Adolescent Smoking Prevalence Research Articles

Prevalence of Tobacco Smoking in A Sample of General Secondary School Students in Cairo and Its Correlation to Other Psychiatric Disorders

Abstract Background Tobacco smoking is considered currently as a global public health concern among youth especially school student. There is a scarcity of data about the impact of this global phenomenon in Middle Eastern countries. This study assesses the prevalence of tobacco smoking, including conventional cigarettes, E-cigarettes and waterpipe and its sociodemographic and psychiatric correlates among a sample of general secondary school students in Cairo, Egypt. Results A convenient sample of 391 Egyptian general secondary students from different areas of Greater Cairo were assessed using the Socioeconomic scale, Fagerstrom Test For Nicotine Dependence, The Lebanon Water pipe Dependence Scale, questionnaire for electronic cigarette using, Barratt impulsivity scale 11, The MINI International Neuropsychiatric Interview for Children and Adolescents. 12.8% (n = 50) were smokers. There is significant relation between family history of smoking and substance use and smoking and significant relation between smoking, impulsivity and mood symptoms. Conclusions Prevalence of tobacco smoking in Egyptian adolescents was 12.8% with significant relation between smoking and impulsivity and mood symptoms.

Effect of a peer-led prevention program (P2P) on smoking in vocational high school students: Results from a two-school-year cluster-randomized trial.

The aim of this work was to measure the impact of P2P (i.e. peer-to-peer), a peer-led smoking prevention intervention, on daily smoking prevalence of adolescents over 2 school years. A cluster-randomized controlled trial was performed over a 16-month follow-up (trial status: closed to follow-up). P2P was implemented 1-3 and 13-15 months after baseline. Assessments took place at baseline and 4, 10 and 16 months after baseline. The research team, assessors and adolescents were blinded to the study-arm assignment only at baseline. Fifteen vocational high schools in France were randomized into two clusters, using a 1:1 allocation ratio per French department (n intervention = 7, n control = 8). Participants comprised a sample of 2010 students in year 11 (i.e. 15-16 years) in vocational high schools. A total of 437 students could not be assessed at baseline (absent or left school), yielding a total sample of 1573 students (n intervention = 749, n control = 824). The P2P programme trained voluntary students to become peer educators and design smoking prevention actions for their schoolmates in the intervention group (n = 945 students), compared with a passive control group (n = 1065 students). The primary outcome was change from baseline in the prevalence of self-reported daily smoking (i.e. at least one cigarette per day) at 16 months. The 'time × group' interaction indicated that, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 16 months [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.20, 0.53]. Similarly, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 4months (OR = 0.50, 95% CI = 0.30, 0.82) and 10months (OR = 0.60, 95% CI = 0.37, 0.98). No adverse events of P2P2 were reported. A cluster-randomized trial found evidence that the peer-led P2P (peer-to-peer) smoking prevention intervention reduced the uptake of daily smoking among high school students in France over 16 months.

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.

Rural Indonesian adolescents’ smoking behaviours during the COVID-19 pandemic: rapid survey and cotinine test of school-attend adolescents in Gunung Kidul, Yogyakarta

The COVID-19 pandemic is predicted to affect adolescent smoking behaviours. We aim to map profiles of adolescents’ smoking behaviours in a rural district in Indonesia during the COVID-19 pandemic and validate their smoking exposures using cotinine tests. This study applied an online survey followed by cotinine tests for high-school students in Gunung Kidul, Yogyakarta. The participants were asked to complete the survey and participate in a cotinine test. Univariate and multivariate regressions were performed to seek potential determinants of the smoking status and diagnostic accuracy of the cotinine test. A total of 281 participants completed the survey, with 19.6% (n = 55) and 22.8% (n = 64) being ever-smokers and current smokers. The impacts of the pandemics on their smoking behaviours were found in the urgency and numbers of daily smoked cigarettes. Univariate regression analysis revealed age, gender, learning mode, and whether father/friend smokes correlate with the adolescents’ smoking behaviours. Multivariate regression analysis revealed that the odds of planning to stop smoking were 0.01 (95% CI 0.001–0.22, p-value 0.003) for having positive attitudes towards cigarettes compared to none. Of the 65 cotinine tests, 19 tested positive, with the sensitivity and specificity of the cotinine test at 94.7% and 95.6%. The prevalence of adolescent smoking during the COVID-19 pandemic in Gunung Kidul is high, with the impacts of the pandemic on the urgency and number of cigarette smoke. There are opportunities to help them stop smoking by providing reliable quit-tobacco access and advocacy in collaboration with schools, parents, and health providers.

Impact of regulatory tightening of the Hungarian tobacco retail market on availability, access and cigarette smoking prevalence of adolescents

IntroductionPolicies that reduce tobacco retail density to decrease tobacco use among the youth are critical for the tobacco endgame. This paper reviews a Hungarian tobacco regulatory measure, which, since 2013,...

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.

Prevention of tobacco use in an adolescent population through a multi-personal intervention model.

The study aimed to assess the impact of a new intervention proposal involving students, teachers, and parents on smoking prevalence in secondary school adolescents. A quasi-experimental study was conducted, in which the response to a preventive multi-personal intervention model (intervention) against tobacco consumption was compared with a standard anti-smoking activity carried out by the local government administration (control). The study was carried out during the 2017-2018 academic year. The study population included 306 students (intervention 151, control 155) with a mean age of 13.4 years. The model involved the parents, the students (aged 15-17 years), and the teachers. The primary outcome was the change in smoking status one year after the intervention. The percentage of non-smokers increased from 84.1% to 88.7% in the intervention group and remained almost unchanged among controls (89.3% vs 89.9%). After one year, there was an increase in the prevalence of non-smokers of 4.6% and a decrease in the prevalence of smokers of 4.7% among students who received the multi-personal intervention, whereas changes among controls were almost negligible (there was in fact a slight increase in the prevalence of smokers of 0.9%). The students who received the intervention smoked less or quit smoking more than those in the control group (OR=0.135; 95% CI: 0.019-0.973, p=0.047). The multi-personal model developed in the study with the participation of teachers and parents focused on students was feasible, and effectively reduced the prevalence of smoking among high school adolescents.

TOBACCO USE BEHAVIOR AMONG ADOLESCENTS IN HANOI, 2023

The study was conducted to determine the prevalence of adolescent smoking in Hanoi city in 2023 and the perception of adolescents toward adverse impacts of tobacco. The piece of research was a cross-sectional study, using quantitative methods. In total, 1009 students aged from 12 to 18 years old in 4 districts in Hanoi participated in the research through answering online form of question. The survey results showed that: 21,3% adolescents have ever smoked, 16,2% adolescents currently smoke, prevalence of male and high school students are respectively higher than female and secondary student, respectively; e - cigarettes were the most popular among adolescents; e – cigarettes and heated tobacco were supposed to be less toxic. The proportion of secondary and high school students in Hanoi who have used tobacco are critically high. Basing on research results, some recommendations were indicated: update the policies related to tobacco management including advertising and sale; conduct behavior change campaign to raise awareness for students about the harmful effects of nicotine on physical development, brain, negative health effects caused by tobacco; establish support groups for adolescents to quit smoking and promote penalizing students smoking.

DO ANTI-SMOKING ADVERTISEMENTS INFLUENCE STUDENTS TO QUIT SMOKING?

Background: The prevalence of adolescent smoking in Indonesia increased from 2013 to 2018. Aims: This study examines the influence of pro and anti-cigarette advertising on students' smoking cessation. Methods: The study uses the Global Youth Tobacco Survey Indonesia 2019 data. The sample was students aged 13-15 years who had smoked. The dependent variable is quitting smoking, and the independent variables are pro-cigarette and anti-smoking ads: chi-square and logistic regression tests with a 95% confidence interval and a p-value of 0.05. Results: The total sample was 1023 students, and 79.32% wanted to quit smoking. In the anti-smoking ads variables: anti-smoking messages in various media (OR=1.63, 95% CI=1.14-2.34); pictorial health warnings (PHW) on cigarette packs (OR=3.46, 95% CI=2.40-4.97); feeling afraid when seeing health warnings on packaged cigarettes (OR=3.03, 95% CI=2.16-4.26); education about harmful of cigarette consumption (OR=1.40, 95% CI=1.00 – 1.96) had a significant association to quit smoking. The most dominant factor in multivariate analysis was pictorial health warnings on cigarette packs (OR=2.53, 95% CI=1.67-3.81). Conclusion: Most student smokers express a desire to quit smoking. Pictorial health warnings are significantly associated with quitting smoking among students. Keywords: cigarette ads, GYTS, pictorial health warning, students

Pengetahuan Dan Sikap Tentang Berhenti Merokok Pada Perokok Aktif Di Kelurahan Ketintang Surabaya: Mix-Method

The prevalence of smoking in adolescents has increased from year to year. Smoker awareness is very important inincreasing the success of quitting smoking. The level of knowledge and attitudes is needed for self-managementattitudes for smokers. The aim of this study was to determine the level of knowledge and attitudes about smokingcessation among active smokers in the Ketintang Village, Surabaya. The design that will be used in this study isMix-Methods with Convergent Parallel Design. This research was conducted in Ketintang, Surabaya, with theconsideration of the availability of active smokers in a Mosque Youth and Youth Organization organization, whichwas carried out for 2 months starting April 2022 - June 2022. The variables measured in this study included thelevel of knowledge and attitudes of active smokers about quitting smoking. Data collection was carried out by indepth interviews and data were analyzed descriptively. Respondents involved in the study were 40 people. Theaverage respondent has good knowledge (90.00%) and a positive attitude (95.00%). Respondents thought that thetypes of cigarettes according to respondents were ordinary cigarettes (conventional), shisya, and vape. Respondentsthought that the way to quit smoking could be done by making an independent effort to quit, avoiding smokers'surroundings, and replacing conventional cigarettes with electric cigarettes (vape). Therefore, smoking cessationprograms need to be improved, especially for smokers who wish to quit smoking.

Assessing the Effects of Standardized School-Based Educational Cessation Programs for Adolescent Smokers: A Research Protocol

Introduction: Cigarette smoking is a significant public health issue, and the primary cause of preventable health problems in the Greater Toronto Area (GTA). Nevertheless, the prevalence of adolescent smoking remains high. Our proposed study aims to investigate the effectiveness of school-based educational programs in reducing adolescent smoking rates in the GTA. It will compare the results of weekly integrated education sessions offered throughout a school term to more focused, discrete sessions offered at two different points in the term at 10 secondary schools in the GTA. The findings will help inform potential policy and curricular changes to promote smoking cessation among current and future youth. Methods: This study utilizes an experimental quantitative research design. Multi-stage cluster sampling will be used. 10 schools will be selected, with 20 students being recruited per school. The intervention group will receive a school-based education program for smoking cessation, lasting an academic semester. The control group will receive an educational session at the beginning and end of the semester. The inclusion criteria is as follows: participants must be (a) adolescents aged 12-17 and attending an accredited primary or secondary school, (b) living in the GTA, and (c) current daily smokers. The Fagerström Test for Nicotine Dependence (FTND) and biochemical tests will be used to collect pertinent data about smoking cessation rates. Abstinence will also be assessed using the Russell Standard. Results: The study will use statistical tests to compare the proportion of students in the intervention group who quit smoking to the control group. The primary outcome measures will be 4-week and 6-month abstinence counts and nicotine dependency as measured by the FTND. The analysis will be conducted using IBM SPSS ver. 29. Discussion: The results of this study will provide valuable insight into the effectiveness of educational programs in promoting smoking cessation among youth, which will inform the design of future school-based interventions. Additionally, the study will help to understand adolescent smoking patterns, which can be used to guide public health policies. Conclusion: The results will have the potential to inform future education and public health strategies for encouraging adolescent smoking cessation.

Prevalence and associated factors to cigarette smoking among school adolescents in Tunisia, 2021

IntroductionTobacco use among youth is a real public health concern in most developing countries. To provide recent epidemiological data regarding tobacco use among this specific population, a national survey was conducted in Tunisia in 2021. We aimed to determine cigarette smoking prevalence in Tunisian adolescents and assess associated factors.ObjectivesWe aimed to determine cigarette smoking prevalence in Tunisian adolescents and assess associated factors.MethodsData from the Mediterranean school survey on alcohol and other drugs (MedSPAD 2021) were used. Based on three-stage stratification sampling method, first and second grade high school students were enrolled. A self-administered standardized questionnaire was used and weighted prevalence estimates for cigarette smoking “at least once in a lifetime” were studied. Binary logistic regression model was used to assess associated factors and Adjusted Odds Ratios (AORs) were presented. The independent factors included were: sex, area of residence, private or public sector, alcohol and cannabis use, and being exposed to tobacco smoking in family and peer’s environment. Epidata and STATA software were used for data entry and statistical analysis, respectively.ResultsAmong 6.201 participants with a mean age of 16.8 years, 60.4% were girls; the prevalence of cigarette smoking was 24,75% 95% CI [23.24,26.32], significantly higher among boys (41.1% versus 14.2%, p&lt;10-3). Univariate analysis revealed a significant difference in cigarette smoking by region (p-value&lt; 10-4). The highest prevalence of cigarette smoking was observed in the capital city. Cigarettes were perceived as easily accessible by less than a third of the students (38.46% and 20.94% of boys and girls respectively, p=10-4). In multivariable analysis, the only independently associated factor to this behaviour was male sex (AOR=1.5[0.15 – 2.9], p-value=0.03).ConclusionsOur study revealed a high prevalence of smoking among students with male sex as an associated factor. Developing a healthy school environment and implementing school-based intervention programs are therefore, highly required.Disclosure of InterestNone Declared

Estimated prevalence and trends in smoking among adolescents in South Korea, 2005-2021: a nationwide serial study.

Although smoking is classified as a risk factor for severe COVID-19 outcomes, there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic. Thus, this study aims to analyze the trends of prevalence of smoking in adolescents over the COVID-19 pandemic period. The present study used data from middle to high school adolescents between 2005 and 2021 who participated in the Korea Youth Risk Behavior Web-based Survey (KYRBS). We evaluated the smoking prevalence (ever or daily) by year groups and estimated the slope in smoking prevalence before and during the pandemic. A total of 1,137,823 adolescents participated in the study [mean age, 15.04years [95%confidence interval (CI) 15.03-15.06]; and male, 52.4% (95% CI 51.7-53.1)]. The prevalence of ever smokers was 27.7% (95% CI 27.3-28.1) between 2005 and 2008 but decreased to 9.8% (95% CI 9.3-10.3) in 2021. A consistent trend was found in daily smokers, as the estimates decreased from 5.4% (95% CI 5.2-5.6) between 2005 and 2008 to 2.3% (95% CI 2.1-2.5) in 2021. However, the downward slope in the overall prevalence of ever smokers and daily smokers became less pronounced in the COVID-19 pandemic period than in the pre-pandemic period. In the subgroup with substance use, the decreasing slope in daily smokers was significantly more pronounced during the pandemic than during the pre-pandemic period. The proportion of ever smokers and daily smokers showed a less pronounced decreasing trend during the pandemic. The findings of our study provide an overall understanding of the pandemic's impact on smoking prevalence in adolescents. Supplementary file2 (MP4 64897 KB).

The association between MPOWER tobacco control policies and adolescent smoking across 36 countries: An ecological study over time (2006-2014).

To examine associations over time between national tobacco control policies and adolescent smoking prevalence in Europe and Canada. In this ecological study, national tobacco control policies (MPOWER measures, as derived from WHO data) in 36 countries and their changes over time were related to national-level adolescent smoking rates (as derived from the Health Behaviour in School-aged Children study, 2006-2014). MPOWER measures included were: Protecting people from tobacco smoke (P), offering help to quit tobacco use (O), warning about the dangers of tobacco (W), enforcing bans on advertising, promotion and sponsorship (E) and raising taxes on tobacco (R). Across countries, adolescent weekly smoking decreased from 17.7% in 2006 to 11.6% in 2014. It decreased most strongly between 2010 and 2014. Although baseline MPOWER policies were not directly associated with differences in average rates of adolescent smoking between countries, countries with higher baseline smoke-free policies (P) showed faster rates of change in smoking over the time period. Moreover, countries that adopted increasingly strict policies regarding warning labels (W) over time, faced stronger declines over time in adolescent weekly smoking. A decade after the introduction of the WHO MPOWER package, we observed that, in our sample of European countries and Canada, measures targeting social norms around smoking (i.e., smoke-free policies in public places and policies related to warning people about the dangers of tobacco) are most strongly related to declines in adolescent smoking.

Alarming trends in Tobacco use in high school Tunisian adolescents: MedSPAD2013-2021

Abstract Background Tobacco use is a global health concern, with smoking initiation often beginning in adolescence. In Tunisia, published data assessing trends of tobacco consumption at the national level only concerns middle school students aged 13 to 15 years. No data related to high school students are however published yet. We aimed to determine tobacco smoking prevalence in Tunisian adolescents and assess trends from 2013 to 2021. Methods Pooled data from three Mediterranean school surveyson alcohol and other drugs (MedSPAD surveys: 2013, 2017, and 2021) were used. Based on three-stage stratification sampling method, teenagers aged between 15 and 17 years, were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Data collection was performed using a self-administered standardized questionnaire assessing socio-demographic characteristics and risky behaviours. We studied weighted prevalence estimates of cigarettes and water pipe (WP) smoking. All statistical analysis, including trend analysis, were performed with STATA software. Results A total of 14.723 students were enrolled with sex ratio (M/F) equal to 0.6 and mean age of 16.2±0.8 years. The prevalence of cigarette smoking increased from 17.8%, to 20.2% then to 24.7% for 2013, 2017 and 2021, respectively. As for WP smoking, its prevalence increased from 14.8%, to 16.7% then to 19.9% for 2013, 2017 and 2021, respectively. Trends analysis concluded to significant increase over study period for cigarettes and WP smoking (p &amp;lt; 10-3). The increase was most alarming for girls regarding WP smoking (consistent increase over the study period). Conclusions Our findings underscore the alarming increasing trend for different forms of tobacco smoking among Tunisian youth. It is therefore crucial to strengthen tobacco control measures among young adolescents in order to counteract the tobacco industry’s expanding marketing of new products primarily targeting this population. Key messages • The prevalence of cigarette and water pipe smoking increased significantly among high school Tunisian adolescents from 2013 to 2021. • A better commitment to the implementation of MPOWER measures for tobacco control is therefore urgent.

Literature Review: Lingkungan Sosial dan Perilaku merokok pada Remaja

Smoking behavior is a problem related to public health conditions because it can lead to various health problems. A Global Youth Tobacco study in 2008 showed that the prevalence rate of adolescent smokers in Indonesia was very alarming. This study aims to determine a relationship between the social environment and smoking behavior in adolescents. The research method uses scientific research literature review, by analyzing various articles which valid and relevant to the topic. This study uses the literature of the National Journal published from 2018 to 2021. The database used to collect literature is Google Scholar with the keywords "Social Environment", "Smoking Behavior", "Adolescents". Researchers found 1,030 articles on Google Scholar then finally researchers got 10 articles relevant to the inclusion criteria. The results showed that from the ten articles, it was stated that the social environment and smoking behavior in adolescents were two interrelated things. The social environment is one ofthe driving factors for adolescents to smoke. The most influential adolescent social environment is family or parents and peers. Special assistance to adolescents is needed in order to reduce the prevalence of smoking in adolescents, especially in Indonesia.

KENAIKAN DAN PENYEDERHANAAN TARIF CUKAI UNTUK MENURUNKAN PENGELUARAN KONSUMSI ROKOK DAN PREVALENSI PEROKOK REMAJA

The prevalence of smokers in Indonesia is one of the highest in the world and is expected to continue to increase. This cannot be separated from the high household expenditures for consuming cigarettes and smoking habits that began in the times of youth. In order to decrease cigarette consumption and smoking habits among adolescents, the government is trying to control the rate by increasing tariffs and simplifying the structure of the tobacco excise tariffs. However, as seen from the data, the expenditures for household consumption in Indonesia for cigarette commodities has been increasing from year to year. Meanwhile, the prevalence of youth smoking did not show a significant decrease. Based on this, the authors conducted a study that aims to determine the effect of increasing tariffs and simplifying the structure of tobacco excise rates on household cigarette consumption expenditure and the prevalence of youth smokers. This study uses random effect model to analyse the panel data for 34 provinces in Indonesia in the period 2015 until 2019. The results reveals that an increase in tariffs and simplification of the tariff structure has a significant and negative effect on household cigarette consumption expenditure, and have a significant and positive effect on the prevalence of adolescent smoking.

Metabolic Syndrome Associated with Tobacco and Caffeine Products Use Among Refugee Adolescents: Risk of Dyslipidemia.

IntroductionDue to their stressful lives, Palestinian refugees are prone to use cognitive enhancers (CE) and psychostimulant substances (PS). Recognising health problems associated with CE/PS use can indicate how preventive programs should be directed towards adolescents. Unfortunately, research has not thoroughly investigated the health problems related to tobacco and caffeine products, the most socially acceptable CE/PS among Palestinian refugee adolescents.MethodologyIn 2021, schoolchildren from five Palestinian refugee camps (N=271) aged 12-<16 years agreed to give blood samples and to be interviewed to address the association between metabolic syndrome (MetS) and tobacco smoking, coffee, energy drinks (ED), black tea, and chocolate consumption. MetS was diagnosed based on International Diabetic Federation Criteria. To address the association, we used binary logistic regression models adjusted to age, gender, BMI, and central obesity.ResultsThe prevalence of MetS was [17 (6.3%)]; (7.4%) in males, (5.1%) in females. The prevalence of substance use was as follows: ED [163 (48.9%)], coffee [255 (76.6%)], black tea [295 (89.1%)], cigarette [35 (10.5%)], waterpipe [59 (17.7%)], and chocolate [309 (93.6%)], with male predominance. Cigarette smokers have increased central obesity (p-value=0.024), and decreased HDL-cholesterol (p-value=0.015) than non-smokers. Similar results were observed for waterpipe smokers besides the increased levels of triglycerides (p-value=0.01). ED consumers have increased central obesity (p-value=0.03) and fast blood sugar (p-value=0.003) than non-consumers. Chocolate consumers have decreased central obesity (p-value=0.008) and increased HDL levels (p-value=0.04) than non-consumers. ED consumers were significantly at higher risk of MetS (OR=9.97, p-value=0.019) than non-consumers and chocolate consumers were at lower risk of MetS (OR=0.14, p-value=0.046) than non-consumers. Waterpipe smokers were at a higher risk of having increased plasma triglycerides than non-consumers (OR=3.4, p-value=0.03).ConclusionThe high prevalence of ED consumption and waterpipe smoking in Palestinian refugee adolescents is problematic. Their use was associated with higher odds of MetS, dyslipidemia, and central obesity, which justifies greater attention.

Rural disparities in adolescent smoking prevalence.

Rural residence is a well-established risk factor for risk behaviors and subsequent morbidity and mortality in the United States. Smoking is the primary cause of preventable death and is more prevalent in rural America. As chronic smoking habits typically develop during adolescence, the discrepancy in smoking rates between rural and urban youth likely contributes to a significant geographic disparity in the long-term health of adults. Data were extracted from 12th-grader surveys of the US Monitoring the Future study from 1998 to 2018. The historic trends of smoking initiation, ever-regular and current-regular smoking rates of rural and urban adolescents were estimated with intercept-only time-varying effect models. Differences in prevalence between rural and urban youth were calculated for each smoking behavior. Though overall smoking prevalence continues to decline, this trend is significantly attenuated among rural adolescents compared to urban youth. The absolute difference in lifetime smoking prevalence between rural and urban youth has markedly increased from 6.9% in 1998 to 13.5% in 2018, which is among the highest in the past 20 years and is a potentially alarming upward trend. However, the absolute differences in ever-regular and current-regular smoking prevalence have shown an overall net decline, decreasing from 6.4 to 4.8%, and from 5.5 to 3.0%, respectively. This geographic disparity between rural and urban adolescents represents a potentially modifiable cause of increased morbidity and mortality in rural areas. Interventions and regulatory efforts should be tailored for rural adolescents to reduce the narrowing but persistent disparity in regular smoking.

Prevalence of cigarette smoking in Iranian adolescents and young adults: a systematic review and meta-analysis

Background: Cigarette smoking is a shared risk factor for a variety of health conditions. Aims: To estimate the prevalence of cigarette smoking among Iranian adolescents and young adults. Methods: In this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Scopus and domestic databases from January 2001 to December 2018. Cross-sectional studies that reported the prevalence of cigarette smoking among high school students, university students or general population aged 14–30 years were eligible. Data on prevalence of smoking, age and gender of subjects, sample size, date, and location of studies were extracted by 2 independent reviewers. Results: We included 99 studies in the analysis. For high school students, the pooled life-time prevalence of cigarette smoking was 13% in girls and 23% in boys. For university students, the life-time prevalence was 11% in women and 33% in men. The pooled prevalence of current and regular smoking among high school boys was 9% and 5%, respectively, compared with 3% and 1% in girls. The pooled prevalence of current and regular smoking among male university students was 22% and 11%, respectively, compared with 5% and 1% among female students. The prevalence of current smoking among the general population aged 15–24 years was 3.3–13.9%. The prevalence of regular smoking among this population was 1.0–10.2%. Conclusion: Cigarette smoking is notable among Iranian young adults especially boys and university students. Our findings call for reinforcement of tobacco prevention and control policies across Iranian schools and universities.