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.     

Cannabis and Amphetamine Use and Socio-Ecological Proximal and Distal Factors Among School-Going Adolescents in Six Pacific Island Countries

The study aimed to assess the prevalence of cannabis and amphetamine use and socio-ecological proximal and distal factors among adolescents in six Pacific Island countries. We analyzed cross-sectional survey data from 9,849 adolescents (mean age 14.2 years, SD?=?1.2) from Cook Islands, Kiribati, Samoa, Solomon Islands, Tonga and Tuvalu that participated in the “Global School-Based Student Health Survey (GSHS)” in 2011–2013. The prevalence of past-month cannabis use was 15.5%, and lifetime amphetamine use was 14.5%, with the highest prevalence in Samoa, 37.1% and 34.6%, respectively. In adjusted mixed-effects logistic regression analysis male gender, personal attributes (anxiety, loneliness, current tobacco use, current alcohol use and school truancy) and environmental stressors (having been in a physical fight, been physically attacked, sustained an injury, hunger and being bullied) were associated with past-month cannabis and/or lifetime amphetamine use. Parental substance use was positively and parental involvement negatively associated with past-month cannabis and/or lifetime amphetamine use. Measures to prevent and control cannabis and amphetamine use in this adolescent population should include personal attributes, environmental stressors and parental support.     

Content analysis of food advertising strategies and ethical implications on South African television

The study aimed to investigate strategies and ethical implications of food advertising in South African television. The sample included 343 food advertisements recorded over two weeks and 224 hours from two major South African TV channels. Results indicate 45 products of food advertisements. Fast food, restaurant and convenience food type had the highest number of products (17), followed by “beverage, drink and juice” (6), and “candy and sweets” group (6). Conceptual consumption (people are as interested in consuming ideas, information, and concepts as they are physically consuming things) was used as the main strategy (76.2%) for advertising food, while only 7% focused on physical consumption (fiber, energy and vitality). The majority of food advertisement used human models (78.5%), adults only (38%) and about half used both sexes. White models were used twice as often as Black models. Other advertisement strategies included claims to having fun (majority), being perceived of a higher status, acquiring a superior of products and adding social worth to the quality of person who consume the products. A few claims related to the physical benefit to the consumer, such as high fibre, whole grain, and weight loss.     

Prevalence and social and health correlates of insomnia symptoms among middle-and older-age persons in rural South Africa

This study investigated the prevalence and social and health correlates of insomnia symptoms among middle-and older-adults in rural South Africa. We analysed baseline survey data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa (HAALSI) (N = 5 059; females = 53.6%; largely African Shangaan/Tsonga-speaking). In all, 8.0% of the adults had three insomnia symptoms, 8.9% of participants had difficulty initiating sleep, 13.6% had difficulty in sleep maintenance, and 6.5% had poor sleep quality. In adjusted logistic regression, lower education, perceived unsafe neighbourhood, poorer self-rated health status, vision difficulty, pain, depressive symptoms, and posttraumatic stress disorder (PTSD) symptoms increased the odds of having insomnia symptoms. Insomnia symptoms are common in middle-and older-age adults in rural South Africa, and various risk factors were identified. This can help in improving insomnia prevention treatment in this population.     

Perceptions of alcohol risk among people on antiretroviral treatment in South Africa: a qualitative study

This study explored perceptions of alcohol abuse risk among people on antiretroviral treatment (ART) who self-identified as alcohol users. Twenty six people receiving ART from an out-patient setting were interviewed on their alcohol abuse risk perception. Data were thematically analysed. Findings suggest participants developed routines to drink alcohol around the times they took their antiretroviral medications to reduce adverse impact. They also reported alcohol abuse risk reduction strategies such as reducing alcohol use because of the event of an HIV positive diagnosis and/or getting on antiretroviral treatment, and alcohol use reduction following health education or counselling by health care staff. These findings suggest a need for alcohol interventions tailored to ART patients.     

Effects of tobacco use on non-adherence to antiretroviral therapy among HIV-positive patients in South Africa

This study aimed to estimate the relationship between tobacco use and non-adherence to antiretroviral therapy (ART) in a South African sample. Participants were 1 963 HIV patients who attended a primary care clinic in Pretoria (female = 68.5%; black African = 99.5%; median age = 37.0 years; tobacco users only = 8.6%, problem drinkers only = 14.9%, and tobacco users and problem drinkers = 10.5%). In adjusted logistic regression analysis, tobacco use only was not significantly associated with non-adherence to ART. Alcohol use only (OR: 1.72; CI: 1.26, 2.36) and tobacco use and problem drinking (OR: 2.31; CI: 1.60, 3.33) were highly associated with non-adherence to ART.     

Prevalence and behavioural risk factors of light or moderate and heavy cigarette smoking in 32 countries

The aim of this study was to predict the prevalence of light or moderate and heavy smoking from lifestyle behavioural risk factors among South African adults compared to others from 31 countries around the world. Secondary data from 53 391 adults who completed the International Social Survey Program (ISSP), 2011–2013, Health and Health Care Module were accessed for this study (South Africans, N = 3 004). Findings from multinomial logistic regression with adjustment for personal factors (e.g. physical and psychological well-being variables) were used to explain a significant proportion of both light or moderate smoking and heavy smoking among South African adults as well as adults from the other countries. Specifically, lifestyle factors of being underweight and overweight or obese were negatively associated with light or moderate smoking, but body mass index (BMI) weight status was not associated with heavy smoking. Smoking interventions should target modifiable lifestyle factors to prevent risk for light or moderate smoking and heavy smoking.     

Multiple health risk behaviours and posttraumatic stress disorder symptoms among university students from 22 countries

The goal of the study was to investigate multiple health risk behaviours in relation to PTSD symptoms in a sample of university students from 22 countries. Using anonymous questionnaires, data were collected from 16804 undergraduate university students (mean age 20.8, SD?=?2.8) from 23 universities in 22 countries in Africa, Asia, Caribbean and South America. Results indicate that overall, 20.9% of the university students screened positive for PTSD, and the overall mean of health risk behaviours (range from 1–10) was 2.7 for university students from all countries. Logistic regression adjusted for sociodemographic characteristics and social support found that each of the ten individual health risk behaviours was significantly associated with PTSD symptoms. In addition, logistic regression with multiple health risk behaviours found a steady increase from 1 (Odds Ratio (OR): 1.37, CI 1.05–1.77) to 5 or more (OR: 3.57, CI 2.75–4.64) health risk behaviours in association with PTSD symptoms, adjusted for age, gender, economic family background and social support.     

Factors associated with self-rated health status among university students from 26 low,middle and high income countries

The aim of this study was to investigate self-reported health status and associated factors in low, middle and high income countries. Using anonymous questionnaires, data were collected in a cross-sectional survey from 19 811 undergraduate university students (mean age=20.8, SD=2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Results indicate that the overall self-rated health status score was 3.0 (range 1–5). Generally, university students from study countries of the Caribbean, South America and North Africa, Near East and Central Asia had greater self-rated health status scores than students from study countries in Asia. In multivariate stepwise linear regression analysis, older age, coming from an upper middle income or high income country, higher personal control, better mental health (not having sleep problems, and having no or fewer PTSD symptoms), and having normal weight predicted better self-rated health status. Paradoxically, a poor healthy dietary score and low physical activity were also associated with better self-rated health status. In comparing self-rated health status across a large sample of students across many countries, associations were found between sociodemographic, psycho-social and health related variables and self-rated health status.