Smoking Friends Research Articles

Electronic cigarette use and consumption patterns in medical university students.

A major public health hazard is youth e-cigarette use. Although new, e-cigarette health hazards are becoming well-known in the literature. E-cigarette sale restrictions and laws differ globally. In this cross-sectional study, we studied medical university students' tobacco and e-cigarette use and characteristics in a country where sales and import of e-cigarettes are banned. The primary objective is to determine the prevalence of electronic cigarette use and understand consumption patterns among medical faculty students in this setting. The questionnaire was sent using a web-based student information system. Sociodemographic features, tobacco and e-cigarette use, consumption patterns, and e-cigarette risk perceptions were covered in 54 questions. The study comprised 1,054 students (48.7% male) aged 21.5 ± 2.6 years who completed the questionnaire. 37.7%, 20.9% and 23.6% have smoked cigarettes, e-cigarettes, or water pipes. Current cigarette smokers were 17.0%, e-cigarette users 4.0%, and water pipe smokers 4.5%. E-cigarette users were 52.3% dual smokers. The most common symptoms reported by e-cigarette users were cough (58.4%) and dyspnea (54.2%). Multivariable models showed that the male sex, greater monthly income, and a current smoker friend were independent risk factors for e-cigarette ever use, while the male sex, paternal current smoking, and close friends' current smoking status were risk factors for dual use among medical trainees. Many medical students who used electronic cigarettes underestimated nicotine's health hazards and harmful chemicals in e-cigarettes. Despite e-cigarette sales being prohibited in our country, 56.4% and 25.4% of e-cigarette users provided e-cigarettes from tobacco shops and through online sales, respectively. Medical university students use tobacco most often by smoking cigarettes. Despite medical university students being aware of the health hazards of e-cigarettes, the current use of electronic cigarettes is 4.0%. Male sex, greater monthly income, and having current smoker friends are independent risk factors for e-cigarette use, while paternal smoking is a risk factor for dual use among medical trainees. Although in the country, sales of e-cigarettes are banned, ever-use rates for e-cigarettes were remarkably high at 20.9%, and the ease of accessing e-cigarettes was striking.

Secondhand smoke exposure among adolescents in the gulf cooperation council countries: analysis of global youth tobacco surveys

This study aimed to analyze patterns and predictors of secondhand smoke (SHS) exposure among adolescents (12–16 years old) in Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Nationally representative data from the most recent Global Youth Tobacco Survey in each country were analyzed (N = 17,220). SHS exposure at home, in public places, and at school was assessed. Descriptive statistics summarized exposure prevalence overall and by sex. Multivariable logistic regression examined factors associated with each SHS exposure’s outcome. The results showed that SHS exposure was high overall, with exposure at home and school ranging from 12.7 to 20.7%, respectively, in Oman to 39.4% and 36.7%, respectively, in Kuwait. Almost half of the adolescents reported exposure to SHS in public places, with a prevalence of 40.8% in Saudi Arabia to 65.9% in Kuwait. The prevalence of exposure varied between countries, with the highest rates occurring in Kuwait. Girls had higher exposure at home, while boys had higher exposure in public and at school. Factors associated with higher exposure included parental smoking, friend smoking, and tobacco advertising. The belief that SHS is harmful was associated with lower home exposure. In conclusion, adolescents in the Gulf Cooperation Council countries are exposed to concerning levels of SHS, especially in public places. These findings underscore the urgent need for stronger tobacco control policies, including comprehensive smoke-free laws covering all public venues, to protect youth from SHS exposure. Additionally, the results support the development of targeted interventions promoting smoke-free homes and social norms against smoking.

Patterns of Cigarette and Waterpipe Smoking in Erbil City, Iraq. A Household Survey

Background and objective: Globally, tobacco use is one of the most serious public health concerns and preventable causes of morbidity and mortality, expected to reach annually more than 8 million deaths by the year 2030. In light of this estimation and limited surveillance of smoking, this study aimed to identify the tobacco use trends and patterns in various forms in Erbil city. Methods: A community‐based cross‐sectional household survey was carried out from September 2021 through June 2022, on a sample of 2601 respondents selected through a multi‐stage cluster sampling method in Erbil city. A specially designed questionnaire through direct interviews was used to collect socio-demographic and smoking-related data. Results: The prevalence of current daily smoking was 44.3%, occasional smoking was 14.5%, Ex-smoking was 8.0%, and those who never smoked before 33.2%.The prevalence of cigarette, and waterpipe smoking was 37.2%, and 46.5%respectively. More than half (51.0%) had tried to quit smoking at least once in their life, while 11.9% succeeded to quit. The main reason behind quitting was anticipated health risks (97.3%). The prevalence of smoking was significantly higher among those aged 20-29 years, single, males, college education, those having skilled manual /non-manual occupations, those who have smoker friends, and from a middle socioeconomic level Conclusion: The prevalence of smoking (current daily and occasional) was more than half and about one-third never smoked before. More than half had tried to quit smoking at least once in their life but (11.9%) succeeded to quit due to anticipate health risks and family pressure.

Prevalence and Determine Knowledge and Attitude of Tobacco Smoking Among Secondary School Students in Sulaimani City

Objective: This study aimed to determine the prevalence rate and assess knowledge and attitudes among secondary students in Sulaimani city. Methods: A cross-sectional study was conducted among school students, from eight randomly selected secondary schools in Sulaimani city, Iraq. 1200 students participated in this study during six months from October 2022 to April 2023. The respondents were explained about each section of the questionnaire form. It describes behaviors, knowledge, beliefs, opinions, and other variables related to tobacco use. Results: The prevalence rate of current tobacco use (all types) is 21.8%, from this rate; 13.2% were cigarette smoking, 11.9% waterpipe, 24.7% used electronic smoke such as vape and pods and 50.2% of students used all types of tobacco product. The prevalence rates of tobacco use in males (31.3%) and females (12.1%). The rates were higher among students whose mother and father, schoolmates, relatives, and friends were smokers than those whose parents, schoolmates, relatives, and friends were non-smokers. A higher rate of smokers have not thought about the harmful of other people’s cigarettes on them, 16.7%, 25%, 9.9%, and 4.8% of smokers have not thought definitely, probably not, probably yes, and definitely yes. Regarding the attitude of the smokers, it showed statistically that there were significant associations for example only 6.6% of smokers were with the banning of smoking in public places while 21.7% of them were with not banning smoking in public places. Conclusion: Despite the prevalence rate of smoking in Sulaimani City being relatively lower than in other cities in Iraq the rate is still high. The rate was higher in males than females. In addition, there were factors connected with smoking initiation which are parents, schoolmates, relatives, and friends smoking. A higher rate of smokers did not think about the harmful of other people’s cigarettes to them and a lower rate of smokers were with the banning smoking in public places.

Predicting longitudinal changes in patterns of tobacco and nicotine product use among adolescents: A Latent Transition Analysis based on the X:IT study

IntroductionUnderstanding factors influencing the transition from non-use to tobacco and nicotine product initiation among adolescents is crucial for designing and implementing effective preventive strategies. This study explores transition patterns among 13–15-year-old adolescents in lower secondary school, focusing on the transition from non-use to tobacco and nicotine product initiation and the influence of individual, social, risk behavioral, and mental health factors on this transition. MethodsBased on data from a Danish smoking prevention trial between 2017 and 2019, this study employed questionnaire surveys at three time points: baseline (start of seventh grade, n = 1,990, response rate = 86.3%), eight-month follow-up (end of seventh grade, n = 1,666, response rate = 74,8%), and 20-month follow-up (end of eighth grade, n = 1,149, response rate = 70,6%). Tobacco and nicotine use indicators included current and lifetime use of cigarettes and lifetime use of e-cigarettes, smokeless tobacco, and hookah. A latent transition analysis was applied to identify longitudinal transition patterns across waves and to explore predictors of these patterns. ResultsThree user classes emerged across all waves: none-use, lifetime e-cigarette and cigarette use, and poly-tobacco use. While the most prevalent class was the non-user class (71%–86%), the proportion of the lifetime e-cigarette and cigarette class increased over time (from 12% to 17%). Similarly, the poly-tobacco user class increased from 2% to 12%. The probability of transitioning from non-use to lifetime e-cigarette and cigarette use increased from 0.5% at baseline to 12% by the second follow-up, while the probability of transitioning from lifetime e-cigarette and cigarette use remained stable over time (12%–15%). Across all waves, elevated risk behavior predicted this transition. For instance, binge-drinking (OR = 3.76, 95% CI: 1.51–9.34), susceptibility to smoking (OR = 7.63, 95% CI: 3.68–16.83), and truancy (OR = 7.00, 95% CI: 1.98–24.59) influenced the transition from non-use at baseline to lifetime e-cigarette and cigarette use at first follow-up. Additionally, boys, adolescents with low socioeconomic status, low life satisfaction, and those with smoking friends or parents were more likely to transition from non-use to lifetime e-cigarette and cigarette use. ConclusionThis study demonstrates that sociodemographic, social risk, behavioral, and mental health factors impact the transition from non-use to lifetime e-cigarette and cigarette use. The findings provide valuable insights for developing targeted preventive strategies focusing on these influencing factors.

Predictors Of Tobacco Smoking Initiation Among Indonesian Teenagers: The 2019 Global Youth Tobacco Survey

Introduction We examined the predictors of tobacco smoking initiation considering factors such as age, gender, pocket money, exposure to smoke in public outdoor places, anti-tobacco media, smoking parents, smoking teachers, and smoking friends among adolescents in Indonesia. Methods Using data from the 2014–2019 National Youth Tobacco Survey grades 7–12, data from 9,655 teenagers were analyzed. The research used the Global Youth Tobacco Survey (GYTS) questionnaire. The analysis used univariate, chi-square and logistic regression with the STATA application version 15. Results In total, 9655 adolescent respondents participated. Multivariate tests indicated that teenagers aged 13-15 years (AOR: 1.34, 95% CI: 1.08-1.66) and teenagers aged> 15 years (AOR: 1.65, 95% CI: 1.25-2.17), teenagers who were male (AOR: 13.99, 95% CI: 11.11-17.63), teenagers who were exposed to cigarette smoke in public places outside the room (AOR: 2.00, 95% CI: 1.74-2.29), teenagers who had never seen anti-tobacco messages in the mass media (AOR: 1.23, 95% CI: 1.02-1.48), Teenagers who had parents who smoke (AOR: 1.26, 95% CI: 1.08-1.46), teenagers who saw teachers smoking in the school area (AOR: 1.42, 95% CI: 1.18-1.71), and teenagers who accepted offers of cigarettes from friends (AOR: 15.11, 95% CI: 10.33-22.11). Conclusion The initiation of tobacco smoking among teenagers in Indonesia can be predicted by various factors such as age, gender, exposure to smoke in outdoor public places, exposure to anti-tobacco media, and influence of parents, teachers, and friends.

Exposure to pro-tobacco and anti-tobacco media messages and events and smoking behaviour among adolescents in Gambia

BackgroundDespite the widespread prevalence of adolescent smoking in Gambia, a West African country, there is limited research exploring the relationships between exposure to pro-tobacco and anti-tobacco media messages and events and smoking behaviour among young people. This study investigates the interplay of these exposures and smoking behaviour among 11-17-year-old adolescents in Gambia.MethodsSecondary data analysis was conducted using the 2017 Gambia Global Youth and Tobacco Survey (GYTS), which included a total of 9,127 respondents. Descriptive and inferential analyses, including proportions, Pearson’s chi-squared tests, and multivariable logistic regression models, were employed to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI).ResultsThe final model revealed significant associations between exposure to anti-tobacco media messages and events and smoking behaviour. Adolescents exposed to anti-tobacco media messages had a 29% increased odds of smoking (aOR 1.29,CI = 1.08,1.53) compared to those unexposed, while exposure to anti-tobacco media events showed a 31% increased odds (aOR 1.31,CI = 1.09,1.59) compared to those unexposed. Exposure to pro-tobacco messages, such as witnessing tobacco use on TV (aOR 1.41, CI = 1.17,1.69) and owning objects with tobacco brand logos (aOR 1.49,CI = 1.19,1.86), was associated with higher odds of smoking. Covariates, including sex, age, and exposure to smoking behaviour by significant others, also demonstrated associations with smoking behaviour. Notably, male respondents showed significantly higher odds of smoking (aOR = 4.01,CI = 3.28,4.89) compared to females. Respondents aged 15 years and older had increased odds of smoking (aOR = 1.47,CI = 1.22,1.76) compared to those below 15 years old. Those whose fathers smoke displayed higher odds of smoking (aOR = 1.35, CI = 1.04,1.76) compared to individuals with non-smoking parents. Additionally, those whose closest friends smoke showed remarkably higher odds of smoking (aOR = 2.87,CI = 2.37, 3.48) compared to those without such influence.ConclusionThis study underscores the significant impact of exposure to both anti-tobacco and pro-tobacco media messages and events on smoking behaviour among adolescents in Gambia. However, pro-tobacco messages had a greater influence on smoking prevalence than anti-tobacco messages and events. Understanding these associations is crucial for devising effective public health interventions aimed at reducing tobacco use in this population.

A study on the dual use of e-cigarettes and cigarettes among adolescents in Shandong Province

Objective: To understand the current status and its associated factors of dual use of e-cigarettes and cigarettes among adolescents in Shandong Province and explore the reasons for dual use behavior. Methods: A self-administered survey was conducted among 7 999 middle school students who were selected by stratified multi-stage cluster sample method. Data were weighted and analyzed by the SPSS 25.0 complex program. Results: In Shandong Province, the prevalence rates of attempting and current dual use of e-cigarettes and cigarettes among adolescents appeared as 7.7% and 1.3%, respectively. Male, friends smoking, and secondhand smoke exposure in the past 7 days were risk factors for dual use. Compared with cigarette smokers, dual users have no differences in cognition and behavior in quitting smoking (P>0.05). The main reason for dual users to smoke e-cigarettes was curiosity. Conclusions: Dual use of e-cigarettes and cigarettes is common among adolescents in Shandong Province, and its influencing factors are similar to traditional cigarettes. Dual use is not a transitional stage for smoking cessation. Dual users are more likely to continue smoking in the future, which should be paid attention and concern.

Effectiveness of a Digital Health Game Intervention on Early Adolescent Smoking Refusal Self-Efficacy.

Smoking poses a significant threat to adolescent health because of its immediate and long-term detrimental health effects. Smoking refusal self-efficacy predicts smoking behavior in adolescence. In adolescents' health education, digital interventions are potential tools to support smoking refusal self-efficacy. The aim of this two-arm cluster randomized controlled trial was to evaluate the effectiveness of a digital health game intervention compared with a no-intervention control group on smoking refusal self-efficacy in 10- to 13-year-old Finnish early adolescents. The early adolescents (n = 781) were randomized to the control group (n = 394) and the health game intervention group (n = 387). Smoking refusal self-efficacy, sources of smoking and snus refusal self-efficacy, and motivation to decline smoking and snus use in the future were measured at baseline, 2-week postintervention, and 3-month follow-up. Data were analyzed using linear mixed model and Wilcoxon rank-based test for clustered data. According to the results, the intervention group made improvements in sources of smoking and snus refusal self-efficacy between baseline and postintervention, and in sources of snus refusal self-efficacy between baseline and follow-up, compared with the control group. The intervention group showed improvements in smoking refusal self-efficacy among 12-year-olds between baseline and follow-up, and postintervention and follow-up compared with the control group. Similar improvements were also found among those with a smoking friend or a smoking parent between postintervention and follow-up. The results were promising for the use of digital health game interventions to promote early adolescent smoking refusal self-efficacy and preventing smoking experimentation. Further research can evaluate the long-term effects for adolescents.

Predictors of smoking exposure in non-smoking adolescents in Indonesia

Exposure to secondhand smoke is one of the leading causes of death for non-smokers worldwide. The prevalence of exposure to secondhand smoke is higher among adolescents. Research on predictors of secondhand smoke exposure in adolescents is still rarely conducted in Indonesia. This study aimed to analyze the predictors of exposure to secondhand smoke among non-smoking adolescents in Indonesia. This study used data from the Global Youth Tobacco Survey (GYTS) Indonesia 2019 with a cross-sectional design. A total of 7,594 adolescents aged 13 to 15 were selected using purposive sampling. The dependent variables were exposure to secondhand smoke at home and in public. The independent variables included age, gender, smoking parents, smoking friends, and knowledge of the dangers of secondhand smoke. Data were analyzed using STATA with inferential tests, namely chi-square and logistic regression. The prevalence of adolescents exposed to secondhand smoke at home and in public was 49.57% and 71.86%, respectively. At-home exposure was significantly associated with smoking parents [AOR=3.50, 95% CI=2.97 to 4.12], smoking friends [AOR=1.50, 95% CI=1.30 to 1.73], and knowledge of the dangers of secondhand smoke [AOR=2.11, 95% CI=1.52 to 2.93]. Public exposure was associated with ages 13-15 [AOR=1.32, 95% CI=1.10 to 1.58] and older than 15 [AOR=1.77, 95% CI=1.39 to 2.25], male gender [AOR=1.31, 95% CI=1.11 to 1.53], smoking parents [AOR=1.58, 95% CI=1.36 to 1.84], smoking friends [AOR=2.16, 95% CI=1.85 to 2.53], and knowledge of secondhand smoke dangers [AOR=2.84, 95% CI=2.15 to 3.75]. Adolescents’ exposure to secondhand smoke in public spaces is higher in prevalence and has more associated factors compared to exposure at home. Exposure reductions require comprehensive actions from authorities by strictly implementing and expanding non-smoking areas covered by existing regulations. Also, family and school management should be involved in prevention efforts.

Examining awareness of tobacco's oral health effects: Dentists' role in smoking cessation among dental patients.

Tobacco products are well-known as a major risk factor for systemic and oral diseases. Dentists may play an important role in the prevention and progression of oral problems related to smoking. The aim of this study was to evaluate the level of awareness about the poor oral health effects of tobacco products and the role of dentists in smoking cessation among dental patients. A survey containing 40 questions was prepared, and patients seeking dental treatment between June and October 2019 at the School of Dentistry, Ege University, were asked to participate. The survey included demographic variables in the first part, habits of using tobacco products in the second part, relations between smoking and oral health, and the possible role of dentists in smoking cessation in the last part. Data were tested statistically by Mann Whitney U and chi-squared tests. A total of 501 patients participated in the survey; more than half of the participants were non-smokers (63.7%). Cigarettes (95.06%), hookah (7.69%), e-cigarettes (2.75%), and cigars (1.65%) were the most frequently consumed tobacco products. The biggest obstacle to quitting smoking was 'having smoker friends'. The rate of non-smokers (41.4%) agreeing that smoking is related to periodontal diseases was more than that of smokers (32.4%) (p<0.05). The most known side effect of tobacco products was halitosis (81.6%). Half of the respondents (46.7%) did not know about dentists' role in helping them quit smoking. The rate of participants previously recommended by a dentist to quit smoking was only 36%. The aesthetic and social consequences of using tobacco products are well known, but smokers are substantially less aware than non-smokers of the relationship between tobacco products and oral diseases. The present findings suggest that dentists should inform their patients about the detrimental effects of tobacco products and play an active role in advising them to quit.

Factors Associated With the Changes in Smoking and Electronic cigarette use in Adolescents During the COVID-19 Pandemic: A Longitudinal Analysis

PurposeExplore the factors associated with the changes in smoking and electronic cigarette (e-cigarette) use and susceptibility among adolescents during the COVID-19 pandemic. MethodsWe surveyed a cohort of students (7th–12th grade) from private schools in Guatemala. Baseline (May–September 2019) was conducted in-person and follow-up (June–November 2020) online during the lockdown. Separate Generalized Estimating Equations logistic models regressed current smoking (n = 3,729), current e-cigarette use (n = 3,729), smoking susceptibility among never-smokers (n = 2,596), and susceptibility to e-cigarette use among never-users (n = 1,597) on online ad exposure, visiting stores, social network smoking/e-cigarette use, substance use (alcohol, marihuana, and cigarette or e-cigarette), perceived harm of using cigarettes/e-cigarettes, sociodemographic characteristics, and survey wave. Interactions were assessed between time and ad exposures, friends smoking and e-cigarette use. ResultsFrequency of store visits, exposure to online ads, and the use of cigarette and e-cigarette lowered at follow-up. Online e-cigarette ads, having family and friends who smoke, and current e-cigarette use increased the likelihood of being a current smoker. Frequent exposure to online e-cigarette ads, having family who use e-cigarettes, and being a current smoker were associated with higher likelihood of current e-cigarette use. Exposure to either online ads or having friends that smoke or use e-cigarettes, increased susceptibility to using either product. Interaction results showed that high exposure to online e-cigarette ads overtime increased the susceptibility to use e-cigarettes. DiscussionExposure to online ads and friends and family cigarette and e-cigarette use increased adolescent consumption and susceptibility during the pandemic.

Predictive Factors of Attitude Toward Smoking and Hookah use in Medical Students: A Cross-sectional Study

Background: Today, tobacco use is considered a pervasive health problem globally, with projections indicating that by 2020, tobacco will account for one in three adult deaths. Despite the well-documented harmful effects of tobacco use and societal expectations for future healthcare providers to lead healthy lifestyles, smoking remains prevalent among medical students. Materials and Methods: In this study, 248 medical students of Hormozgan University of Medical Sciences were selected. After providing comprehensive explanations and obtaining their consent to participate, each student received a questionnaire comprising two parts: the first part gathered demographic information, while the second part utilized a Likert scale to measure attitudes toward smoking and hookah use. Results: In this study, 63.3% of participants were female, 36.7% were male, and the majority (37.1%) were between 21 and 23 years old. Additionally, 89.5% of participants were single. Also, 17.7% had a history of smoking or hookah use, 35.1% had family members who smoked or used hookahs, and 37.1% had friends who smoked or used hookahs. Furthermore, 6.9% had a history of neurological disease, and 11.7% had underlying medical conditions. Conclusion: We found statistically significant relationships between attitudes towards smoking and various factors, including gender, personal history of smoking, family history of smoking, presence of smoking or hookah-using friends, place of residence, ethnicity, parents’ level of education, history of chronic disease and grade point average.

Investigating Social Proliferation in Korean College Students’ Smoking Perceptions and Behaviors

The present study investigated the processes of social proliferation in Korean college students’ smoking perceptions and behaviors. Using cross-sectional survey data (N = 208), the study tested associations between smoking status of friends, frequency and contents of communication about smoking and Korean college students’ smoking perceptions and behaviors. The results showed that college students with smoking friends were significantly higher on pro-smoking cultural norms, pro-smoking subjective norms, and positive attitude toward smoking than students with nonsmoking friends. Effects of frequency, negative evaluation of communication about smoking, and contents of communication about smoking differed between smoking friends and nonsmoking friends.

Adolescent smoking patterns: Associations with sociodemographic factors, cyberbullying, and psychiatric diagnoses in an outpatient clinical sample

There is a scarcity of research on smoking in adolescents within a clinical (outpatient) sample, and there is no existing knowledge on the relationship between cyberbullying and smoking in this population. The primary aim of this study is to determine the prevalence of smoking among adolescents in a clinical sample. Additionally, it aims to examine the potential associations between smoking status and factors such as socioeconomic characteristics, psychiatric diagnoses, and cyberbullying levels. A cross-sectional study was performed on 200 adolescents who visited a tertiary child and adolescent psychiatry outpatient clinic. Participants were assessed using the DSM-5 based psychiatric evaluation, the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-DSM-5 Turkish Adaptation (K-SADS-PL-DSM-5-T), the Revised Cyber Bullying Inventory-II, and the Fagerström Test for Nicotine Dependence. The study found that 21% of the sample consisted of regular smokers, with a higher prevalence observed among older adolescents. The prevalence of depression and disruptive behavior disorders was significantly greater in the smoking group compared to other groups (p:0.043, p < 0.001, respectively). There was a significant difference in the scores for the cyberbullying bully subdimension among smokers (p = 0.013). The results of the multinomial logistic regression analysis indicated significant associations between smoking and age, maternal smoking status, friends smoking status, and a diagnosis of disruptive behavior disorder (p < 0.05 for all variables). This study reveals a significant prevalence of adolescent smoking in an outpatient clinic. These findings highlight the necessity of implementing focused smoking cessation interventions for this specific population.

Resistance to peer influence, smoking friends, cigarette and betel nut use, and gender among Pacific Islander youth

The present study examined the relationships between resistance to peer influence and cigarette and betel nut use, as well as the potential mediating role of friends who use cigarettes and betel nut, among boys and girls in Guam. This study included 673 ethnically diverse students (49% female; M age = 12.7, SD = 0.89) from eight public middle schools. The mediation analysis demonstrated that higher resistance to peer influence for both cigarette and betel nut use was associated with lower cigarette and betel nut use directly and that this association was mediated by friends who used cigarette and betel nut products. That is, low resistance to peer influence for both cigarette and betel nut use was associated with a greater number of friends who smoke and use betel nut, which was linked with more cigarette and betel nut use. The moderated mediation analysis revealed no gender difference in the indirect effect (i.e., the mediation of friends who used cigarettes and betel nut). These findings can be used to inform the design and implementation of intervention and prevention programs for at-risk youth, regardless of gender, who are vulnerable to substance use in the Pacific.

Szociális és pszichológiai tényezők szerepe a középiskolások dohányzásában és alkoholfogyasztásában

The study aimed to research background factors and motivations for smoking and alcohol consumption among Hungarian adolescents. 501 students from Debrecen participated in the survey. Among the social variables, the best friend's smoking (EH=16.72; p&lt;0.001) and alcohol consumption (EH=22.77; p&lt;0.001) as well as the harmful passions of peers acted as risk factors in the sample. Among the psychological variables, high self-esteem is a risk factor (alcohol: EH=1.04; p&lt;0.05), while shyness (alcohol: EH=0.97; p&lt;0.01; smoking: EH=0.97; p&lt;0.05) and the feeling of loneliness (alcohol: EH=0.96; p&lt;0.001) also proved to be protective factors. The behavior of psychological variables is explained by the primary role of social variables. The results highlight the importance of teaching young people how to behave assertively in social situations, avoiding peer pressure, before they start using drugs for self-strengthening and coping.

Influencing factors for electronic cigarette use among Chinese adolescent students: a Meta-analysis

Objective: To explore the influencing factors of electronic cigarette use among adolescent students in China. Methods: We searched CNKI, Database of Chinese sci-tech periodicals (VIP), Wan-fang database, PubMed, Web of Science and ScienceDirect for potentially relevant articles published from the inception to March 20th, 2023. The Metagen package in R was used for Meta-analysis. Results: A total of 19 publications with a sample size of 5 336 017 were identified. The results showed that electronic cigarette use among Chinese adolescent students was associated with gender (OR=2.41, 95%CI: 2.03-2.86), close friends smoking (OR=3.02, 95%CI: 2.08-4.39), current smoking (OR=11.26, 95%CI: 4.35-29.18), friends using electronic cigarettes (OR=5.19, 95%CI: 2.01-13.38), thinking smoking makes young people look more attractive (OR=2.00, 95%CI: 1.35-2.97), type of school (OR=2.10, 95%CI: 1.59-2.78), thinking smoking makes people feel more comfortable in social situations (OR=3.58, 95%CI: 2.99-4.28), other tobacco use (OR=5.53, 95%CI: 3.33-9.20), and ever experimented with cigarette use (OR=9.32, 95%CI: 4.38-19.80). Conclusion: The influencing factors for electronic cigarette use among adolescent students in China include gender, close friends smoking, current smoking, friends using electronic cigarettes, thinking smoking makes young people look more attractive, type of school, thinking smoking makes people feel more comfortable in social situations, other tobacco use, and ever experimented with cigarette use.

Uncovering Polysubstance Use Patterns in Canadian Youth with Machine Learning on Longitudinal COMPASS Data

AbstractUnderstanding polysubstance use (PSU) patterns and their associated factors among youth is crucial for addressing the complex issue of substance use in this population. This study aims to investigate PSU patterns in a large sample of Canadian youth and explore associated factors using data from COMPASS, a longitudinal health survey of Canadian secondary school students. The study sample consisted of 8824 students from grades 9 and 10 at baseline in 2016/17, followed over 3 years until 2018/19. Leveraging machine learning methods, especially the least absolute shrinkage and selection operator (LASSO) and multivariate latent Markov models, we conducted a comprehensive examination of PSU patterns. Our analyses revealed distinct PSU patterns among Canadian youth, including no-use (C1), alcohol-only (C2), concurrent use of e-cigarettes and alcohol (C3), and poly-use (C4). C1 showed the highest prevalence (60.5%) in 2016/17, declining by 2.4 times over 3 years, while C3 became the dominant pattern (32.5%) in 2018/19. The prevalence of C3 and C4 increased by 2.3 and 4.4 times, respectively, indicating a growing trend of dual and multiple substance use. Risk factors associated with PSU patterns included truancy (ORC2 = 1.67, 95 % CI [1.55, 1.79]; ORC3 = 1.92, 95 % CI [1.80, 2.04]; ORC4 = 2.79, 95 % CI [2.64, 2.94]), having more smoking friends, more weekly allowance, elevated BMI, being older, and attending schools unsupportive in quitting drugs/alcohol. In contrast, not gambling online (ORC2 = 0.22, 95 % CI [−0.16, 0.58]; ORC3 = 0.14, 95 % CI [-0.24, 0.52]; ORC4 = 0.08, 95 % CI [−0.47, 0.63]), eating breakfast, residing in urban areas, and having higher school connectedness were protective factors against a higher-use pattern. This study provides insights for policymakers, educators, and health professionals to design targeted and evidence-based interventions, addressing youth substance use challenges through a comprehensive examination of PSU patterns and influential factors impacting substance use behaviors.

The association of adolescents' smoking with the physical activity levels of their friends

BackgroundSmoking is inversely related to people's Physical Activity Level (PAL). As the behavior of friends may affect the choices and behavior of adolescents, having friends with a high PAL may potentially protect against adolescent smoking. This study aims to assess whether adolescents' smoking is associated with the PAL of their friends. MethodsSILNE-R survey data of 11.918 adolescents from 55 different schools in 7 European cities was used to determine weekly smoking, individual PAL, PAL of friends, school PAL, and smoking of friends. Multilevel, multivariable logistic regression analysis were used to assess the association between the PAL of friends and weekly smoking. Several socio-demographic variables were included as covariates in the analysis. ResultsOur results indicated that 10.8% of the respondents was smoking weekly. Weekly smoking was most common among adolescents whose friends had a PAL of 0–42.0 min per day (14.5%). Respondents were significantly more likely to be smoking weekly if their friends were on average 0–42 min vs. 80–180 min physically active (OR 1.27 [95% CI 1.04–1.55]). This association existed independently of the individual PAL of respondents. Stratification for smoking of friends yielded equal results, although the association appeared to be somewhat stronger for those with smoking friends (OR 1.38 [95% CI 1.06–1.82]). ConclusionAdolescents are less likely to smoke weekly if they associate with friends who spend >80 min per day on physical activity. Initiatives aimed at the prevention of smoking among adolescents may benefit from organizing group-based physical activity programs.