Smoking Friends Research Articles

Chilaiditi

El entorno sociocultural influye en el tabaquismo juvenil, y actualmente parece que hay descenso de su prevalencia.Valorar la prevalencia del tabaquismo en estudiantes de bachillerato, la influencia del entorno en su inicio en la Comarca de Osona (Barcelona) (COB) y analizar, si existiera, su disminución.Estudio transversal en alumnos de bachillerato de COB. Mediante encuesta anónima se interrogó sobre tabaquismo, influencia del entorno y contexto sociocultural en el inicio.Participaron 842, se recogieron 714 encuestas y 705 se consideraron válidas. Tenían residencia urbana 303 (93,5%). Fumaban 159 (22,6%) y el 62% eran mujeres; 70 (44%) eran cristianos, 3 (1,9%) musulmanes, 14 (8,8%) de otras religiones y 72 (45,3%) aconfesionales. Consumían alcohol 529 (76,3%) y otras sustancias 308 (46,5%). Padecían alguna enfermedad 40 (6,1%) alumnos y 334 (47,5%) familiares. Había 207 (29,4%) padres fumadores y 152 (22%) madres. Existía tabaquismo familiar en 214 (59%) alumnos y en 582 (82,6%) amigos. Los padres tenían estudios superiores en 212 (30,1%), medios en 331 (48,7%) y primarios en 137 (20,1%); en relación con las madres en 279 (39,6%), en 294(41,7%) y en 116 (16,5%) respectivamente. Ser fumador se relacionaba con consumir alcohol (p = 0,000) y otras sustancias (p = 0,000), ser aconfesional (p = 0,000), no padecer enfermedades (p = 0,043) y con tener madre (p = 0,001), padre (p = 0,005), hermano (p = 0,006), familiares (p = 0,016) o amigos fumadores (p = 0,000).La prevalencia del tabaquismo en estudiantes de bachillerato en COB es elevada, aunque ha disminuido. Fumar se relacionó con tabaquismo de progenitores, familiares y amigos, ser aconfesional, consumir alcohol y otras sustancias. Se deben implantar programas preventivos dirigidos a estudiantes, progenitores y personal docente.The socio-cultural setting influences youth smoking and its prevalence presumibly has decreased.To assess smoking prevalence in high school students, as well as the environmental influence on its onset in the Osona Disrtict of Barcelona (ODB), and to determine whether it has decreased.A cross-sectional study was conducted on high school students in the ODB. In the anonymous questionnaire it was sked asked about smoking and the influence of the social and cultural setting on its onset.A total of 842 students participated, with 714 questionnaires completed, of which 705 were included as valid. A total of 203 (93.5%) students lived in an urban setting. There were 159 smoker students and 62% were women. The smokers were 70 (44%) christians, 3 (1.9%) muslims, 14 (8.%) students with other religions, and 72 (45.3%) non-denominational students. It was detected that 529 (76.3%) of the students consumed alcohol consumers, and 308 (46.5%) consumed other substances. There were 40 (61%) students that suffered a disease, and also 334 students who had ill relatives. There were 207 (29.4%) fathers and 152 (22%) mothers who smoked and 214 (59%) students declared family smoking. Finally 582 (82.6%) had smoker friends. Among fathers, 212 (30.1%), had high level studies, 331 (48.7%) had mid- level studies, and 137 (20.1%) fathers had primary studies. Among mothers, it was 279 (39.6%), 294 (41.7%), and 116 (16.5%). respectively.Being a smoker was associated with alcohol (P = .000) and other substances consumption (P = .000), being non-denominational (P = .000), did not to suffer any disease (P = .043), with having mother (P = .001), father (P = .005), brother or sister (P = .006), and family members (P = .016) who smoked, and smoker friends (P = .000).smoking prevalence in high school students in the ODB is high, but has decreased. Smoking was associated with alcohol and consumption of other substances, being non-denominational, and with friends, parents, and relatives who smoked. It is necessary to establish prevention programs addressed to teenagers, parents and teachers.

Social norms towards smoking and electronic cigarettes among adult smokers in seven European Countries: Findings from the EUREST-PLUS ITC Europe Surveys.

INTRODUCTIONThis study explores whether current smokers’ social norms towards smoking and electronic cigarettes (e-cigarettes) vary across seven European countries alongside smoking and e-cigarette prevalence rates. At the time of surveying, England had the lowest current smoking prevalence and Greece the highest. Hungary, Romania and Spain had the lowest prevalence of any e-cigarette use and England the highest.METHODSRespondents were adult (≥18 years) current smokers from the 2016 EUREST-PLUS ITC (Romania, Spain, Hungary, Poland, Greece, Germany) and ITC 4CV England Surveys (N=7779). Using logistic regression, associations between country and (a) smoking norms and (b) e-cigarette norms were assessed, adjusting for age, sex, income, education, smoking status, heaviness of smoking, and e-cigarette status.RESULTSCompared with England, smoking norms were higher in all countries: reporting that at least three of five closest friends smoke (19% vs 65–84% [AOR=6.9–24.0; Hungary–Greece]), perceiving that people important to them approve of smoking (8% vs 14–57% [1.9–51.1; Spain–Hungary]), perceiving that the public approves of smoking (5% vs 6–37% [1.7–15.8; Spain–Hungary]), disagreeing that smokers are marginalised (9% vs 16–50% [2.3–12.3; Poland–Greece]) except in Hungary. Compared with England: reporting that at least one of five closest friends uses e-cigarettes was higher in Poland (28% vs 36% [2.7]) but lower in Spain and Romania (28% vs 6–14% [0.3–0.6]), perceiving that the public approves of e-cigarettes was higher in Poland, Hungary and Greece (32% vs 36–40% [1.5–1.6]) but lower in Spain and Romania in unadjusted analyses only (32% vs 24–26%), reporting seeing e-cigarette use in public at least some days was lower in all countries (81% vs 12–55% [0.1–0.4]; Spain–Greece).CONCLUSIONSSmokers from England had the least pro-smoking norms. Smokers from Spain had the least pro-e-cigarette norms. Friend smoking and disagreeing that smokers are marginalised broadly aligned with country-level current smoking rates. Seeing e-cigarette use in public broadly aligned with country-level any e-cigarette use. Generally, no other norms aligned with product prevalence.

Profile of first year secondary school children involved in the anti-smoking prevention trial "PEPITES"

Many programs which aim to reduce tobacco consumption in young people are carried out in the school environment, addressing a "captive audience" and monitoring the actions over a period of several years. The approaches identified as promising involve putting in place a tobacco prevention program throughout the entire school years incorporated in the school program. Several studies showed that early initiation to psychoactive substances is a strong predictor of addiction. Considering the above points, an intervention trial on tobacco prevention covering the four years of secondary school (±11-15 years old) was implemented in the Essonne area, in France. This study was based on a cluster randomized trial comparing three groups: two intervention groups and a control group. The present paper describes the school children (1st year in six secondary schools) included in the trial. It studies the national representativity of this population, the comparability between the control and intervention groups and the items link to tobacco initiation. When considering tobacco behavior in 2014, the included population was representative of the school children in 1st year of secondary school in France with 11.5% of tobacco initiation and 2.5% of regular smokers. The groups were comparable except for four items (family and friends smoking, only child, sensitive urban areas). With this knowledge on factors linked to smoking behaviors this population can be included in the trial analysis. The study of the included population will help to perform the trial analysis and authorize the transferability of the trial results if positive.

Pictorial health warnings on cigarette packs and effect on smoking: Medical student's perspective.

To evaluate the knowledge, attitude and practice of medical students towards pictorial warnings on cigarette packets. The cross-sectional study was conducted from October 2017 to December 2018 at King Saud bin Abdulaziz University for Health Sciences Riyadh, Saudi Arabia, Riyadh, Saudi Arabia, and comprised medical students from third to sixth year. Data was collected using a self-administered structured questionnaire which was validated through pilot-testing. A five-point Likert scale was used to access each item, with 1 as strongly disagree and 5 as strongly agree. Data was analysed using SPSS 22. Of the 335 subjects, 181(54%) were males. The overall mean age was 23±2.2 years and 307(92%) were non-smokers. The overall knowledge, attitude and practice was low with a total median score of 3.3 (interquartile range: 3.1-3.6). However, knowledge was better 4 (interquartile range: 3.7-4.7). Males had significantly more knowledge about the pictorial health warnings compared to females (p<0.001). Having a smoker friend had significantly better effect on the overall knowledge and attitude with (p<0.05). The study concludes that pictorial warnings are not helpful in persuading the current smokers to give up smoking. The knowledge about who take the decision of printing these warnings is not known to majority of the participants. Those who had a friend smoker had considerably better knowledge about pictorial warnings. Display of pictorial warnings might not be enough to serve the purpose of discouraging future smokers. Innovative strategies involving the non-smokers (peers and friends) should also be considered in the new era for cessation of smoking.

Prevalencia del tabaquismo en los estudiantes de bachillerato de la Comarca de Osona (Barcelona)

The socio-cultural setting influences youth smoking and its prevalence presumibly has decreased. ObjectivesTo assess smoking prevalence in high school students, as well as the environmental influence on its onset in the Osona Disrtict of Barcelona (ODB), and to determine whether it has decreased. Material and methodsA cross-sectional study was conducted on high school students in the ODB. In the anonymous questionnaire it was sked asked about smoking and the influence of the social and cultural setting on its onset. ResultsA total of 842 students participated, with 714 questionnaires completed, of which 705 were included as valid. A total of 203 (93.5%) students lived in an urban setting. There were 159 smoker students and 62% were women. The smokers were 70 (44%) christians, 3 (1.9%) muslims, 14 (8.%) students with other religions, and 72 (45.3%) non-denominational students. It was detected that 529 (76.3%) of the students consumed alcohol consumers, and 308 (46.5%) consumed other substances. There were 40 (61%) students that suffered a disease, and also 334 students who had ill relatives. There were 207 (29.4%) fathers and 152 (22%) mothers who smoked and 214 (59%) students declared family smoking. Finally 582 (82.6%) had smoker friends. Among fathers, 212 (30.1%), had high level studies, 331 (48.7%) had mid- level studies, and 137 (20.1%) fathers had primary studies. Among mothers, it was 279 (39.6%), 294 (41.7%), and 116 (16.5%). respectively.Being a smoker was associated with alcohol (P=.000) and other substances consumption (P=.000), being non-denominational (P=.000), did not to suffer any disease (P=.043), with having mother (P=.001), father (P=.005), brother or sister (P=.006), and family members (P=.016) who smoked, and smoker friends (P=.000). Conclusionssmoking prevalence in high school students in the ODB is high, but has decreased. Smoking was associated with alcohol and consumption of other substances, being non-denominational, and with friends, parents, and relatives who smoked. It is necessary to establish prevention programs addressed to teenagers, parents and teachers.

Harm perceptions of electronic cigarettes and nicotine: A nationally representative cross-sectional survey of young people in Great Britain

BackgroundE-cigarettes often contain nicotine without the most harmful constituents of tobacco smoke. AimsThis study aims to assess prevalence and correlates of accurately perceiving e-cigarettes as less harmful than cigarettes and that none or a small amount of the harm from smoking comes from nicotine. MethodsCross-sectional survey of 2,103 11–18-year-olds in Great Britain in 2016. Prevalence of e-cigarette and nicotine harm perceptions were calculated. Logistic regressions assessed associations between accurate e-cigarette and nicotine harm perceptions and smoking, e-cigarette use, gender, age, region, social grade, family smoking, family e-cigarette use, smoking friends, public approval of smoking, and public approval of e-cigarettes. Associations between accurate e-cigarette and nicotine harm perceptions were also assessed. ResultsMost (63.4%) accurate e-cigarette harm perceptions were higher among those aged 16+ (OR = 1.89 [95%CI = 1.45–2.47]), 14–15 (OR = 1.29 [1.00–1.65]), who tried/used an e-cigarette sometimes (OR = 1.51 [1.03–2.21]), with family e-cigarette use (OR = 2.11 [1.46–3.04]), who perceived public disapproval of smoking (OR = 2.11 [1.18–3.77]) and approval of e-cigarettes (OR = 2.44 [1.73–3.45]), and with accurate nicotine harm perceptions (OR = 2.05 [1.28–3.28]). Accurate nicotine harm perceptions were higher among those aged 16+ (OR = 2.60 [1.62–4.16]), from North England (OR = 1.87 [1.02–3.43]) and Wales/Scotland (OR = 2.61 [1.35–5.03]) vs. London, with family smoking (OR = 1.59 [1.05–2.42]), and with accurate e-cigarette harm perceptions (OR = 2.12 [1.32–3.41]). ConclusionsMany young people have inaccurate harm perceptions of e-cigarettes and nicotine. Accurate e-cigarette and nicotine harm perceptions were associated with one another. E-cigarette use was associated with accurate e-cigarette but not nicotine harm perceptions; smoking was not associated with either.

Why has adolescent smoking declined dramatically? Trend analysis using repeat cross-sectional data from New Zealand 2002–2015

ObjectivesAdolescent smoking has declined in New Zealand and in many other countries since the late 1990s, yet the reasons for the decline are not well understood. We investigated the extent...

Perceived Effectiveness of Differing Health Warning Label Messaging Strategies among Adults in the Republic of Georgia: One Size Does Not Fit All.

Background: While pictorial health warning labels (HWLs) are evidence-based, the different messaging strategies are understudied. Methods: We analyzed 2014 national survey data from 1163 Georgian adults to examine: (1) perceived effectiveness of pictorial vs. text-only HWLs; (2) pictorial HWL themes; and (3) correlates of perceived effectiveness of different pictorial themes. Participants were randomized to evaluate the effectiveness of either Set A or Set B of HWLs (each contained half pictorial, half text-only). Results: All but 2 pictorial HWLs were perceived as more effective than text-only. Factor analyses identified one factor among Set A (“benign”) and two in Set B pictorial HWLs (“benign”, “gruesome”). Among Set A pictorial HWLs, correlates of greater perceived effectiveness included being female, rural residence, not having children, and nonsmoker status. Among smokers, correlates included being female and unmarried, fewer smoking friends, and higher quitting importance. Among Set B, 43.8% rated gruesome pictorial HWLs more effective, 12.9% benign more effective, and 43.4% equally effective. Correlates of perceiving benign more effective included fewer smoking friends and higher income. Among smokers, lower income predicted gruesome being perceived as more effective; fewer smoking friends and higher quitting importance predicted perceiving benign as more effective. Conclusion: A variety of pictorial HWL strategies should be used.

Nicotine dependence among adolescents in the European Union: How many and who are affected?

Nicotine dependence during adolescence increases the risk of continuing smoking into adulthood. The magnitude of nicotine dependence among adolescents in the European Union (EU) has not been established. We aimed to estimate the number of nicotine dependent 15-year-old adolescents in the EU, and identify high-risk groups. The number of nicotine dependent 15-year-olds in the EU was derived combining: (i) total number of 15-year-olds in the EU (2013 Eurostat), (ii) smoking prevalence among 15-year-olds (2013/2014 HBSC survey) and (iii) proportion of nicotine dependent 15-year-olds in six EU countries (2013 SILNE survey). Logistic regression analyses identified high-risk groups in the SILNE dataset. We estimated 172 636 15-year-olds were moderately to highly nicotine dependent (3.2% of all 15 years old; 35.3% of daily smokers). In the total population, risk of nicotine dependence was higher in males, adolescents with poor academic achievement, and those with smoking parents or friends. Among daily smokers, only lower academic achievement and younger age of smoking onset were associated with nicotine dependence. According to our conservative estimates, more than 172 000 15-year-old EU adolescents were nicotine dependent in 2013. Prevention of smoking initiation, especially among adolescents with poor academic performance, is necessary to prevent a similar number of adolescents getting addicted to nicotine each consecutive year.

The Tobacco Smoking among Rural Adolescents

The article presents results of study of prevalence of tobacco smoking among school adolescents carried out in rural comprehensive schools of the Kaliningrad oblast obtained within the framework of large-scale study (monitoring) of using psychoactive substances by rural school adolescents aged 15-17 years in 2016-2017 in Russia. The technique of multistage sampling was applied to select contingents of adolescents. The sampling included 1085 adolescents, including 531 boys and 554 girls. The analysis demonstrated that prevalence of tobacco smoking among rural adolescents in the Kaliningrad oblast made up to 16.8 among boys and 9.2 among girls per 100 adolescents of corresponding gender and age. Every day smoked 15.8 boys and 8.3 girls out of 100 adolescents aged 15-17 years. In comparison with data of 2013, the indicator of everyday smoking decreased on 37% among boys and on 62% among girls. Never tried to smoke 57.4% of boys and 67.5% of girls aged 15-17 years. Among those who tried continued to smoke 39.9% of boys and 28.3% of girls. The main motives of tobacco smoking are "motives of dependence". These motives were more often mentioned by boys (p>0,05).The girls in 4.3 times more often than boys smoke tobacco "for company" (p<0,05). The factors effecting "development" and "non-development" of tobacco smoking were established. Also, certain indices characterizing family of adolescent, sources of information about tobacco smoking, academic performance, spending free time and attitude of friends to tobacco smoking were analyzed. The results demonstrated that in hierarchy of factors promoting development of tobacco smoking in adolescent age first place if taken by influence of tobacco smoking friends, conditioned by psychological characteristics of adolescent age. The tobacco smoking adolescents have rather high 74%) awareness about harm of smoking. Since this information is acquired by them from separated and very often incidental sources it does not avert them from tobacco smoking.

Cigarette smoking patterns in relation to religiosity and familial support among Iranian university students: A Latent Class Analysis.

INTRODUCTIONEntering University is an important developmental milestone that might be associated with cigarette smoking. The aim of this study was to identify the subgroups of university students on the basis of cigarette smoking patterns, and to assess the role of familial support and religious beliefs on membership in specific subgroups.METHODSThis cross-sectional study was performed in 2016 using multistage random sampling among students of Bushehr University (n=977). Anonymous, structured questionnaires were distributed to the students in each selected class. Cigarette smoking prevalence was assessed in three time intervals: lifetime, last year, and last month. All of the analyses were performed using PROC LCA in the SAS software.RESULTSThe lifetime, last-year and last-month prevalence of cigarette smoking was 13.7%, 10.0% and 7.0%, respectively. In this study, the prevalence of passive smoking was relatively high (15.3%) among students. Four latent classes were identified: 1) non-smoker 58.2%, 2) passive smoker 31.3%, 3) moderate smoker 3.4%, and 4) heavy smoker 7.1%. The prevalence of cigarette smoking of close friends was: 73% among passive smokers, 81% for heavy smokers and 63% for moderate smokers. Being male (OR=4.42, 95% CI; 2.90–6.74) and a higher score of religious beliefs (OR=0.97, p<0.001 95% CI; 0.96–0.98) were associated with the heavy smoker class.CONCLUSIONSAmong students at Bushehr University in Iran, 10.5% were either moderate or heavy smokers in 2016. These results point out the critical importance of designing specific preventive interventional programs for university students. Higher level of religiosity may serve as a preventive factor in engaging in cigarette smoking.

Interpersonal and intrapersonal relapse predictors in a structured group intervention for smoking cessation

ABSTRACTBackground: Cigarette smoking is a widespread behaviour and associated with increased risk for nicotine dependence, morbidity and mortality. The structured group-based intervention ‘Rauchfrei-Programm’ is effective; however, no study has yet identified psychological factors predicting immediate (within two weeks after smoking cessation), short-term (within 3 months) and middle-term relapse (within 6 months).Methods: This naturalistic pre-post-follow-up phase-3 field study analyses self-reported smoking status, age, gender, percentage of smoking friends and questionnaire scores for self-efficacy, severity of dependence and perceived social support of N = 160 treatment-seeking outpatients (out of N = 556 overall participants) using binary logistic regressions.Results: Immediate relapse (18.8%) was not predicted by any predictor. Short-term relapse (55.6%) was predicted by lower self-efficacy (OR = 0.87), higher percentage of smoking friends (OR = 1.02) and more severe nicotine dependence (OR = 1.19). Middle-term relapse (64.4%) was predicted by lower self-efficacy (OR = 0.90) and higher percentage of smoking friends (OR = 1.02).Conclusions: Results support the standard relapse prediction model, proposing self-efficacy during and after the intervention as an important factor for relapse for up to 6 months after cessation. We recommend a regular assessment of self-efficacy in the ‘Rauchfrei-Programm’ and standardized strategies to intervene with low-esteem participants. Findings might be limited to multimodal and structured group interventions.

Uptake of e-cigarettes among a nationally representative cohort of UK children.

INTRODUCTIONUsing nationally representative data this study examined experimentation with and regular use of e-cigarettes among children not using tobacco at age 11 years, followed up to age 14 years.METHODSData come from 10 982 children in the UK Millennium Cohort Study. Logistic regression assessed experimentation with and current use of e-cigarettes by age 14 years. We considered associations of sociodemographics at age 11 years with subsequent e-cigarette use, including data on family income, peer and caregiver smoking. Subsequent models were adjusted for current tobacco use to assess both the strength of the assocations between e-cigarette use and tobacco, and whether sociodemographics were associated with e-cigarettes independently of tobacco.RESULTSAmong 10 982 children who reported never smoking at age 11 years, 13.9% (1525) had ever tried an e-cigarette by age 14 years, and of these 18.2% (278) reported being current users. Children in lower income households were more likely to have tried an e-cigarette than those in higher income households (Adjusted Odds Ratio, AOR 1.89, p=0.002). Children who reported friend (AOR 2.28, p<0.001) or caregiver smoking (AOR 1.77, p<0.001) at age 11 years were more likely to have tried an e-cigarette by age 14 years. After adjusting for current tobacco use, there was some attenuation of these associations, although associations of friend and caregiver smoking with e-cigarette use remained statistically significant.CONCLUSIONSChildren from lower income families were more likely to experiment with e-cigarettes by age 14 years, although this was heavily mediated by concurrent tobacco use. Caregiver and friend smoking are linked to trying e-cigarettes, although these relationships are less clear for regular e-cigarette use.

Do predictors of smoking relapse change as a function of duration of abstinence? Findings from the United States, Canada, United Kingdom and Australia.

To estimate predictors of time to smoking relapse and test if prediction varied by quit duration. Longitudinal cohort data from the International Tobacco Control Four-Country survey with annual follow up collected between 2002 and 2015. Canada, United States, United Kingdom and Australia. A total of 9171 eligible adult smokers who had made at least one quit attempt during the study period. Time to relapse was the main outcome. Predictor variables included pre-quit baseline measures of nicotine dependence, smoking and quitting-related motivations, quitting capacity and social influence, and also two post-quit measures, use of stop-smoking medications and quit duration (1-7days, 8-14days, 15-31days, 1-3months, 3-6months, 6-12months, 1-2years and 2+ years), along with socio-demographics. All factors were predictive of relapse within the first 6months of quitting but only wanting to quit, quit intentions and number of friends who smoke were still predictive of relapse in the 6-12-month period of quitting [hazard ratios (HR)=1.20, P< 0.05; 1.13, P< 0.05; and 1.21, P<0.001, respectively]. Number of friends smoking was the only remaining predictor of relapse in the 1-2years quit period (HR=1.19, P=0.001) with none predictive beyond the 2-year quit period. Use of stop-smoking medications during quit attempts was related negatively to relapse during the first 2weeks of quitting (HR=0.71-0.84), but related positively to relapse in the 1-6-month quit period (HR=1.29-1.54). Predictive effects of all factors showed significant interaction with quit duration except for perceiving smoking as an important part of life, prematurely stubbing out a cigarette and wanting to quit. Among adult smokers in the United States, Canada, United Kingdom and Australia, factors associated with smoking relapse differ between the early and later stages of a quit attempt, suggesting that the determinants of relapse change as a function of abstinence duration.

The role of social norms and socioeconomic status in smoking-related stigma among smokers in Mexico and Uruguay

Policies that promote the social unacceptability of smoking may also result in smoking-related stigma. The aim of this study is to evaluate how norms against smoking and socioeconomic status (SES) are associated with stigma among smokers. We used data from a panel of adult smokers who participated in the 2008–2012 administrations of the International Tobacco Control Policy Evaluation Survey in Mexico (n = 6670 observations) and Uruguay (n = 3296 observations). Generalized estimating equations were used to account for correlations in the outcomes over time within individuals. We evaluated if injunctive smoking norms (i.e. significant other norms and societal norms), descriptive smoking norms (i.e. number of smoking friends), and two markers of SES (i.e. education and income) were associated with different aspects of smoking-related stigma (i.e. feeling uncomfortable, negative stereotype of smokers, and perceived marginalization). We found that stronger anti-smoking injunctive norms were associated with higher levels of all indicators of perceived stigma in Mexico and Uruguay. Having fewer smoking friends was associated with feeling uncomfortable and perceived marginalization in Mexico. Higher income and education were associated with a stronger negative stereotype of smokers in Mexico. Lower income and education were associated with a stronger negative stereotype of smokers in Uruguay. Study results suggest that factors that drive the social unacceptability of tobacco may stigmatize smokers, although further research is needed to determine whether policy-promoted stigmatization produces undesirable outcomes (e.g. lower cessation rates).

Dual Use of E-Cigarettes and Traditional Cigarettes Among Adolescents in Taiwan, 2014-2016.

We investigated the use of electronic cigarettes (e-cigarettes) with traditional cigarettes among adolescents during 2014 to 2016 to identify risk factors for using e-cigarettes only, traditional cigarettes only, or both products. We used cross-sectional data from the Taiwan Global Youth Tobacco Survey, (conducted over a 3-year period by the Health Promotion Administration, Ministry of Health and Welfare, Taiwan), which is representative of tobacco use among adolescents aged 12-18 years. The outcome variable was smoking behavior. Dependent variables included gender, grade, monthly income/allowance, parents' educational level, parents' smoking status, close friends' smoking status, use of other tobacco products, contact with cigarette/e-cigarette advertisements, and access to free cigarettes/e-cigarettes. Multinomial regression identify factors influencing the smoking behaviors of adolescents, as manifested in the use of traditional cigarettes only, e-cigarettes only, e-cigarettes with traditional cigarettes, and nonsmoking. When weighted to the population, the sample included 1723150 adolescents in 2014, 1691568 adolescents in 2015, and 1627216 adolescents in 2016. The rates averaged over three years were as follows: nonsmoking (91.6%), traditional cigarettes only (5.4%), e-cigarettes only (1.5%), and dual usage (1.6%). Among adolescents in Taiwan, the following were risk factors for dual use: male, older, high monthly allowance, smoking parents, smoking friends, use of other tobacco products, contact with cigarette advertisements, and access to free cigarettes. Our results revealed an increase in the number of adolescents using e-cigarettes with traditional cigarettes. We recommend that the government continue smoking cessation programs while maintaining control over advertisements and promotions for tobacco products. This is the first study to examine the dual use of e-cigarettes and traditional cigarettes among adolescents in Taiwan. This study identified the risk factors of using traditional cigarettes only, using e-cigarettes only, and the dual use of e-cigarettes and traditional cigarettes, with nonsmokers used as a reference group. This study examined the relationship between exposure to cigarette promotions and the use of various tobacco products including the dual use of e-cigarettes and traditional cigarettes, both of which have been disregarded in previous studies.

Prevalence and determinants of smoking behavior among male school adolescents in Saudi Arabia.

Objective Smoking and tobacco use is a growing public health problem, with often begins in adolescence. This study aims to estimate the prevalence of smoking behavior and the associated determinants among adolescents. Methods A cross-sectional study was conducted using a self-administered questionnaire with 453 male adolescent students in Riyadh, the capital of Saudi Arabia. Descriptive and binary logistic regression analyses were performed to aggregate the findings and examine associations. Results The prevalence of smoking was 24.3% among adolescents. The main predictors of smoking behavior were found to be age (OR = 1.6; 95% CI: 1.3-2.0; p < 0.001), studying in private schools (OR = 1.4; 95% CI: 1.2-1.5; p < 0.001), having friends who smoke (OR = 13.9; 95% CI: 6.6-29.9; p < 0.001), smoking parent (OR = 18.1; 95% CI: 8.8-37.1; p < 0.001), perceived poor health (OR = 2.9; 95% CI: 1.9-3.9; p = 0.041) and perceived dissatisfaction with life (OR = 4.1; 95% CI: 1.33-13.3; p = 0.017). Smokers were more likely to believe that it is difficult to quit smoking (OR = 3.0; 95% CI: 1.6-5.5; p < 0.001). The top reasons for smoking were having smoker friends (78.2%), family neglect (45.5%), having smoker parents (41.8%), family problems (37.3%), enjoyment, and having smoker relatives. Conclusion This study concluded that a considerable proportion of adolescents are smokers. Adolescents with a smoking habit report poorer health and lower life satisfaction than non-smokers. Several personal and social factors were identified as important determinants for smoking.

Peer Smoking and Smoking-related Beliefs Among College Students in Bangladesh.

ObjectivesSmoking is a significant public health issue in Bangladesh. The purpose of this study was to examine peer smoking and smoking-related beliefs among college students in Bangladesh.MethodsCollege students at two universities in Dhaka, Bangladesh participated in a self-administered survey in May and June 2017.ResultsFirst, being a current or former smoker is associated with lower levels of beliefs among respondents that they would not smoke even with smoker friends or nervousness, and lower levels of intentions that they would not smoke, while current smokers and former smokers have different smoking-related beliefs. Second, having smoker friends is associated with lower levels of intentions that they would not smoke. Third, higher levels of normative beliefs that it is important not to smoke are associated with higher levels of beliefs that they would not smoke even with smoker friends or nervousness, higher levels of intentions that they would not smoke, and higher levels of avoidance of smoking.ConclusionsSmoking-related beliefs and perceived norms in individuals’ social networks are important components in promoting tobacco cessation in Bangladesh. But it is challenging to prevent or intervene in smoking because of the high rates of smoking in this country and the high prevalence of smokers in individuals’ social networks. Future studies should examine the most effective interventions to combat smoking in high-smoking social networks, such as using mobile apps or social media, and evaluate the effectiveness of such interventions.

Prevalence of Home Smoking Bans and its Determinants in Families with Infants

Background Exposure to cigarette smoke has numerous health risks for infants and children. Home smoking ban is a simple way to reduce the detrimental impacts of cigarette smoke. This study aimed to determine the prevalence of cigarette smoking bans in homes as well as associated factors in families with infants in Tehran, Iran. Materials and Methods This study was a population-based cross-sectional survey on 1,112 families with infants, selected through stratified-cluster sampling. In this study, a researcher made questionnaire including four parts: sociodemographic characteristics, smoking status, smoking restrictions, and parental awareness and belief, was completed. The multivariable logistic regression was used to investigate the relationship between smoking bans in homes and associated factors. Results Complete smoking ban in homes was 37.3%. In the multivariable logistic regression, cigarette smoking ban in homes was significantly higher for employed mothers (odds ratio [OR] = 3.03, 95% confidence interval [CI]: 1.2-7.2, P<0.001), for those who did not have any smoker friends or relatives (OR = 2.3, 95% CI: 1.3-4.4, P<0.001), for those smoking a smaller number of cigarettes (OR = 2.7, 95% CI: 1.4-5.3, P=0.003), and for parents who concurred with the impacts of thirdhand cigarette smoke on infant health (OR = 4.7, 95% CI: 1.4-14.9, P<0.001). Conclusion This study indicates that complete smoking ban is not established in many households with infants in Iran. Furthermore, it is necessary to perform health interventions for reducing infant exposure to cigarette smoke, while considering the factors associated with smoking ban. Keywords

Substance Abuse and Its Predictors in Freshmen Students of Lorestan Universities: Subgrouping of College Students in West of Iran

Background: Risk-taking behaviors have negative consequences on adolescents and young adults’ health. Numerous studies have revealed that the prevalence of risk- taking behaviors in college students is high. However, little information is available about risk- taking behaviors in freshmen students. Objectives: The present study was conducted to determine the prevalence of risk- taking behaviors and related factors in freshmen students of Khorramabad universities. Methods: This study was performed in 3 universities in Khorramabad, west of Iran, from January to February 2015. A total of 1181 students were selected proportionally and randomly. A self-administered questionnaire was used to measure risk- taking behaviors, including cigarette smoking, hookah smoking, alcohol use, and drug abuse, as well as demographic and related risk factors. Logistic regression model was performed to analyze the data. Results: The prevalence of ever cigarette smoking was 3.7%, the prevalence of ever hookah smoking was 21.7%, almost 2.4% of students had used at least one illicit drug, and 5.5 % of students had used alcohol at least once in their lifetime. After adjustment for other factors, being male, presence of any smoker in the family, and having smoker friends were factors associated with students’ risk- taking behaviors. The results showed co-occurrence of risk- taking behaviors. Conclusions: The prevalence of risk- taking behavior in freshmen students was pretty low compared to other studies. Nevertheless, this study demonstrated the co-occurrence of risky behaviors, which emphasizes the importance of interventions that are aimed at reducing or preventing different high- risk behaviors simultaneously during university years.