Prevalence Of Cigarette Use Research Articles

With socioeconomic status controlled, cigarette use is lower among American Indians/Alaska Natives than whites

BackgroundHigher crude prevalence of cigarette use among American Indians/Alaska Natives (AI/AN) than non-Hispanic whites (NHW) has helped engender an assumption that race/ethnicity explains the difference. This study examines whether being AI/AN versus NHW predicts greater use when socioeconomic status and demographics are controlled. MethodsData came from the National Survey on Drug Use and Health (2013–2017). Using logistic regressions with socioeconomic (income, education) and demographic (gender, age, marital status) controls, differences between AI/AN (n = 4,305) and NHW (n = 166,348) regarding heavier cigarette use (past month daily use, past month use of 300+ cigarettes, and nicotine dependence) and current cigarette use (past month use plus 100+ cigarettes in lifetime) were assessed. Adjusted predicted probabilities were also constructed. ResultsNHW, compared to AI/AN, had greater odds of daily use: adjusted odds ratio (AOR) = 1.23 (95% CI: 1.03–1.49); predicted probabilities—15.3% and 13.0%, respectively. NHW had greater odds of using 300+ cigarettes: AOR = 1.47 (CI: 1.19–1.83); predicted probabilities—13.6% and 9.9%. NHW had greater odds of being nicotine dependent: AOR = 1.57 (CI: 1.31–1.89); predicted probabilities—10.3% and 7.1%. A difference in current use was not found. As controls, income and education were especially impactful. ConclusionsWith controls, particularly for socioeconomic status, heavier cigarette use was lower among AI/AN than NHW, and a current cigarette use difference was not indicated. This contradicts the idea that being AI/AN versus NHW independently predicts greater cigarette use, and it underscores the importance of socioeconomic status for understanding cigarette use among AI/AN.

Use of Cigarettes and E-Cigarettes and Dual Use Among Adult Employees in the US Workplace.

IntroductionEvidence-based interventions for tobacco control in the US workplace can reach a large audience. The purpose of our study was to explore the prevalence and determinants of type of tobacco use (ie, cigarettes only, e-cigarettes only, or dual use) among adult employees in the United States and to examine type of use by state.MethodsWe used data from the 2017 Behavioral Risk Factor Surveillance System to examine the prevalence of cigarette use, e-cigarette use, dual use, and quit attempts. We used multinomial logistic regression to examine the relationships between sociodemographic characteristics and type of tobacco product used, and we estimated adjusted prevalence.ResultsApproximately 17% of respondents were current smokers, 5% were current e-cigarette users, and 2% were dual users. E-cigarette-only and dual use were generally highest among young (aged 18–24), male, and less-educated respondents and lower for respondents who identified as black, Asian/Native Hawaiian/Pacific Islander, or Hispanic than for white respondents. Cigarette-only and dual use were higher for respondents who did not have health care coverage. Prevalence by state of e-cigarette use only ranged from 1.2% (Vermont) to 3.9% (Arkansas), whereas the prevalence of dual use ranged from 0.6% (District of Columbia) to 4.0% (Oklahoma).ConclusionPrevalence of cigarette, e-cigarette, and dual use varied by sociodemographic characteristics and by state. These findings can support targeting of specific populations when designing and implementing evidence-based interventions for tobacco control in workplace settings.

Cigarette, E-cigarette, Alcohol, and Marijuana Use by Cancer Diagnosis Status: A Longitudinal Analysis

Background:Cancer is the second leading cause of death in the United States. Lifestyle choices such as substance abuse can impact a survivor’s health and overall quality of life.Methods:We used longitudinal data from the Wave 1-3 Population Assessment of Tobacco and Health data to examine sociodemographic characteristics and substance use behaviors (current cigarette, e-cigarette, alcohol, and marijuana use) by cancer diagnosis status. A generalized estimating equation model was used to examine the population-averaged effects of sociodemographic factors on substance use.Results:Among 1527 participants diagnosed with cancer, 14.5% used cigarettes, 3.8% used e-cigarettes, 49.1% used alcohol, and 4.2% used marijuana in the prior 30 days in Wave 1. While the prevalence of cigarette use among those with no cancer history decreased significantly between Wave 1 (21.9%) and Wave 3 (20.2%), it increased significantly among participants diagnosed with cancer from 14.5% to 16.0%. E-cigarette use decreased for both groups, whereas alcohol and marijuana use increased. Results showed that substance use among people diagnosed with cancer significantly varied by sociodemographic characteristics. Age, sex, race-ethnicity, education, income, and region of residence were significantly associated with substance use among patients diagnosed with cancer.Conclusion:Overall, substance use is lower among participants diagnosed with cancer than those with no cancer history. Substance use varies by sociodemographic characteristics among people diagnosed with cancer. More focus on substance use prevention among patients diagnosed with cancer could be beneficial in terms of improving the overall well-being of this population.

Explaining sexual minority young adult cigarette smoking disparities.

Sexual minority (SM) young adults, such as those who identify as lesbian, gay, or bisexual (LGB), have well documented smoking disparities compared to heterosexual young adults. However, no studies have simultaneously tested the role of three risk factors (depressive symptoms, recalling tobacco marketing in bars, and cigarette-related social norms) to explain SM tobacco use disparities. Longitudinal structural equation modeling was used to explore if the association between SM identity and past 30-day cigarette smoking one year later was mediated by these three risk factors. Starting in fall 2015, three surveys were administered every 6 months to 3,972 young adult college students. Surveys assessed SM identity, depressive symptoms, tobacco marketing in bars, normative perceptions of cigarettes, and tobacco use behaviors. Greater depressive symptoms, recalling more tobacco marketing in bars, and more accepting cigarette-related social norms were each hypothesized to explain a unique portion of the association between SM identity and subsequent cigarette use. SM young adults reported higher prevalence of cigarette use, depressive symptom scores reflecting elevated risk for major depressive disorder, and more accepting cigarette-related social norms than their heterosexual peers. Results indicated that only cigarette-related social norms mediated the association between SM identity and subsequent past 30-day smoking, while controlling for depressive symptoms, recalling tobacco marketing in bars, sociodemographic factors, and previous tobacco use. Findings reflect a need for tailored tobacco control messaging that shift the more accepting cigarette-related norms of SM young adults, as doing so may ultimately lead to decreased smoking for this high-risk subgroup. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Tobacco smoking and nicotine dependence in first episode and established psychosis.

People with psychotic disorders have increased premature mortality in comparison with the general population, with high rates of cigarette use a contributing factor. We aimed to describe the prevalence of cigarette use and nicotine dependence (ND) in first episode psychosis (FEP), and established psychosis; and to investigate associations between clinical symptoms and ND. Smoking and clinical data were collected from two cohorts: 181 people with FEP recruited as part of the Physical Health and Substance Use Measures in First Onset Psychosis (PUMP) study and from 432 people with established psychosis recruited as part of the Improving physical health and reducing substance use in psychosis randomised controlled trial (IMPaCT RCT). The prevalence of cigarette smoking was 78% in FEP and 62% in established psychosis. Forty nine percent (n = 60) of smokers in the FEP cohort and 69% (n = 183) of smokers with established psychosis were highly nicotine dependent. Being a highly nicotine dependent smoker was significantly associated with higher PANSS positive symptom scores (F = 5.480 p = 0.004), and with decreased scores on the Rosenberg self-esteem scale (F = 3.261, p = 0.039) in established psychosis. There was no diagnostic specificity identified in relation to smoking or ND in both groups. High rates of cigarette usage and nicotine dependence are problems from the early stages of psychosis. ND is higher in people with established psychosis. Smoking cessation strategies as part of comprehensive management of psychotic disorders at every stage require further development and evaluation.

Menthol Cigarettes, Tobacco Dependence, and Smoking Persistence: The Need to Examine Enhanced Cognitive Functioning as a Neuropsychological Mechanism.

Despite the overall decline in the prevalence of cigarette use in the United States, menthol cigarette use among smokers is rising, and evidence shows that it may lead to more detrimental effects on public health than regular cigarette use. One of the mechanisms by which nicotine sustains tobacco use and dependence is due to its cognitive enhancing properties, and basic science literature suggests that menthol may also enhance nicotine's acute effect on cognition. The purpose of this review is to suggest that the cognitive enhancing effects of menthol may be a potentially important neuropsychological mechanism that has yet to be examined. In this narrative review, we provide an overview of basic science studies examining neurobiological and cognitive effects of menthol and menthol cigarette smoking. We also review studies examining menthol essential oils among humans that indicate menthol alone has acute cognitive enhancing properties. Finally, we present factors influencing the rising prevalence of menthol cigarette use among smokers and the importance of this gap in the literature to improve public health and smoking cessation treatment. Despite the compelling evidence for menthol's acute cognitive enhancing and reinforcing effects, this mechanism for sustaining tobacco dependence and cigarette use has yet to be examined and validated among humans. On the basis of the basic science evidence for menthol's neurobiological effects on nicotinic receptors and neurotransmitters, perhaps clarifying menthol's effect on cognitive performance can help to elucidate the complicated literature examining menthol and tobacco dependence. Menthol cigarette use has continued to be a topic of debate among researchers and policy makers, because of its implications for understanding menthol's contribution to nicotine dependence and smoking persistence, as well as its continued use as a prevalent flavoring in tobacco and nicotine products in the United States and internationally. As international tobacco regulation policies have begun to target menthol cigarettes, research studies need to examine how flavoring additives, specifically menthol, may acutely influence neurobiological and cognitive functioning as a potential mechanism of sustained smoking behavior to develop more effective treatments.

Smoking behaviours among heterosexual and sexual minority youth? Findings from 15 years of provincially representative data.

Sexual identity disparities in smoking behaviours are well established; however, there is limited research on whether these disparities have diminished as the social and political landscape has changed for lesbian, gay and bisexual people. Thus, we examined changes in prevalence and sexual identity disparities in three smoking behaviours among Canadian adolescents from 1998 to 2013. Data are from the provincially representative British Columbia Adolescent Health Survey (N = 99 373). Using sex-stratified, age-adjusted logistic regression models, we estimated: (i) trends in lifetime cigarette use, early onset, and past 30-day use for heterosexual and three subgroups of sexual minority (i.e. mostly heterosexual, bisexual and gay/lesbian) youth; (ii) sexual identity disparities in these cigarette-related behaviours within each survey year (1998, 2003, 2008, 2013); and (iii) whether the size of the disparity has changed from 1998 to 2013. Smoking has declined for all youth from 1998 to 2013, although less consistently for sexual minority youth. Within-year disparity estimates indicated elevated prevalence of cigarette use for sexual minority compared to heterosexual youth, particularly among females. Trends in sexual identity and smoking behaviours indicated that the degree of differences between heterosexual and sexual minority youth have remained stable or, in some cases, widened. Heterosexual and sexual minority youth differences widened for early onset among sexual minority boys and lifetime and past 30-day use for sexual minority girls. Efforts to prevent smoking behaviours among youth should continue. Tailored preventive strategies for sexual minority youth might help address existing disparities.

Sexual and gender minority cigarette smoking disparities: An analysis of 2016 Behavioral Risk Factor Surveillance System data

We examined the association between lesbian, gay, bisexual, and transgender (LGBT) identity, cigarette and e-cigarette use, and potential risk factors in the United States. Using data from 198,057 adults in 26 states in the 2016 Behavioral Risk Factor Surveillance System (BRFSS), we estimated the prevalence of cigarette use, e-cigarette use, and potential risk factors by gender identity and sexual identity. Overall and sex-stratified bivariate and multivariate logistic regressions examined whether the relationship between sexual and gender identity and cigarette and e-cigarette use persisted after adjusting for demographics, socio-economic status, and other unhealthy behaviors. After adjusting for covariates, gender minority identity was no longer associated with increased likelihood of currently smoking cigarettes and ever use of e-cigarettes. Sexual minority identity continued to be significant after adjusting for covariates, indicating that sexual identity disparities in cigarette and e-cigarette use are not fully explained by these factors. Findings varied by identity. Compared to their straight peers, likelihood of tobacco product use among LGB individuals varied between sexes, by product, and by sexual identity (gay/lesbian versus bisexual). More research is needed to understand the mechanisms that influence diverse patterns of cigarette and e-cigarette use among sexual and gender minority adults.

The prevalence and risk factors of psychoactive drug use in primary school students in Turkish Republic of Northern Cyprus

Objective: The age of using psychoactive drug has decreased in recent years while it has threatened children. This study considers types of psychoactive drugs used, risk factors and causal attributions among primary school 5th grade students in TRNC. Methods: The study was conducted with 2345 students during May-June 2015 in 75 public primary schools and two private primary schools that are dependent to Ministry of Education and Culture in TRNC. In this study, USA Department of Education “California Healthy Kids Survey” was used by adapting to Turkish. Results: The study found the lifetime prevalence of cigarette use %10.9, alcohol use %23.5 and illicit drug use %1.2. Half of the students (%51.3) reported they have known name of an illicit drug other than cigarette and alcohol. The most known illicit drug is “bonsai” (%5.3) among students. Living in a city, having brother/sister, having separate parents and being exposed to bad behaviour are predictive risk factors for using cigarette and alcohol. On the other hand, being male, being exposed to bad behavior and physical violence are predictive risk factors for using illicit drugs. Conclusions: This study shows that the age of using psychoactive drug has decreased in TRNC and it even exists among primary school students like all over the world. This study proves that prevention studies for psychoactive drug use for children needs to be put into practice as soon as possible.

Trends in Multiple Tobacco Product Use among High School Students

The purpose of this study was to identify trends of tobacco use, among all students and current tobacco users, in a nationally representative sample of high school students from 1999 to 2013. Trends in individual and concurrent use of cigarettes, cigars, and smokeless tobacco (SLT) products were tested using 8 repeated cross-sections of the YRBS between 1999 and 2013. Tests for effect modification of race/ethnicity and sex were conducted for each trend. Among all students, there were significant non-linear changes detected for the concurrent use of all 3 products, and the dual use of cigarettes and cigars. Girls significantly increased their use of SLT. Among users, significant changes were detected for each individual product and all combinations. Female users significantly increased their concurrent use of cigarettes and cigars and concurrent use of cigarettes and SLT. Male users significantly decreased their use of cigarettes and cigars. While the decrease in the youth prevalence of cigarette use is a public health success, there is concern about the increase in non-cigarette products, among tobacco users. These changes further drive increases in the concurrent use of tobacco products, adding to the potential health burden.

“I have never experienced any problem with my health. So far, it hasn’t been harmful”: older Greek-Australian smokers’ views on smoking: a qualitative study

BackgroundSmoking tobacco products is one of the largest preventable health risk factors for older people. Greek-Australians have the highest prevalence of cigarette use in Australia for older people, but there is a lack of knowledge about Greek-Australian’s perspectives on smoking cessation. The purpose of this exploratory, qualitative study was to progress the knowledge base in this area.MethodsA qualitative study was designed to gather information on participants’ perspectives about, and understanding of, their reasons for smoking and their attitudes to quitting. A snowball sampling technique was used to identify twenty Greek–Australian current smokers, aged ≥50 years. Semi-structured, face-to-face interviews were conducted with the assistance of a Greek translator. The audio-taped interviews were transcribed and then qualitative content analysis was used to categorise responses to the questions.ResultsParticipants’ perspectives on three broad topics were identified in the interviews: perceived benefits of smoking, perceptions of smoking and its effect on health, and barriers to cessation. Smoking behaviour was described as contributing to tiredness, and stress, and yet also was also a source of enjoyment. Level of knowledge about smoking-related diseases and the risks of smoking was very low. The number of cigarettes smoked each day, type of smoking (i.e. pipe rather than cigarettes), and previous family history of smoking were identified as indicators that limited harm flows from smoking. Most participants had a positive attitude towards smoking and described their own life experience and cultural norms as supporting smoking acceptability. Low confidence in quitting was linked to advanced age.ConclusionSmoking among older Greek-Australian smokers has been associated with a number of influences and these need to be addressed in smoking cessation efforts targeted at this group. Promoting knowledge about the health impacts of smoking, changing attitudes towards smoking, and ultimately, decreasing tobacco consumption are critical to the maintenance of health among older Greek Australians. Cultural and experiential influences may increase the difficulty associated with changing these outcomes, but may also serve as a framework from which to develop and implement an educational intervention tailored for older Greek-Australians.

Changes in gender and racial/ethnic disparities in rates of cigarette use, regular heavy episodic drinking, and marijuana use: Ages 14 to 32

BackgroundThe purpose of this study is to investigate disparities in substance use behaviors across gender and race/ethnicity as a flexible function of age from mid-adolescence through young adulthood. MethodsUsing data from the National Longitudinal Study of Adolescent Health, the time-varying effect model (TVEM) was used to examine gender and racial/ethnic differences in the prevalence of cigarette use, regular heavy episodic drinking (HED), and marijuana use as a smooth function of developmental age. ResultsPrevalence of cigarette use, regular HED, and marijuana use was higher for males than females overall, although gender differences varied with age. With regard to race, prevalence of each substance was higher for White than Hispanic or Black individuals; these differences increased considerably from ages 16 to 20, particularly for cigarette use. Differences in cigarette use by race/ethnicity were found across age, but were largest at age 18, when cigarette use peaks for White individuals, but continues to climb throughout the 20s among Hispanic and Black individuals. ConclusionsThese results suggest that substance use, particularly for certain population subgroups, increases past early adolescence. Disparities in substance use behaviors fluctuate considerably throughout adolescence and young adulthood, suggesting that targeted intervention programs are more critical at particular ages. These findings also demonstrate that TVEM can advance our understanding of health risk behaviors and their correlates across developmental time.

Substance use among inmates at the Eldoret prison in Western Kenya

BackgroundCriminal activity and social problems are recognized as important outcomes of substance use and abuse. Little research has been carried out on substance use among prison inmates in Kenya. General population surveys that have examined drug use usually omit this ‘hidden’ population which may offer insight into drug related morbidity and invaluable preventive measures. This study is set out to determine the lifetime prevalence and factors associated with substance use, including the most frequently used substances, among inmates at a government prison in Western Kenya.MethodsDesign: A cross-sectional descriptive study, using the WHO model questionnaire and an additional drug use and effects questionnaire among prisoners at the Eldoret Government of Kenya (GK) prison, Kenya.Setting: Study was carried out at the Eldoret G.K. prison, with a population of 1325 (1200 males and 125 females) inmates.Subjects: Three hundred and ninety five prisoners, who gave consent, were selected, consisting of 271 males (68.6%) selected by simple random sampling, and 124 females (31.4%) enrolled consecutively due to their small number. The mean age was 33.3 years (18–72, s.d. 9.8) while the mean number of years of formal education was 8.4 (0–15, s.d. 3.4).ResultsLifetime prevalence of substance use was 66.1%, while that of alcohol use was 65.1%. Both were significantly associated with male gender, urban residence and higher level of education. The lifetime prevalence of cigarette use was 32.7% while 22.5% admitted to chewing tobacco. Factors significantly associated with tobacco use were male gender, urban residence, being unmarried, younger age, lack of income in the past year. The prevalence of cannabis use was 21%, and this was associated with male gender, urban residence, being unmarried, and being a student in the past year. Other substances used included amphetamines (9.4%), volatile inhalants (9.1%), sedatives (3.8%), tranquillizers (2.3%), cocaine (2.3%), and heroine (1.3%). Users were commonly introduced to the habit by friends (70.8%), immediate family members (13.7%) and other close relatives (6.2%). Among those who reported lifetime substance use the common reasons attributed to the habit were the need to relax (26.5%), relieve stress (24.5%) and confidence to commit a crime (4.5%). Majority of those who reported alcohol use were already suffering ill effects.ConclusionsThere is a high prevalence of substance use among prisoners at the Eldoret G.K. prison. The increased morbidity and unpleasant psychosocial consequences of this habit suggest a need for establishment of substance use management programmes in Kenyan prisons.

Mapping the Tobacco Retailers in Edirne, Turkey

The youth smoking rate is on the rise in Turkey. Although many marketing bans have been effectively implemented, regulations related to retail tobacco outlets have gone unnoticed and have not been effectively supervised. In this study, we aimed to show the lack of legal regulation related to the high retail tobacco outlet density with displays. In the center of Edirne, the marketing environment, numbers and geographical distribution of retail tobacco outlets were documented and mapped with geographical positions. There were 569 retail tobacco points of sale in 520 stores. We calculated one tobacco retail outlet per 270 people. This retail outlet density rate is above the national average and about four times higher than the density in Istanbul. Products especially attracting children, such as chocolate, sweet candy and chewing gum, were set up near the tobacco stands and were easy for children to recognize and reach. It can be seen on the city map that 47% of retail tobacco outlets are within 100 m of education, health or sport facilities. We concluded that one of the reasons for the increasing prevalence of cigarette use, especially among adolescents in Turkey, is deregulation of the retail tobacco marketing industry as a result of the privatization process of the national tobacco monopoly. Using mapping techniques can be useful in terms of controlling the retail marketing environment.

¿Cuántas personas fuman?: Percepción del nivel de consumo y su relación con el consumo de cigarrillos en adolescentes chilenos

Cigarette smoking among adolescents is a major health problem in Chile, which is determined by several factors. Among these, it is important the role of perceived norms regarding cigarette use among peers and the general population. To study the social norms about the perceived prevalence of smoking and its relationship with cigarette smoking among Chilean adolescents. Participants were 480 adolescents of educational institutions from the South-East area of the Metropolitan Region, who completed a questionnaire that included questions regarding cigarette use and the perceived prevalence of cigarette use among peers and adults. Adolescents overestimated the percentage of smokers compared to national statistics regarding their peers and adult population. The perception of adolescents regarding the rates of use among peers predicted both current and future use. Cigarette smoking is influenced by perceived norms regarding use and, despite the current smoking restrictions in place, youth continue to perceive that smoking is a common behavior.

Implicit Cognition and Substance Use: The Role of Controlled and Automatic Processes in Children

Most cognitive models of substance abuse and dependence posit that controlled and automatic processes are central to substance use. Tests of these models rely on methods that are interpreted to measure one or the other of these processes. There has been growing interest in the use of implicit substance use tasks, which are posited to reflect automatic processes. Recent model advancements suggest that behavior is determined by multiple cognitive processes and that dual-process models may provide an overly simplistic account of the cognitive process involved in the assessment of implicit cognition. The goal of the current study was to apply the Quad Model to children's performance on implicit substance use tasks and consider associations with early substance use. Children (N = 378; 52% girls) ranging from 10 to 12 years old completed alcohol and cigarette Single Category Implicit Association Tests (SC-IATs) and self-reports of substance use. Four distinct cognitive processes were found to influence SC-IAT performance, one of which reflected automatic activation, the process typically viewed as central to IAT performance. Differences across drinking status revealed weaker automatic activation of negative alcohol associations for those who had (vs. had not) initiated drinking, and a strong likelihood to overcome biased attitudes was supported for all children. The low prevalence of cigarette use in our young sample prohibited examination of the model across smoking status. Findings suggest that performance on implicit substance use tasks is not process pure. Quantifying and interpreting the multiple influencing processes are crucial for further development and evaluation of cognitive risk models of substance use.

Determinants of cigarette smoking among school adolescents in eastern Ethiopia: a cross-sectional study.

BackgroundThe World Health Organization (WHO) attributes more than 4 million deaths a year to tobacco, and it is expected that this figure will rise to 10 million deaths a year by 2020. Moreover, it is now a growing public health problem in the developing world.ObjectiveTo assess the prevalence of cigarette use and its determinant factors among high school students in eastern Ethiopia.MethodsA cross-sectional study was conducted using structured self-administered questionnaires among 1,721 school adolescents in Harar town, eastern Ethiopia. Univariate and multivariate logistic regression analyses were performed to examine associations.ResultsThe analysis revealed that prevalence of ever cigarette smoking was 12.2% (95% CI 10.8% - 13.9%). Reasons mentioned for smoking cigarettes were for enjoyment (113, 52.8%), for trial (92, 42.9%), and for other reasons (9, 4.3%). The main predictors of cigarette smoking were sex (OR 4.32; 95% CI 2.59-7.22), age (OR 1.20; 95% CI 1.05-1.38) and having friends who smoke (OR 8.14; 95% CI 5.19-12.70). Living with people who smoke cigarettes was not significantly associated with smoking among adolescents (OR 1.25; 95% CI 0.81-1.92).ConclusionThis study concluded that high proportion of school adolescents in Harar town smoked cigarettes. Sex, age and peer influence were identified as important determinants of smoking. There is a need for early cost-effective interventions and education campaigns that target secondary school students.

Non-Medical Use of Prescription Drugs among Youth in an Appalachian Population: Prevalence, Predictors, and Implications for Prevention

This article examines prevalence of non-medical use of prescription drugs (NMUPD) in a sample of elementary and high school students in an Appalachian Tennessee county. We found that lifetime prevalence of NMUPD (35%) was higher than prevalence of cigarette use (28%) and marijuana use (17%), but lower than lifetime prevalence of alcohol use (46%). We examined characteristics, as well as risk and protective factors in several domains, as predictors of NMUPD. For comparison, we also examined these characteristics and factors as predictors of alcohol, cigarette, and marijuana use. Using survey data from a sample of late elementary school and high school students (grades 5, 7, 9, and 11), logistic regression analyses showed that the risk factors of friends' non-medical use and perceived availability, and the protective factors of preceived risk, parents' disapproval, school commitment, and community norms against youth NMUPD were significant predictors of lifetime prevalence of NMUPD. Implications for prevention are discussed.

Prevalence and predictors of smoking among adolescent schoolchildren in Monastir, Tunisia

A study in Monastir, Tunisia estimated the prevalence of smoking and analysed the determinants of tobacco use among adolescents aged 10-19 years. An observational cross-sectional study was performed in the 8 colleges and high schools of Monastir city in 2004. The mean age of the 900 respondents was 15.8 (SD 2.2) years and 47.7% were aged under 16 years. The overall prevalence of cigarette use during the past year was 16.0% (30.2% among males and 4.6% among females). The first smoking experience was initiated by friends in 45.8% of cases, at a mean age of 13.8 (SD 2.3) years. One-fifth of smokers (21.5%) had used other forms of tobacco. In multivariate analysis, male sex, academic failure, poor family management, antisocial behaviour and addictive behaviour were the main predictors of adolescent smoking status. The prevalence of smoking among adolescents in Monastir is high and requires targeted action.

Psychosocial determinants of cigarette smoking among university students in Jordan.

The objectives of this study were to describe the prevalence of cigarette use and water pipe smoking in Jordanian university students and to analyze differences in determinants between cigarette smokers and non-smokers. A cross-sectional questionnaire was administered to a random sample of 400 students (18-24 years, 51% males). Smokers were compared with non-smokers on several smoking-related determinants. Data were analyzed using descriptive statistics, t-test, χ 2 test and binary logistic regression analysis. The prevalence rates of cigarette use and water pipe smoking were 25.9% and 23.3%, respectively. Cigarette smokers differed significantly from non-smokers on almost all of the assessed determinants. The I-Change model explained 85% of the total variance of cigarette-smoking behavior. Cigarette smoking was determined by being male and older, having more depressive symptoms, having less Muslim identity, being more emancipated, perceiving more pros of smoking, having more modeling from peers and having lower self-efficacy. The popularity of cigarette use and water pipe smoking among Jordanian students necessitates health promotion interventions that motivate students not to engage in smoking behaviors by clearly outlining the outcomes of smoking and the healthier alternatives, how to cope with social influences and difficult situations in order to increase self-efficacy.