education level, family income, employment status, location of residence (type of metro area), self-reported health status, first use of alcohol before age 21, first use of tobacco before age 21 and first use of marijuana before age 21. Results: Regarding alcohol use, 51.8% of Hispanic young adults reported that they had consumed alcohol in the past month and 35.0% reported that they had engaged in heavy episodic drinking. Hispanic young adults at highest risk for recent alcohol use were male, had some college or more, had high family income, were employed, lived in a large metropolitan area, had excellent/very good health status, and had early initiation of substance use. Those at highest risk for heavy episodic drinking were male, were employed, and had early initiation of substance use. Discussion: The present study found that a sizeable percentage of Hispanic young adults are involved in recent alcohol use and heavy episodic drinking. Since Hispanic young adults are disproportionately at risk for substance use and scarce resources are available to effectively address the needs of this population, further interventions are warranted. Findings may aid prevention scientists in developing, implementing and evaluating alcohol use programs for this population.

Interventional study plan to investigate the training effects on physical and psychological outcomes awareness of smoking in teenagers.

BACKGROUND:Studies have found that nearly 90% of the first use of tobacco takes place before high school graduation (teenagers) and training discussion due to prevention can be useful, therefore, here, we aimed to determine the effects of training on awareness of cigarette outcomes (physical and psychological) in male teenagers.MATERIALS AND METHODS:We conducted an interventional study using Solomon's four-group plan, which used a two-stage cluster sampling in four groups (two experimental groups and two control groups). The three sessions of at least 2 h of education intervention including visual displaying using photo, film, and short scientific texts were held for the interventional group. After 1 month, all four groups took posttest, and research groups were followed up after 8 months of intervention. All data were analyzed using one-way analysis of variance and covariance in SPSS.RESULTS:According to the results, the mean of posttest scores had increased rather than pretest scores, and generally, a significant difference was observed (P ≤ 0.001). These results were significant in the aspect of both physical and psychological outcomes awareness. The difference between the mean of scores in follow-up period and posttest was not statistically significant, and it shows training retention after 8 months (P < 0.666).CONCLUSIONS:It can be concluded that through the training, it is possible to increase the awareness of teenagers about physical and psychological outcomes of cigarette smoking that this can have an important role in smoking prevention.

The Relationship Between Subjective Experiences During First Use of Tobacco and Cannabis and the Effect of the Substance Experienced First

We examined the positive and negative subjective feelings associated with initial tobacco and cannabis use as well as the role of these experiences in regular use. Additionally, we investigated the effect of the first substance experienced on initial subjective experiences and later regular use. Baseline data from a representative sample of young Swiss men were obtained from an ongoing Cohort Study on Substance Use Risk Factors, which includes 2,321 lifetime tobacco and cannabis users. We assessed the age of first tobacco and cannabis use along with the subjective experiences associated with initial use. Additionally, subjective experiences related to regular use of both substances were analyzed. The initial subjective experiences were divided into positive and negative for each substance, and we found that the feelings associated with first use of tobacco and cannabis were similar. Moreover, the participants who used cannabis before tobacco reported fewer negative experiences associated with first tobacco use, whereas the participants who initially used tobacco reported more negative experiences related to first cannabis use. Also, we identified that regular use was encouraged by positive experiences and that negative experiences were more adverse for regular use of cannabis compared with tobacco. Taken together, these results indicate that similar subjective experiences were associated with the first use of tobacco and cannabis. Also, the use of cannabis before tobacco, which occurred in only a minority of users, had the potential to enhance the effects of initial tobacco use.

Modest Time-Dependent Misclassification in Recalling Age at First Use of Alcohol and Tobacco

To investigate whether recall of age at first use of alcohol and tobacco is time dependent. Respondents aged 14–89 years from the 2001 and 2007 waves of the Australian National Drug Strategy Household Survey were considered as independent samples of the Australian population at two different time points. The means of reported age at first use of alcohol and age at first use of tobacco from the two surveys were compared for each birth cohort. The mean differences were generally small (&lt; 1 year) across birth cohorts. Overall, the increase in mean age at first use from 2001 to 2007 was 0.31 years for alcohol and 0.33 years for tobacco, after controlling for birth cohort and gender effects. The time lag between actual onset of first use and subsequent survey recall can introduce a small systematic bias, but the error is unlikely to pose a threat to retrospective studies that rely on recall information to estimate cumulative exposure of alcohol and tobacco use.

Disruptive symptoms in childhood and adolescence and early initiation of tobacco and cannabis use: The Gazel Youth study

Purpose To examine the link between symptoms of hyperactivity-inattention and conduct disorder in childhood, and the initiation of tobacco and cannabis use, controlling for other behavioral symptoms, temperament and environmental risk factors. Method The sample ( N = 1107 participants, aged 4 to 18 years at baseline) was recruited from the population-based longitudinal Gazel Youth study with a follow-up assessment 8 years later. Psychopathology, temperament, environmental variables, and initiation of tobacco and cannabis use were self-reported. Event time analyses were performed to assess the effects of childhood disruptive symptoms on age at first use of tobacco and cannabis. Results Proportional hazard models revealed that participants with high levels of childhood symptoms of both hyperactivity-inattention and conduct disorder were at highest risk of early tobacco initiation (in males: hazard ratio [HR] = 2.05; confidence interval [CI]: 1.24–3.38; in females: HR = 2.01; CI: 1.31–3.09), and, in males, of early cannabis initiation (HR = 1.95; CI: 1.04–3.64). Temperament, through activity in both males and females and negative emotionality in females, was also associated to early substance use initiation. Conclusions Children who simultaneously have high levels of symptoms of hyperactivity-inattention and conduct disorder are at increased risk for early substance initiation. These associations may guide childhood health professionals to consider the liability for early substance initiation in high-risk groups.

Anxiety as a Predictor of Age at First Use of Substances and Progression to Substance Use Problems Among Boys

This study examined associations of generalized and social anxiety with (1) age at first use of tobacco, alcohol, and marijuana and (2) interval from first use to first problem use of each substance. Participants were 503 males who comprised the youngest cohort (first assessed in the first grade) of the Pittsburgh Youth Study, a longitudinal community-based study of boys. Annual assessments of generalized and social anxiety, delinquency, and substance use from first grade through high school were included. Both types of anxiety predicted earlier first use of alcohol and tobacco, and generalized anxiety predicted earlier first use of marijuana. Both types of anxiety predicted the progression from first use to problems related to marijuana. The effect of generalized anxiety tended to be significant above and beyond the effect of delinquency, while the effect of social anxiety on risk for first use of substances was not. Overall, the associations between anxiety and substance use and related problems depend on the class of substance and the type of anxiety.

Hepatites B e C em usuários de drogas injetáveis vivendo com HIV em São Paulo, Brasil

To describe the profile of injecting drug users living with HIV/AIDS and estimate hepatitis B and hepatitis C prevalence rates within this group. Cross-sectional study conducted with 205 injecting drug users living with HIV/AIDS receiving attention in three public health clinics in the city of Sao Paulo, in 2003. A non-probabilistic sample of volunteers was selected consecutively on the days respondents appeared for their appointments at the clinics. Personal data and information on sexual behavior, drug use and knowledge of hepatitis was collected through interviews. Tests were conducted to detect infections of the hepatitis B and C viruses. Out of the interviewees, 81% were men and 19% women, with an average age of 39 (SD=6.1) and six years of formal education (SD=2.0). There was no difference in marital status between the sexes, of which 48% were single, 42% were married, and 8% were divorced. The average ages for first use of tobacco, alcohol and illegal drugs were 13, 15 and 18, respectively. Hepatitis B and C prevalence were 55% (95% CI: 49;63) and 83%(95% CI: 78;88), respectively. Eighty percent of respondents had not heard of Hepatitis B and C prior to the first time they used injecting drugs. The high prevalence rates of Hepatitis B and C and low level of knowledge regarding the diseases justify the inclusion of information about hepatitis infections and the hepatitis B vaccines in HIV harm reduction strategies.

Früher Einstieg in den Alkohol- und Tabakkonsum - Indikator für eine erhöhte Suchtgefährdung?

The early onset of substance use is considered to be one of the best predictors of later addiction problems according to a number of U.S.-American studies. The current study investigates the influence of an early age of substance use on addiction behavior in a culture whose attitude towards it is relatively permissive and in which adolescents thus begin to use the substances earlier and exhibit higher rates of consumption. In a prospective longitudinal study of a birth cohort of 384 children at risk, the age at first use of tobacco and alcohol and at begin of regular consumption, as well as different parameters of alcohol and tobacco consumption were assessed at the age of 15 years. The age at first use proved to be a significant predictor of consumption behavior (frequency and amounts), as well as of binge drinking as a specific consumption pattern, and of initial symptoms of tobacco dependency at the age of 15 years. The correlation is higher in general for tobacco consumption and for female adolescents. The findings replicate in a German sample the role of the age of first use as a significant risk factor for consumption of alcohol and tobacco even at a very early stage of substance use. It remains for future studies to investigate whether the relationship is causal or noncausal.

A flexible model for multivariate interval‐censored survival times with complex correlation structure

We focus on the analysis of multivariate survival times with highly structured interdependency and subject to interval censoring. Such data are common in developmental genetics and genetic epidemiology. We propose a flexible mixed probit model that deals naturally with complex but uninformative censoring. The recorded ages of onset are treated as possibly censored ordinal outcomes with the interval censoring mechanism seen as arising from a coarsened measurement of a continuous variable observed as falling between subject-specific thresholds. This bypasses the requirement for the failure times to be observed as falling into non-overlapping intervals. The assumption of a normal age-of-onset distribution of the standard probit model is relaxed by embedding within it a multivariate Box-Cox transformation whose parameters are jointly estimated with the other parameters of the model. Complex decompositions of the underlying multivariate normal covariance matrix of the transformed ages of onset become possible. The new methodology is here applied to a multivariate study of the ages of first use of tobacco and first consumption of alcohol without parental permission in twins. The proposed model allows estimation of the genetic and environmental effects that are shared by both of these risk behaviours as well as those that are specific.

Short term patterns of early smoking acquisition

Objective: To describe short term patterns of smoking acquisition exhibited by adolescent smokers. Design: Interview records from the prospective development and assessment of nicotine dependence in youth study were examined...

Tobacco use by Indian adolescents.

Adolescents are the most vulnerable population to initiate tobacco use. It is now well established that most of the adult users of tobacco start tobacco use in childhood or adolescence. There has been a perceptible fall in smoking in the developed countries after realization of harmful effects of tobacco. The tobacco companies are now aggressively targeting their advertising strategies in the developing countries like India. Adolescents often get attracted to tobacco products because of such propaganda. There has been a rapid increase in trade and use of smokeless tobacco products in recent years in the country, which is a matter of serious concern to the health planners. It is important to understand various factors that influence and encourage young teenagers to start smoking or to use other tobacco products. The age at first use of tobacco has been reduced considerably. However, law enforcing agencies have also taken some punitive measures in recent years to curtail the use of tobacco products. This paper focuses on various tobacco products available in India, the extent of their use in adolescents, factors leading to initiation of their use, and the preventive strategies, which could be used to deal with this menace.

Tobacco use by Indian adolescents

Adolescents are the most vulnerable population to initiate tobacco use. It is now well established that most of the adult users of tobacco start tobacco use in childhood or adolescence. There has been a perceptible fall in smoking in the developed countries after realization of harmful effects of tobacco. The tobacco companies are now aggressively targeting their advertising strategies in the developing countries like India. Adolescents often get attracted to tobacco products because of such propaganda. There has been a rapid increase in trade and use of smokeless tobacco products in recent years in the country, which is a matter of serious concern to the health planners. It is important to understand various factors that influence and encourage young teenagers to start smoking or to use other tobacco products. The age at first use of tobacco has been reduced considerably. However, law enforcing agencies have also taken some punitive measures in recent years to curtail the use of tobacco products. This paper focuses on various tobacco products available in India, the extent of their use in adolescents, factors leading to initiation of their use, and the preventive strategies, which could be used to deal with this menace.

Early onset and recent drug use among children of parents with alcohol problems: data from a national epidemiologic survey

There is good evidence that children of parents with alcohol problems have more drug involvement, plus related mental health and behavioral problems. In this study, we sought to estimate the degree to which these children might be more likely to initiate drug use precociously. A sample of 2888 parent–child pairs was identified within public data files of the National Household Survey on Drug Abuse (NHSDA), 1995–1997. Alcohol dependence of one parent was assessed by that parent's report of three or more dependence manifestations. Independently, one randomly selected 12–17 year-old child of the parent answered self-report survey questions on age at first use of tobacco, alcohol, and marijuana. In analyses contrasting 114 children of alcohol dependent parents (AD+) with 2774 other children (AD−), youths with alcohol dependent parents had higher odds than other kids to have used tobacco in the past year (odds ratio, OR=3.2, 95% confidence interval, CI=2.05–4.98), as well as alcohol (OR=1.6, 95% CI=1.05–2.50), and marijuana (OR=2.9, 95% CI=1.71–4.90). Survival analyses were used to clarify excess risk of early-onset drug use. For example, by age 17, an estimated 73% of AD+ children had smoked tobacco cigarettes, 70% had started drinking, and 41% had smoked marijuana, versus 44%, 57%, and 26% of AD− children, respectively. This new evidence helps build a case that children of parents with alcohol problems experience precocious drug use.

The report of the Surgeon General: preventing tobacco use among young people.

This year's surgeon general's report on smoking and health is the first such report to focus on young people. From extensive data that indicate that tobacco use is a pediatric epidemic, the report reached six major conclusions: (1) Nearly all first use of tobacco occurs by age 18. (2) Most adolescent smokers are addicted to nicotine. (3) Tobacco is often the first drug used by young people who subsequently use illegal drugs. (4) There are identified psychosocial risk factors for the onset of tobacco use. (5) Cigarette advertising also appears to increase young people's risk of smoking. (6) Communitywide efforts have successfully reduced adolescent use of tobacco. This commentary restates each of the six conclusions, summarizes the data that support each, and then considers the implications of the conclusions for public health action.

Rebound intragastric hyperacidity after abrupt withdrawal of histamine H2 receptor blockade.

In a series of 24 hour studies, intragastric acidity and plasma gastrin concentration were measured simultaneously in 46 healthy subjects before, during, and 24 to 48 hours after abrupt withdrawal of a histamine H2 receptor antagonist regimen. For 34 days subjects were given either cimetidine 800 mg at night (n = 8), ranitidine 150 mg twice daily (n = 10), ranitidine 300 mg at night (n = 12), nizatidine 300 mg at night (n = 8), or famotidine 40 mg at night (n = 8). All subjects responded to H2 blockade by a decrease in 24 hour intragastric acidity. Withdrawal of H2 blockade resulted in a significant rise in median nocturnal integrated intragastric acidity in 42 of 46 subjects (+36%; 95% CI +19, +55%) compared with prestudy values, but this rise was not associated with a significant change in the median integrated plasma gastrin concentration (+1%; 95% CI -12, +13%). A statistically significant rise in nocturnal acidity was observed after all regimens, except after dosing with famotidine. After stopping, median daytime integrated acidity and plasma gastrin concentrations in the whole group were raised, but not significantly: values were +15% (95% CI +4, +34%) and +5% (95% CI -2, +12%), respectively. A statistically significant increase in daytime acidity was observed only after dosing with ranitidine. In conclusion, intragastric hyperacidity occurs in most subjects after abrupt withdrawal of a histamine H2 receptor blocker, but this phenomenon is not associated with hypergastrinaemia.