High School Students United States Research Articles

Disposable e-cigarette use: Factors, frequency and cigarette smoking among United States high school students.

Disposable e-cigarette use has increased among United States (US)high school students in recent years. However, there is limited research on the profile of these users, how often they use these products, and whether they displace cigarette smoking. This study aimed to measure how disposable e-cigarette use among US youth varies according to demographic characteristics and whether there is any association between e-cigarette use and reduced use of traditional cigarettes. We used cross-sectional data from the 2022 National Youth Tobacco Survey and conducted a multinomial logistic regression to examine factors associated with the types of e-cigarette devices used in the prior 30 days, adjusting for sex, sexual identity, grade level and race/ethnicity. We also used a finite mixture model to account for unobserved differences among users and identify e-cigarette use patterns in different subgroups of users. United States. High school students in grades 9-12 (n = 14 389). Survey participants self-reported the type of e-cigarette device used, the frequency of e-cigarettes used and cigarettes smoked over the past 30 days. Disposable e-cigarettes were the most popular e-cigarette type. Sex, sexual orientation, grade level and race/ethnicity were associated with disposable e-cigarette use. The odds of disposable e-cigarette use were lower in male students than in female students (odds ratio [OR] = 0.78, 95% confidence interval [CI] = [0.64-0.96]), and higher in students who identified as gay or lesbian (OR = 1.70, 95% CI = [1.11-2.61]) or bisexual (OR = 1.52, 95% CI = [1.16-1.99]) than in heterosexual students. The odds of disposable use were higher among students in higher grades (10th, 11th and 12th) than in 9th graders (OR = 1.71, 2.24 and 2.52, respectively). Disposable e-cigarette users had a lower frequency of traditional cigarette use than other e-cigarette users, both in the low-frequency class (incidence rate ratio [IRR] = 0.33, 95% CI = [0.12-0.92]) and the high-frequency class (IRR = 0.27, 95% CI = [0.08-0.92]). Disposable e-cigarette use appears to be higher among United States high school students who are female, older and/or identify as gay, lesbian or bisexual. Disposable e-cigarettes appear to be associated with reduced traditional cigarette use.

Disposable e-cigarette use: Factors, frequency and cigarette smoking among United States high school students.

Disposable e-cigarette use has increased among United States (US)high school students in recent years. However, there is limited research on the profile of these users, how often they use these products, and whether they displace cigarette smoking. This study aimed to measure how disposable e-cigarette use among US youth varies according to demographic characteristics and whether there is any association between e-cigarette use and reduced use of traditional cigarettes. We used cross-sectional data from the 2022 National Youth Tobacco Survey and conducted a multinomial logistic regression to examine factors associated with the types of e-cigarette devices used in the prior 30 days, adjusting for sex, sexual identity, grade level and race/ethnicity. We also used a finite mixture model to account for unobserved differences among users and identify e-cigarette use patterns in different subgroups of users. United States. High school students in grades 9-12 (n = 14 389). Survey participants self-reported the type of e-cigarette device used, the frequency of e-cigarettes used and cigarettes smoked over the past 30 days. Disposable e-cigarettes were the most popular e-cigarette type. Sex, sexual orientation, grade level and race/ethnicity were associated with disposable e-cigarette use. The odds of disposable e-cigarette use were lower in male students than in female students (odds ratio [OR] = 0.78, 95% confidence interval [CI] = [0.64-0.96]), and higher in students who identified as gay or lesbian (OR = 1.70, 95% CI = [1.11-2.61]) or bisexual (OR = 1.52, 95% CI = [1.16-1.99]) than in heterosexual students. The odds of disposable use were higher among students in higher grades (10th, 11th and 12th) than in 9th graders (OR = 1.71, 2.24 and 2.52, respectively). Disposable e-cigarette users had a lower frequency of traditional cigarette use than other e-cigarette users, both in the low-frequency class (incidence rate ratio [IRR] = 0.33, 95% CI = [0.12-0.92]) and the high-frequency class (IRR = 0.27, 95% CI = [0.08-0.92]). Disposable e-cigarette use appears to be higher among United States high school students who are female, older and/or identify as gay, lesbian or bisexual. Disposable e-cigarettes appear to be associated with reduced traditional cigarette use.

Current United States High School Students’ Perceptions of Pathology Professions as Determined by Pathology Outreach Program Survey Results

Abstract Introduction/Objective There is a current pathologist shortage in the United States (US) exacerbated by both a retiring population of aging pathologists and limited medical student exposure to formal pathology and clinical laboratory medicine training. This is supported by data from the National Residency Match Program (NRMP) between 2000 to 2019, which shows a “40% decrease in the number of American medical school graduates applying to pathology residency programs”. This limited exposure to pathology has led to a shortage of other lab professionals, too, and has affected more than just medical students. Both undergraduates and high school students have little access to literature discussing the perceptions of pathology professions, which impacts their abilities to consider pathology as a possible future career. Understanding these recent trends, Pathology Outreach Program (POP) was established in 2018 to determine current US high school students' perceptions of pathology and raise awareness towards the importance of careers in lab medicine via interactive PowerPoint sessions. Methods/Case Report Before sessions, an online Google Forms (“pre-course”) survey was distributed which students could voluntarily and anonymously complete. Results (if a Case Study enter NA) From February 2018 to May 2022, 162 high school students completed the pre- course survey (n=162) in Chicagoland and Michigan Schools. Although 130 students (80.2%) stated they were inclined towards a career in medicine/healthcare and 112 students (69.1%) had admitted to being aware of the pathology field, only 18 students (11.1%) stated “Yes” when asked if they understood the roles of pathologists. Furthermore, 127 students (78.4%) reported they were uninformed to the career pathways of a pathologist or pathology-related professional, and 142 (87.7%) reported not ever meeting a pathologist before. Conclusion This data suggests inadequate current US high school student accessibility to pathology professions and supports the continual need for pathology outreach initiatives like POP in increasing pathology exposure to high school students.

Trends in Passenger Seat Belt Use Among High School Students—United States, 1991–2019

PurposeDespite having the highest risk per miles driven for motor vehicle crash involvement, only 57% of US high school students reported always using a seat belt when riding in a car with another driver in 2019. MethodsData from the national Youth Risk Behavior Surveys conducted biennially from 1991 to 2019 were used to assess trends in seat belt use. Modified Poisson regression with robust variance estimates and linear splines was used to examine seat belt use trend changes overall and by gender, race/ethnicity, and grade. ResultsFrom 1991 to 2015, seat belt use was about 3.3% higher each survey cycle compared with the previous survey cycle, adjusting for gender, race/ethnicity, and age. After 2015, seat belt use was about 1.8% lower each survey cycle than the previous survey cycle, adjusting for the same covariates. DiscussionNew and effective strategies should be considered for promoting consistent seat belt use among US high school students.

The Type of Substance Use Mediates the Difference in the Odds of Sexual Risk Behaviors Among Adolescents of the United States.

BackgroundAlthough the relationship between sexual risk behaviors and substance use has been established, It remains to be studied if different types of substances have differences in the odds of sexual risk behaviors. Therefore, we aimed to identify the prevalence of sexual risk behaviors in high school students of the United States (US) and study the difference in the odds of sexual risk behaviors for various substances.MethodsWe performed a retrospective cross-sectional study using Youth Risk Behavior Surveillance System (YRBSS) data of 2019 that nationally represents US high school students in grades 9-12. We identified individuals with sexual risk behaviors as participants with four or more lifetime sexual partners and who did not use a condom during the last intercourse.ResultsOut of 11,191 participants, 463 (3.9%) engaged in sexual risk behaviors. The prevalence of substance use, including anabolic steroids (11.5 vs. 1.1%), cocaine (27.2 vs. 2.0%), marijuana (87.1 vs. 34.7%), alcohol (92.4 vs. 54.3%), e-cigarette (90.3 vs. 48.0%), and traditional cigarette (62.2 vs. 21.6%) was higher in participants with sexual risk behaviors compared to participants with no sexual risk behaviors (p<0.0001 for all substances). In regression analysis, anabolic steroid use was associated with the highest odds of sexual risk behaviors (adjusted odds ratio (aOR):4.87, 95%CI: 2.48-9.57; p<0.0001) followed by cocaine (aOR:3.80, 1.80-8.00; p=0.001), marijuana (aOR:3.36, 1.64-6.89; p<0.0001), alcohol (aOR:2.41, 1.05-5.55; p=0.039), electronic vapor products (2.05, 1.004-4.19; p=0.049), and traditional cigarette use (aOR:1.58, 1.10-2.28; p=0.016). We did not find a statistically significant increase in the odds of sexual risk behaviors for the rest of the substances.ConclusionAlthough the prevalence of sexual risk behaviors is low, the prevalence of substance use is significantly higher in participants with sexual risk behaviors. Among the different types of substances, anabolic steroid use has the highest odds of sexual risk behaviors. Therefore, clinicians should remain vigilant for anabolic steroid use when screening adolescents for substance use. Further large-scale randomized studies are needed to study the effects of anabolic steroids on sexual risk behaviors.

E-cigarette exposures, respiratory tract infections, and impaired innate immunity: a narrative review.

Electronic cigarettes (e-cigarettes) are commonly used devices by adolescents and young adults. Since their introduction, the popularity of e-cigarettes has increased significantly with close to twenty percent of United States high school students reporting current use in 2020. As the number of e-cigarette users has increased, so have reports of vaping related health complications. Overall, respiratory tract infections remain one of the top ten leading causes of death in the US for every age group. Specific to the pediatric population, lower respiratory tract infections are the leading cause for hospitalization. This review highlights the current evidence behind e-cigarette exposure and its association with impaired innate immune function and the risk of lower respiratory tract infections. To date, various preclinical models have evaluated the direct effects of e-cigarette exposure on the innate immune system. More specifically, e-cigarette exposure impairs certain cell types of the innate immune system including the airway epithelium, lung macrophage and neutrophils. Identified effects of e-cigarette exposure common to the lung’s innate immunity include abnormal mucus composition, reduced epithelial barrier function, impaired phagocytosis and elevated systemic markers of inflammation. These identified impairments in the lung’s innate immunity have been shown to increase adhesion of certain bacteria and fungi as well as to increase virulence of common respiratory pathogens such as influenza virus, Staphylococcus aureus or Streptococcus pneumoniae. Information summarized in this review will provide guidance to healthcare providers, policy advocates and researchers for making informed decisions regarding the associated respiratory health risks of e-cigarette use in pediatric and young adults.

Differential Decline in Illicit Drug Use by Sexual Identity Among United States High School Students, 2005-2017.

Purpose: Adolescent drug use remains a significant public health concern. Sexual minority youth (SMY) are at elevated risk for illicit drug use compared with their heterosexual peers. We investigated this pattern at the national level, exploring whether trends and disparities in drug use vary over time and by sexual identity. Methods: This study used Youth Risk Behavior Survey (YRBS) data, which were collected at seven time points from 2005 to 2017. Trends and disparities over time in the use of five drugs, as well as any drug use, were analyzed by self-reported sexual identity. Results: The results demonstrated a general decrease in drug use behaviors from 2005 to 2017. The greatest number of significant decreases was among heterosexual and bisexual students; the fewest were among gay and lesbian students. Disparities between heterosexual youth and SMY persisted across years, and were greater for gay and lesbian students in 2017 than for bisexual and not-sure youth. Conclusions: Our results represent the most comprehensive analysis of recent trends in drug use by sexual identity to date. Disparities in drug use remained significant despite overall downward trends within our sample. The significant decreases among bisexual students are not readily explained. We emphasize the need for ongoing research in this area, particularly given the currently volatile social position of sexual minority populations in the United States, and for culturally responsive and trauma-informed responses to SMY drug use.

103. Trends in Sexual Risk Behaviors by Contraceptive Type Among High School Students—United States, 2007-2017

Increasing use of highly and moderately effective contraception has contributed to consistent declines in unintended pregnancies among young people. However, such methods do not prevent sexually transmitted diseases (STDs). To assess STD risk among adolescent users of highly and moderately effective contraception relative to other adolescents, we examine 10-year trends in sexual risk behaviors by contraceptive type among U.S. high school students.

Experts Call For More Action to Thwart Youth Vaping ‘Epidemic’

Experts Call For More Action to Thwart Youth Vaping ‘Epidemic’

Prevalence and Correlates of Missing Meals Among High School Students-United States, 2010.

To determine the prevalence and correlates of missing meals among adolescents. The 2010 National Youth Physical Activity and Nutrition Study, a cross-sectional study. School based. A nationally representative sample of 11 429 high school students. Breakfast, lunch, and dinner consumption; demographics; measured and perceived weight status; physical activity and sedentary behaviors; and fruit, vegetable, milk, sugar-sweetened beverage, and fast-food intake. Prevalence estimates for missing breakfast, lunch, or dinner on ≥1 day during the past 7 days were calculated. Associations between demographics and missing meals were tested. Associations of lifestyle and dietary behaviors with missing meals were examined using logistic regression controlling for sex, race/ethnicity, and grade. In 2010, 63.1% of students missed breakfast, 38.2% missed lunch, and 23.3% missed dinner; the prevalence was highest among female and non-Hispanic black students. Being overweight/obese, perceiving oneself to be overweight, and video game/computer use were associated with increased risk of missing meals. Physical activity behaviors were associated with reduced risk of missing meals. Students who missed breakfast were less likely to eat fruits and vegetables and more likely to consume sugar-sweetened beverages and fast food. Breakfast was the most frequently missed meal, and missing breakfast was associated with the greatest number of less healthy dietary practices. Intervention and education efforts might prioritize breakfast consumption.

AMA Recommends Schools Start Later To Improve Teen Sleep

AMA Recommends Schools Start Later To Improve Teen Sleep

Active Gaming Among High School Students--United States, 2010.

Our study is the first to describe the prevalence and correlates (demographics, body mass index [BMI], sedentary behaviors, and physical activity) of high school youth who report active videogame playing (active gaming) in a U.S. representative sample. The National Youth Physical Activity and Nutrition Study of 2010 provided data for this study. Active gaming was assessed as the number of days in the 7 days prior to the survey that students in grades 9-12 (14-18 years of age) reported participating in active videogames (e.g., "Wii™ Fit" [Nintendo, Kyoto, Japan], "Dance Dance Revolution" [Konami, Osaka, Japan]). Students reporting ≥1 days were classified as active gamers. Logistic regression was used to examine the association among active gaming and demographic characteristics, BMI, sedentary behaviors, and physical activity. Among 9125 U.S. high school students in grades 9-12 surveyed, 39.9 percent (95 percent confidence interval=37.9 percent, 42.0 percent) reported active gaming. Adjusting for covariates, the following characteristics were positively associated (P<0.05) with active gaming: being in 9th and 10th grades compared with being in 12th grade; being of black, non-Hispanic race/ethnicity; being overweight or obese; watching DVDs >0 hours/day; watching TV >0 hours/day; and meeting guidelines for aerobic and muscle-strengthening physical activity. Four out of 10 U.S. high school students report participating in active gaming. Active gamers tend to spend more time watching DVDs or TV, meet guidelines for physical activity, and/or be overweight or obese compared with nonactive gamers. These findings may serve to provide a baseline to track active gaming in U.S. youth and inform interventions that target sedentary behaviors and/or physical activity.

HIV testing among United States high school students at the state and national level, Youth Risk Behavior Survey 2005-2011.

BackgroundHuman immunodeficiency virus (HIV) remains an important public health issue and CDC recommends routine HIV screening for Americans aged 13–64. Adolescents and young adults are disproportionately affected compared to the overall population. We analyzed self-reported HIV testing and related risk behaviors at the state and national level among youths who had sexual intercourse, with a focus on state level differences.MethodsThis study used the state and national Youth Risk Behaviors Surveys 2005–2011. It included a total of 59,793 national-level observations and 39,421 state-level observations of US high school students, of which respectively 28,177 and 13,916 reported ever having sexual intercourse.The outcome of interest was having ever been tested for HIV. The risk behaviors were condom use at last intercourse, number of sexual partners in lifetime, age at first intercourse, ever forced sexual intercourse, and ever illegal injection drug use. Analyses performed included logistic regression and t-test analyses.ResultsHIV testing was positively associated with HIV-related risk behaviors among sexually active high school students. However, HIV testing remained relatively low (22%) between 2005 and 2011, even for those engaging in risk behaviors. Results differed among the only 7 states that monitored HIV testing through YRBS, most commonly with respect to HIV testing and condom use.ConclusionsRoutine HIV testing is critical for early identification of HIV, which was set as a priority in a recent Executive Order. Our data suggest further efforts are needed to achieve widespread uptake of HIV testing among high school students. Furthermore, differences observed across states likely reflect different needs and should be followed up closely by states. Finally, having accurate data that reflects the reality of youths’ lives is crucial for efficient prevention planning. Thus, more states should consider collecting HIV testing data to evaluate uptake of HIV testing among youth.

Drug Use Risk Behavior Co-Occurrence Among United States High School Students

Purpose: Prevalence estimates for drug use health risk behaviors among high school students are widely available, but relatively few studies describe how and to what extent these risk behaviors occur together. Furthermore, little research has examined whether the co-occurrence of health risk behaviors varies by key demographic characteristics such as gender and race/ethnicity. The purpose of this study is to develop prevalence estimates for combinations of co-occurring drug use health risk behaviors among United States high school students, and to investigate demographic differences in co-occurrence. Methods: Survey data from a representative sample of United States high school students (N = 16,410) were analyzed. This research is on four health risk behaviors: tobacco use, alcohol use, marijuana use, and cocaine use. Explicit descriptions of the risk behavior combinations that students engage in are presented, and comparisons are made among gender, grade, and racial/ethnic student groups using chi-squared tests. Results and Conclusions: Study results suggest that most adolescents do not engage in multiple risk behaviors simultaneously and that race, gender, and grade level significantly impact the prevalence of co-occurring risk behaviors.

Exploring Secondary Students' Knowledge and Misconceptions about Influenza: Development, validation, and implementation of a multiple-choice influenza knowledge scale

Understanding infectious diseases such as influenza is an important element of health literacy. We present a fully validated knowledge instrument called the Assessment of Knowledge of Influenza (AKI) and use it to evaluate knowledge of influenza, with a focus on misconceptions, in Midwestern United States high-school students. A two-phase validation process was used. In phase 1, an initial factor structure was calculated based on 205 students of grades 9–12 at a rural school. In phase 2, one- and two-dimensional factor structures were analyzed from the perspectives of classical test theory and the Rasch model using structural equation modeling and principal components analysis (PCA) on Rasch residuals, respectively. Rasch knowledge measures were calculated for 410 students from 6 school districts in the Midwest, and misconceptions were verified through the χ 2 test. Eight items measured knowledge of flu transmission, and seven measured knowledge of flu management. While alpha reliability measures for the subscales were acceptable, Rasch person reliability measures and PCA on residuals advocated for a single-factor scale. Four misconceptions were found, which have not been previously documented in high-school students. The AKI is the first validated influenza knowledge assessment, and can be used by schools and health agencies to provide a quantitative measure of impact of interventions aimed at increasing understanding of influenza. This study also adds significantly to the literature on misconceptions about influenza in high-school students, a necessary step toward strategic development of educational interventions for these students.

Electronic Media and Beverage Intake Among United States High School Students—2010

To describe electronic media exposure and its associations with beverage intake among United States high school students. School-based survey data from a nationally representative sample of 9th- through 12th-grade students from the National Youth Physical Activity and Nutrition Study were analyzed using chi-square and multivariate logistic analyses. On an average school day, 23.5% of students used a computer or played video/computer games ≥ 3 h/d, 28.3% watched television (TV) ≥ 3 h/d, 79.9% had ≥ 3 TVs in the home, 70.2% had a TV in their bedroom, and 41.0% most of the time or always had a TV on while eating dinner at home. Students with high media exposure were more likely to drink sugar-sweetened beverages ≥ 3 times per day and less likely to drink water ≥ 3 times per day and drink ≥ 2 glasses of milk per day. Efforts to reduce sugar-sweetened beverage intake among adolescents may include limiting exposure to electronic media.

Pro-Tobacco Influences and Susceptibility to Smoking Cigarettes Among Middle and High School Students—United States, 2011

Smoking is a leading cause of cancer, and most smokers begin during adolescence. We examined the proportion of adolescents exposed to pro-tobacco advertising and assessed the association between this exposure and susceptibility to smoking. Data from the 2011 National Youth Tobacco Survey were used to calculate the proportion of susceptible middle school (MS) and high school (HS) students exposed to pro-tobacco advertisements through stores, magazines, and the Internet. Following previous work, susceptibility to smoking cigarettes was defined as "never smoked but open to trying cigarettes." In 2011, 81.5% of MS students and 86.9% of HS students were exposed to tobacco advertisements in stores; 48.2% of MS students and 54.0% of HS students were exposed to such advertising in magazines. Exposure to tobacco advertisements on the Internet was similar for MS (40.8%) and HS students (40.2%). Of those surveyed, 22.5% of MS students and 24.2% of HS students were susceptible to trying cigarettes. Exposure to magazine advertising declined from 71.8% in 2000 to 46.1% in 2009 among susceptible MS students; however, exposure increased to 55.4% in 2011. Tobacco advertising seen through the Internet among susceptible HS students increased from 25.9% in 2000 to 44.7% in 2011. Adolescents continue to be exposed to pro-tobacco advertisements. Adolescents susceptible to smoking are more likely to report exposure to pro-tobacco advertisements. In addition to continued monitoring, more effective interventions to eliminate youth exposure to pro-tobacco marketing are needed.

Exploring the impact of knowledge and social environment on influenza prevention and transmission in Midwestern United States high school students

We used data from a convenience sample of 410 Midwestern United States students from six secondary schools to develop parsimonious models for explaining and predicting precautions and illness related to influenza. Scores for knowledge and perceptions were obtained using two-parameter Item Response Theory (IRT) models. Relationships between outcome variables and predictors were verified using Pearson and Spearman correlations, and nested (student within school) fixed effects multinomial logistic regression models were specified from these using Akaike's Information Criterion (AIC). Neural network models were then formulated as classifiers using 10-fold cross validation to predict precautions and illness. Perceived barriers against taking precautions lowered compliance with the CDC recommended preventative practices of vaccination, hand washing quality, and respiratory etiquette. Perceived complications from influenza illness improved social distancing. Knowledge of the influenza illness was a significant predictor for hand washing frequency and respiratory etiquette. Ethnicity and gender had varying effects on precautions and illness severity, as did school-level effects: enrollment size, proficiency on the state's biology end-of-course examination, and use of free or reduced lunch. Neural networks were able to predict illness, hand hygiene, and respiratory etiquette with moderate success. Models presented may prove useful for future development of strategies aimed at mitigation of influenza in high school youths. As more data becomes available, health professionals and educators will have the opportunity to test and refine these models.

Cross community study of mathematics anxiety between the high school students in Illinois USA and Jordan

The purpose ofthe study is to examine whether there are any significant differences in the mathematics anxiety levels between high school students in Jordan and their counterparts in the United States. Another purpose is to examine whether there are gender differences related to mathematics anxiety among high school students ofboth communities. A total of 1,386 high school students in the United States and Jordan participated in main study. This study showed that Jordanian high school students exhibited a significantly higher mathematics anxiety than United States high school students. Furthermore, the study revealed that female high schooLstudents in the United States acquired a significantly higher mathematics anxiety level than males. Another finding of this study was that males in Jordan had a significantly higher leveL of mathematics anxiety than males in the United States. The findings and educational implications ofthe study are discussed in light ofthe cultural difference between the two communities.

Secondhand Smoke Exposure in Cars Among Middle and High School Students—United States, 2000–2009

Exposure to secondhand smoke (SHS) from cigarettes poses a significant health risk to nonsmokers. Among youth, the home is the primary source of SHS. However, little is known about youth exposure to SHS in other nonpublic areas, particularly motor vehicles. Data were obtained from the 2000, 2002, 2004, 2006, and 2009 waves of the National Youth Tobacco Survey, a nationally representative survey of US students in grades 6 to 12. Trends in SHS exposure in a car were assessed across survey years by school level, gender, and race/ethnicity by using binary logistic regression. From 2000 to 2009, the prevalence of SHS exposure in cars declined significantly among both nonsmokers (39.0%-22.8%; trend P < .001) and smokers (82.3%-75.3%; trend P < .001). Among nonsmokers, this decline occurred across all school level, gender, and race/ethnicity subgroups. SHS exposure in cars decreased significantly among US middle and high school students from 2000 to 2009. Nevertheless, in 2009, over one-fifth of nonsmoking students were exposed to SHS in cars. Jurisdictions should expand comprehensive smoke-free policies that prohibit smoking in worksites and public places to also prohibit smoking in motor vehicles occupied by youth.