Actions taken by schools when tobacco policies are violated: associations with adolescent smoking prevalence

This study examined the association of adolescent smoking prevalence with actions taken by schools (i.e., informing parents or disciplining pupils at school) for violating the school tobacco policy. Interaction terms between actions taken by schools and role models' smoking behavior or support for adolescents were also examined. Data were collected using self-completed questionnaires from a nationally representative Norwegian sample of 15-year-olds (1,404 pupils, 51% males) and 73 staff members. Informing parents when the school tobacco policy was violated by contrast with other actions taken by schools was not associated with lower levels of adolescent smoking. Disciplining pupils was associated with lower levels of adolescent smoking but the association was no longer significant when examined together with parents' and teachers' smoking behavior or support. Exposure to parents' and teachers' smoking, and teachers' support were associated with adolescent smoking prevalence, irrespective of actions taken by schools. Identifying the mechanism under which these different home and school factors relate to adolescent smoking may be worthwhile to inform intervention initiatives.     

Inattention as a key predictor of tobacco use in adolescence

The authors examined the prediction from inattention to tobacco use among 2 cohorts (ages 7 and 13) of a community sample followed to young adulthood. Changes in self-reported tobacco use were tested with marginal transitional regression models, using parent and teacher ratings of inattention, hyperactivity-impulsivity, and other psychopathology, along with other factors, as predictors. Inattention, but not hyperactivity-impulsivity, significantly predicted adolescent tobacco use and young adult daily tobacco use. Peer substance use, parental substance use, and conduct disorder also predicted increases in tobacco use. African American ethnicity was strongly protective against later tobacco use.     

Adolescent socialization and use of licit and illicit substances: Impact on adult health

Abstract

This study examined the impact of adolescent substance use on young adult health. Longitudinal data from 825 participants were assessed when the participants were junior high school and high school students (1969-1973) and again in 1981. Latent variable models were used to determine what effect adolescent drug use had on later health. General substance use, which included tobacco, alcohol, stimulants, sedatives, and other hard drugs, had a small effect on adult health problems associated with substance use, and also predicted accidents related to substance use. In addition, the specific use of tobacco and cannabis in adolescence predicted later respiratory problems, while cigarette smoking during adolescence also predicted decreased physical hardiness. Lower adolescent socialization predicted post high school accidents (automobile and other) serious enough to require medical attention, and predicted increased psychosomatic and seizure symptoms, as well as general psychiatric distress. Implications of these results for the successful prevention or intervention of drug use are discussed. In addition to these results, gender differences are also examined.     

Concurrent alcohol and tobacco use among school-going adolescents in Namibia: Prevalence and risk factors

The aim of this study was to investigate the prevalence and risk factors for concurrent alcohol and tobacco use among school-going adolescents in Namibia. Data were from a sample of 4 531 Namibian middle school children (females = 53.1%; mean age = 15.8 years, SD = 1.8 years). They completed the Namibia Global School-based Student Health Survey (GSHS) in 2013. Overall, 74.4% of alcohol users in the past month were frequent tobacco users; whereas 40.5% of tobacco users in the past month were frequent alcohol users. Compared to students who were neither alcohol nor tobacco users (63.1%), concurrent alcohol and tobacco users were more likely to self-report with a lack of parent support, to have used illicit drugs, to have engaged in school truancy, to be sedentary in behaviour, to have engaged in a physical fight, and to have had two or more sexual partners. Substance use prevention and treatment programmes with adolescents should routinely address their risk for comorbid tobacco and alcohol use.     

Psychosocial antecedents of tobacco chipping.

The authors examined adolescent antecedents and adult correlates of tobacco "chipping" compared with heavy smoking, experimental smoking, and nonsmoking in a representative community sample. As adolescents, future "chippers" had some smoking risk factors (attitudes, health beliefs, smoking intentions, and tolerance for deviance) and several protective factors (high values for academic success, internal locus of control, supportive relationships, and little smoking among peers and parents). As adults, risk factors included lessened belief in nicotine's addictiveness, lower conscientiousness, higher extraversion, and lower positive affect and life satisfaction; protective factors included high levels of educational attainment and employment and low levels of negative affect and stress (men only). Thus, chippers experience a complex mixture of risk and protective factors for smoking.     

Evaluation of the school-based smoking-prevention program "BE smokeFREE"

This article examines the impact of the school-based smoking-prevention program "BE smokeFREE" on adolescent smoking. A national representative sample of 99 schools (195 classes, 4,441 students) was used when the intervention started in November 1994. Schools were allocated to one of four groups: a comparison group (A) and three intervention groups (B, C, and D). Group B received the most comprehensive intervention. A baseline (autumn 1994) and three follow-up data collections (1995, 1996, and 1997) were conducted. There were no significant differences in smoking habits among the four groups at baseline. The smoking habits in the group that was involved in the most comprehensive intervention (group B) changed more favourably than those of students in the comparison schools over the three follow-up data collections. At the third follow-up, the proportion of students smoking weekly or more in the comparison group was 29.2%, compared with 19.6% in the model intervention group. The two less comprehensive interventions (no teacher in-service courses in group C, and no involvement of parents in group D) appeared to be less effective than the model intervention. Multilevel multiple logistic regression analyses, comparing changes in smoking habits between students in group B with those among students in the comparison schools, confirm the conclusion that the comprehensive intervention was the most effective. This school-based intervention, based on a social influence approach, proved to be effective at reducing smoking rates among participants.     

Tobacco use in adolescence: longitudinal links to later problem behavior among African American and Puerto Rican urban young adults

In this study, the authors assessed the relationship between adolescent tobacco smoking and measures of inner control, deviant behavior, and associating with deviant peers, which are indicators of problem behavior. African American (N = 333) and Puerto Rican (N = 329) early adolescents completed questionnaires in their classrooms in 1990 at Time 1 (T1) and were individually interviewed thereafter when they were late adolescents in 1995 at Time 2 (T2) and as young adults in 2000 at Time 3 (T3). The authors used ordinary least squares regression analysis to assess the comparative association of adolescent smoking patterns at T1 and T2 and the young adult outcomes at T3; they controlled for demographic variables, level of the outcome measure at T2, and marijuana use at T2. The analyses suggested that experimental tobacco smokers demonstrated more problem behaviors than did nonsmokers, and late and continuous smokers demonstrated more problem behaviors as young adults than did experimental smokers and nonusers. These findings may provide a useful guide to a next step that involves translational research.     

School Substance Use Norms and Racial Composition Moderate Parental and Peer Influences on Adolescent Substance Use

Parental and peer influences on adolescent substance use have been well demonstrated. However, limited research has examined how parental and peer influences vary across school contexts. This study used a multilevel approach to examine the effects of school substance use norms and school racial composition in predicting adolescent substance use (a composite measure of alcohol, tobacco, and marijuana use) and in moderating parental and peer influences on adolescent substance use. A total of 14,346 adolescents from 34 schools in a mid‐western county completed surveys electronically at school. Analyses were conducted using hierarchical linear modeling. Results indicated that school‐level disapproval against substance use and percentage of minority students at school were negatively associated with adolescent substance use. School‐level disapproval moderated the association between peer substance use and adolescent substance use, with the association being stronger when school‐level disapproval was lower. School racial composition moderated the influence of parental disapproval and peer substance use on adolescent substance use. Specifically, both the association between parental disapproval and adolescent substance use and the association between peer substance use and adolescent substance use were weaker for adolescents who attended schools with higher percentages of minority students. Findings highlighted the importance of considering the role of school contexts, in conjunction with parental and peer influences, in understanding adolescent substance use.     

Beliefs About Tobacco, Health, and Addiction Among Adults in Cambodia: Findings from a National Survey

There remains a very high rate of smoked and smokeless tobacco use in the Western Pacific Region. The most recent findings from national adult tobacco surveys indicate that very few daily users of tobacco intend to quit tobacco use. In Cambodia, a nation that is predominantly Buddhist, faith-based tobacco control programs have been implemented where, under the fifth precept of Buddhism that proscribes addictive behaviors, monks were encouraged to quit tobacco and temples have been declared smoke-free. In the present study, we included items on a large national tobacco survey to examine the relation between beliefs (faith-based, other) about tobacco, health, and addiction among adults (18 years and older). In a stratified, multistage cluster sample (n = 13,988) of all provinces of Cambodia, we found that (1) 88–93% believe that Buddhist monks should not use tobacco, buy tobacco, or be offered tobacco during a religious ceremony; (2) 86–93% believe that the Wat (temple) should be a smoke-free area; (3) 93–95% believe that tobacco is addictive in the same way as habits (opium, gambling, alcohol) listed under the fifth precept of Buddhism; and (4) those who do not use tobacco are significantly more likely to cite a Buddhist principle as part of their anti-tobacco beliefs. These data indicate that anti-tobacco sentiments are highly prevalent in the Buddhist belief system of Cambodian adults and are especially evident among non-users of tobacco. Our findings indicate that faith-based initiatives could be an effective part of anti-tobacco campaigns in Cambodia.     

Hope as a Moderator of the Associations Between Common Risk Factors and Frequency of Substance Use Among Latino Adolescents

Ample research suggests that delinquency, depressive symptoms, and peer substance use are common risk factors associated with adolescent substance use. However, the factors that may help to buffer the deleterious effects of these risk factors on adolescent substance use, such as hope, have yet to be examined. The current study evaluated hope as a moderator of the associations between these common risk factors and frequency of substance use (alcohol, tobacco, and marijuana) in a sample of Latino high school students (M _age ?=?16.14 years, SD?=?1.30; 55 % female). Findings indicated that the influence of delinquency on frequency of tobacco and marijuana use depended on levels of hope, with delinquency only positively associated with frequency of use when levels of hope were low. Additionally, hope moderated the association between depressive symptoms and alcohol use, such that depressive symptoms were only positively associated with frequency of alcohol use when levels of hope were low. Results and their implications for intervention are reviewed.     

A review of research on the effects of religion on adolescent tobacco use published between 1990 and 2003

An electronic search of Medline and PsycInfo produced 29 studies that specifically investigated the effects of religion on adolescent tobacco use. Independent (religion) and dependent (tobacco use) variables and variables controlled for in statistical analyses were categorized. Twenty-two of the 29 studies reported at least one significant effect of religion on tobacco use, with 31 of 43 separate analyses of religious variables yielding significant negative correlations between religion and tobacco use. Religion was inversely related to all measures of tobacco use (lifetime, occasional, and regular use), but the findings suggest religion's primary effect is its prohibitive influence against ever using tobacco.     

Experimental evaluation of a modular approach to mobilizing antitobacco influences of peers and parents

The experimental evaluation of two components of a community intervention to prevent adolescent tobacco use are described. Youth antitobacco activities (e.g., peer quizzes, sidewalk art, poster and T-shirt giveaways, etc.) and family communications activities (pamphlets to parents and student quizzes of parents) were evaluated in two time-series experiments, each of which was conducted in two experimental and one control community. Students in Grades 6 and 8 and their parents were assessed in a series of four phone surveys in the first experiment and six phone surveys in the second. Implementation of the youth antitobacco and family communications activities led to significantly greater exposure of young people to antitobacco information. They led to increases in parent and youth knowledge about tobacco use and more negative attitudes toward tobacco. In Experiment 2, youths in intervention communities had significantly lower rated intentions to smoke. The findings suggest the value of a modular approach to community interventions for influencing the social context relevant to the onset of adolescent tobacco use.     

Concurrent tobacco use and risky drinking in South Africa: Results from the South African National Health and Nutrition Examination Survey

The aim of this study was to examine socio-demographic and psychosocial correlates of concurrent tobacco use and risky drinking. We analysed data from the cross-sectional South African National Health and Nutrition Examination Survey (SANHANES-1) 2011–2012. The sample included 14 764 adolescents and adults aged 15 years and older. They responded to questions on tobacco and alcohol use, psychosocial, and socio-demographic indicators. Results indicate that 9.6% (16.8% among men and 3.5% among women) of South Africans were involved in concurrent tobacco use and risky drinking, 18.2% in current tobacco use only, and 20.3% in risky drinking only. In covariate adjusted analysis, being 25 to 64 years, being male, belonging to the coloured population group, residing in urban areas, having experienced three or more traumatic events, and poor self-rated health were associated with concurrent tobacco use and risky drinking. Findings suggest socio-demographic and health factors are important for public health interventions in addressing concurrent tobacco and alcohol use in South Africa.     

Adaptation of an HIV Medication Adherence Intervention for Adolescents and Young Adults

Rising rates of human immunodeficiency virus (HIV) infection among adolescents and young adults underscore the importance of interventions for this population. While the morbidity and mortality of HIV has greatly decreased over the years, maintaining high rates of adherence is necessary to receive optimal medication effects. Few studies have developed interventions for adolescents and young adults and none have specifically been developed for sexual minority (lesbian, gay, and bisexual; LGB) youth. Guided by an evidence-based adult intervention and adolescent qualitative interviews, we developed a multicomponent, technology-enhanced, customizable adherence intervention for adolescents and young adults for use in a clinical setting. The two cases presented in this paper illustrate the use of the five-session positive strategies to enhance problem solving (Positive STEPS) intervention, based on cognitive-behavioral techniques and motivational interviewing. We present a perinatally infected heterosexual woman and a behaviorally infected gay man to demonstrate the unique challenges faced by these youth and showcase how the intervention can be customized. Future directions include varying the number of intervention sessions based on mode of HIV infection and incorporating booster sessions.     

National Ambulatory Medical Care Survey: Tobacco intervention practices in outpatient clinics

Tobacco use remains the leading cause of preventable death. The outpatient medical clinic represents an important venue for delivering evidence-based interventions to large numbers of tobacco users. Extensive evidence supports the effectiveness of brief interventions. In a retrospective database analysis of 11,827 adult patients captured in the 2005 National Ambulatory Medical Care Survey (of which 2,420 were tobacco users), we examined the degree to which a variety of patient demographic, clinical and physician-related variables predict the delivery of tobacco counseling during a routine outpatient visit in primary care settings. In 2005, 21.7% of identified tobacco users received a tobacco intervention during their visit. The probability of receiving an intervention differed by gender, geographic region and source of payment. Individuals presenting with tobacco-related health conditions were more likely to receive an intervention. Most physicians classified as specialists were less likely to intervene. The provision of tobacco intervention services appears to be increasing at a modest rate, but remains well below desirable levels. It is a priority that brief interventions be routinely implemented to reduce the societal burden of tobacco use. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Use in 1992 of tranquilizers and smokeless tobacco among Miami's public school students

This analysis examined tranquilizer use by 466 adolescents in Dade County, Florida public schools in 1992. Significant factors which increased the probability of use include that the adolescents were female, older students, peers' use of tranquilizers, ready access, and they lived alone. Smokeless tobacco use among 468 students was positively and significantly linked to peer influence, students being male, younger, living alone, and the availability of smokeless tobacco.     

Locus of control and smokeless tobacco use among adolescents

Seventh-grade students from two school districts in rural North Carolina were surveyed to determine the prevalence and correlates of smokeless tobacco use. The survey was carried out as part of a larger project intended to study prevalence of "risky" behaviors, specifically alcohol and tobacco use. Data were collected from 322 students: 49% male, 36.6% nonwhite. Of those reporting use of smokeless tobacco (11.4%), virtually all were male; most reported weekly use, with a small proportion (1.3%) reporting daily use. Locus of control of "occasional" users was significantly more internal than those reporting "regular" use (p less than .05).     

Saving the best for last: how adults treat social partners of different ages

Older adults report more positive feelings and fewer problems in their relationships than do younger adults. These positive experiences may partially reflect how people treat older adults. Social partners may treat older adults more kindly due to their sense that time remaining to interact with these older adults is limited. Younger (n = 87, age 22 to 35) and older (n = 89, age 65 to 77) participants indicated how positively they would behave (i.e., express affection, proffer respect, send sentimental cards) and what types of conflict strategies they would use in response to hypothetical negative interactions with two close social partners, a younger adult and an older adult. Multilevel models revealed that participants were more avoidant and less confrontational when interacting with older adults than when interacting with younger adults. Time perspective of the relationship partially mediated these age differences. Younger and older participants were also more likely to select sentimental cards for older partners than for younger partners. Findings build on socioemotional selectivity theory and the social input model to suggest that social partners facilitate better relationships in late life.     

The impact of a history of sexual abuse on high-risk sexual behaviors among females attending alternative schools

The goal of this study was to explore whether a history of sexual abuse is associated with high-risk sexual behaviors among female adolescents attending alternative schools in a large urban city in the southwestern United States, and to examine the role of depression and substance abuse in explaining this association. One hundred eighty-four sexually active female adolescents constituted the sample for this analysis. Forty-nine (26.6%) reported that they were forced to have sex. Having a history of sexual abuse substantially increased sexual risk behaviors. Adolescents reporting a history of sexual abuse, compared to those who did not report such a history, were significantly more likely to have initiated sexual activity (intercourse) before age 14, to have had three or more sexual partners in the last 3 months, and to have had a history of sexually transmitted diseases. These associations remained significant after controlling for age, ethnicity, and family income. Depression and substance abuse did not explain the association between sexual abuse and high-risk sexual behaviors. It seems reasonable to conclude that adolescents with a history of sexual abuse have greater difficulty practicing safe sexual behaviors than do those who have not been sexually abused. Given the prevalence of child sexual abuse and the extent of its impact, it is critical that intervention strategies for adolescent females address the issue of abuse and help them adopt self-protective sexual behaviors. The findings also highlight the importance of targeting adolescents who attend alternative schools.