Onset Of Smoking Research Articles

Latent Trajectories and Profiles of Commercial Cigarette Smoking Frequency From Adolescence to Young Adulthood Among North American Indigenous People.

North American Indigenous people (ie, American Indian/Alaska Native and Canadian First Nations) have the highest rates of commercial cigarette smoking, yet little is known about long-term trajectories of use among this population. The purpose of this study is to examine heterogeneous trajectories and profiles of Indigenous cigarette use frequency from early adolescence (mean age: 11.1 years) to young adulthood (mean age: 26.3 years). Data come from a nine-wave prospective longitudinal study spanning early adolescence through young adulthood among Indigenous people in the Upper Midwest of the United States and Canada (N = 706). Smoking frequency was examined at each wave, and latent class growth analysis was used to examine heterogeneous patterns. Early adolescent and young adult demographics and smoking-related characteristics were examined across these latent trajectory groups. In young adulthood, 52% of participants smoked daily/near-daily, and an additional 10% smoked weekly or monthly. Four latent trajectory groups emerged: low/non-smokers (35.2%) who had low probabilities of smoking across the study; occasional smokers (17.2%) who had moderate probabilities of smoking throughout adolescence and declining probabilities of smoking into young adulthood; mid-adolescent onset smokers (21.6%) who showed patterns of smoking onset around mid-adolescence and escalated to daily use in young adulthood; and early-adolescent onset smokers (25.9%) who showed patterns of onset in early adolescence and escalated to stable daily use by late adolescence. The findings suggest multiple critical periods of smoking risk, as well as a general profile of diverse smoking frequency patterns, which can inform targeted intervention and treatment programming. Nearly two-thirds (62%) of this sample of Indigenous people were current smokers by early adulthood (mean age = 26.3 years), which is substantially higher than national rates in the United States and Canada. Moreover, in all but one trajectory group, smoking prevalence consistently increased over time, suggesting these rates may continue to rise into adulthood. The longitudinal mixture modeling approach used in this study shows that smoking patterns are heterogeneous, and implications for public health policy likely vary across these diverse patterns characterized by timing of onset of use, escalation in frequency of use, and stability/change over time.

RETRACTED ARTICLE: A classification model to predict onset of smoking and drinking habits based on socio-economic and sociocultural factors

Addictive habits are often initiated due to peer pressure. Smoking, drinking, and exercising are examples of such habits that are also performed as a part of socializing activities. Past researches have tried to predict the early onset of smoking and drinking problems using machine learning. However, these researches were mainly based on daily stress levels, and mood. Taking daily measures is inconvenient for a surveyor. The studies have also failed to account for socio-cultural and socio-economic factors which also play an important in the onset of these behaviours. Availability of items like tobacco and alcohol can significantly impact the onset of early alcohol and smoking in adolescents. In this paper, we analyze how socio-economic such as lifestyle, monthly savings, and socio-cultural factors like size of friends group, number of friends that drink and smoke, details about parents, etc., play a role in the initiation and cultivation of addictive behaviours and use a machine learning approach to predict the early onset of such behaviours. We compared Gaussian Naive Bayes, Support Vector Machine and Logistic Regression algorithms in order to train and predict our multi-classifier prediction system. We found Logistic Regression to be the best performing classifier to predict both drinking and smoking habits with 86.4% and 97.2% accuracies respectively. We also achieved an F1 measure of 0.76 for the drinking classifier and an F1 measure of 0.85 for the smoking classifier.

Similarities Between Alcohol and Tobacco Advertising Exposure and Adolescent Use of Each of These Substances.

Objective:Underage alcohol use is a major public health problem and substantial corporate money supports alcohol advertising across multiple venues. A diverse research literature demonstrates that adolescent exposure to such advertising is associated with drinking attitudes and behavior, but no scientific body has determined these associations to be causal. The objective of this study was to assess the association between alcohol advertising and teen drinking in the context of the “Analogy” criterion of the Bradford Hill criteria and consider a determination that the association between exposure to alcohol advertising and alcohol use is causal.Method:This study was a narrative review on the association between adolescent exposure to alcohol advertising and subsequent alcohol use in the context of domains utilized in the Surgeon General’s 2012 Report, Preventing Tobacco Use Among Youth and Young Adults, which concluded, “Advertising and promotional activities by tobacco companies have been shown to cause the onset and continuation of smoking among adolescents and young adults.”Results:In every aspect compared (i.e., adolescent knowledge; attitudes toward; initiation of use; continuation of use; mediums of advertisement; the use of mascots, celebrities, and themes; and frequency and density of advertisements and retailers), the findings for both tobacco and alcohol and their association with exposure to advertising are analogous.Conclusions:Application of the Analogy criterion of the Bradford Hill criteria comparing alcohol and tobacco supports a judgment that the association between exposure to alcohol advertising and increased adolescent knowledge, attitudes toward, initiation, and continuation of alcohol use are causal in nature.

Do the socioeconomic context and the European geographical area modify parental influences on smoking experimentation among adolescents?

Adolescent smoking is a major public health problem. While the socioeconomic status (SES) of the neighbourhood and that of the family are known to play a role in smoking onset and progression, it is not clear whether it modifies the association between parental influences and adolescent behaviour. The purpose of this study is to investigate family correlates of adolescent smoking experimentation and to explore the modifying role of socioeconomic context and European geographical area in a sample of European adolescents. This is a secondary analysis of the baseline survey of the European Drug Addiction Prevention (EU-Dap) trial which took place in seven European countries and involved 7079 students. School SES was used as indicator of socioeconomic context. European countries were aggregated in two geographical areas: North-Central and South. The associations between parental, family factors, and adolescents smoking experimentation were analysed through multilevel mixed-effect logistic regression models, stratified by school SES and European geographical area. Parental smoking, permissiveness towards tobacco, family conflicts, problematic relationships, low connectedness, and low parental control were significantly associated with adolescent smoking experimentation. Paternal smoking was a stronger correlate of adolescent smoking in low SES schools, while maternal smoking in high SES schools. Parental permissiveness was a stronger correlate in low SES schools. Family conflicts and low parental control were correlates only in low SES schools. The associations did not substantially differ between European geographical areas, with the exception of parental smoking that was a stronger correlate in the North, and parental control that was a correlate only in the South of Europe. To reduce inequalities in tobacco-related outcomes, prevention efforts in low socioeconomic contexts appear to be a public health priority. Parental smoking, permissiveness, family relationships, and connectedness should be addressed in preventive programs.

Tabaquismo en los estudiantes de alto nivel académico en la Comunidad de Madrid y comparación con estudio previo similar realizado en 2014

Smoking is a public health problem that affects young people, and influenced by the environment and cultural level. ObjectivesTo determine smoking prevalence among high-level baccalaureate students in the Autonomous Community of Madrid during the 2018-2019 academic year. To assess the influence of the socio-cultural environment on the onset of youth smoking. To compare the results with previous studies conducted on students of baccalaureate of excellence (BE) and the general population. Population and methodsCross-sectional study on BE students in the Autonomous Community of Madrid. Using an anonymous questionnaire, they were asked about tobacco, alcohol and drug consumption, as well as the influence of the environment, friends, and family in the beginning. To compare with previous studies. ResultsA total of 740 valid questionnaires were collected, of which 430 (58.1%) were female, an overall mean age of 16.57±0.61 years, and 53 (7.18%) were smokers. The majority 39 (78%) of smokers acknowledged their friends’ influence at its onset. Alcohol was consumed by 349 (47.48%) and other drugs by 109 (15.27%). Being a smoker was related to alcohol, other drugs, a smoking mother, smoking siblings and smoking friends. ConclusionsSmoking prevalence among students of BE in Autonomous Community of Madrid continues to be lower than the prevalence of adolescents of their age and there are no variations from previous reports. Starting smoking is related to smoking by friends, siblings, and the mother and with the consumption of alcohol and other substances.Education is very important in the beginning and prevention of smoking, and it is necessary to implement prevention programs at early ages in order to promote their effectiveness, and aimed at young people, parents and teachers.

Smoking behaviour after enforcement of a 100% tax on tobacco products in Saudi Arabia: a cross-sectional study.

Raising the prices of cigarettes is a common intervention to control tobacco use. In June 2017, Saudi Arabia imposed a 100% excise tax on tobacco products and energy drinks. This study aimed to evaluate the impact of the increase in prices on tobacco products and the resulting cigarette smoking behaviour in Jeddah, Saudi Arabia before and after the increase in tobacco product prices. This cross-sectional study was conducted between December 2017 and March 2018 in Saudi Arabian smokers aged 18 years and more. A validated questionnaire was distributed to a convenience sample in public places and through Twitter. The McNemar matched pairs chi-squared test was used to evaluate the self-reported difference in cigarette smoking before and after the tax came into effect. Binary logistic regression analysis was done to identify the socioeconomic and health factors associated with stopping smoking. In all, 376 participants (80.0% men) completed the questionnaire. A large proportion of the participants (39.6%) reported no change in their smoking behaviour after the tax was imposed, whereas 29.8% switched to cheaper brands. Before the tax, 154 participants smoked 15 cigarettes or more a day; this figure decreased to 134 after the tax (McNemar test, P < 0.001). Respondents who were married, unemployed, had a higher income or who rated their health as fair were significantly more likely to have stopped smoking after the tax. The sharp increase in cigarette prices in Saudi Arabia has led to a statistically significant reduction in smoking. Future research should assess the long-term effects of this intervention on smoking onset, prevalence and relapse.

Prevencija upotrebe duvana među mladima

For majority of smokers, onset of smoking occurs during adolescence, period of intensive growth and development, and this early smoking initiation is associated with many adverse health effects. Smoking prevention measures include not only prevention of onset, but also prevention of transition from experimentation to chronic tobacco use and dependence and smoking cessation. Effective preventive measures should be based on relevant theory and scientific evidence on behavior determinants. In this review article, we present evidence from researches on effectiveness of school programs, community-based programs, media campaigns and stress the importance of considering new challenges in tobacco control and other promising strategies, as well as the need for early detection of nicotine dependence signs among adolescents. In practice, many preventive measures are not based on theory and some interventions can be contra productive. Regardless of type of intervention and setting in which is implemented, it is of importance to take into account context for its implementation.

Targeting cognitive and emotional regulatory skills for smoking prevention in low-SES youth: A randomized trial of mindfulness and working memory interventions

Research to date provides striking evidence that youth from low socio-economic status (SES) households are at an increased risk for smoking. Converging evidence from developmental studies, psychopathology studies, intervention studies, and basic research on self-control abilities have identified working memory and distress tolerance as potential crucial modifiable risk factors to prevent smoking onset in this cohort. To confirm the value of these mechanistic targets, this randomized trial was designed to evaluate the influence of working memory and distress tolerance interventions on risk of smoking initiation. Recruiting primarily from low-income community afternoon programs, we randomized 93 adolescents to one of three intervention conditions, all of which were a prelude to a smoking-prevention informational intervention: (1) a working memory intervention, (2) a mindfulness training intervention to target distress tolerance, and (3) a wellness-focused control condition. Despite a number of adherence efforts, engagement in treatment was limited, and under these conditions no significant evidence was found either for differential efficacy for smoking prevention or for intervention effects on mechanistic targets. However, working memory capacity and distress tolerance were found to be negatively related to smoking propensity. As such, our mechanistic targets—working memory and distress tolerance--may well be processes undergirding smoking, despite the fact that our interventions did not adequately engage these targets.

E-cigarette use and onset of first cigarette smoking among adolescents: An empirical test of the 'common liability' theory.

Background: E-cigarettes have become the most commonly used tobacco products among youth in the United States (US) recently. It is not clear whether there is a causal relationship between e-cigarette use and the onset of cigarette smoking. The "common liability" theory postulates that the association between e-cigarette use and cigarette smoking can be attributed to a common risk construct of using tobacco products. This study aims to investigate the relationship between ever e-cigarette use and cigarette smoking onset in the US using a structural equation modeling approach guided by the "common liability" theory. Methods: The study population is non-institutionalized civilian adolescents living in the US, sampled in the longitudinal Population Assessment of Tobacco and Health study. Information about tobacco product use was obtained via confidential self-report. A structural equation modeling approach was used to estimate the relationship between e-cigarette use at wave 1 and the onset of cigarette smoking at wave 2 after controlling for a latent construct representing a "common liability to use tobacco products." Results: After controlling for a latent construct representing a "common liability to use tobacco products", ever e-cigarette use does not predict the onset of cigarette smoking (β=0.10, 95% CI= -0.09, 0.29, p=0.299). The latent "common liability to use tobacco products" is a robust predictor for the onset of cigarette smoking (β=0.42; 95% CI=0.08, 0.76; p=0.015). Conclusions: Findings from this study provide supportive evidence for the 'common liability' underlying observed associations between e-cigarette use and smoking onset.

How Raising Tobacco Prices Affects the Decision to Start and Quit Smoking: Evidence from Argentina.

We used a two-part model for the estimation of the price elasticity of participation and consumption of cigarettes by the duration of the smoking habit and a continuous-time split-population model for the estimation of prevalence and duration of smoking onset and smoking addiction, allowing for covariates in the participation component of the model. Results: We computed the total price elasticity of consumption of cigarettes by quartiles of addiction and found that for the people located in the lowest quartile of addiction the total price elasticity is around −0.51; while for those located in the highest quartile of addiction this figure is only −0.19. Then, a 10% increase in cigarette prices, via taxes, reduces the consumption of those in the early stages of the addiction by 5% and for those with a longer history of addiction by only 1.9%. Estimating the continuous-time split-population model we found that, at the mean starting age of 15 years, an increase of 10% in real cigarette prices is expected to delay smoking onset by almost two and a half years. On the other hand, the same policy is less effective to reduce the duration of the habit because there is no meaningful relationship between the duration of the smoking habit and the real price of cigarettes.The policy of raising cigarette excise taxes, to increment prices, seems to be more effective to delay smoking onset. On the other hand, the same policy is less effective to reduce the duration of the habit. A policy recommendation that emerges from this evidence is that for people with a developed addiction a combination of increasing taxes and other public health policies, like cessation therapies, could prove more effective.

Decreased serum calcium levels and negative correlation with degree of nicotine dependence in heavy smokers

ABSTRACTIntroduction: The objective of the present study was to investigate the influence of cigarette smoking on serum and cerebrospinal fluid (CSF) calcium levels in Chinese heavy smokers.Methods: One hundred and sixty-seven male subjects were divided into non-smokers (95) and heavy smokers (72). Serum and CSF calcium concentrations were assayed. Smoking status was recorded and the degree of nicotine dependence (FNTD) was assessed by questionnaire. Analysis of variance was performed to assess the differences among dichotomous groups. Partial correlations between calcium level and FNTD scores were calculated.Results: In this population-based study, heavy smokers had significantly lower serum calcium levels than did non-smokers (p < .01). There was no difference in CSF calcium levels between heavy smokers and non-smokers. The average number of cigarettes smoked per day contributed to the decreased serum calcium levels in heavy smokers, while the age of smoking onset and smoking years did not affect serum levels within the smoker group. Furthermore, serum calcium levels negatively correlated with FNTD items 1, 4, 5, 6 and total scores; however, no correlation between CSF calcium levels and FNTD scores was found.Conclusions: Serum calcium levels decreased significantly in Chinese heavy smokers and were associated with the average number of cigarettes smoked per day and the degree of nicotine dependence in heavy smokers.

Effects of Prices on Youth Cigarette Smoking and Tobacco Use Initiation in Ghana and Nigeria.

Background: Population growth in the African region is set to outpace the rate of decline in smoking prevalence, leading to a projected increase in the total number of smokers. As most tobacco users initiate during their adolescent years, tobacco prevention strategies targeting youth will be particularly important. Methods: This study estimated the impact of cigarette prices on youth cigarette smoking and tobacco use initiation in Ghana and Nigeria using the Global Youth Tobacco Survey data. First, we used cross-section data and logit models to estimate the effects of prices on youth cigarette smoking. Second, we created pseudo longitudinal data and used continuous-time hazard models to evaluate the impact of cigarette prices on tobacco use initiation. Results: We found that higher cigarette prices decreased both 30-day cigarette smoking and tobacco use onset significantly in both Ghana and Nigeria. Additionally, the price elasticity of cigarette smoking and tobacco use initiation ranged from −0.44 to −1.13, and −1.04 to −3.66, respectively. Conclusions: As one of the first studies on youth tobacco consumption in Sub-Saharan Africa, this study strongly suggests that policies that increase real cigarette prices can lower both cigarette smoking and tobacco use initiation among youth in Ghana and Nigeria.

The impact of tobacco control policies on smoking initiation in eleven European countries

We investigate the effect of tobacco control policies on smoking initiation in eleven European countries. Based on individual data about age of onset of smoking, we use hazard rate models to study smoking initiation. Thus, we are able to take into account observed and unobserved personal characteristics as well as the effect of the introduction of a variety of tobacco control policies including price and and non-price policies, i.e., bans on tobacco advertisements, smoke-free air regulation, health warnings on packages of cigarettes, and treatment programs to help smokers quit smoking. We find that higher tobacco prices have a negative effect on the initiation into smoking for males but not for females. We find no effect of non-price tobacco control policies on smoking initiation.

Educational Differences in Smoking: Selection Versus Causation

Abstract We investigate sources of educational differences in smoking. Using a large German data set containing retrospective information on the age at smoking onset, we compare age-specific hazard rates of starting smoking between (future) low and high educated individuals. We find that up to 90 % of the educational differences in smoking develop before the age of 16, i. e. before compulsory schooling is completed. This education gap persists into adulthood. Further, we examine the role of health-related knowledge (proxied by working in health-related occupations) and find it hardly explains smoking decisions. Our findings suggest that (unobserved) factors determining both the selection into smoking and education are almost exclusively responsible for educational differences in smoking. Only small parts of the education gap seem to be caused by general or health-specific education. The effectiveness of education policy to combat smoking is thus likely limited.

Social Determinants of Health and their influence on the choice of birth control methods.

To verify the association between Social Determinants of Health and birth control methods used by women of childbearing age. Documentary and retrospective study, performed at a Brazilian Natural Birth Center with evaluation of the medical records of patients seen between 2003 and 2011 (n=2410). Data were collected on identification and general history, gynecological, sexual and obstetric. Hormone birth control methods were the most used among participants (25.0%); followed by barrier methods (21.5%) and surgical methods (19.3%). Statistical associations were observed regarding age, menarche, onset of sexual activity, pregnancy, miscarriage, smoking, hypertension, marital status, gynecological care and schooling with the choice of methods. The results confirm the importance of studies involving Social Determinants of Health, since they interfere in the way women choose birth control methods and the risks that this choice may pose to their health.

Adverse childhood events and risk of diabetes onset in the 1979 National longitudinal survey of youth cohort

BackgroundType 2 diabetes is a major public health problem with considerable personal and societal costs. Adverse childhood experiences (ACE) are associated with a number of serious and chronic health problems in adulthood, but these experiences have not been adequately studied in relation to diabetes in a US national sample. The association between ACE and poor health can be partially explained by greater risky health behaviors (RHB) such as smoking, heavy alcohol use, or obesity. Few studies have examined ACE in relation to adult onset Type 2 diabetes mellitus (T2DM) taking into account the role of RHB. Using longitudinal data from a representative US population sample followed over 30 years, this study examines the impact of ACE on the risk of diabetes onset.MethodsData from the 1982 to 2012 waves of the 1979 National Longitudinal Survey of Youth were analyzed, spanning ages 14 to 56. Bivariate and discrete-time survival models were used to assess the relationships between ACE and RHB including smoking, alcohol use, and obesity, and subsequent onset of diabetes.ResultsT2DM was reported by almost 10% of participants. Over 30% of women and 21% of men reported 2+ ACE events. Women reporting 2–3 or 4+ ACE events were more likely to develop diabetes with the mean number of ACE events being greater in those with diabetes compared to without (1.28 vs.1.05, p < .0001). For men there was no significant association between ACE and diabetes onset. For women, ACE was associated with heavy drinking, current smoking, and obesity. For men, ACE was associated with being underweight and daily smoking. In multivariate discrete-time survival models, each additional ACE increased risk of T2DM onset (ORadj = 1.14; 95% CI 1.02–1.26) for women but not for men. The relationship in women was attenuated when controlling for body mass index (BMI).ConclusionACE predicted diabetes onset among women, though this relationship was attenuated when controlling for BMI. Being overweight or obese was significantly more common among women with a history of ACE, which suggests BMI may be on the pathway from ACE to diabetes onset for women.

E-Cigarette Use and Onset of First Cigarette Smoking among Adolescents: An Empirical Test of the ‘Common Liability’ Theory

Background: E-cigarettes have become the most commonly used tobacco products among youth in the United States (US) recently. It is not clear whether there is a causal relationship between e-cigarette use and the onset of cigarette smoking. The “common liability” theory postulates that the association between e-cigarette use and cigarette smoking can be attributed to a common risk construct of using tobacco products. The aim of this study is to investigate the relationship between ever use of e-cigarette and the onset of cigarette smoking in the US using a structural equation modeling approach guided by the “common liability” theory. Methods: The study population is non-institutionalized civilian adolescents 12-17 years of age living in the US, sampled in the longitudinal Population Assessment of Tobacco and Health (PATH) study. Information about tobacco product use, including e-cigarette use and cigarette smoking, was obtained via confidential self-report. A structural equation modeling approach was used to estimate the relationship between e-cigarette use at wave 1 and the onset of cigarette smoking at wave 2 after controlling for a latent construct representing a “common liability to use tobacco products.” Results: After controlling for a latent construct representing a “common liability to use tobacco products”, ever use of e-cigarette at wave 1 does not predict the onset of cigarette smoking at wave 2 (β=0.10, 95% CI= -0.09, 0.29, p=0.299). The latent “common liability to use tobacco products” is a robust predictor for the onset of cigarette smoking (β=0.42; 95% CI=0.08, 0.76; p=0.015). Conclusions: Findings from this study provide supportive evidence for the ‘common liability’ theory underlying observed associations between e-cigarette use and smoking onset.

SUN-250 CIGARETTE SMOKING INFLUENCE THE NEW-ONSET OF CHRONIC KIDNEY DISEASE: IKI EPIDEMIOLOGICAL STUDY OF ARTHEROSCLEROSIS AND CHRONIC KIDNEY DISEASE (ISSA-CKD) RETROSPECTIVE PHASE

In patients with chronic kidney disease (CKD), cigarette smoking increases the incidence of heart failure, peripheral vascular disease, progression of CKD and death. However, it is still unclear whether smoking influences new-onset of CKD in population without CKD. The aim of this study is to verify how smoking influence the new-onset of CKD in Japanese adults. ISSA-CKD retrospective phase is a retrospective cohort study using annual health checkup data in Iki Island (Nagasaki, Japan), which is located in the north of Nagasaki prefecture and has approximately 27,000 residents. The morbidity is one of the highest levels in Japan. From 2008 to 2016, a total of 7645 residents visited annual health check-ups conducted. After excluding residents who visited only 1 health check-up or with CKD at baseline, a total of 4,559 adults were included in the present analysis. Smoking status was obtained by a questionnaire, which classified them into current smoker and non-smoker (including ex-smoker). The outcome of the present analysis was new-onset of CKD, which was defined as estimated glomerular filtration rate <60mL/min/1.73m2 or proteinuria at the end of follow-up. Effects of smoking on development of CKD were evaluated using a Cox’s proportional hazards model. During a mean follow-up of 4.7 years, 744 (16.3%) new-onset CKD were observed. This association of smoking remained significant (hazard ratio 1.24; 95%CI 1.02-1.51, p=0.027) even after adjustment for other risk factors (sex, age, obese, hypertension, dyslipidemia, hyperuricemia, and diabetes mellitus) as well as age, obese, hypertension, hyperuricemia, and diabetes mellitus. Tabled 1Table. Effects of each values on incidence of new-onset chronic kidney disease (n=4559)variableHazard RatioP value95% Confidence Intervalsex0.9760.7770.823-1.156age1.0990.0011.083-1.113obese1.1950.0231.025-1.393smoking1.2450.0271.024-1.512hypertension1.2780.0021.094-1.493dyslipidemia0.9110.2280.784-1.060hyperuremia1.6170.0011.233-2.120diabetes mellitus1.4510.0031.131-1.861 Open table in a new tab The findings of the present analysis support that current cigarette smoking increases the risk of new-onset of CKD in Japanese population. In the future, we attempt to perform prospective study to clarify the relationship between smoking and CKD onset.

Association of Tobacco Control Policies With Youth Smoking Onset in Chile

Tobacco smoking is still responsible for more than 6 million preventable deaths annually, most of which occur in low- and middle-income countries. South American countries, Chile in particular, endure some of the highest cigarette smoking prevalence rates globally. Despite the lack of any meaningful increases in cigarette taxes (the most effective tobacco control measure) between 1999 and 2014, cigarette prices in Chile increased sharply almost entirely driven by British American Tobacco (BAT). To examine the associations between cigarette prices and nonprice tobacco control policies targeted at youth introduced in 2006 (Law 20105) and smoking onset among Chilean youths. This study used data from 8 waves of a large national school survey of urban communities in Chile conducted between October and December in 2001, 2003, 2015, 2007, 2009, 2011, 2013, and 2015 and discrete-time hazard models. Data analysis was performed from May 2017 to January 2019. Prices, advertising, and retail restrictions. Smoking onset (the transition between never smoking and smoking) in youth. In this study of 181 624 survey respondents in 8751 Chilean secondary schools, higher prices (own-price elasticity [percentage change in quantity demanded in response to a 1% change in price], -0.40; 95% CI, -0.45 to -0.36) and the tobacco control policies enacted in 2006 (hazard ratio, 0.83; 95% CI, 0.81-0.85) were associated with lower hazards of starting smoking. The study found that an increase in real prices of 58.6% and the introduction of Law 20105 were associated with similar lower hazards of starting smoking (hazard ratio, 0.83; 95% CI, 0.81-0.85); in comparison, between 1999 and 2017, inflation-adjusted cigarette prices increased by 206%. The findings suggest that higher prices initiated by BAT and the tobacco control policies enacted by the Ministry of Health in 2006 were associated with lower hazards of starting smoking in Chilean youth. Large cigarette tax increases may be a strategy that can be used to help reduce smoking among youths in Chile.

Early smoking-onset age and risk of cardiovascular disease and mortality

Early smoking onset age (SOA) is a public health concern with scant empirical evidence of its role in health outcomes. The study had two aims: i) to assess whether an early SOA was associated with the risk of fatal and non-fatal CVD and all-cause and CVD mortality and ii) to explore the linear and non-linear association between SOA and the outcomes of interest. Data from 4499 current or former smokers, recruited from 1995 to 2005, aged 25 to 79 years, and with a median 7.02 years of follow-up, were obtained from the REGICOR population-based cohort. In the present analysis, performed in 2018, the independent variable was SOA and the dependent variables were CVD events, CVD mortality, and all-cause mortality. Penalized smoothing spline methods were used to assess the linear and non-linear association. During follow-up, 361 deaths and 210 CVD events were recorded. A significant non-linear component was identified in the association between SOA and CVD outcomes with a cut-off point at 12 years: In the group aged ≤12 years, each year of delay in SOA was inversely associated with CVD risk (HR = 0.71; 95%CI = 0.53–0.96) and CVD mortality (HR = 0.58; 95%CI = 0.37–0.90). No association was observed in the older SOA group. A linear association was observed between SOA and all-cause mortality, and each year of delay was associated with 4% lower risk of mortality (HR = 0.96; 95%CI = 0.93–0.98). The associations were adjusted for lifelong exposure to tobacco and cardiovascular risk factors. These results reinforce the value of preventing tobacco use among teenagers and adolescents.