Young Adults In France Research Articles

How Do Young Adult Drinkers React to Varied Alcohol Warning Formats and Contents? An Exploratory Study in France.

Research on alcohol warnings has increased in the last decade, providing key evidence to governments on warning format and contents. The bulk of this research, however, has been conducted in Anglosphere countries, whereas fewer studies have focused on other countries which have high per capita alcohol consumption, and where the high social acceptability of drinking is liable to affect how people accept and react to prevention measures. Since France has one of the highest per capita alcohol consumption rates in the world according to the World Health Organization (WHO), we therefore explore how young adults in France react to warnings on alcoholic beverage advertisements. We conducted 25 in-depth interviews, in 2017, with 18-25-year-old drinkers in France. Respondents were asked open-ended questions on the perceived impact of various warning contents (i.e., on health risk, social-cost risk, and on short- vs. long-term risk) and formats (text only vs. larger text combined with colored pictograms). Warnings that targeted youth-relevant risks (i.e., road accidents or sexual assault) were considered to be the most meaningful and credible, although warnings communicating longer term risks (i.e., brain, cancer) were also thought to be influential. Less familiar risks, such as marketing manipulation and calorie intake, elicited the most negative reactions. Larger text-and-pictogram warnings were considered to be the most effective format in capturing attention and increasing awareness. Regardless of format and content, however, these warnings were not perceived as effective for decreasing alcohol consumption.

Ischemic stroke in France: are younger women at higher risk than men?

Abstract Introduction Recent studies suggested that younger women were more likely to suffer from an ischemic stroke than men of the same age. Purpose Our aim is to confirm whether younger women in France are more exposed to ischemic strokes. Methods We compared male and female one-year hospitalization numbers for ischemic stroke in different age groups in France. We also used the French population data by sex and similar age group. Chi-square Tests of Homogeneity were used to assess statistical significance of the differences among men and women hospitalization numbers for each age group. Results Women in the age group 15–24 y-o experienced more ischemic strokes than men (151 hospitalizations for women vs 113 for men; p=0,0088). In the 25–34 y-o group, no differences were found between men and women (385 hospitalizations for men vs 370 for women; p=0,3497). In the 35–44 y-o group, women experienced less ischemic strokes than men (906 hospitalizations for women vs 1200 for men; p<0,0001). Women older than 85 y-o also had significantly more hospitalizations than men (15143 vs 6950; p=0,0073). All the other age groups showed a significative male predominance. Conclusion Younger women (15–24 y-o) are at higher risk of ischemic strokes than men of the same age in France. As far as ischemic stroke incidence is rising among young adults in France, an urgent awareness should be raised and further studies should focus on the possible etiologies. Funding Acknowledgement Type of funding sources: None.

From Initiation to Apprenticeship in Taste: A Career-Based Approach to Alcohol Consumption in France

Relying on the (classic interactionist) notion of “career,” this paper attempts to explore the alcohol trajectories of a sample of young adults in France. To reconstruct each career, we conducted 30 in-depth interviews with young adults from 19 to 25 years of age. Three distinct stages were identified. The first consists of trying the product; the second involves experimenting with the physical and sensory effects of drinking; the third sets the person on a course toward diversifying consumption patterns.

Measuring the Child Penalty Early in a Career: The Case of Young Adults in France

There is a large literature on the existence of a child penalty for mothers after the birth of a child. There is little discernible effect on fathers' labour incomes, although some studies find that there is a premium. We measure the penalty due to the birth of a first child for both parents for cohorts of young adults after leaving the educational system. Using an event study approach, this paper contributes to the literature by examining the child penalty in France not only in terms of monthly earnings, but also the employment rate, working hours, hourly earnings, and other outcomes. Using on a rich dataset, we estimate child penalty by educational level and for different cohorts. We find evidence of a significant child penalty for mothers: 23% in monthly earnings overall, rising to 35% for those with secondary education only. For the 2010 cohort, we observe the same level of absolute child penalties for mothers, whereas the relative penalty has narrowed. This is due to a decrease in monthly earnings, and more precisely in employment rate of fathers before and after the birth of the child in the aftermath of the 2008 crisis.

Diverging incidence trends of oral tongue cancer compared to other head and neck cancers in young adults in France.

While head and neck cancer incidence decreased worldwide due to reduced tobacco and alcohol consumption, oral tongue cancer (OTC) incidence has been reported to be increasing in several countries. Our study examines the incidence trends of OTC in France from 1990 to 2018, globally and by age; and compares the incidence trends with the evolution of the incidence of other human papilloma virus-unrelated head and neck squamous cell carcinoma, that is, cancers of the remaining subsites of the oral cavity (RSOCC) and laryngeal cancers for the period 1990 to 2018. World age-standardized incidence rates of oral tongue cancers (C02), cancers of the remaining subsites of the oral cavity (RSOCC, C03-06) and laryngeal cancers (C32) were estimated using the French National Network of Cancer Registries for the period 1990 to 2018. Trends in national incidence rates were estimated from a mixed-effect Poisson model including age and year effects using penalized splines and a district-random effect. In women aged 30 and 40, a significant increase in OTC incidence was observed, while ROSCC showed a nonsignificant incidence decrease. In young men aged 25, a marginally significant increase of OTC incidence years was observed, while incidence rates of RSOCC significantly declined. The results suggest a tendency towards diverging incidence trends for OTC compared to RSOCC and laryngeal cancer in young adults. The observed trends may reflect changes in underlying exposures or emerging exposures not yet identified, and stress the need to further investigate the etiology of oral tongue cancers.

Les itinéraires biographiques des jeunes adultes en France : évolutions des différenciations sociale et sexuée sur longue période

[eng] This paper examines the life courses of young adults in France, the differences between courses according to gender and social background, and their evolution. The study is based on the Sante et itineraire professionnel survey (a survey on health and professional career conducted by DREES and Dares), which provides information about courses between the ages of 14 and 35 for individuals born between 1932 and 1975. A traditional threshold approach is complemented by the use of optimal matching methods. The evidence shows that leaving the parents’ home is more associated with the family sphere than the professional sphere and that the family and professional spheres are not significantly correlated. The impact of social background on life courses has increased since the late 1960s and is more pronounced in the family sphere for women and in the professional sphere for men. Gender differences have decreased. Finally, there is no clear trend towards a de-standardisation of life courses. On the other hand, courses appear to be becoming increasingly complex.

Sustainable food education: what food preparation competences are needed to support vegetable consumption?

Contributing to more sustainable diets is a major challenge for contemporary environmental education. It implies an increase in the share of plant-based foods and of home-cooked meals. Awareness of this is widespread but taking concrete action is not easy. What competences does it call for? To identify them, we proposed an 8-month training course to groups of young adults in France. Their consumption of vegetables and the competences they mobilized were collected at the end of the training and 8 months later. The competences used by the participants with the lowest consumption of vegetables included controlling their food budget, collecting information about processed foods and planning what they would like to eat. The competences used by the participants with the highest consumption included planning meal preparation, being flexible, choosing quality products and mastering the preparation of fresh vegetables. These results are of interest for designing education programmes for sustainable diets.

Anxiety Increases the Willingness to Be Exposed to COVID-19 Risk Among Young Adults in France

The COVID-19 outbreak has generated significant uncertainty about the future, especially for young adults. Health and economic threats, as well as more diffuse concerns about the consequences of COVID-19, can trigger feelings of anxiety, leading individuals to adopt uncertainty-reducing behaviours. We tested whether anxiety was associated with an increase in willingness to be exposed to the risk of COVID-19 infection (WiRE) using an online survey administered to 3,110 French individuals aged between 18 and 35 years old during the lockdown period (April 2020). Overall, 56.5% of the sample declared a positive WiRE. Unemployment was associated with a higher WiRE (+8.2 percentage points (pp); 95% CI +0.9-15.4 pp). One standard deviation increases in income (+1160€) and psychological state anxiety raised the WiRE by +2.7 pp (95% CI: +1.1-4.4 pp) and +3.9 pp (95% CI: +1.6-6.2 pp), respectively. A one standard deviation increase in perceived hospitalisation risk was associated with a -4.1 pp (95% CI: -6.2-2.1 pp) decrease in the WiRE. Overall, our results suggest that both the prospect of economic losses and psychological anxiety can undermine young adults’ adherence to physical distancing recommendations. Public policies targeting young adults must consider both their economic situation and their mental health, and they must use uncertainty-reducing communication strategies.

Prise en charge des pneumothorax chez les fumeurs de cannabis : à propos de trois cas

Cannabis consumption is common among adolescents and young adults in France. In addition to its neurological effect, cannabis smoking can induce severe pulmonary emphysema, even in young patients. When a spontaneous pneumothorax occurs in a cannabis smoker, the possibility of a secondary spontaneous pneumothorax should be considered. This may be of importance as management of secondary spontaneous pneumothorax may differ from the well-codified handling of primary spontaneous pneumothorax. Clinical and radiological data from three young cannabis-using patients with spontaneous pneumothorax were collected. Given the presence of emphysema, they were all considered secondary spontaneous pneumothorax. Two patients underwent surgical treatment, with simple postoperative follow-up in one case and prolonged air leak in the other case. The management of the third patient, exclusively medical, was prolonged and complicated. The presence of emphysema in young cannabis smokers complicates the management of spontaneous pneumothorax. In this context, a first-line surgical intervention may be an option to be considered.

Effect of center practices on the choice of the first dialysis modality for children and young adults.

Peritoneal dialysis (PD) remains the modality of choice in children, but there is no clear evidence to support a better outcome in children treated with PD. We aimed to assess factors that have an impact on the choice of dialysis modality in children and young adults in France and sought to determine the roles of medical factors and center practices. We included all patients aged <20years at the start of renal replacement therapy (RRT), recorded in the French RRT Registry between 2002 and 2013. Hierarchical logistic regression models were used to study the association between the patient/center characteristics and the probability of receiving PD as the first dialysis modality. We included 806 patients starting RRT in 177 centers, 23 of which were specialized pediatric centers. Six hundred and one patients (74.6%) started with hemodialysis (HD), whereas 205 (25.4%) started with PD. A greater probability of PD was found in younger children, whereas starting the treatment in an emergency setting was associated with a low use of PD. We found a significant variability among centers that accounted for 43% of the total variability. The probability of PD was higher in adult centers and was proportional to the rate of PD in the center. Center practices are a major factor in the choice of dialysis modality. This raises concerns about patient and family choices and to what extent doctors may influence the final decision. Further pediatric studies focusing on children's and parents' wishes are needed to provide care as close as possible to patients' and families' expectations.

Food insecurity and mental health problems among a community sample of young adults.

Food insecurity has been found to be related to anxiety and depression; however, the association with other psychiatric disorders, particularly among young adults, is not well known. We examined whether food insecurity is independently associated with four common mental health problems among a community sample of young adults in France. Data are from the TEMPO longitudinal cohort study. In 1991, participants' parents provided information on health and family socioeconomic characteristics. In 2011, participants' (18-35years) reported food insecurity, mental health symptoms, and socioeconomic conditions (n=1214). Mental health problems ascertained included major depressive episode, suicidal ideation, attention deficit and hyperactivity disorder, and substance abuse and/or dependence (nicotine, alcohol and cannabis). Cross-sectional associations between food insecurity and mental health problems were tested using modified Poisson regressions, weighted by inverse probability weights (IPW) of exposure. This makes food insecure and not food insecure participants comparable on all characteristics including socioeconomic factors and past mental health problems. 8.5% of young adults were food insecure. In IPW-controlled analyses, food insecurity was associated with increased levels of depression (RR=2.01, 95% CI 1.01-4.02), suicidal ideation (RR=3.23, 95% CI 1.55-6.75) and substance use problems (RR=1.68, 95% CI 1.15-2.46). Food insecurity co-occurs with depression, suicidal ideation and substance use problems in young adulthood. Our findings suggest that reductions in food insecurity during this important life period may help prevent mental health problems. Policies aiming to alleviate food insecurity should also address individuals' psychiatric problems, to prevent a lifelong vicious circle of poor mental health and low socioeconomic attainment.

Unemployment and Substance Use in Young Adults: Does Educational Attainment Modify the Association?

We studied whether patterns of substance use in relation to unemployment vary depending on educational level. Data come from 1,126 community-based young adults in France (18-35 years of age in 2011) and their parents (TEMPO and GAZEL studies). Tobacco use (≥1 cigarette/day, 22.5% prevalence), nicotine dependence (Fagerström test ≥2, 7.1% prevalence), alcohol use (≥2 units/week, 25.3% prevalence), alcohol abuse (WHO AUDIT ≥7 in women and ≥8 in men, 10.8% prevalence), cannabis use (≥1 time, 16.5% prevalence), and cannabis abuse (CAST ≥2, 5.0% prevalence) were assessed by interview. We conducted logistic regression analyses controlled for inverse probability weights of unemployment, calculated based on demographics, negative life events, health, and juvenile and parental characteristics. Compared to participants who were always employed, those who were unemployed and had no higher education were more likely to smoke tobacco (OR: 2.76, 95% CI: 1.86-4.10), to be nicotine dependent (OR: 5.70, 95% CI: 3.03-10.73), to use cannabis (OR: 2.27, 95% CI: 1.42-3.64), and to abuse cannabis (OR: 3.38, 95% CI: 1.63-7.04). Those who were unemployed and had higher education were especially likely to abuse alcohol (OR: 1.89, 95% CI: 1.16-3.09). Increases in unemployment may impact population levels of substance use, particularly in young adults with low educational attainment.

Work characteristics and suicidal ideation in young adults in France.

Job insecurity, unemployment, and job strain can predict psychological distress and suicide risk. Young people, who are particularly at risk of suicide, may be especially vulnerable to the deterioration of labor market conditions as a result of the current economic crisis in Europe. We aimed to examine the effects of work and employment characteristics on suicidal ideation in a contemporary sample of young adults. Using data from a sample of French young adults surveyed in 2011 (TEMPO study, N = 1,214, 18-37 years old) and their parents who took part in a longitudinal cohort study, we used multiple logistic regression to examine the relationship between job insecurity, lifetime and recent unemployment and suicidal ideation in the past 12 months. Our analyses were adjusted for factors associated with suicidal risk including age, sex, educational attainment, living with a partner, insufficient social support, alcohol abuse, depression and parental history of depression. Five percent of the sample reported suicidal ideation in the preceding 12 months. Controlling for all covariates, the likelihood of suicidal ideation was associated with job insecurity (OR 2.24, 95% CI 1.08-4.63), lifetime unemployment (OR 2.25, 95% CI 1.17-4.29), and recent unemployment (OR 2.10, 95% CI 1.04-4.25). After stratifying by educational attainment, the association between suicidal ideation and job insecurity was particularly notable for participants with low educational attainment (OR 9.28, 95% CI 1.19-72.33). Young adults who have unstable and unfavorable employment characteristics are disproportionately likely to be suicidal, which should be monitored, particularly in times of economic downturn.

Lung Cancer in Patients Under 40 Years: a Prospective Observational Multicenter Study (Groupe Français De Pneumo-Cancérologie (Gfpc) 1001 Study)

ABSTRACT Aim: Lung cancer in patients under 40 years is infrequent and few data are available about the presentation and outcomes of lung cancer in this population. This study aimed to describe the clinical characteristics, the treatments and the outcome of lung cancer occurring in the population of young adults in France. Methods: A prospective observational clinical study was conducted in 37 centers in France. All patients under 40 years diagnosed with lung cancer between November 2010 and December 2013 were enrolled. Results: One hundred and fifty nine patients with lung cancer were included. Intermediate results are currently available for 117 patients. Median age at diagnosis was 38 (20-40). The proportion of men was 58%. Median time between symptoms and diagnosis was 2 months. The distribution of stages I- II, IIIA and IIIB-IV was 9%, 9% and 82% respectively; 66% were diagnosed with metastasis at presentation and the first metastasis site was brain in 47% of patients. Adenocarcinoma was the most common histologic subtype (78%). EGFR screening was performed for 83 patients and 10% of the patients had an activating mutation. Analysis of other driver biomarkers is ongoing. Eighty-four patients (86%) were current or former tobacco smoker with a median of 20 packs -year. Sixty-nine patients (59%) have been exposed to passive smoking essentially in childhood. About half of them (46%) were current or former cannabis smoker (among which 50% regularly). Socioeconomic status was lower comparing to general population, 24% of the patients had no diploma. The first line treatments were 88% chemotherapy, 43% radiotherapy, 21% surgery and 5% best supportive care. Median overall survival was 14.7 months. Conclusions: This study is the first national prospective study dedicated to patients under 40 years diagnosed with lung cancer. Compared to the general population of lung cancer, our preliminary results show a high proportion of women, adenocarcinoma histology, advanced disease at diagnosis and tobacco and cannabis use. Final analysis will be presented at the congress. Disclosure: All authors have declared no conflicts of interest.

Cancer Incidence and Survival in Adolescents and Young Adults in France, 2000–2008

This study aimed to describe cancer incidence (2000–2008) and survival (2000–2004) in France in adolescents and young adults (AYA). All cases of cancer diagnosed in 15–24 years, recorded by all French population-based registries (14% of the French population), over the 2000–2008 period, were included. Incidence change over time was described with the conventional annual percentage change (cAPC). The survival of cases diagnosed (2000–2004) was estimated using Kaplan–Meier method. A total of 1022 in adolescents and 1396 in young adults were diagnosed. Overall incidence rates were 219.4/106 in 15–19 year olds and 293.1/106 in 20–24 year olds. The most frequently diagnosed cancers in male AYA were malignant gonadal germ-cell tumors and Hodgkin's disease, and were melanoma, thyroid carcinoma, and Hodgkin's disease in females. The age-standardized rates appeared stable over time in AYA, with a cAPC of +2.0% (P = 0.68). The 5-year overall survival for all cancers was different between genders and age groups, with 78.8% (95%CI: 75.6–82.0) for males and 85.2% (95%CI: 82.2–88.1) for females (P = 0.01), and 78.5% (95%CI: 75.0–82.1) in 15–19 year olds and 84.3% (95% CI: 81.6–87.0) in 20–24 year olds (P = 0.02). Noteworthy, the frequency and the distribution of tumor types in AYA are unique and different from the observed at any other age group. Survival in French AYA has improved over time. Epidemiological data might reflect major trends in the risk factors and preventive interventions. Thus, further research into etiology of cancers affecting AYA should become key priorities for cancer control among AYA.

The combined effects of parental divorce and parental history of depression on cannabis use in young adults in France

BackgroundThe joint effects of multiple social risk factors on substance use, such as parental divorce and parental history of depression, have rarely been studied in young adult offspring. MethodsWe examined the combined effects of parental divorce and parental history of depression on current cannabis use among a community sample of young adults in France. Parental divorce was ascertained as divorce or separation before 2009. Parental history of depression based on parental reports of depression (1989–2009) and offspring reports of parental lifetime history of depression. Current cannabis use was defined as use at least once in the preceding 12months. Data were analyzed using multiple logistic regression models controlling for young adult and parental socio-demographic variables. ResultsApproximately one fourth of youth (23%) reported consuming cannabis at least once in the past year. At the same time, 15% had parents who were divorced and 30% parents with a history of depression. The association between parental divorce and cannabis use in young adults was not statistically significant (adjusted OR: 1.50; 95% CI: 0.97–2.31). History of parental depression conferred a marginally statistically significant 42% higher odds of young adult cannabis use (adjusted OR: 1.42; 95% CI: 1.00–2.01). Young adults who experienced both parental history of divorce and depression were more than two times as likely to be current cannabis users compared to those who experienced neither of these (adjusted OR: 2.38; 95% CI: 1.26–4.48). ConclusionOur findings highlight the critical importance of considering familial context in understanding cannabis use in young adults.

Histoire naturelle de la sclérose en plaques

Multiple sclerosis (MS) is the most frequent chronic, disabling neurological disease in young adults in France. Descriptions of the natural history of large cohorts have provided extensive information about the overall course and prognosis of MS, but individual prognosis remains a major challenge for researchers. Recent studies suggest that the clinical phenotype of MS is mostly age-related and that relapses play a minimal role in the long-term accumulation of disability.

Cancer incidence and survival among adolescents and young adults in France (1978-1997)

Malignancies are rare young French adults but represent the third significant cause of death in the cohort of 15-24 years of age. The aim of this study was to investigate incidence and survival rates of French adolescents and young adults with cancer. All cases of cancer occuring over a 20-year period (1978-1997) in the cohort of patients aged 15 to 24, were obtained from nine population-based registries (10 % of the French population). Basal cell carcinomas of the skin were excluded. 1161 and 1884 cases were recorded in adolescents and young adults, respectively. Overall incidence rates (IR) were 161.4/10(6) in adolescents aged 15-19 years (M/F ratio = 1.3), and 252.6/10(6) in young adults aged 20-24 years (M/F ratio : 1.2). During the 1978-97 period, the IRs appeared stable over the years, +0.4 % [CI95 % = -2.3 ; +3.1] (p = 0.79) for adolescents and +1.7 % [CI95 % = -4.0 ; +7.3] (p = 0.57) for young adults. Five-year overall survival rates were 69.1 % [CI95 % = 66.4-71.8] for adolescents and 74.5 % [CI95 % = 72.3-76.7] for young adults. The 5-year survival rate for patients 15-24 years improved from 62.0 % (CI95 % = 57.5-66.5) in 1978-82 to 80.2 % (IC95 % = 77.7-82.8) in 1993-97. Noteworthy, results in adolescents and young adults are poor compared to the ones from their younger counterparts, especially in patients with acute lymphoblastic leukemia, non-Hodgkin lymphoma, Ewing's sarcoma, osteosarcoma, rhabdomyosarcoma, and astrocytoma. Further studies are warranted to elucidate whether these differences are due to intrinsic biological properties of the tumor or to differences in clinical practices in the two populations.

The effects of family structure and socialization influences on compulsive consumption: a life course study in France

AbstractCompulsive consumption is regarded as a global phenomenon that can adversely affect consumer well‐being. Although the topic has been studied in different cultural settings, we have seen relatively little theory development and explanations of compulsive behaviour. Nearly all previous empirical studies attempt to explain this behaviour by correlating measures of compulsive behaviour with independent variables taken within the same time frame. However, recent developments in social sciences suggest that such a phenomenon may best understood in the context of the person's earlier‐in‐life experiences. Using the life course paradigm as an overarching framework, the present research extends previous work on this topic. Hypotheses derived from life course perspectives are formulated, and a survey of young adults in France is used to test them. The findings have implications for theory development and suggest directions for further research.

High prevalence rates of tobacco, alcohol and drug use in adolescents and young adults in France: Results from the GAZEL Youth study

Background Rates of substance use among adolescents have increased in the 1990s, however little is known about current patterns of substance use among youths entering adulthood. Methods We studied sex and age-specific rates of substance use (tobacco, alcohol, cannabis, other illicit drugs, inhalants and psychotropic medications) in a large sample of French youths aged 12–26 years (the GAZEL Youth study, n = 1333). Results Prevalence rates of substance use were high and varied with age and sex. Tobacco, cannabis and polysubstance use were most frequent among 19–21 year-olds (regular tobacco use: 41.5% in males, 39.9% in females; regular cannabis use: respectively 23.9% and 10.9%; tobacco + alcohol + cannabis: respectively 9.9% and 4.6%). Regular alcohol use was most frequent among 22–26 year-olds (29.8% in males, 15.6% in females). Across successive birth cohorts, the age of initiation of tobacco and cannabis use decreased. Males were consistently more likely to use psychoactive substances than females (except for tobacco and psychotropic medications). Conclusions Rates of substance abuse peak in late adolescence but remain high among a subgroup of young adults. Moreover, substance use initiation appears to be occurring at increasingly younger ages.