SHEU Literature search from 2007: Smoking

SHEU : nationally-recognised, since 1977,
as the specialist provider of reliable local survey data for schools and colleges

How will smoking affect your appearance? NHS Choices

SHEU Literature search from 2007

Smoking

SHEU has provided a literature search resource about young people, smoking and school-based research from 2007 (308 items currently-not definitive)

Thanks to Zotero and Jason Priem

Last updated July 03 2012  - - - - - SEE ALSO LINKS TO "DRUGS"

http://sheu.org.uk

 


Does smoking affect schooling? Evidence from teenagers in rural China

Abstract Youth smoking can biologically reduce learning productivity. It can also reduce youths’ expected returns to education and lower their motivation to go to school, where smoking is forbidden. Using rich household survey data from rural China, this study investigates the effect of youth smoking on educational outcomes. Youth smoking is clearly an endogenous variable; to obtain consistent estimates of its impact, we use counts of registered alcohol vendors and a food price index as instrumental variables. Since the variable that measures smoking behavior is censored for non-smoking adolescents, we implement a two-step estimation strategy to account for the censored nature of this endogenous regressor. The estimates indicate that smoking one cigarette per day during adolescence can lower students’ scores on mathematics tests by about 0.08 standard deviations. However, we find no significant effect of youth smoking on either Chinese test scores or total years of schooling.
Publication Journal of Health Economics
Date 7/2012
URL http://linkinghub.elsevier.com/retrieve/pii/S0167629612000537

 


Analysis of Influential Factors Associated With the Smoking Behavior of Aboriginal Schoolchildren in Remote Taiwanese Mountainous Areas

Abstract BACKGROUND: A disparity in smoking behavior exists between the general and minority populations residing in Taiwan's mountainous areas. This study analyzed individual and environmental factors associated with children's smoking behavior in these areas of Taiwan. METHODS: In this school-based study, data on smoking behavior and related factors for mountain-dwelling students were obtained from the 2008 and 2009 Control of School-aged Children Smoking Study surveys. A representative sample (N = 1239) from 26 primary schools was included. The association among 3 groups (never-, former-, and current-smokers) and the potential variables were simultaneously examined using unordered polytomous logistic regression analysis. RESULTS: Between 13% and 34% of ever-smokers reported that their first smoking experience was in third grade. More than 70% were found to have bought cigarettes and 87% reported that the tobacco retailers had sold them cigarettes. The significant factors for current-smokers were predisposing factors, ie, attitude toward smoking (adjusted odds ratio [AOR] = 1.21); reinforcing factors, ie, family smoked in front of me (AOR = 2.44), friends smoked in front of me (AOR = 16.24), and school staff smoked in front of me (AOR = 2.98); and enabling factors, ie, cigarette availability and accessibility (AOR = 2.16 and 2.42, respectively). A student's perceived punishment for smoking at school had a positive significant effect on the risk of being former-smokers (AOR = 1.57). CONCLUSION: The findings provide a basis for school and community to design and implement effective anti-smoking programs for remote mountain-based students to further reduce youth smoking.
Publication Journal of School Health
Date 07/2012
URL http://doi.wiley.com/10.1111/j.1746-1561.2012.00705.x

 


Ambivalence and Fluidity in the Teenage Smoking and Quitting Experience: Lessons from A Qualitative Study at an English Secondary School

Abstract Objective: To evaluate a school-based stop smoking pilot project and to understand the teenage experience of smoking and quitting within that context. Design: Flexible design methods. Setting: A Kent (United Kingdom [UK]) secondary school. Methods: Semi-structured interviews analyzed following a grounded theory approach. Results: The main themes that emerged were ambivalence and fluidity. Young people can have mixed feelings towards their smoking behaviour. They experience ambivalence at the societal level in the messages they get about starting and stopping smoking and at the individual level in how they feel about other people smoking. Ambivalence in the quitting process is intensified by the phenomenon of addiction. Fluidity characterizes their way of life; things are not fixed and arrangements open to change. This was reflected in the way they approached coming to appointments. Conclusion: This research contributes a new perspective on the teenage smoking and quitting experience which others working in the field may find useful in characterizing their experience of working with young people. This ambivalence and fluidity suggests that a flexible approach in interventions with young people may be a key to success.
Publication Health Education Journal
Date 2012-06-05
URL http://hej.sagepub.com/cgi/doi/10.1177/0017896912446561

 


Smoking family, secondhand smoke exposure at home, and nicotine addiction among adolescent smokers

Abstract INTRODUCTION Smoking family predicts adolescent smoking, but whether the level of nicotine addiction is affected by exposure to secondhand smoke (SHS) is unclear. We investigated the associations of smoking family and SHS exposure at home with morning smoking and heavier smoking among Chinese adolescent smokers. METHODS In a school-based anonymous survey, 2182 adolescent smokers reported their smoking behaviors, smoking status of family members and peers, and SHS exposure at home and outside home in the past 7 days. Families with one or more smoking members (excluding the subject) were classified as smoking families and otherwise as non-smoking families. Smoking or wanting to smoke first thing in the morning (morning smoking), and consuming more cigarettes (heavier smoking) denoted higher levels of nicotine addiction. Regression analysis yielded adjusted odds ratios (AORs) for morning smoking and β-coefficients for heavier smoking adjusting for potential confounders. RESULTS Living with siblings and other co-residing family members who smoked was significantly associated with morning smoking and heavier smoking. Compared with non-smoking families without SHS exposure at home, the AORs (95% CI) for morning smoking were 0.99 (0.76 to 1.29) for 0 day/week, 1.19 (0.95 to 1.50) for 1-3 days/week, 1.76 (1.41 to 2.21) for 4-7 days/week (p for trend
Publication Addictive behaviors
Date Jun 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22406053

 


The effectiveness of school-based smoking prevention interventions among low- and high-SES European teenagers

Abstract Preventing smoking initiation among adolescents of lower socio-economic groups is crucial for the reduction of socio-economic inequalities in health. The aim of the present study was to examine whether effective smoking prevention interventions in Europe are equally effective among adolescents of low- and high-socio-economic status (SES). As part of the European Union-funded TEENAGE project, three school-based smoking prevention intervention studies in Europe were selected for secondary analyses: (i) a Dutch class competition intervention, (ii) the European Smoking Prevention Framework (ESFA) study and (iii) the A Stop Smoking in Schools Trial (ASSIST) intervention. All three studies differed in effectiveness by SES. The Dutch class competition study only had a significant effect among higher SES adolescents. The results for the ESFA study and ASSIST study were mixed and depended on which SES indicator was used. The conclusion of the study is that stratified analyses provide important insights in differential intervention effects for higher and lower socio-economic groups. Although findings from the different studies were mixed, interventions that use a social network approach in which youngsters are allowed to deliver the intervention themselves may be a successful strategy in targeting adolescents from lower socio-economic groups.
Publication Health education research
Date Jun 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22350193

 


Ethnic differences in patterns of secondhand smoke exposure among adolescents in Israel

Abstract INTRODUCTION Adolescent secondhand smoke exposure (SHSe) is associated with smoking initiation and independently damages health. METHODS We used data from the school-based 2003-2004 Israel National Health and Nutrition Youth survey (MABAT) to examine patterns and determinants of SHSe in a multiethnic sample of Israeli adolescents. School and child response rates were high (school: 91.8%, child: 87.9%), with 6,274 participants. We used generalized estimating equations to examine SHSe determinants. RESULTS Most Israeli adolescents were exposed to SHS (total: 85.6%; home: 40%; school: 31.4%; entertainment: 73.3%; other: 16.3%). Exposure patterns differed between the Jewish and non-Jewish sectors. Jews were more frequently exposed at school and entertainment venues than were non-Jews but were less frequently exposed at home. Druze were the least exposed and non-Arab Christians the most exposed. Secular Jews were more exposed than were religious Jews; the opposite was true among Arabs. Children of less-educated fathers were exposed more than children of more-educated fathers. Adolescents who smoked were more exposed than were nonsmokers. Conclusions: The high levels of SHSe among Israeli adolescents were characterized by different patterns of exposure among different population groups. Interventions to reduce adolescent SHSe, with appropriate tailoring, are urgently needed. These findings provide support for sustainable implementation of the recent governmentally approved tobacco control plan, which includes extended legislation for, and increased enforcement of, laws about smoking bans in schools and entertainment venues. Researchers elsewhere should be aware that levels and patterns of SHSe may vary greatly by subpopulation.
Publication Nicotine & tobacco research: official journal of the Society for Research on Nicotine and Tobacco
Date Jun 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22311964

 


Patterns of snus and cigarette use: a study of Norwegian men followed from age 16 to 19

Abstract BackgroundThe use of moist snuff (snus) in young Norwegians is increasing, while smoking rates are declining. It is not clear whether snus facilitates smoking.ObjectiveTo assess whether 16-year-old men who were never-smokers, but snus users in 2001, had an increased risk of smoking 3 years later.MethodsIn a prospective school-based cohort study, 1440 men, who responded to questionnaires in 2001 and 2004, were included in the analyses. The participation rate was 89% in 2001 and 50% in 2004. Multinomial logistic regression models were used to assess the OR of snus users, smokers and dual users of cigarettes and snus, compared with non-tobacco users at baseline, to be smokers at follow-up.ResultsSnus use at baseline was associated with increased odds of dual use at follow-up when the outcome was (1) current dual use versus no tobacco (OR 3.49, 95% CI 1.8 to 6.8) and when the outcome was (2) current dual use versus no smoking but including snus-only use (OR 1.88, 95% CI 1.1 to 3.3). Baseline snus users who were dual users at follow-up seemed to prefer using snus daily and cigarettes occasionally. Use of snus only at baseline was not associated with increased odds of smoking only at follow-up, after adjusting for known risk factors.ConclusionsYoung men who only used snus at baseline had an increased risk of being dual users at follow-up. Snus use may therefore facilitate smoking.
Publication Tobacco control
Date May 26, 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22634571

 


Childhood respiratory symptoms and mental health problems: The role of intergenerational smoking

Abstract OBJECTIVE: The aim of this study was to investigate the potential role of youth smoking, parental cigarette smoking and parental anxiety/depressive disorders in the relationship between respiratory symptoms and mental health problems among youth. WORKING HYPOTHESIS: Adjusting for both parental smoking and parental anxiety/depressive disorders in the association between respiratory symptoms and mental health problems among young persons will significantly reduce the strength of the observed relationship. STUDY DESIGN: Prospective cohort study. PATIENT-SUBJECT SELECTION: Data were drawn from a school-based sample of 1709 young persons in Oregon. METHODOLOGY: Physical and mental health data were collected on youth. RESULTS: Respiratory symptoms were associated with significantly increased odds of mental health problems among youth. After adjusting for youth smoking, the relationship between respiratory symptoms and depressive disorders was no longer statistically significant. The relationships between respiratory symptoms and anxiety and depressive disorders were no longer significant after adjusting for parental smoking. Parental anxiety/depressive disorders did not appear to influence these relationships. CONCLUSIONS: These results provide initial evidence that exposure to parental smoking may play a role in the observed co-occurrence of respiratory and mental health problems in youth, and youths' own smoking appears to influence the link with depressive disorders, but not anxiety disorders. Pediatr Pulmonol. © 2012 Wiley Periodicals, Inc.
Publication Pediatric pulmonology
Date May 15, 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22588945

 


Overweight and lifestyle among 13-15 year olds: A cross-sectional study in northern Sweden

Abstract Aim: To increase knowledge of self-rated health and lifestyle in relation to overweight/obesity among 13-15 year olds in northern Sweden. Methods: All 6768 13-15 year olds in nine out of 15 municipalities in Västerbotten County were asked to complete a cross-sectional school-based on-line survey in 2007. Eighty-two per cent participated in the study. Responses were considered reliable for 74% of the participants (2517 boys/2470 girls). The survey addressed demography, self-rated health, self-reported weight, height, and lifestyle characteristics. Simple and multiple logistic regression analyses were used. Results: Overweight/obesity (ISO body mass index ≥25 kg/m(2)) was more prevalent among boys (20%) than girls (11%), but more girls (19%) than boys (9%) reported fair or bad health. Overweight/obese boys and girls were more often physically inactive. For the boys, overweight/obesity was also associated with skipping breakfast, insufficient tooth brushing, and using snuff. For the girls, overweight/obesity was also associated with living with one parent and more television watching. Boys reported healthier habits concerning sleep duration, physical activity, eating breakfast, and smoking compared to the girls. On the other hand, girls reported better dietary and tooth brushing habits. Conclusions: This study uncovered two alarming findings: a fifth of the boys were overweight/obese and a fifth of the girls reported fair or bad health. Girls living with a single parent and boys and girls with unhealthy lifestyles were more likely to be overweight. Our findings emphasise the need for developing and implementing effective health promotion strategies for school-aged children to prevent an overweight and obesity epidemic that could continue into adulthood.
Publication Scandinavian journal of public health
Date May 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22637360

 


Parental compliance - an emerging problem in Liverpool community child health surveys 1991- 2006

Abstract Compliance is a critical issue for parental questionnaires in school based epidemiological
Publication BMC Medical Research Methodology
Date 2012-04-20
URL http://www.biomedcentral.com/1471-2288/12/53/abstract

 


Ethnic Identity and Substance Use among Mexican-Heritage Preadolescents: Moderator Effects of Gender and Time in the United States

Abstract This study examined interactive relationships among ethnic identity, gender, time in the US, and changes in substance use outcomes among a school-based sample of 1,731 Mexican-heritage preadolescents (ages 9-13). Residual change multilevel models adjusting for school clustering and using multiply imputed data assessed changes from beginning to end of fifth grade in use of alcohol, cigarettes, marijuana and inhalants, and four substance use antecedents. Effects of ethnic identity were conditional on time in the US, and in opposite directions by gender. Among males living longer in the US, stronger ethnic identity predicted desirable changes in all but one outcome (substance offers). Among females living longer in the US, stronger ethnic identity predicted undesirable changes in alcohol use, pro-drug norms, and peer substance use. Interpretations focus on differential exposure to substance use opportunities and the erosion of traditional gender role socialization among Mexican-heritage youth having lived longer in the US. (Contains 3 tables.)
Publication Journal of Early Adolescence
Date April 00, 2012
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ962929

 


Cigarette smoking and mood disorders in U.S. adolescents: sex-specific associations with symptoms, diagnoses, impairment and health services use

Abstract OBJECTIVE To report sex-specific associations between cigarette smoking and DSM-IV disorders, symptoms, and mental health services use related to depression and anxiety in a nationally representative sample of U.S. adolescents. METHODS Data on two samples were drawn from the 1999-2004 National Health and Nutrition Examination Surveys to examine the association of ever smoking (versus never smoking) with depression (n=1884 12-15 year-olds) and anxiety (n=6336 12-19 year-olds). Sex-specific associations between smoking and DSM-IV diagnoses, subthreshold and severe disorder, symptoms, impairment and mental health services use were assessed using logistic regression modeling. RESULTS Rates of DSM-IV depression and anxiety were increased in adolescent female ever smokers as compared to never smokers (OR=3.9, 95% CI: 1.3-11.3 and OR=10.6, 95% CI: 3.1-37.0, respectively). Females also showed statistically significant increases in severe disorder, subthreshold disorder, all symptoms of major depressive disorder, most symptoms of panic disorder, and increases in severe impairment, especially those related to schoolwork and teachers. Male adolescents showed smaller variations in depression and anxiety by smoking status, but were more likely to seek mental health services. CONCLUSIONS Smoking prevention efforts may benefit from specifically targeting female youth who show signs of depression or anxiety diagnoses through a school-based program, while greater benefits with males may be evident through programs integrated into mental health services.
Publication Journal of psychosomatic research
Date Apr 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22405220

 


Potential reach of effective smoking prevention programmes in vocational schools: determinants of school directors' intention to adopt these programmes

Abstract OBJECTIVES Investigating the current, intended and potential reach of two effective smoking prevention programs in Dutch vocational schools and identifying determinants of school directors' intention to adopt these programs. STUDY DESIGN Cross-sectional survey. METHODS Two questionnaires were developed based on the Diffusion of Innovation theory and the I-Change model, focussing on either the 'Healthy School and Stimulants program' (HSS program) or the 'Out-of-school Computer Tailoring program' (CT program). The questionnaires were distributed amongst all Dutch vocational school directors (n = 452) of which 34% completed the questionnaire. RESULTS The potential reach of the HSS program was 29% whereas the potential reach of the CT program was 5%. Regression analyses revealed that being female, perceiving a higher percentage of smoking students in school, having a personality more open towards change, perceiving a low need for a smoking prevention program, fewer disadvantages of the program, a higher level of self-efficacy towards adopting the program and a more positive social norm towards adopting a smoking prevention program from other school directors resulted in a positive intention towards adopting either program. CONCLUSIONS The present study showed that the reach of effective smoking prevention programs is fairly low. School-based smoking prevention efforts are likely to improve if schools choose to use programs that are proven to be effective, which can be encouraged by adapting existing and newly designed programs to school directors' characteristics and providing easy access to reliable information regarding available programs.
Publication Public health
Date Apr 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22365060

 


Smoking cessation with teenagers: the relationship between impulsivity, emotional problems, program retention and effectiveness

Abstract AIMS This study examines whether individual differences in impulsivity and emotional problems in adolescent smokers are related to initial smoking characteristics of participants, acceptance, retention and outcome of a school-based smoking cessation program. DESIGN The data was obtained from a feasibility study of a youth-specific, cognitive-behavioral and motivation enhancing program at 22 schools with 139 participating teenage smokers in Germany. A one-group-pre-posttest design was realized. MEASUREMENT Impulsivity levels were assessed by use of the impulsivity scale of the IVE ("Inventar zur Erfassung von Impulsivität, Risikoverhalten und Empathie", Stadler, Janke, & Schmeck, 2004). To evaluate the extent of emotional problems, the corresponding 5-items scale of the SDQ-Deu ("Strength and difficulties questionnaire", Klasen et al., 2000) was applied. Smoking behavior and acceptance of the program were assessed by students' self-reports. FINDINGS Acceptance and retention did not differ with regard to impulsivity and emotional problems, but initial smoking status did. Cessation rates varied with level of impulsivity: compared to non-impulsive participants, impulsive adolescents succeeded in quitting smoking less often. Emotional problems were not related to the rate of quitting. CONCLUSIONS Impulsive adolescents were similarly compliant to the offered cessation intervention as less impulsive smokers. In spite of their general positive evaluation, impulsive adolescents seem to benefit less from a smoking cessation program than their non-impulsive counterparts. Specific elements supporting impulsive teenage smokers in their goal to quit should be incorporated into youth-specific cessation programs.
Publication Addictive behaviors
Date Apr 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22273584

 


h3>A Qualitative Exploration of Youth in the “new” China: Perspectives on Tobacco Use From Adolescents in Southwest China

Abstract School-based prevention programs are not common in China and the attempts to modify successful Western prevention programs have largely shown little effect. Distinct cultural and social systems differences could explain why modified programs have been unsuccessful. Smoking behavior is examined from the perspective of Chinese adolescents as part of the development of a large intervention trial. A total of 16 focus groups with 128 participants were conducted in Chengdu in Sichuan province of China. Impressions of adolescent smokers were mixed, most seeing the behavior as common among boys. Smokers were seen as being overwhelmed and stressed. Girls’ smoking was mostly seen as universally “bad” and reflecting poorly on a girl’s character. However, a small portion of focus group participants suggested that female smoking was fashionable and trendy. With social norms changing rapidly in the “new” China, understanding what the new generation of Chinese youth thinks about smoking is critical in determining how to address and tailor prevention efforts.
Publication Asia-Pacific Journal of Public Health
Date March 01 , 2012
URL http://aph.sagepub.com/cgi/content/abstract/24/2/296

 


What limits the effectiveness of school-based anti-smoking programmes?

Abstract UNLABELLED BACKROUND: It is generally accepted that living in families where there are smokers, children are stressed not only by the harmful physical exposure to second-hand and third-hand tobacco smoke, but also by the negative models of the adult relatives' behaviour, as relatives who smoke can inspire children to imitate this behaviour, influencing attitudes towards, and early experiments with smoking. In this paper, some of the most important results about influence of family smoking on the effects of the anti-smoking educational programme "Non-smoking Is Normal" are described. METHODS The school-based programme was created by medical and educational specialists and targets children at the first level of primary schools (aged from 6 to 11 years). The data about interesting outcomes of the programme (knowledge, attitudes, behaviour) were collected by anonymous questionnaire, administered twice in each school year: one month before the complex of 5 lectures (pre-tests) and 4-5 months after the last lecture (post-tests). The sample of participants (860-910) was divided into four groups, according to the intervention and family backrounds: (1) programme children from smoking families "P-S"; (2) control children from smoking families "C-S"; (3) programme children from non-smoking families "P-NS"; (4) control children from non-smoking families "C-NS". The differences in the frequency of children's answers were analysed using the tests in statistic Epi Info software, version 6.04a (chi-square, Mantel Haenszel, Yates, Fisher). RESULTS In the programme group, the number of children with smoking relatives was significantly higher than in the control group (80.1% vs. 73.0%, p
Publication Central European journal of public health
Date Mar 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22571011

 


Smoking of Parents and Best Friend--Independent and Combined Effects on Adolescent Smoking and Intention to Initiate and Quit Smoking

Abstract INTRODUCTION: This study investigates the independent and combined effects of smoking of parents and best friend on smoking and the intention to initiate or quit smoking in adolescents. METHODS: In this school-based survey, 6,553 Hong Kong students aged 13-18 reported their demographic characteristics, smoking status of themselves, parents, and best friend; and intention to smoke (initiation among never-smokers and reinitiation among ex-smokers) or quit smoking among current smokers. Logistic regression yielded adjusted odds ratios (AORs) of student smoking (current/ever) and intention to smoke or quit smoking for parental (paternal/maternal/both parents vs. none) and best friend (yes vs. no) smoking. RESULTS: Parental smoking and having a smoking best friend were associated with adolescent current smoking, ever smoking, and intention to initiate smoking. Having a smoking best friend was also associated with reinitiating and quitting smoking. The AORs (95% CI) of current smoking for having a smoking best friend, in addition to smoking father, mother, or both were 19.14 (14.36-25.51), 20.38 (12.42-33.43), and 24.18 (15.89-36.77). The respective AORs of ever smoking were 8.30 (6.74-10.22), 8.92 (5.63-14.12), and 11.99 (8.05-17.87).Conclusions:Parental smoking and best friend smoking have independent effects on adolescent smoking behaviors. Their combined effects on current and ever smoking were particularly large. Smoking prevention programs should pay special attention to adolescents with both best friend and parents who smoke.
Publication Nicotine & tobacco research: official journal of the Society for Research on Nicotine and Tobacco
Date Feb 17, 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22345315

 


The Impact of School Suspension on Student Tobacco Use: A Longitudinal Study in Victoria, Australia, and Washington State, United States

Abstract Context: School suspension may have unintended consequences in contributing to problem behaviors, including dropping out from school, substance use, and antisocial behavior. Tobacco use is an early-onset problem behavior, but prospective studies of the effects of suspension on tobacco use are lacking. Method: Longitudinal school-based survey of students drawn as a two-stage cluster sample, administered in 2002 and 2003, in Washington State, United States, and Victoria, Australia. The study uses statewide representative samples of students in Grades 7 and 9 (N = 3,599). Results: Rates of tobacco use were higher for Victorian than Washington State students. School suspension remained a predictor of current tobacco use at 12-month follow-up, after controlling for established risk factors including prior tobacco and other drug use for Grade 7 but not Grade 9 students. Conclusions: School suspension is associated with early adolescent tobacco use, itself an established predictor of adverse outcomes in young people. Findings suggest the need to explore process mechanisms and alternatives to school suspensions as a response to challenging student behavior in early adolescence. (Contains 4 tables.)
Publication Health Education & Behavior
Date February 00, 2012
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ955134

 


The cost-effectiveness of a school-based smoking prevention program in India

Abstract Intervention programs aimed at preventing tobacco use among youth have been shown to be effective in curbing tobacco use onset and progression. However, the effects of even very successful tobacco prevention programs may not always impress policy-makers and lay audiences. Economic analysis potentially strengthens the case. In this paper, we evaluate the cost-effectiveness of a youth tobacco use prevention program which has been translated and implemented in India, a developing country. Although programs like these are inexpensive to implement in the USA, they are even less expensive in India due to low labor costs. Our results show that the costs per quality-adjusted life-year added, due to averted smoking, was $2057, even without including averted medical costs. If we ignore student time, cost-effectiveness improves by roughly 10%. To put the cost-effectiveness of this smoking prevention program into context, it is over 24 times more cost-effective than dialysis in the USA, which costs $50 000 for a life-year.
Publication Health promotion international
Date Jan 23, 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22271928

 


"Unplugged": A school-based randomized control trial to prevent and reduce adolescent substance use in the Czech Republic

Abstract BACKGROUND: The Czech Unplugged Study, inspired by the European Drug Addiction Prevention Trial, is a prospective, school-based, randomized controlled prevention trial designed to reduce the risk of alcohol, tobacco, inhalant, and illegal drug use in 6th graders in the Czech Republic. The intervention uses the comprehensive social influence model to affect alcohol and drug using norms among primary school students. METHODS: Descriptive statistics and chi-square analyses were used to assess differences between the experimental and control groups on demographic characteristics and study outcomes. Multilevel techniques were used to take the hierarchical structure of the data into account. Prevalence odds ratios using the Bonferroni correction were calculated to assess the differences between the experimental (N=914) and control (N=839) groups on each outcome 1, 3, 12, 15, and 24 months after the end of the intervention. RESULTS: Multilevel analysis using the Bonferroni correction showed statistically significant intervention effects at the final follow-up for any smoking (OR=0.75, 99.2% CI 0.65-0.87), daily smoking (OR=0.62, 99.2% CI 0.48-0.79), heavy smoking (OR=0.48, 99.2% CI 0.28-0.81), any cannabis use (OR=0.57 99.2% CI 0.42-0.77), frequent cannabis use (OR=0.57, 99.2% CI 0.36-0.89), and any drug use (OR=0.78, 99.2% CI 0.65-0.94). CONCLUSIONS: This study adds new evidence on the effectiveness of the Unplugged school-based prevention program for primary school students in the Czech Republic.
Publication Drug and alcohol dependence
Date Jan 20, 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22266087

 


Household secondhand smoke exposure of elementary schoolchildren in Southern Taiwan and factors associated with their confidence in avoiding exposure: a cross-sectional study

Abstract Exposure to household Secondhand Smoke (SHS) poses a major health threat to children after an indoor smoking ban was imposed in Taiwan. This study aimed to assess the household SHS exposure in elementary school children in southern Taiwan and the factors associated with their avoidance of SHS exposure before and after the implementation of Taiwan's new Tobacco Hazards Prevention Act in 2009.
Publication BMC Public Health
Date 2012-01-17
URL http://www.biomedcentral.com/1471-2458/12/40/abstract

 


Social Normative Beliefs About Smoking Among Vietnamese Adolescents

Abstract

Tobacco-related deaths in Vietnam are forecast to climb from 40 000 annually to 70 000 by 2030. Previous research in Western nations has found social factors to be important determinants of adolescent smoking. Because these factors remain unexplored in Vietnamese youth, the purpose of this study was to examine social normative beliefs regarding smoking in a school-based sample of North Vietnamese adolescents and the association of these factors with smoking behavior and susceptibility to smoking. Three measures of normative beliefs regarding smoking were evaluated in cross-sectional surveys of secondary students. Of the 3 measures, parent/peer disapproval was the most consistent normative belief associated with smoking behavior and susceptibility to smoking. Youth smoking prevention programs should consider assessing and taking into account normative beliefs and develop strategies that provide accurate information about the actual prevalence of smoking, the types of individuals who smoke, and approval/disapproval of smoking by parents and peers.
Publication Asia-Pacific Journal of Public Health
Date January 01 , 2012
URL http://aph.sagepub.com/cgi/content/abstract/24/1/68

 


Meta-analysis on the effects of the smoke-free class competition on smoking prevention in adolescents

Abstract BACKGROUND The 'Smoke-Free Class competition' (SFC) is a school-based smoking prevention programme including commitment not to smoke, contract management and prizes as rewards broadly implemented in Europe. OBJECTIVES To meta-analyse (randomised) controlled trials on the effects of SFC on current smoking at latest follow-up in adolescents. METHODS A systematic review of articles using MEDLINE and the Cochrane Library was conducted. The study selection included randomised controlled trials and controlled trials with follow-up assessment that investigated the efficacy of SFC on current smoking in students participating in SFC compared to non-participating students. Independent extraction of articles was performed by both authors. Results: Of 24 records identified, five fulfilled the inclusion criteria. These studies were conducted in three European countries (Finland, The Netherlands and Germany) and recruited 16,302 students altogether. A random effects meta-analysis of these five studies revealed a pooled risk ratio of 0.86 (95% CI 0.79-0.94; z = 3.44, p = 0.001) on current smoking at follow-up by participation in the competition. CONCLUSION SFC appears to be an effective tool in school-based smoking prevention.
Publication European addiction research
Date 2012
URL http://www.ncbi.nlm.nih.gov/pubmed/22285973

 


A snapshot of smokers after lung and colorectal cancer diagnosis

Abstract BACKGROUND:Continued smoking after a cancer diagnosis may adversely affect treatment effectiveness, subsequent cancer risk, and survival. The prevalence of continued smoking after cancer diagnosis is understudied.METHODS:In the multi-regional Cancer Care Outcomes Research and Surveillance cohort (lung cancer [N = 2456], colorectal cancer [N = 3063]), the authors examined smoking rates at diagnosis and 5 months after diagnosis and also study factors associated with continued smoking.RESULTS:Overall, 90.2% of patients with lung cancer and 54.8% of patients with colorectal cancer reported ever smoking. At diagnosis, 38.7% of patients with lung cancer and 13.7% of patients with colorectal cancer were smoking; whereas, 5 months after diagnosis, 14.2% of patients with lung cancer and 9.0% of patients with colorectal cancer were smoking. Factors that were associated independently with continued smoking among patients with nonmetastatic lung cancer were coverage by Medicare, other public/unspecified insurance, not receiving chemotherapy, not undergoing surgery, prior cardiovascular disease, lower body mass index, lower emotional support, and higher daily ever-smoking rates (all P
Publication Cancer
Date 2012
URL http://onlinelibrary.wiley.com/doi/10.1002/cncr.26545/abstract

 


Thai Adolescents' Normative Beliefs of the Popularity of Smoking Among Peers, Adults, the Successful and Elite, and Parents

Abstract The purpose of this study was to assess the perceptions of Thailand adolescents regarding the prevalence of smoking, the popularity of smoking among successful/elite elements of society, and disapproval of smoking by friends and parents. These perceptions were analyzed in conjunction with actual smoking and smoking susceptibility rates among the subjects to determine whether beliefs and behaviors were associated with each other. This study was conducted among a school-based sample of 2516 Chiang Mai, Thailand upper secondary and vocational students. Although perceived prevalence of smoking was not associated with smoking outcomes, perceived popularity of smoking among the successful and elite was associated with higher risk, and perceived disapproval by friends/parents was associated with lower risk. Youth smoking programs should consider assessing and taking these social normative factors into account when considering educational intervention strategies that aim to lower adolescent smoking rates.
Publication Social Development
Date 2012
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1467-9507.2011.00641.x/abstract

 


Smoking cessation and characteristics of success and failure among female high-school smokers

Abstract Aim: The purpose of this study was to investigate the effects of a smoking cessation program on female high-school students and to analyze the characteristics of students who quit smoking compared to those of students who failed to quit.Methods: This study used a mixed research design, including a pre- and post-experimental design for measuring the effects of the smoking cessation intervention and a qualitative design using a focus group interview to analyze the characteristics of individuals who successfully quit in comparison to those who failed to stop smoking. Data were collected before and after the intervention through a self-report questionnaire, a biochemical index, and a focus group interview.Results: After the intervention, positive changes in stage in the transtheoretical model for smoking-cessation behavior increased significantly (P
Publication Japan Journal of Nursing Science
Date 2012
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7924.2012.00212.x/abstract

 


Adolescent smoking behavior and outcome expectancies

Abstract Jøsendal, O. & Aarø, L. E. (2012). Adolescent smoking behavior and outcome expectancies. Scandinavian Journal of Psychology 53, 129–135.Adolescent smoking behavior is assumed to be associated with smoking outcome expectancies. Results in this paper are based on data from the control group of two data collections among Norwegian secondary school students taken approximately 30 months apart (T1 and T2). The dimensionality of smoking outcome expectancies was the same at both time points, revealing three components (“Addicted”, “Not harmful” and “Social”). After correction for attenuation, the Pearson’s correlation between T1 and T2 was 0.41 for the total sumscore, indicating low to moderate relative stability. When examining smoking expectancy sumscore means by smoking habits at T1 and T2, never smokers were different from smokers on both occasions. Never smokers scored low on “Social” and “Not harmful”, and high on “Addictive”. All associations were statistically significant (p
Publication Scandinavian Journal of Psychology
Date 2012
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1467-9450.2011.00927.x/abstract

 


A Network Method of Measuring Affiliation-Based Peer Influence: Assessing the Influences of Teammates’ Smoking on Adolescent Smoking

Abstract Using a network analytic framework, this study introduces a new method to measure peer influence based on adolescents’ affiliations or 2-mode social network data. Exposure based on affiliations is referred to as the “affiliation exposure model.” This study demonstrates the methodology using data on young adolescent smoking being influenced by joint participation in school-based organized sports activities with smokers. The analytic sample consisted of 1,260 American adolescents from ages 10 to 13 in middle schools, and the results of the longitudinal regression analyses showed that adolescents were more likely to smoke as they were increasingly exposed to teammates who smoke. This study illustrates the importance of peer influence via affiliation through team sports.
Publication Child Development
Date 2012
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8624.2011.01729.x/abstract

 


Media literacy and cigarette smoking in Hungarian adolescents

Abstract Objective: To assess smoking media literacy in a sample of Hungarian youth and to determine its association with current smoking and susceptibility to future smoking. Design: Quantitative cross-sectional survey. Setting: Four elementary and four high schools in Mako, Hungary. Method: A survey form was administered in regularly-scheduled classes to 546 eighth- and twelfth-grade students that included the smoking media literacy (SML) scale and items assessing cigarette use. Logistic regression was used to examine the relationship of smoking media literacy with current smoking, and also separately for susceptibility to smoking in the future, as dependent dichotomous variables. Results: Smoking media literacy was lower among the Hungarian adolescents than what has been previously reported in American adolescents. Multivariate logistic regression analysis results showed smoking media literacy to be associated with reduced risk of current smoking status at a similar level to that found in American adolescents. However, unlike previous research in American adolescents, smoking media literacy and susceptibility to future smoking was not associated. Reduced smoking may be most associated with the representation-reality domain of media literacy, which relates recognition of what is portrayed in the media with reality. Conclusion: Based on this study’s findings, prevention and health promotion planners in Hungary should consider media literacy training as a possible addition to smoking prevention efforts in community- and school-based efforts.
Publication Health Education Journal
Date December 01 , 2011
URL http://hej.sagepub.com/cgi/content/abstract/70/4/446

 


Evaluation of the efficacy of a school-based program to prevent tobacco smoking among adolescents in Lombardy (Article in Italian)

Abstract The program "Free to choose" was a school-based program aimed at encouraging secondary school students to lead healthy lifestyles and free from tobacco smoke. The project was part of a wider project named "Free from tobacco smoke", implemented in kindergarten, elementary and secondary schools in Lombardy (Italy). The "Free to choose" program was a controlled, non randomized study involving 2,145 subjects aged 16 years, of whom 1,063 participated in the activities laid out by the program (treatment group) and 1,082 only completed the questionnaires (control group). The program did not achieve the aim of reducing the number of subjects who start smoking. However, an increased awareness of the risks of smoking was observed among "treated" subjects as well as an increased number of non smokers who intend to refuse a cigarette if they were offered one.
Publication Igiene e sanità pubblica
Date 2011 Nov-Dec
URL http://www.ncbi.nlm.nih.gov/pubmed/22508642

 


Design, Baseline Results of Irbid Longitudinal, School-Based Smoking Study

Abstract Objective: To compare patterns of water pipe and cigarette smoking in an eastern Mediterranean country. Methods: In 2008, 1781 out of 1877 seventh graders enrolled in 19 randomly selected schools in Irbid, Jordan, were surveyed. Results: Experimentation with and current water pipe smoking were more prevalent than cigarette smoking (boys: 38.7% vs 26.8%; 20.2% vs 9.0%, girls: 21.2% vs 9.5%; and 7.5% vs 2.3%, P less than 0.05 for all). Parent- and peer-smoking correlated more strongly with water pipe than with cigarette smoking. Conclusion: Water-pipe smoking is more prevalent than cigarette smoking at this early age.
Publication American Journal of Health Behavior
Date November 00, 2011
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ956277

 


Association between substance use and psychosocial characteristics among adolescents of the Seychelles

Abstract We examined the associations between substance use (cigarette smoking, alcohol drinking, and cannabis use) and psychosocial characteristics at the individual and family levels among adolescents of the Seychelles, a rapidly developing small island state in the African region.
Publication BMC Pediatrics
Date 2011-10-11
URL http://www.biomedcentral.com/1471-2431/11/85/abstract

 


A randomized, controlled trial of a school-based intervention to reduce violence and substance use in predominantly Latino high school students

Abstract PURPOSE Few studies have rigorously evaluated school-based interventions to reduce violence and substance use in high school students, especially Latinos. This study assessed the effects of a school-based program on reducing violence and substance use among primarily Latino high school students. METHODS Ninth-grade students at risk for violence and substance use were randomized to intervention or control groups. The intervention was based on an existing program developed for white and African American youth. Data on smoking, alcohol and drug use, fighting, and grades were collected at baseline and 4 and 8 months post enrollment. RESULTS There were 55 students in the control and 53 in the intervention group; 74% of controls and 78% of intervention students were Latino. There were no significant changes in fighting, smoking, or alcohol or drug use, from baseline to 8-month follow-up, between the intervention and control group. Pre and post grade point average (GPA) decreased from 2.3 at baseline to 1.8 at follow-up (p<.01 in="" the="" intervention="" group="" with="" no="" significant="" between-group="" changes="" gpa="" from="" baseline="" to="" follow-up.="" conclusions="" this="" school-based="" program="" showed="" reduction="" violence="" or="" substance="" use.="" findings="" suggest="" that="" a="" targeting="" non-latino="" youth="" may="" not="" be="" optimal="" for="" reducing="" and="" use="" latinos="" greater="" attention="" cultural="" appropriateness="" racial="" differences="" needed.="" there="" was="" decrease="" intervention-group="" but="" change="" compared="" controls.="" further="" studies="" of="" impact="" prevention="" programs="" on="" academics="" effectiveness="" afterschool="" community-based="" are="">
Publication Journal of the National Medical Association
Date 2011 Sep-Oct
URL http://www.ncbi.nlm.nih.gov/pubmed/22364063

 


Self-reported poor oral hygiene among in-school adolescents in Zambia

Abstract Dental health is a neglected aspect of adolescent health globally but more so in low-income countries. Secondary analysis using the 2004 Zambia Global School-Based Health Survey (GSHS) was conducted in which we estimated frequencies of relevant socio-demographic variables and explored associations between selected explanatory variables and self-reported poor oral hygiene (not cleaning or brushing teeth) within the last 30 days of the completion of questionnaire.
Publication BMC Research Notes
Date 2011-07-22
URL http://www.biomedcentral.com/1756-0500/4/255/abstract

 


Early smoking in school-aged children with and without a diagnosis of asthma

Abstract Background: Research has shown that adolescents with asthma are as likely as and sometimes even more likely to smoke than their peers without asthma. The current study examined whether the prevalence of the first active smoking experience differs for children (9–12 years of age) diagnosed with asthma compared with children who do not have asthma. The association between asthma and smoking was evaluated with logistic regression analysis, controlling for socio-economic status, parental smoking and child’s internalizing and externalizing behaviours. Method: A nation-wide sample of 1476 mother and child dyads participated, of which 220 children (14.9%) had been diagnosed with childhood asthma. Results: Children diagnosed with asthma were 2.45 times more likely to have taken a puff of a cigarette compared with children without asthma. In addition, the association between asthma and early smoking remained significant after including potential confounders in the regression equation. Discussion: Suggestions are provided for preventing school-aged children, especially youths with asthma, from smoking. Additional research is needed to gain further insights into the mechanisms underlying the higher likelihood of early smoking among children with asthma.
Publication The European Journal of Public Health
Date 2011-07-11
URL http://eurpub.oxfordjournals.org/cgi/doi/10.1093/eurpub/ckr085

 


A Mediation Analysis of a Tobacco Prevention Program for Adolescents in India: How Did Project MYTRI Work?

Abstract This article presents the results of a mediation analysis of Project MYTRI (Mobilizing Youth for Tobacco Related Initiatives in India), a randomized, controlled trial of a multiple-component, school-based tobacco prevention program for sixth- to ninth-graders (n = 14,085) in Delhi and Chennai, India. A mediation analysis identifies how an intervention achieves its effects. In MYTRI, changes in students’ (a) knowledge about the negative health effects of tobacco, (b) beliefs about its social consequences, (c) reasons to use tobacco, (d) reasons not to use tobacco, (e) advocacy skills self-efficacy, and (f) normative beliefs about tobacco use were significantly associated with reductions in students’ intentions to use tobacco and tobacco use behaviors. In contrast, changes in students’ perceptions of the prevalence of smoking and chewing tobacco were significantly related to increases in students’ intentions to use and use of tobacco. Implications for intervention design are considered.
Publication Health Education & Behavior
Date June 01 , 2011
URL http://heb.sagepub.com/cgi/content/abstract/38/3/231

 


Media Health Literacy (MHL): Development and Measurement of the Concept among Adolescents

Abstract Increasing media use among adolescents and its significant influence on health behavior warrants in-depth understanding of their response to media content. This study developed the concept and tested a model of Media Health Literacy (MHL), examined its association with personal/socio-demographic determinants and reported sources of health information, while analyzing its role in promoting empowerment and health behavior (cigarette/water-pipe smoking, nutritional/dieting habits, physical/sedentary activity, safety/injury behaviors and sexual behavior). The school-based study included a representative sample of 1316 Israeli adolescents, grades 7, 9 and 11, using qualitative and quantitative instruments to develop the new measure. The results showed that the MHL measure is highly scalable (0.80) includes four sequenced categories: identification/recognition, critical evaluation of health content in media, perceived influence on adolescents and intended action/reaction. Multivariate analysis showed that MHL was significantly higher among girls ([beta] = 1.25, P less than 0.001), adolescents whose mothers had higher education ([beta] = 0.16, P = 0.04), who report more adult/interpersonal sources of health information ([beta] = 0.23, P less than 0.01) and was positively associated with health empowerment ([beta] = 0.36, P less than 0.0005) and health behavior ([beta] = 0.03, P = 0.05). The findings suggest that as a determinant of adolescent health behavior, MHL identifies groups at risk and may provide a basis for health promotion among youth.
Publication Health Education Research
Date April 00, 2011
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ918808

 


Effectiveness of health promotion in preventing tobacco use among adolescents in India

Abstract This case study has two aims. First, it describes intervention strategies from two school-based programs designed to prevent tobacco use among adolescents in India. Second, it explains how evidence from randomized controlled trials of these intervention programs was used by a local non-governmental organization in Delhi to advocate for scaling up the Government of India’s tobacco control efforts to include school health interventions as one of the components of India’s National Tobacco Control Program. This case study illustrates the need for developing countries to conduct rigorous evaluation in order to provide context-relevant evidence prior to scaling up interventions.
Publication Global Health Promotion
Date March 01 , 2011
URL http://ped.sagepub.com/cgi/content/abstract/18/1/09

 


Mental Health Characteristics and Health-Seeking Behaviors of Adolescent School-Based Health Center Users and Nonusers

Abstract Background: The purpose of this study is to compare the mental health risk profile and health utilization behaviors of adolescent school-based health center (SBHC) users and nonusers and discuss the role that SBHCs can play in addressing adolescent health needs. Methods: The sample included 4640 students in grades 9 and 11 who completed the California Healthy Kids Survey between fall 2000 and spring 2005 at 4 high schools in Alameda County, California. Chi-squared tests of significance and multivariate logistic regression were used to compare characteristics of SBHC users and nonusers and identify demographic, health status, and behavioral characteristics predictive of SBHC use. Results: Controlling for demographic variables and general health status, students who reported frequent feelings of sadness, trouble sleeping, suicide ideation, alcohol or marijuana use, the recent loss of a close friend or relationship, or other difficult life event were significantly more likely to seek SBHC services than their peers. Neither health insurance status nor a student's "usual" source of health care was predictive of general SBHC use, but being on public assistance or having no insurance was predictive of a student seeking SBHC mental health services. Conclusions: These findings suggest that SBHCs are able to attract students with the most serious mental health concerns and can play an important role in meeting needs that might otherwise go unmet. The provision of SBHC mental health services in particular may fill a need among adolescents with public or no insurance. (Contains 3 tables.)
Publication Journal of School Health
Date March 00, 2011
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ917969

 


Tobacco use, exposure to secondhand smoke, and cessation counseling among medical students: cross-country data from the Global Health Professions Student Survey (GHPSS), 2005-2008

Abstract GHPSS is a school-based survey that collects self-administered data from students in regular classroom settings. GHPSS produces representative data at the national or city level in each country. This study aims to investigate the prevalence of tobacco use, exposure to secondhand smoke, and cessation counseling among medical students using the GHPSS data.
Publication BMC Public Health
Date 2011-02-01
URL http://www.biomedcentral.com/1471-2458/11/72/abstract

 


Secondhand Tobacco Smoke Exposure Among School-Aged Youth Enrolled in School-Based Asthma Management Programs

Abstract The high prevalence of asthma among school-aged youth places a significant burden on students, families, and communities. Secondhand smoke (SHS) exacerbates asthma symptoms and attacks. Parental smoking is likely the most common and recurring source of SHS exposure among children. School-based asthma management programs can play a major role in educating students and their families about how to reduce, eliminate, and cope with SHS exposure. Between January 2007 and May 2008, a total of 121 middle and 248 elementary school students who participated in school-based asthma management programs in elementary school completed pretest and posttest surveys assessing asthma behaviors and management difficulties. Subgroups of 40 middle and 54 elementary school students participated in 15 focus groups. Quantitative data were analyzed using descriptive statistics and independent sample t tests. Thematic analysis was used to identify and interpret prominent themes within qualitative data. Quantitative analysis of elementary school student data revealed students exposed to SHS had significantly higher asthma management difficulties at pretest (2.79 vs 1.98, respectively; t = 3.4, P = .001) and posttest (2.56 vs 1.74, respectively; t = 3.8, P
Publication Journal of Asthma & Allergy Educators
Date 2011
URL http://jaa.sagepub.com/cgi/content/abstract/2/4/173

 


Tobacco Smoking and Suicidal Ideation in School-Aged Children 12–15 Years Old: Impact of Cultural Differences

Publication Journal of Addictive Diseases
Date 2011
URL http://dx.doi.org/10.1080/10550887.2011.609802

 


Parental behaviours, but not parental smoking, influence current smoking and smoking susceptibility among 14 and 15 year-old children

Abstract Objective: To explore whether parental behaviours related to smoking socialisation and parenting are associated with smoking susceptibility and current smoking in 14–15 year old students.Method: Data were sourced from the New Zealand 2006 Year 10 In-depth Survey, a school-based survey of 3,189 students. Outcome measures were susceptibility to smoking and current smoking. Potential determinants were second-hand smoke exposure in the home, parental smoking, parental anti-smoking expectations, anti-smoking rules, pocket money, monitoring of pocket money expenditure, general rule setting and monitoring, and concern about education. Analysis used logistic regression to adjust for potential confounding factors.Results: Exposure to second-hand smoke and lack of parental anti-smoking expectations were independently associated with smoking susceptibility and current smoking. Parental smoking was not independently associated with current smoking or susceptibility. Receiving pocket money and an absence of monitoring of expenditure were associated with smoking susceptibility and current smoking. Lack of parental rule setting was associated with smoking susceptibility. Findings were similar whether or not one or more parents were smokers.Conclusions: Not allowing smoking in the home, communicating non-smoking expectations to children, monitoring pocket money, and setting rules to guide behaviour are strategies which are likely to reduce risk of smoking uptake.Implications: The study provides evidence to inform the development of parent-focused interventions to reduce the risk of smoking initiation by children.
Publication Australian and New Zealand Journal of Public Health
Date 2011
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1753-6405.2011.00772.x/abstract

 


Social normative beliefs regarding cigarette smoking in Hungarian adolescents

Abstract Background: Hungary will continue to experience a high burden of disease and death from lung cancer and other tobacco-induced disease unless there is a significant reduction in youth smoking. Social factors have been found to be among the most important determinants of adolescent smoking, yet few studies have investigated social normative beliefs in Hungarian youth. The purpose of the current study was to investigate three measures of smoking normative beliefs thought to influence adolescent smoking: perceived prevalence of smoking; perceived popularity of smoking among successful/elite elements of society; and perceived disapproval by friends and family.Methods: A cross-sectional school-based survey of eighth grade (n = 258) and 12th grade (n = 288) students in Mako, Hungary was conducted to assess social normative beliefs about smoking, current smoking, ever smoking, and susceptibility to smoking. The association of the normative beliefs with the smoking behavior variables was examined through logistic regression analysis, and the underlying factor structure of the normative belief items in the current sample was determined through factor analysis.Results: The percent of boys reporting current smoking was 40.5% in 12th grade and 27.0% in eighth grade. Among girls, the percent was 44.0% of 12th graders and 29.1% of eighth graders. Parent/peer disapproval was the most consistently associated normative belief with smoking behavior and susceptibility to smoking across both samples.Conclusions: Youth smoking prevention programs should consider assessing and taking into account normative beliefs and develop strategies that provide accurate information about the actual prevalence of smoking, the types of individuals who smoke, and approval/disapproval of smoking by parents and peers.
Publication Pediatrics International
Date 2011
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1442-200X.2011.03336.x/abstract

 


Smoking Media Literacy in Vietnamese Adolescents

Abstract BACKGROUND: Smoking media literacy (SML) has been found to be independently associated with reduced current smoking and reduced susceptibility to future smoking in a sample of American adolescents, but not in other populations of adolescents. Thus, the purpose of this study was to assess SML in Vietnamese adolescents and to determine the association with smoking behavior and susceptibility to future smoking.METHODS: A cross-sectional survey of 2000 high school students completed the SML scale, which is based on an integrated theoretical framework of media literacy, and items assessing cigarette use. Ordinal logistic regression was used to determine the association of SML with smoking and susceptibility to future smoking. Ordinal logistic regression was also to determine whether smoking in the past 30 days was associated with the 8 domains/core concepts of media literacy which comprise the SML.RESULTS: Smoking media literacy was lower among the Vietnamese adolescents than what has been previously reported in American adolescents. Ordinal logistic regression analysis results showed that in the total sample SML was associated with reduced smoking, but there was no association with susceptibility to future smoking. Further analysis showed that results differed according to school and grade level. There did not appear to be association of smoking with the specific domains/concepts that comprise the SML.CONCLUSIONS: The association of SML with reduced smoking suggests the need for further research involving SML, including the testing of media literacy training interventions, in Vietnamese adolescents and also other populations of adolescents.
Publication Journal of School Health
Date 2011
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2010.00555.x/abstract

 


No smoke without fire: The impact of future friends on adolescent smoking behaviour

Abstract Objective. This study examined the impact of future friends and the contribution of different social influence and selection processes in predicting adolescents' smoking behaviour by extending the theory of planned behaviour (TPB). We investigated the impact of previous smoking, direct pressure from friends, descriptive norms of present and future friends, smoking-based selection of future friends, and distinguished between reciprocal and desired friends.Design. A longitudinal design with three measurements was used.Methods. The sample consisted of 1,475 Dutch high school students (mean age = 12.7 years) that participated as a control group in the European Smoking prevention Framework Approach study at three measurements.Results. Structural equation modelling revealed that adolescent smoking was influenced by intention, previous smoking, descriptive norms of parents and siblings, and that desired as well as reciprocal friends were selected based on similar smoking behaviour. Future friends indirectly influenced adolescent smoking through intention, as did attitude, subjective norms of parents and siblings, previous smoking, and descriptive norms of reciprocal friends and siblings.Conclusions. The present results suggest that descriptive norms and selection of friends need to be considered as major factors explaining smoking behaviour among adolescents besides the TPB components. These insights contribute to the further refinement of smoking prevention strategies.
Publication British Journal of Health Psychology
Date 2011
URL http://onlinelibrary.wiley.com/doi/10.1348/135910710X531608/abstract

 


Examining gender differences in emerging tobacco use using the adolescents' need for smoking scale

Abstract Aims To investigate the influence of gender on emerging tobacco use by testing for gender-based measurement invariance of the Adolescents' Need for Smoking Scale (ANSS) and examining gender differences on each dimension across increasing levels of amount smoked.Design Cross-sectional survey.Setting Thirteen secondary schools located in British Columbia, Canada.Participants Data from 1425 youth who reported smoking at least once in the past month.Measurements Survey questions about demographic characteristics, tobacco smoking history and need for smoking.Findings The multi-dimensional structure of the ANSS is equivalent in boys and girls and the ANSS questions are not gender-biased. There were no significant gender differences in the levels of physical dependence across increasing levels of amount smoked. Girls scored higher than boys on levels of emotional dependence across increasing levels of life-time cigarette exposure. Girls also had higher scores on the social dimension of the ANSS compared to boys among those who smoked 100 or more cigarettes.Conclusions Canadian girls score higher than boys on measures of emotional dependence and social attitudes associated with tobacco smoking.
Publication Addiction
Date 2011
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2011.03496.x/abstract

 


Are Substance Use Prevention Programs More Effective in Schools Making Adequate Yearly Progress? A Study of Project ALERT

Abstract This exploratory study sought to determine if a popular school-based drug prevention program might be effective in schools that are making adequate yearly progress (AYP). Thirty-four schools with grades 6 through 8 in 11 states were randomly assigned either to receive Project ALERT (n = 17) or to a control group (n = 17); of these, 10 intervention and nine control schools failed to make AYP. Students completed three self-report surveys. For lifetime cigarette use and 30-day alcohol use, Project ALERT was more effective in schools that made AYP. However, in these schools, Project ALERT negatively affected students' lifetime marijuana use. This study provided some preliminary evidence that prevention programming may not work as well in poorer performing schools; however, further exploration is needed. (Contains 1 table and 3 figures.)
Publication Journal of Drug Education
Date 2011
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ942595

 


Development and Testing of an Antitobacco School-Based Curriculum for Deaf and Hard of Hearing Youth

Abstract A tobacco use prevention curriculum tailored for deaf/hard of hearing youth was tested using a quasi-experimental design. Two schools for the deaf received the curriculum; two served as noncurriculum controls. Surveys assessed changes in tobacco use, tobacco education exposure, and tobacco-related attitudes and knowledge among students in grades 7-12 over 3 school years (n = 511-616). Current (past month) smoking decreased significantly at one intervention school (23% to 8%, p = 0.007), and current smokeless tobacco use at the other (7.5% to 2.5%, p = 0.03). Tobacco education exposure and antitobacco attitudes and knowledge increased significantly at one or both intervention schools. At one control school, reported tobacco education exposure decreased ( p less than 0.001) and antitobacco attitudes increased (p = 0.01). The results indicate that the curriculum increased perceived tobacco education exposure and significantly affected tobacco-related practices, attitudes, and knowledge. (Contains 4 tables and 2 figures.)
Publication American Annals of the Deaf
Date 2011
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ935973

 


Trial protocol and preliminary results for a cluster randomised trial of behavioural support versus brief advice for smoking cessation in adolescents

Abstract Many young people report they want to stop smoking and have tried to do so, but most of their quit attempts fail. For adult smokers, there is strong evidence that group behavioural support enhances quit rates. However, it is uncertain whether group behavioural support enhances abstinence in young smokers trying to quit.
Publication BMC Research Notes
Date 2010-12-14
URL http://www.biomedcentral.com/1756-0500/3/336/abstract

 


Do socioeconomic differences in tobacco use exist also in developing countries? A study of Ghanaian adolescents

Abstract In Western countries, tobacco use is most prevalent among adolescents in lower socioeconomic groups. The association between socioeconomic status (SES) and tobacco use among adolescents in developing countries is unexplored. Using multiple SES measures, we investigated this association among adolescents in Ghana.
Publication BMC Public Health
Date 2010-12-08
URL http://www.biomedcentral.com/1471-2458/10/758/abstract

 


Prevalence and Psychosocial Correlates of Current Smoking Among Adolescent Students in Thailand, 2005

Abstract This article examines the prevalence of current smoking and associated psychosocial correlates and whether these correlates differ by sex among adolescent students in Thailand. Data were analyzed from the Thailand Global Youth Tobacco Survey (GYTS), a school-based, cross-sectional survey conducted in 2005 and completed by Mathayom 1, 2, and 3 (U.S. seventh through ninth grades) students. Weighted prevalence estimates of the percentage of students who were current smokers (smoked on ≥1 day during the past 30 days) and noncurrent smokers were calculated for the sample and for each psychosocial variable. Separate logistic regression models were calculated for males and females to examine the independent association of the psychosocial correlates of current smoking. Significant correlates for both males and females included close peer smoking, secondhand smoke exposure, being offered a free cigarette by a tobacco industry representative, and belief that smoking is not harmful. These correlates are examined in the context of comprehensive tobacco control laws in Thailand.
Publication Health Education & Behavior
Date December 01 , 2010
URL http://heb.sagepub.com/cgi/content/abstract/37/6/863

 


Response rates and selection problems, with emphasis on mental health variables and DNA sampling, in large population-based, cross-sectional and longitudinal studies of adolescents in Norway

Abstract Selection bias is a threat to the internal validity of epidemiological studies. In light of a growing number of studies which aim to provide DNA, as well as a considerable number of invitees who declined to participate, we discuss response rates, predictors of lost to follow-up and failure to provide DNA, and the presence of possible selection bias, based on five samples of adolescents.
Publication BMC Public Health
Date 2010-10-12
URL http://www.biomedcentral.com/1471-2458/10/602/abstract

 


Evaluation of a Peer-Led Smoking Prevention Programme for Romanian Adolescents

Abstract The goal of this study was to assess the effects of a school-based smoking prevention programme that used both a video and peer-led discussion groups among Romanian junior high school students aged 13-14 years. The programme embraced the social influence approach and concentrated on enhancing self-efficacy and the acquisition of cigarette refusal skills. Twenty schools were randomly assigned to the control and experimental conditions, resulting in 55 participating classes from the seventh grade (28 in the control group and 27 in the experimental group). Pretest and 9 months follow-up data on weekly smoking initiation and psychosocial variables were collected from 1071 students. Multilevel logistic regression analyses demonstrated a significant effect of the programme on adolescents' smoking behaviour after 9 months. At post-test, weekly smoking onset was 4.5% in the experimental group versus 9.5% in the control group. Furthermore, the programme had significant effects on smoking-related beliefs. In the experimental group, this resulted in a more negative attitude towards smoking, increased social self-efficacy levels and a more negative intention towards smoking. These findings show that short-term effects of the smoking prevention programme can be realized in Romania. More studies are needed to analyse how to maintain these effects over time.
Publication Health Education Research
Date October 00, 2010
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ897786

 


The effectiveness of interventions to change six health behaviours: a review of reviews

Abstract Several World Health Organisation reports over recent years have highlighted the high incidence of chronic diseases such as diabetes, coronary heart disease and cancer. Contributory factors include unhealthy diets, alcohol and tobacco use and sedentary lifestyles. This paper reports the findings of a review of reviews of behavioural change interventions to reduce unhealthy behaviours or promote healthy behaviours. We included six different health-related behaviours in the review: healthy eating, physical exercise, smoking, alcohol misuse, sexual risk taking (in young people) and illicit drug use. We excluded reviews which focussed on pharmacological treatments or those which required intensive treatments (e.g. for drug or alcohol dependency).
Publication BMC Public Health
Date 2010-09-08
URL http://www.biomedcentral.com/1471-2458/10/538/abstract

 


Biomarker evaluation of Greek adolescents’ exposure to secondhand smoke

Abstract Exposure to secondhand smoke (SHS) is a significant threat to public health, and represents a danger for both the development and health status of children and adolescents. Taking the above into account, our aim was to quantify Greek adolescents’ exposure to SHS using serum cotinine levels. During 2006, 341 adolescents aged 13-17 were randomly selected from high schools in Heraklion and agreed to participate as part of the European Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Blood samples were drawn from a random sample of 106 adolescents, while serum cotinine/nicotine concentrations were measured by Gas Chromatography—Mass Spectrometry (GC-MS). The mean levels of serum cotinine and nicotine were calculated at 1.60 ± 2.18 ng/mL and 4.48 ± 4.00 ng/mL, respectively, while 97.7% of the non-smoker adolescents were found to have measureable levels of serum cotinine indicating exposure to SHS. The analysis revealed that their paternal (p = .001) and maternal smoking habits (p = .018) as also the existence of a younger brother or sister (p = .008) were the main modifiers of SHS exposure during adolescence. Conclusively, almost all of the measured Greek adolescents were exposed to SHS, even when their parents were non-smokers. This finding indicates the need for both community and school-based educational programmes as also the implementation of a comprehensive ban on smoking in public places.
Publication Human & Experimental Toxicology
Date June 01 , 2010
URL http://het.sagepub.com/cgi/content/abstract/29/6/459

 


A Multilevel-Based Study of School Policy for Tobacco Control in Relation to Cigarette Smoking among Children in Elementary Schools: Gender Differences

Abstract The aim was to comprehensively examine school-based tobacco policy status, implementation and students' perceived smoking at school in regard to gender-specific differences in smoking behavior. We conducted a multilevel-based study to assess two-level effects for smoking among 2350 grades three to six students in 26 randomly selected elementary schools in southern Taiwan. A series of multilevel models were analyzed separately for male and female students. The school-level variables appear to be related to smoking behavior in male students. Among males, the risk of ever-smoking was significantly associated with those schools without antitobacco health education activities or curricula [adjusted odds ratio (aOR) = 6.23, 95% confidence interval (CI): 2.55-15.24], with a high perceived smoking rate (aOR = 3.08, 95% CI: 1.41-6.72) and located in a mountainous region (aOR = 2.53, 95% CI: 1.15-5.58). The risk of ever-smoking among females was significantly associated with those schools without antitobacco activities or curricula (aOR = 3.10, 95% CI: 1.27-7.55). As compared with female counterparts, the specific school that the male students attended had a positive significant effect on the risk of being ever-smokers. The findings suggest that effective tobacco policy implementation should be considered in elementary schools that are currently putting children at the greatest risk for cigarette smoking, especially in regard to male students. (Contains 5 tables.)
Publication Health Education Research
Date June 00, 2010
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ911580

 


Impact of a School Health Coordinator Intervention on Health-Related School Policies and Student Behavior

Abstract Background: Health-related, school-based interventions may serve to prevent disease and improve academic performance. The Healthy Maine Partnerships (HMP) initiative funded local school health coordinators (SHCs) as a part of Maine's Coordinated School Health Program (CSHP) beginning in January 2001. SHCs established school health leadership teams and implemented annual work plans to address health risk behaviors. This study evaluates the impact of the Healthy Maine Partnerships SHC (HMPSHC) intervention on school policies and student risk behaviors after its first 5 years. Methods: Data sources include the Maine School Health Profiles Survey and the Maine Youth Drug and Alcohol Use Survey/Youth Tobacco Survey. Cross-sectional analyses were performed on 2006 data to assess physical activity, nutrition, and tobacco-related policy associations with the HMPSHC intervention. Finally, policy and student behavior analyses were conducted to assess associations. Results: Intervention schools were more likely to be associated with physical activity intramural offerings, improved nutritional offerings, and tobacco cessation programs. In intervention schools, supportive school policies were associated with decreased soda consumption, decreased inactivity, and decreased tobacco use. Required school health education curricula were more predictive of decreased risk behavior in intervention schools than in nonintervention schools. Conclusions: In schools with SHCs, there exists a stronger association with improved school programs. Improved policies and programs were associated with decreases in risk behavior among students in intervention schools. The HMPSHC intervention may be a viable CSHP model to replicate and evaluate in other settings. (Contains 4 tables.)
Publication Journal of School Health
Date April 00, 2010
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ882517

 


Do 'good values' lead to 'good' health-behaviours? Longitudinal associations between young people's values and later substance-use

Abstract Past studies have linked certain values (traditional vs. individualistic) with adolescent substance-use. The aims of this study are to replicate cross-sectional research linking values and adolescent substance-use and to determine if such values predict future substance-use.
Publication BMC Public Health
Date 2010-03-26
URL http://www.biomedcentral.com/1471-2458/10/165/abstract

 


Enrollment in Physical Education Is Associated with Health-Related Behavior among High School Students

Abstract Background: Physical education (PE) plays a critical role in the healthy development of youth; however, the influence of PE classes in helping to provide students with health-related behavior patterns is not clear. This study aims to analyze whether participation in PE classes is associated with health-related behavior among high school students. Methods: A total of 4210 students attending public high schools in Pernambuco (northeast of Brazil) were selected using random 2-stage cluster sampling. Data were collected by using the Global School-based Student Health Survey. The independent variable was the frequency of participation in PE classes, whereas physical activity, television viewing, smoking, and alcohol, fruit, vegetables and soda consumption were dependent variables. Logistic regressions were carried out to perform crude and adjusted analysis of the association between enrollment in PE classes and health-related behaviors. Results: Sixty-five percent of students do not take part in PE classes, with a significantly higher proportion among females (67.8%). It was observed that enrollment in PE classes was positively associated with physical activity, TV viewing, and fruit consumption, but was negatively associated with soda drinking. The likelihood of reporting being active and eating fruit on a daily basis was 27% and 45% higher, respectively, among those who participate in at least 2 classes per week in comparison with those who do not. Students who participate in PE classes had 28-30% higher likelihood of reporting lower TV viewing during week days. Conclusions: Findings suggest that higher levels of enrollment in PE classes could play a role in the promotion of health-related behaviors among high school students. (Contains 4 tables.)
Publication Journal of School Health
Date March 00, 2010
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ882511

 


Emotional, behavioural problems and cigarette smoking in adolescence: findings of a Greek cross-sectional study

Abstract Although several studies have reported findings concerning the association between smoking and emotional/behavioural problems, little research has investigated this association after controlling for confounding factors which have been found to be significantly correlated with both cigarette smoking and emotional/behavioural problems and may have a strong effect on the relationship between adolescents' mental health and smoking. The present study attempted to assess the association between adolescents' smoking status and their emotional/behavioural problems after controlling for a number of possible confounders (i.e. age, gender, parental smoking status, exposure to family smoking, family socioeconomic status, adolescents' leisure time) in a Greek nation-wide school-based sample.
Publication BMC Public Health
Date 2010-02-03
URL http://www.biomedcentral.com/1471-2458/10/57/abstract

 


Predicting the life-time benefit of school-based smoking prevention programmes

Abstract Aim School-based smoking prevention programmes may delay the age of smoking initiation, but do not appear to achieve lasting reductions in smoking prevalence beyond school-leaving age. We explored whether delaying the age at which someone initiates smoking may have life-time benefits by increasing the likelihood of quitting in later life.Design and setting Data from the General Household Survey of Great Britain were used in a logistic regression model to examine the association between age at which someone initiates regular smoking and the probability that the person will quit smoking later in life. The effect of confounding variables (sex, ethnicity, socio-economic class, education and geographical location) was taken into account. The predicted relationship was used in a cohort model to estimate the life-time reduction in smoking prevalence and all-cause mortality of a school-based smoking prevention programme.Results Age of regular smoking initiation was associated strongly with the probability of quitting later in life (coefficient −0.103, P
Publication Addiction
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.02924.x/abstract

 


Smoking-based selection and influence in gender-segregated friendship networks: a social network analysis of adolescent smoking

Abstract Aims The main goal of this study was to examine differences between adolescent male and female friendship networks regarding smoking-based selection and influence processes using newly developed social network analysis methods that allow the current state of continuously changing friendship networks to act as a dynamic constraint for changes in smoking behaviour, while allowing current smoking behaviour to be simultaneously a dynamic constraint for changes in friendship networks.Design Longitudinal design with four measurements.Setting Nine junior high schools in Finland.Participants A total of 1163 adolescents (mean age = 13.6 years) who participated in the control group of the ESFA (European Smoking prevention Framework Approach) study, including 605 males and 558 females.Measurements Smoking behaviour of adolescents, parents, siblings and friendship ties.Findings Smoking-based selection of friends was found in male as well as female networks. However, support for influence among friends was found only in female networks. Furthermore, females and males were both influenced by parental smoking behaviour.Conclusions In Finnish adolescents, both male and female smokers tend to select other smokers as friends but it appears that only females are influenced to smoke by their peer group. This suggests that prevention campaigns targeting resisting peer pressure may be more effective in adolescent girls than boys.
Publication Addiction
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.02930.x/abstract

 


Passive smoking is associated with lower serum HDL-C levels in school children

Abstract Background: In recent years, a number of studies have reported that exposure to environmental tobacco smoke (ETS) reduces high-density lipoprotein cholesterol (HDL-C) levels in children, as well as in adults. Further, a number of countries have indicated that passive smoking increases the risk of early arteriosclerosis onset. Here, to evaluate the effects of ETS exposure, we conducted a cross-sectional epidemiological study on primary school children in Japan using answers from a questionnaire survey, as well as urine cotinine and lipid metabolism-related variable measurements.Methods: A total of 121 sixth-grade primary school children participated in this study by completing a questionnaire about their food intake, lifestyle and family smoking habits. Early in the morning, we also measured height, weight, blood pressure, serum levels of total cholesterol, triglyceride, HDL-C, and blood sugar, as well as urine levels of cotinine and creatinine under unfed conditions.Results: From the questionnaire, 40 and 81 children reported being exposed and not exposed to ETS, respectively. Serum HDL-C levels, which were adjusted for the degree of corpulence and exercise habits, were significantly lower in the passive smoker group than the non-passive-smoker group (65.3 and 72.1 mg/dL, respectively; P= 0.012). In addition, proportional differences in serum HDL-C levels were also observed based on the amount of cigarettes smoked at home by family members of the child.Conclusions: Results suggest that ETS exposure at home is associated in a dose-related manner with lower serum HDL-C levels in primary school children. In addition, our results suggest that smoking in the presence of children who are not usually exposed to ETS increases the risk of arteriosclerosis. Given these findings, we strongly recommend the establishment of anti-passive-smoking measures.
Publication Pediatrics International
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1442-200X.2009.02957.x/abstract

 


Use of emergency contraceptive pill by 15-year-old girls: results from the international Health Behaviour in School-aged Children (HBSC) study

Abstract Please cite this paper as: Gaudineau A, Ehlinger V, Nic Gabhainn S, Vayssiere C, Arnaud C, Godeau E. Use of emergency contraceptive pill by 15-year-old girls: results from the international Health Behaviour in School-aged Children (HBSC) study. BJOG 2010;117:1197–1204.Objective To describe emergency contraceptive pill (ECP) use and variation across countries/regions; and to explore personal and contextual factors associated with ECP use and differences across countries/regions.Design Data were obtained from 11 countries/regions in the 2006 Health Behaviour in School-aged Children cross-sectional study.Setting Data were collected by self-report questionnaire in school classrooms.Population The analysis is based on 2118 sexually active 15-year-old girls.Methods Contraceptive behaviours were compared across countries/regions by chi-square tests. Individual factors related to ECP use were investigated with separate logistic regression models. Multilevel random-intercept models allowed the investigation of individual and contextual effects, by partitioning the variance into student, school and country/region levels.Main outcome measures ECP use at last sexual intercourse.Results ECP use rate varied significantly across countries/regions. Poor communication with at least one adult (odds ratio [OR] 1.62 [1.12–2.36], P = 0.011) and daily smoking (OR 1.46 [1.00–2.11], P = 0.048) were independently associated with ECP use in comparison with condom and/or birth-control pill use. Sexual initiation at 14 years or later (OR 2.02 [1.04–3.93], P = 0.039), good perceived academic achievement (OR 1.69 [1.04–2.75], P = 0.035) and daily smoking (OR 1.63 [1.01–2.64], P = 0.045) were associated with higher levels of ECP use in comparison with unprotected girls. The country-level variance remained significant in both comparisons.Conclusions These data document the large heterogeneity in rates of ECP use between countries/regions. These differences could not be explained by individual or contextual factors, and raise further questions in relation to ECP access for adolescents and their education in its appropriate use.
Publication BJOG: An International Journal of Obstetrics & Gynaecology
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2010.02637.x/abstract

 


School Disrepair and Substance Use Among Regular and Alternative High School Students

Abstract BACKGROUND: The physical environment influences adolescent health behavior and personal development. This article examines the relationship between level of school disrepair and substance use among students attending regular high school (RHS) and alternative high school (AHS).METHODS: Data were collected from students (N = 7058) participating in 2 randomized controlled trials of a school-based substance abuse prevention program implemented across the United States. Students provided substance use and demographic information on a self-reported survey. Data for the physical disrepair of schools were collected from individual rater observations of each school environment. We hypothesized that school disrepair would be positively associated with substance use controlling for individual characteristics and a socioeconomic status proxy. Multilevel mixed modeling was used to test the hypothesized association and accounted for students nested within schools.RESULTS: Findings indicated that students attending AHS with greater school disrepair were more likely to report the use of marijuana and other illicit drugs (ie, cocaine, heroin). Students attending RHS with greater school disrepair were less likely to report smoking cigarettes.CONCLUSIONS: Differences in findings between RHS and AHS students are discussed, and implications for substance use prevention programming are offered. Students attending AHS with greater school disrepair may require more substance abuse prevention programming, particularly to prevent illicit substance use.
Publication Journal of School Health
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2010.00518.x/abstract

 


Associations of Diet and Lifestyle With Headache in High-School Students: Results From a Cross-Sectional Study

Abstract (Headache 2010;50:1104-1114)Background.— Diet and lifestyle are seen as factors which influence headache in adults. However, population-based studies on this issue in adolescents are rare.Objective.— Aim of the present study was to investigate associations between diet and lifestyle factors and different types of headache, ie, migraine and tension-type headache (TTH) in adolescents.Methods.— A total of 1260 adolescents from the 10th and 11th grades of high schools filled in questionnaires on intake of meals, coffee, nonalcoholic and alcoholic drinks, smoking, and physical activity. Type of headache was classified according to the International Classification of Headache Disorders – 2nd edition. Multiple logistic regression models, adjusted for sex and grade, were calculated.Results.— High consumption of cocktails (odds ratio = 3.4; 95% confidence interval 1.9-6.0) and coffee (2.4; 1.3-4.7), smoking (2.7; 1.4-5.1), and lack of physical activity (2.2; 1.3-3.7) were significantly associated with migraine plus TTH episodes, consumption of coffee and physical inactivity particularly with migraine (3.4; 1.6-7.0 and 4.2; 2.2-7.9, respectively) and physical inactivity with TTH (1.7; 1.1-2.7). Skipping of meals or insufficient fluid intake were not associated with any type of headache.Conclusions.— Adolescents with any type of headache might benefit from regular physical activity and low consumption of alcoholic drinks, while for migraine patients a low consumption of coffee should additionally be recommended. Intervention studies are warranted to assess whether psycho-educational programs conferring knowledge of these associations will influence headache-triggering behavior and headache in adolescents.
Publication Headache: The Journal of Head and Face Pain
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.2010.01706.x/abstract

 


Operation Wellness: A University/Community Collaboration to Enhance Adult Wellness

Abstract Operation Wellness, a 4-year collaborative university/community-based initiative for individuals in a small, rural county in Indiana, was designed to promote physical activity, improve nutrition, and implement other healthy lifestyle changes. A variety of programs and strategies were offered for children who enrolled in Wellness Preparatory (toddlers through middle school) and for adults who enrolled in Wellness University (high school through senior citizens). This article describes the adult program. Results for the 4-year program include the following: The percentage of those who reporting exercising 3–4 days per week increased from 29.7% to 37.4%; smoking or using smokeless tobacco declined from 11.2% to 10.0%, but there was no difference in the number of servings of fruits and vegetables consumed per day. One of the most cost-effective and successful programs was Dump Your PlumpTM worksite weight loss competition where 333 individuals on 52 worker-led teams lost 2,256 pounds of body weight.
Publication Family and Consumer Sciences Research Journal
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1552-3934.2010.02053.x/abstract

 


A Quasi-Experimental Study of Maternal Smoking During Pregnancy and Offspring Academic Achievement

Abstract The current study, based on all births in Sweden from 1983 to 1991 (N = 654,707), explored the processes underlying the association between smoking during pregnancy (SDP) and offspring school grades and mathematic proficiency at age 15. The analyses compared relatives who varied in their exposure to SDP and who varied in their genetic relatedness. Although SDP was statistically associated with academic achievement (AA) when comparing unrelated individuals, the results suggest that SDP does not cause poorer academic performance, as full siblings differentially exposed to SDP did not differ in their academic scores. The pattern of results suggests that genetic factors shared by parents and their offspring help explain why offspring exposed to SDP have lower levels of AA.
Publication Child Development
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8624.2009.01382.x/abstract

 


Sports and leisure-time physical activity in pregnancy and birth weight: a population-based study

Abstract We examined the association between sports and other leisure-time physical activities during pregnancy and birth weight of babies born after 37 completed weeks of gestation. All Danish-speaking pregnant women attending routine antenatal care at the Department of Obstetrics, Aarhus University Hospital, Denmark, from August 1989 to September 1991 were invited to participate in the study. A total of 4458 healthy women who delivered after 37 completed gestational weeks participated in this study. The associations between sports (0, 1–2, 3+ h/week) or leisure-time physical activity (sedentary, light, and moderate to heavy) and birth weight were examined by linear and logistic regression and adjusted for potential confounding factors such as smoking, parity, schooling, pre-pregnancy body mass index and gestational age. The results showed that pregnant women who practiced sports or were moderate to heavy leisure-time physical active during the early second or the early third trimester gave birth to infants with a similar birth weight as inactive women. The proportion of newborns with a low (
Publication Scandinavian Journal of Medicine & Science in Sports
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2009.00918.x/abstract

 


Covariate adjusted weighted normal spatial scan statistics with applications to study geographic clustering of obesity and lung cancer mortality in the United States

Abstract In the field of cluster detection, a weighted normal model-based scan statistic was recently developed to analyze regional continuous data and to evaluate the clustering pattern of pre-defined cells (such as state, county, tract, school, hospital) that include many individuals. The continuous measures of interest are, for example, the survival rate, mortality rate, length of physical activity, or the obesity measure, namely, body mass index, at the cell level with an uncertainty measure for each cell. In this paper, we extend the method to search for clusters of the cells after adjusting for single/multiple categorical/continuous covariates. We apply the proposed method to 1999–2003 obesity data in the United States (US) collected by CDC's Behavioral Risk Factor Surveillance System with adjustment for age and race, and to 1999–2003 lung cancer age-adjusted mortality data by gender in the United States from the Surveillance Epidemiology and End Results (SEER Program) with adjustment for smoking and income. Copyright © 2010 John Wiley & Sons, Ltd.
Publication Statistics in Medicine
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.1002/sim.3990/abstract

 


Perinatal and childhood risk factors for overweight in a provincial sample of Canadian Grade 5 students

Abstract Background. The risk of obesity is determined by a complex interaction of prenatal, lifestyle, genetic, and environmental factors. Objective. To investigate the differential impact of prenatal, child, and family factors on body weight status in childhood. Methods. The current study links population-based survey data of Grade 5 students who participated in the 2003 Children's Lifestyle and School Performance Study in Nova Scotia, Canada, with a provincial perinatal registry. Multilevel logistic regression was used to investigate the association between prenatal, lifestyle, and socioeconomic factors and childhood overweight. Results. Of the 4 298 participating children, 3 426 (80%) could be linked with information in the perinatal registry. Small-for-gestational age infants appeared to be less likely to be overweight at age 10 or 11 years (odds ratio [OR]=0.68) whereas those born large-for-gestational age were more likely to be overweight (OR=1.23). Maternal pre-pregnancy weight was associated with childhood overweight (OR=4.42 for >80 kg vs. 7x/week vs. ≤2x/week) and screen time (OR=1.82 for >6 h/day vs. ≤1h/day). Smoking during pregnancy increased the child's odds for being overweight (OR=1.42 for >0.5 packs/day vs. none). Children living in neighborhoods with higher housing values were less likely to be overweight (OR=0.68 for highest vs. lowest tertile). Conclusions. Overweight young women should be advised on the importance of healthy eating, active living and maintaining a healthy weight in the pre-pregnancy years to reduce the risk of overweight in their offspring.
Publication International Journal of Pediatric Obesity
Date 2010
URL http://onlinelibrary.wiley.com/doi/10.3109/17477160903060028/abstract

 


Does Successful School-Based Prevention of Bullying Influence Substance Use among 13- To 16-Year-Olds?

Abstract Aim: To test whether the school-based Olweus prevention programme against bullying may have lasting effects on substance use, a hypothesis based on the characteristics of bullies having misconduct behaviour associated with substance use. Methods: The Olweus programme was introduced from grades 7 through 9 in four schools and monitored up to grade 10 in Oslo in 2001/02, with two schools serving as controls. Students responded to annual questionnaires about substance use. Three-level analyses were applied to check for increases in substance use over time. Findings: There was no significant difference in the frequency of alcohol use between the experimental schools and the control schools. Alcohol intoxication and cannabis use, and possibly smoking, were higher in the control schools than in the experiment schools. Conclusion: Elements of the Olweus programme characterized by positive interest and engagement on the part of adults, firm boundaries between acceptable/unacceptable behaviour, and the consistent application of non-physical, non-hostile consequences, in addition to the multi-modal and permanence of the approach, may be of interest for further studies of school-based programmes aimed at achieving lower levels of or at delaying the onset of substance use. (Contains 3 tables and 4 figures.)
Publication Drugs: Education, Prevention & Policy
Date 2010
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ869262

 


"Project ALERT's" Effects on Adolescents' Prodrug Beliefs: A Replication and Extension Study

Abstract This article represents a replication and extension of previous studies of the effects of "Project ALERT", a school-based substance use prevention program, on the prodrug beliefs of adolescents. Specifically, the authors' research examined "Project ALERT's" effects on adolescents' intentions to use substances in the future, beliefs about substance use consequences, normative beliefs, and resistance self-efficacy. In all, 34 schools with Grades 6 to 8 completed this randomized controlled trial and 71 "Project ALERT" instructors taught 11 core lessons to 6th graders and 3 booster lessons to 7th graders (one grade level earlier than in previous studies). Students were assessed in 6th grade prior to the onset of the intervention, in 7th grade after the completion of the 2-year curriculum, and again 1 year later in 8th grade. The authors found no evidence to suggest that "Project ALERT" had a positive impact on any alcohol, cigarette, or marijuana prodrug beliefs. Implications for school-based substance use prevention are discussed. (Contains 2 tables.)
Publication Health Education & Behavior
Date 2010
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ884318

 


Working with young smokers: The development and implementation of a tailored behavioral support intervention model within Upper Schools in North Bedfordshire

Publication Education and Health
Date 2010
URL /x/EH/eh383ae.pdf

 


Teen Perceptions of Facilitator Characteristics in a School-Based Smoking Cessation Program

Abstract Background: Facilitators are often responsible for the implementation of public health programs, yet little is known about how they influence outcomes. Not-On-Tobacco (N-O-T) is a youth smoking-cessation program implemented by trained facilitators. The purpose of this study was to investigate teens' perceptions of facilitator characteristics and the relationship between those perceptions and program outcomes. Methods: Data were collected from N-O-T participants aged 14 to 19 who completed a survey about perceptions of facilitator characteristics that were linked to program outcomes 3 months post-baseline (n = 769). Eight facilitator characteristics were ordered, based on importance to participants. Chi-square tests measured differences in perceptions of facilitator characteristics according to race and sex, and an aggregate facilitator favorability score was created and analyzed in relation to program outcomes (smoking reduction or cessation vs increase/no change). Logistic regression was used to analyze facilitator characteristics' relationship to outcomes, controlling for race and sex. Results: Participants rated facilitator characteristics of trustworthy, cares about students, and confidential as most important. Girls consistently ranked facilitator characteristics as more important than did boys. There were few significant differences based on race, except that white students rated nonjudgmental to be more important than did nonwhite students. There were no significant findings from the logistic regression, but there was a significant relationship between the aggregate facilitator favorability score and favorable changes in smoking outcomes (reduction or cessation). Conclusions: This study provides insights into the facilitator characteristics that are important to teen participants. It demonstrates that teens' overall perceptions of facilitators contribute to their perception of how the program contributes to their success and program outcomes. (Contains 2 tables.)
Publication Journal of School Health
Date July 00, 2009
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ862401

 


High School Students Who Tried to Quit Smoking Cigarettes: United States, 2007

Abstract In the United States, cigarette use is the leading cause of preventable death, and most adult smokers started before the age of 18 years. Nicotine dependence maintains tobacco use and makes quitting difficult. Despite their relatively short smoking histories, many adolescents who smoke are nicotine dependent, and such dependence can lead to daily smoking. To examine the extent to which high school students had tried to quit smoking cigarettes, CDC analyzed data from the 2007 Youth Risk Behavior Survey (YRBS), a nationally representative survey of students in grades 9-12 in the United States. This report describes the results of that analysis, which found that 60.9 percent of students who ever smoked cigarettes daily tried to quit smoking cigarettes, and 12.2 percent were successful. These findings indicate that comprehensive tobacco control programs need to continue to implement community-based interventions that prevent initiation and increase cessation and increase the use of evidence-based cessation strategies for youths. YRBS measures the prevalence of health risk behaviors among high school students through biennial national, state, and local surveys. The national YRBS uses a three-stage cluster sample design to obtain cross-sectional data representative of public- and private-school students in grades 9-12 in the 50 states and the District of Columbia. Students complete school-based, anonymous, self-administered questionnaires that examine the prevalence of health risk behaviors, including tobacco use. In 2007, the school response rate was 81 percent, the student response rate was 84 percent, the overall response rate was 68 percent, and 14,041 students completed a usable questionnaire. The following two behaviors were examined: (1) ever smoked cigarettes daily and tried to quit smoking cigarettes; and (2) ever smoked cigarettes daily, tried to quit smoking cigarettes, and were successful. Race/ethnicity data are presented for non-Hispanic black, non-Hispanic white, and Hispanic students; the numbers of students from other racial/ethnic groups were too small for meaningful analysis. Data were weighted to provide national estimates. Statistical software that takes into account the complex sampling design was used to calculate prevalence estimates and 95 percent confidence intervals and to conduct t-tests for subgroup comparisons (p less than 0.05). (Contains 1 table.)
Publication Centers for Disease Control and Prevention
Date May 01, 2009
URL http://www.eric.ed.gov/ERICWebPortal/contentdelivery/servlet/ERICServlet?
accno=ED505590

 


A Six-Wave Study of the Consistency of Mexican/Mexican American Preadolescents' Lifetime Substance Use Reports

Abstract In the Fall of 2004, 1,948 5th grade students from Phoenix, AZ enrolled in an evaluation of a school-based, substance use prevention intervention. To assess the consistency of Mexican and Mexican-American students' self-reports of lifetime substance use, the present study analyzed data reported by 1,418 students who reported Mexican ancestry and completed 2 to 6 questionnaires administered over a 40-month period. By wave 6, which was completed in March 2008, lifetime alcohol, cigarette, marijuana, and inhalant use rates were 86.0%, 65.0%, 64.5%, and 62.1%, respectively. Corresponding rescission rates were 24.0%, 9.6%, 5.8%, and 9.2%. Reporting patterns with one "Yes-No" sequence accounted for more than 88% of the inconsistent self-reports. This finding suggests that the majority of Mexican/Mexican-American preadolescents participating in a substance use prevention intervention provided logically consistent self-reports of lifetime substance use. (Contains 4 tables.)
Publication Journal of Drug Education
Date January 00, 2009
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ878333

 


Change in tobacco use among 13—15 year olds between 1999 and 2008: findings from the Global Youth Tobacco Survey

Abstract Tobacco use is the leading preventable cause of death and disease in the world; yet little is known about the levels or patterns of youth tobacco use on a global basis. The purpose of this paper is to focus on change in youth tobacco use using data from 100 sites that have conducted repeat Global Youth Tobacco Surveys (GYTS). The GYTS is a school-based survey that collects data from students aged 13—15 years using a standardized methodology for constructing the sample frame, selecting schools and classes, and processing data. GYTS is conducted in school classes using self-administered anonymous data collection. The GYTS sample produces representative, independent, cross-sectional estimates for each sampling frame. Of the 100 sites surveyed, 61 reported no change over time in prevalence of cigarette smoking, likewise in 50 of the 97 sites with data on use of other tobacco products there was no change. However, 34 sites reported an increase in other tobacco use. This appears to be attributed to waterpipe, an emerging trend in tobacco use. Evidence was found supporting the idea that tobacco use among adolescent girls is likely increasing. The global tobacco control effort continues to face many challenges in reversing the tobacco epidemic. Few countries have implemented comprehensive tobacco control legislation laid out by the World Health Organization. The few countries that have adopted some of these proven policies can serve as examples in achieving positive results in curbing the tobacco epidemic. (Global Health Promotion, 2009; Supp (2): pp. 38-90)
Publication Global Health Promotion
Date 2009
URL http://ped.sagepub.com/cgi/content/abstract/16/2_suppl/38

 


Depression, Suicide, Tobacco Control Policies, and Cigarette Smoking Among High School Students

Publication Journal of Dual Diagnosis
Date 2009
URL http://dx.doi.org/10.1080/15504260902886430

 


Comparing the effects of entertainment media and tobacco marketing on youth smoking in Germany

Abstract Aims To examine differential effects of smoking in films and tobacco advertising on adolescent smoking. We hypothesize that movie smoking will have greater effects on smoking initiation, whereas tobacco advertising receptivity will primarily affect experimentation.Design Longitudinal observational study of adolescents.Setting School-based surveys conducted in Schleswig-Holstein, Germany.Participants A total of 4384 adolescents age 11–15 years at baseline and re-surveyed 1 year later; ever smoking prevalence was 38% at time 1.Measurements The main outcome variable combined two items assessing life-time and current smoking (alpha = 0.87). Baseline never smokers were analyzed separately from those who had tried smoking (ever smokers). Exposure to smoking in 398 internationally distributed US movies was modeled as a continuous variable, with 0 corresponding to the 5th percentile and 1 to the 95th percentile of exposure. Tobacco marketing receptivity consisted of naming a brand for a favorite tobacco advertisement. Ordinal logistic regressions controlled for socio-demographics, other social influences, personality characteristics of the adolescent and parenting style.Findings Whereas 34% of ever smokers were receptive to tobacco marketing at time 1, only 6% of never smokers were. Among time 1 never smokers, exposure to movie smoking was a significantly stronger predictor of higher time 2 smoking level [adjusted proportional odds ratio = 2.76, 95% confidence interval (1.84, 4.15)] than was tobacco marketing receptivity (1.53 [1.07, 2.20]). Among time 1 ever smokers, both tobacco marketing receptivity and exposure to movie smoking predicted higher levels of time 2 smoking [2.17 (1.78, 2.63) and 1.62 (1.18, 2.23), respectively], and the two estimates were not significantly different.Conclusions In this longitudinal study, exposure to movie smoking was a stronger predictor of smoking initiation than tobacco marketing receptivity, which was more common among ever smokers. The results suggest that entertainment media smoking should be emphasized in programs aimed at preventing onset, and both exposures should be emphasized in programs aimed at experimental smokers.
Publication Addiction
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2009.02542.x/abstract

 


Salient Environmental and Perceptual Correlates of Current and Established Smoking for 2 Representative Cohorts of Indiana Adolescents

Abstract PURPOSE: A secondary analysis of 2000 and 2004 Indiana Youth Tobacco Survey (IYTS) data was conducted to investigate salient environmental and perceptual correlates of adolescents’ current and established smoking while controlling for demographic variables such as gender, grade, and race/ethnicity and to compare the pattern of significant correlates between the years.METHODS: The IYTS was an anonymous school-based survey regarding tobacco use; familiarity with pro- and anti-tobacco media messages; exposure to environmental tobacco smoke (ETS); minors’ access to tobacco products; and general knowledge, attitudes, and beliefs about tobacco. In 2000, a representative sample of 1416 public high school students in grades 9-12 and 1516 public middle school students in grades 6-8 (71.44% and 72.53% response rates, respectively) were surveyed. In 2004, 3433 public high school students and 1990 public middle school students (63.04% and 65.44 % response rates, respectively) were surveyed.RESULTS: Significant predictors of adolescents’ current and established smoking habits included exposure to ETS either in homes or in cars, exposure to pro-tobacco messages, perceived benefit of smoking, and perceived peer acceptance of smoking. The influence of exposure to pro-tobacco messages greatly outweighed exposure to any anti-tobacco messages.CONCLUSIONS: The findings of this study warrant that more efforts and resources be placed on preventing youth from being exposed to ETS, and to control pro-tobacco marketing and improve the tobacco counter-marketing messages. The perceived benefits of smoking found here indicate that smoking for relaxation and weight control may be major influencing factors on adolescent smoking.
Publication Journal of School Health
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2009.00393.x/abstract

 


Association between tobacco control policies and smoking behaviour among adolescents in 29 European countries

Abstract Aims To investigate the associations between well-known, cost-effective tobacco control policies at country level and smoking prevalence among 15-year-old adolescents.Design Multi-level modelling based on the 2005–06 Health Behaviour in School-aged Children Study, a cross-national study at individual level, and with country-level variables from the Tobacco Control Scale and published country-level databases.Setting Twenty-nine European countries.Participants A total of 25 599 boys and 26 509 girls.Main outcome measures Self-reported regular smoking defined as at least weekly smoking, including daily smoking (dichotomous).Findings Interaction effects between gender and smoking policies were identified, therefore boys and girls were analysed separately. Large cross-national differences in smoking prevalence were documented. Intraclass correlations (ICC) of 0.038 (boys) and 0.035 (girls) were found. In the final multi-level model for boys, besides the significance of the individual variables such as family affluence, country-level affluence and the legality of vending machines were related significantly to regular smoking [b(country affluence) = −0.010; b(partial restriction vending machines) = −0.366, P
Publication Addiction
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2009.02686.x/abstract

 


Overweight and perception of overweight as predictors of smokeless tobacco use and of cigarette smoking in a cohort of Swedish adolescents

Abstract Aims To study the association between measured or perceived overweight in adolescence and subsequent uptake of cigarette smoking and of the Swedish smokeless tobacco ‘snus’ (oral moist snuff).Design Population-based prospective cohort study with 7 years' follow-up.Setting Self-administered questionnaires and school nurses' visits.Participants A total of 2922 children of both sexes and mean age 11.6 years at recruitment, resident in the Stockholm region, Sweden.Measurements Tobacco use was self-reported at baseline and on six subsequent surveys. Subjects' height and weight were measured by school nurses during the first 4 years, self-reported thereafter. Overweight perception was self-reported at the age of 15 years.Findings Overweight and perception of overweight were not associated with subsequent uptake of either smoking or snus among males. Among females, overweight at baseline was associated with uptake of smoking [adjusted hazard ratio (HR) 1.34, 95% confidence interval (CI) 1.09–1.63], but not of snus. A similar pattern was found with overweight status during follow-up. Among girls with low-educated parents, overweight at baseline predicted the uptake of both snus and smoking. Among 15-year-old females who never used tobacco perceived overweight was associated with subsequent uptake of smoking (adjusted HR 1.71, 95% CI 1.20–2.46), but not of snus.Conclusions In Sweden, adolescent girls with actual or perceived overweight are at increased risk to start smoking, while indications that this increased risk applies to smokeless tobacco (snus) are limited to girls of low socio-economic status.
Publication Addiction
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2009.02506.x/abstract

 


The Relationship Between School Policies and Youth Tobacco Use

Abstract BACKGROUND: The school setting is frequently used both to educate youth about risks involved in tobacco use and to implement tobacco prevention and cessation programs. Given that school-based programs have resulted in limited success, it is necessary to identify other setting-level intervention strategies. School tobacco policies represent a type of universal intervention that might have some promise for preventing or reducing tobacco use.METHODS: Hierarchical linear modeling was used to assess whether school tobacco policies were related to observations of tobacco use and current smoking among 16,561 seventh through twelfth graders attending 40 middle and high schools in Illinois.RESULTS: Results indicated that the enforcement of school tobacco policies, but not the comprehensiveness of those policies, was associated with fewer observations of tobacco use by minors on school grounds as well as lower rates of current smoking among students.CONCLUSIONS: The school setting is a key system to impact youth tobacco use. Findings underscore the need to train school personnel to enforce school tobacco policy.
Publication Journal of School Health
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2008.00369.x/abstract

 


What Works to Prevent Adolescent Smoking? A Systematic Review of the National Cancer Institute's Research-Tested Intervention Programs

Abstract BACKGROUND: Cigarette use remains the leading preventable cause of death in the United States. Although school is an ideal setting for antismoking interventions, school-based programs have not been successful in the long term. The purpose of this study was to explore characteristics of programs deemed to be successful short-term Research-Tested Intervention Programs (RTIPs) by the National Cancer Institute (NCI).METHODS: To identify adolescent smoking prevention programs, 2 independently working researchers applied specified selection criteria to all programs in the NCI's RTIP database. Selected programs were abstracted using a structured form for general information, participants, interventions, outcomes, and quality. Extracted data were then assessed for common themes and contrasts in each category.RESULTS: As of June 2008, 18 studies met the NCI's standards for RTIPs preventing smoking among adolescents. After selection criteria were applied, only 5 programs remained. Each independently working researcher arrived at the same pool of programs. In chronological order according to date of publication of outcomes evaluation, the 5 programs ultimately included were Project Towards No Tobacco Use, Pathways to Health, Native FACETS, Kentucky Adolescent Tobacco Prevention Project, and Sembrando Salud. The majority of these programs were targeted toward a particular sociodemographic group (eg, American Indians, Hispanic migrant communities).CONCLUSIONS: New school-based programs are needed to address current issues in tobacco control. To improve chances of success, these programs may wish to target certain specific high-risk demographic groups, use professional health educators and/or trained community members, and build in methods of updating material.
Publication Journal of School Health
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2009.00426.x/abstract

 


Parental divorce and adolescent cigarette smoking and alcohol use: assessing the importance of family conflict

Abstract Aim: To investigate how family conflict contributes to the relationship between parental divorce and adolescent cigarette smoking and alcohol use.Design: Population-based cross-sectional survey.Setting: School classrooms in Iceland in which an anonymous questionnaire was administered to respondents by supervising teachers. Participants were 7430 (81.4%) of 9124 14- to 16-year-old adolescents.Main outcome measure: Cigarette smoking and alcohol use during the last 30 days were assessed by self-report.Results: Parental divorce was related to adolescent cigarette smoking during the last 30 days (OR = 2.12, 95% CI 1.84–2.44) when controlling for gender only, but was insignificant (OR = 1.18 95%, CI 0.99–1.44) when controlling for relationship with parents, disruptive social changes and family conflict. There was a significant relationship between parental divorce and adolescent alcohol use during last 30 days (OR = 1.66, 95% CI 1.48–1.87), controlling only for gender; however, the relationship disappeared (OR = 1.04, 95% CI 0.91–1.20) when controlling for other variables.Conclusion: Family conflicts are important contributors to the relationship between parental divorce and adolescent cigarette smoking and alcohol use. Conflict between parents and adolescents, but not inter-parental conflict, appears to be the most important factor in the relationship between family conflict and adolescent substance use.
Publication Acta Pædiatrica
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1651-2227.2008.01133.x/abstract

 


Predictors of young adults' amphetamine use and disorders: A prospective study

Abstract Introduction and Aims. Understanding the risk factors that predict amphetamine use and development of amphetamine abuse or dependence (disorder) may help guide preventive interventions. This study aimed to investigate the correlates and predictors of young adults’ amphetamine use and use disorders. Design and Methods. Prospective cohort, population-based study which started in Brisbane, South East Queensland (Australia) in 1981. The study participants were a cohort of 2042 young adults, followed up from birth to young adulthood. At the 21-year follow-up, amphetamine use was assessed via a self-report questionnaire, and amphetamine use disorder (AUD) was assessed using the Composite International Diagnostic Interview (CIDI-Auto). Potential predictors (15 risk factors) were assessed between baseline (antenatal visit) and the 21-year follow-up. These included participant's gender, mother's age and education, maternal marital status and quality of marital relationship, maternal tobacco and alcohol consumption, mother-child communication, child mental health and problem behaviours, child smoking and alcohol consumption and child school performance. Results. Young adult amphetamine users were more likely to have concurrent symptoms of mental illness and problem behaviours and to use or abuse cigarettes, cannabis, or other illicit drugs. In multivariate analyses, young adults’ amphetamine use and disorder were disproportionately more common among males and those who have prospectively reported aggression/delinquency or smoking at 14 years, or who have experienced childhood sexual abuse. Conclusions. Our findings suggest that problem behaviours, smoking and childhood sexual abuse are predictors of initiation to use of amphetamines and development of amphetamine abuse and dependence.[Hayatbakhsh MR, Najman JM, Bor W, Williams GM. Predictors of young adults' amphetamine use and disorders: A prospective study. Drug Alcohol Rev 2009]
Publication Drug and Alcohol Review
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1465-3362.2009.00032.x/abstract

 


Longitudinal association of adolescents’ sense of coherence with tooth-brushing using an integrated behaviour change model

Abstract Abstract – Objective: To determine the association between adolescents’ sense of coherence (SOC) and their tooth-brushing behaviour.Methods: This 18-month longitudinal study involved a representative sample of 8th-graders (n = 1025) from 11 randomly selected public high schools in the Limpopo Province, South Africa. Data collected by means of a self-administered questionnaire included respondents’ socio-demographic profiles, vulnerability to depression, smoking status, dental treatment attendance pattern, frequency of and motivation for tooth-brushing. Based on the responses to the question on readiness to change brushing behaviour and in line with the integrated change model, respondents were also categorized as being in the pre-contemplation, contemplation or preparation/action stages. Respondents’ SOC was measured using a six-item adapted Antonovsky SOC scale. Data analysis included chi-squared analysis, t-tests and step-wise multiple logistic regression.Results: At baseline, 72.6% (n = 744) of the respondents reported that they were not consistently brushing twice daily. Of those who did not brush twice daily and were followed up on (n = 578), those living with their mother at baseline not only presented with a greater increase in their SOC over time (follow-up minus baseline), but they were also more likely to be brushing twice daily at the time of the follow-up (15.4% versus 10.6%; P = 0.04). Adding baseline intention state to a multivariate model attenuated the influence of baseline SOC to a statistically insignificant level. However, increasing within-subject SOC changes (β = 0.16; P
Publication Community Dentistry and Oral Epidemiology
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0528.2008.00444.x/abstract

 


Indoor environmental risk factors and seasonal variation of childhood asthma

Abstract Seasonality of asthma may result from varying exposures. This cross-sectional study was designed to examine the relationship between indoor environmental factors and seasonal childhood asthma. Study subjects were participants from the International Study of Asthma and Allergies in Childhood (ISAAC) in 2004, a population-based surveillance, which included school children aged 6–15 yr in south Taiwan. Cases included 1725 children who experienced asthma symptoms in the past 12 months and the references consisted of 19,646 children who reportedly have no asthma history. By using a moving average and principal component analysis, asthmatic children were grouped into four asthma subtypes: winter, spring, summer/fall, and perennial. Multivariate logistic regression was used to evaluate the effect of indoor environmental factors on seasonality of childhood asthma. For all asthma prevalence, a peak occurred in the winter and a nadir appeared in summer. Contributing factors of asthma for children, regardless of seasonality, included younger age, parental atopy, maternal smoking during pregnancy, breast feeding, and perceived air pollution. After adjusted for salient risk factors, water damage was significantly associated with all subtypes of asthma. Presence of cockroaches was related to the summer/fall asthma (adjusted odds ratio [aOR] = 1.65, 95% confidence interval [CI] = 1.12–2.55). Visible mold on the walls was associated with an increased occurrence of winter and spring asthma (aOR = 1.53, 95% CI = 1.26–1.85 and aOR = 1.34, 95% CI = 1.10–1.62, respectively). Passive smoking was shown to be related to spring and summer/fall asthma. Water damage is a possible risk for childhood asthma year-round. Cockroaches and visible mold on the walls may play essential roles for seasonality of childhood asthma in Taiwan. Plausible mechanisms and allergic effects should be further determined. Elimination of these allergens is necessary to help prevent the development of asthma.
Publication Pediatric Allergy and Immunology
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1399-3038.2009.00871.x/abstract

 


Asthma management and asthma control in São Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison

Abstract Background and Aims: The Global Initiative Against Asthma (GINA) was developed to meet the global challenge of asthma. GINA has been adopted in most countries and comparison of asthma management in different parts of the world may be of help when assessing the global dissemination of the guideline. The overall goals in GINA include that asthma patients should be free of symptoms, acute asthma attacks and activity limitations. The aim of the present study was to compare asthma management and asthma control in São Paulo, Brazil and Uppsala, Sweden.Materials and Methods: Information was collected from asthmatics in São Paulo and Uppsala with a questionnaire. The questionnaire dealt with the following issues: symptoms, smoking, self-management, hospital visits, effect on school/work and medication.Results: The São Paulo patients were more likely to have uncontrolled asthma (36% vs 13%, P
Publication The Clinical Respiratory Journal
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1752-699X.2008.00103.x/abstract

 


The low prevalence of allergic disease in Eastern Europe

Abstract Background The prevalence of allergic disease is known to be low in Eastern Europe.Objective To assess the association of suspected risk factors, including several closely linked to the hygiene hypothesis, with allergic symptoms and atopic sensitization in young school-aged children.Methods Observational study of 13 889 Belarusian children followed up at age 6.5 years in the Promotion of Breastfeeding Intervention Trial (PROBIT). Allergic symptoms and diseases were based on parental responses to the International Study of Asthma and Allergy in Childhood questionnaire, and prick tests to five common inhalant allergens were performed using standard methods.Results Significantly increased risks of wheezing and hayfever symptoms in the past 12 months, and of recurrent itchy rash were observed in boys, children with a positive first-degree family atopic history, and those who had received probiotics (especially as prophylaxis with antibiotic use). Pet ownership, contact with farm animals, the presence and number of younger and (especially) older siblings, and residency in rural areas of Western Belarus were associated with reduced risks. Maternal postnatal smoking was associated with wheezing and hayfever symptoms, while the duration of exclusive breastfeeding was not protective against any of the studied outcomes. The risk factors for allergic symptoms were similar in children with positive skin-prick tests to those in the overall cohort.Conclusion Many of the risk and protective factors we identified are consistent with those reported in Western countries and with the hygiene hypothesis. Further research on dietary and other environmental and genetic factors is necessary to understand the low prevalence of allergic disease in Belarus and other Eastern European countries.
Publication Clinical & Experimental Allergy
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2222.2009.03205.x/abstract

 


Weight gain in childhood and blood lipids in adolescence

Abstract Aim: To assess the effect of weight gain in childhood on blood lipid levels in adolescence.Methods: A population-based birth cohort carried out in Pelotas, Southern Brazil. All newborns in the city's hospitals were enrolled in 1982. The subjects have been followed up for several times in childhood. At age 18, 79% of all males were followed, and 2083 blood samples were available. Adjusted analyses controlled for household assets index, family income, parental schooling at birth, maternal smoking during pregnancy and breastfeeding duration.Results: Birth weight for gestational age and weight gain in the first 20 months was not associated with blood lipid levels in adolescence. On the other hand, those subjects whose weight gain from 20 to 42 months of age was faster than that predicted from birth weight and weight-for-age z-score at the mean age of 20 months had lower high-density lipoprotein cholesterol (HDL) cholesterol [−0.78 (95% confidence interval: −1.28; −0.29)] and higher very low-density lipoprotein cholesterol (VLDL) and low-density lipoprotein cholesterol (LDL)/HDL ratio in adolescence. After controlling for current body mass index (BMI), the regression coefficient for HDL cholesterol decreased from −0.78 mg/dL to −0.29 mg/dL (95% confidence interval: −1.00 to 0.05).Conclusion: Weight gain from 2 to 4 years is related to an atherogenic lipid profile in adolescence and this association is mediated by current BMI.
Publication Acta Pædiatrica
Date 2009
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1651-2227.2009.01247.x/abstract

 


Beyond the "Model Minority" Stereotype: Trends in Health Risk Behaviors among Asian/Pacific Islander High School Students

Abstract Background: Asian/Pacific Islander (API) students have been stereotyped as the "model minority." The objective of this study was to examine the trends in health risk behaviors among API students who participated in the San Diego City Schools Youth Risk Behavior Survey (YRBS) between 1993 and 2005. Methods: High school students from the San Diego City School District completed the self-administered YRBS between 1993 and 2005. Among sexually active students, logistic regression for survey data was used to examine trends in health risk behaviors. Results: From 1993 to 2005, condom use at last sexual intercourse was consistently lower among API students than their cross-ethnic peers. We observed a significant increasing trend in lifetime smoking, drinking, and marijuana use. Parental communications regarding human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) were significantly less frequent and decreased over time. Conclusions: Our findings challenge the notion of API youth being the "model minority." API students face unique challenges, including barriers to good communication about sex and lower rates of condom use. School-based prevention programs are needed for API students, including a focus on HIV communication with parents. (Contains 3 tables.)
Publication Journal of School Health
Date 2009
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ862407

 


High Fidelity? How Should We Consider Variations in the Delivery of School-Based Health Promotion Interventions?

Abstract Objective: The complexity and scale of health promotion interventions present challenges for the standardization of delivery. Furthermore, health promotion practice favours adapting interventions according to perceived client need. This paper examines the fidelity of intervention delivery within A Stop Smoking in Schools Trial (ASSIST), identifying if and why variations occurred, the consequences of these variations for the integrity of the intervention, and the broader implications for the delivery of evidence-based health promotion in schools. Design: The ASSIST intervention involved influential Year 8 students being trained to encourage their peers, through informal conversations, to be smoke-free. Its effectiveness was evaluated by a pragmatic randomized controlled trial with an integral process evaluation to examine the context, implementation and receipt of the intervention. Setting: Thirty secondary schools in South Wales and the west of England. Method: A variety of methods, including interviews, questionnaires and observation, were used to obtain data from key participants. Qualitative data were analysed using the constant comparative method. Results: Whilst overall fidelity was high, some variations were observed. Despite this variation, the intervention was largely delivered successfully and appropriately across a range of schools. Lessons learned from ASSIST enabled us to develop a model to categorize variations in intervention delivery. Conclusion: The model developed can inform the design of health promotion interventions and identify the level of fidelity which should be expected outside of a trial. We believe that this model can contribute to good practice in the implementation of evidence-based health promotion in schools. (Contains 8 tables and 1 figure.)
Publication Health Education Journal
Date 2009
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ828755

 


Addictive Substances: Textbook Approaches from 16 Countries

Abstract Schools have been identified as one of the appropriate settings for addiction prevention since this is the place where pupils may come into contact with drugs for the first time and experiment with them, with the possibility of becoming addicted. To be effective, school-based drug education must be firmly based on knowledge of oneself and knowledge of the effects of various addictive substances. Biology education is then an essential part of school-based drug education. The aim of this work was to compare the approach taken towards addictive substances in textbooks within 16 countries involved in the European project BIOHEAD-CITIZEN. We used a specific part of the project grid for substance abuse (alcohol, tobacco and other drugs) and focussed on three major indicators: physical effects, psychological effects and social effects. Generally, in all 16 countries, the educative approaches taken in their textbooks include the three dimensions. Textbooks mainly employ text rather than visual images, and some countries' textbooks have only text. Moroccan and Mozambican textbooks do not mention tobacco and other drugs, respectively. The comparative analyses highlighted that the Finnish textbook is the most comprehensive; the only one, in the study, to have a specific Health Education teaching module. (Contains 3 figures.)
Publication Journal of Biological Education
Date 2009
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ937520

 


The Potential of Coaching as a Strategy to Improve the Effectiveness of School-Based Substance Use Prevention Curricula

Abstract Research-based substance use prevention curricula typically yield small effects when implemented by school teachers under real-world conditions. Using a randomized controlled trial, the authors examined whether expert coaching improves the effectiveness of the All Stars prevention curriculum. Although a positive effect on students' cigarette use was noted, this finding may be attributed to marked baseline differences on this variable across the intervention and control groups. No effects were found on students' alcohol or marijuana use or on any of several variables thought to mediate curriculum effects. The effects of coaching on teachers may not become evident until future years, when they have moved beyond an initial mechanical delivery of the curriculum. (Contains 3 tables.)
Publication Health Education & Behavior
Date 2009
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ849576

 


Prevalence of smoking and other smoking related behaviors reported by the Global Youth Tobacco Survey (GYTS) in four Peruvian cities

Abstract In 2004, Peru ratified the Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) and in 2006 passed Law 28705 for tobacco consumption and exposure reduction. The Global Youth Tobacco Survey (GYTS) provides data on youth tobacco use for development of tobacco control programs. Findings from the GYTS conducted in four main cities in Peru in 2000 and 2003 are reported in this paper and can be used to monitor provisions of the WHO FCTC.
Publication BMC Public Health
Date 2008-12-15
URL http://www.biomedcentral.com/1471-2458/8/S1/S2/abstract

 


A Multilevel Analysis Examining the Association between School-Based Smoking Policies, Prevention Programs and Youth Smoking Behavior: Evaluating a Provincial Tobacco Control Strategy

Abstract This paper examined how smoking policies and programs are associated with smoking behavior among Grade 10 students (n = 4709) between 1999 and 2001. Data from the Tobacco Module from the School Health Action Planning and Evaluation System were examined using multilevel logistic regression analyses. We identified that (i) attending a school with smoking prevention programs only was associated with a substantial risk of occasional smoking among students with two or more close smoking friends and (ii) attending a school with both smoking prevention programs and policies was associated with substantial risk of occasional smoking among students who did not believe there were clear smoking rules present. Students attending schools where year of enrolment in high school starts in Grade 9 were more likely to be regular and occasional smokers. Each 1% increase in Grade 12 smoking rates increased the odds that a Grade 10 student was an occasional smoker. It appears that grade of enrolment, senior student smoking behavior, close friend's smoking behavior and clear rules about smoking at school can impact school-based tobacco control programming. These preliminary study findings suggest the need for further research targeting occasional smoking behavior and the transition stage into high school. (Contains 3 tables and 3 figures.)
Publication Health Education Research
Date December 00, 2008
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ912216

 


Health Risks Information Reaches Secondary School Smokers

Abstract This cross-sectional study aimed to assess smoking prevention and cessation education delivered as part of the UK National Curriculum and to evaluate the relative effectiveness of health, social influence and other/non-health components. In all, 1789 students aged 11-15 from 12 secondary schools completed online surveys assessing smoking status, factors known to be related to smoking and experience of smoking education. A total of 1421 of 1722 (83%) students remembered some school-based education. Of these, 803 (57%) said that the lessons changed their ideas about smoking. Multinomial logistic regression was used to assess whether lesson recall was associated with smoking status in a model adjusting for age, gender, ethnicity, family and best friend smoking status, socioeconomic status, and school. Quitters were more likely than smokers to report having changed their ideas about smoking as a result of a lesson (OR 5.78, 95% CI 2.44-13.72). The relative effectiveness of 16 lesson themes was assessed. Significantly more students changed their ideas about smoking as a result of "health" compared with "social influence" (([chi][superscript 2] (1) 124.0, P less than 0.001) or "other/non-health" ([chi][superscript 2] (1) 63.16, P less than 0.001) topics. Mouth cancer was the most effective health topic and may provide a suitable model for both smoking and risky drinking prevention. (Contains 5 tables.)
Publication Health Education Research
Date December 00, 2008
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ912221

 


Cigarette and waterpipe smoking among adolescents in Estonia: HBSC survey results, 1994–2006

Abstract Smoking is a major single cause of preventable morbidity and premature mortality. Tobacco use among adolescents is a significant public health problem as smoking behaviour is undeniably established in adolescence. While cigarette smoking among adolescents has been a significant public health problem for years, waterpipe smoking is considered to be a new global public health threat. The objectives of this study were to describe trends of cigarette smoking and the prevalence of waterpipe smoking and to study the association between cigarette and waterpipe smoking among adolescents in Estonia.
Publication BMC Public Health
Date 2008-11-25
URL http://www.biomedcentral.com/1471-2458/8/392/abstract

 


Correlates of susceptibility to smoking among Mexican origin youth residing in Houston, Texas: A cross-sectional analysis

Abstract Survey data suggest that in Texas Latino youth exhibit higher rates of susceptibility to smoking than youth from other ethnic groups. In this analysis we examined the relationship between susceptibility to smoking and well-known risk factors associated with smoking initiation among a cohort of 11 to 13 year old Mexican origin youth residing in Houston, Texas.
Publication BMC Public Health
Date 2008-09-26
URL http://www.biomedcentral.com/1471-2458/8/337/abstract

 


Social differences in smoking and snuff use among Norwegian adolescents: A population based survey

Abstract A change in pattern of tobacco use has been observed in the last decade in Norway. Snuff use and occasional smoking have to some degree replaced daily smoking among adolescents and young adults. Daily smoking is known to be negatively associated with social background factors, but little is known about these associations for other types of tobacco use. Our aim was to study different types of tobacco use among adolescents according to gender, educational ambitions, family background factors, and urbanization.
Publication BMC Public Health
Date 2008-09-22
URL http://www.biomedcentral.com/1471-2458/8/322/abstract

 


Commitment and compatibility: Teachers' perspectives on the implementation of an effective school-based, peer-led smoking intervention

Abstract Objective Although current UK policy argues that schools have a key role in raising health standards, emphasis on the core curriculum restricts teachers' opportunities to undertake health promotion activities. The challenge is to design effective health promotion interventions that minimize pressures on teaching staff and curriculum space. Here we consider teachers' perspectives of an effective peer-led, school-based smoking intervention, implemented by external trainers. Design The intervention, during which influential Year 8 students identified through a whole-year peer nomination process were trained to reduce smoking uptake through informal interactions with students in their year group, was evaluated by a pragmatic randomized controlled trial (ASSIST: A Stop Smoking In Schools Trial). An integral process evaluation examined the context, implementation and receipt of the intervention. Setting Thirty secondary schools in south-east Wales and the west of England. Methods Teachers in all intervention schools completed questionnaires at key stages of the intervention. Semi-structured interviews were undertaken in four schools at baseline and immediately post-intervention. The method of constant comparison, derived from grounded theory, was used throughout the analysis. Results The intervention was successfully implemented in a wide range of schools; recruitment and retention rates were good; and outcome data showed a reduction in smoking levels. Some teachers expressed concern about the participation of challenging students, external trainers setting standards of discipline, and communication over timetabling. Conclusion Overall, teachers showed commitment to the ASSIST intervention and felt it was compatible with the Year 8 curriculum. If implemented more widely, the importance of peer nomination should be stressed.
Publication Health Education Journal
Date June 01 , 2008
URL http://hej.sagepub.com/cgi/content/abstract/67/2/74

 


Chinese version of the Global Youth Tobacco Survey: cross-cultural instrument adaptation

Abstract Tobacco smoking poses public health concerns because of its high risk for many chronic diseases. Most smokers begin using tobacco in their teens and recent reports indicate that smoking prevalence is climbing among youth. The Global Youth Tobacco Survey (GYTS) is a worldwide, school-based, tobacco-specific survey, but cross-cultural differences limit its effectiveness in international studies. Specifically, the GYTS assesses not only the prevalence of smoking, but also tobacco-related attitudes, school curricula, and advertisements, which are culturally influenced. Therefore, we conducted this study to develop a Chinese version of the GYTS for both national surveillance and international comparison.
Publication BMC Public Health
Date 2008-04-30
URL http://www.biomedcentral.com/1471-2458/8/144/abstract

 


Program Strategies for Adolescent Smoking Cessation

Abstract School nurses who work with adolescents are in an ideal position to promote smoking cessation. This opportunity is important because research suggests teens who smoke are likely to become habitual smokers. This study characterizes adolescents’ patterns and levels of smoking, describes adolescents’ perceptions toward smoking, and delineates quit strategies that may prove helpful for adolescents who attempt smoking cessation. Results suggest adolescent smokers have highly variable patterns and levels of smoking. They fail to consider their future health and continue to be unaware of the harmful effects of smoking and the addictive nature of tobacco. Among adolescent smokers, there are few gender differences in perception of smoking. Therefore, gender specific cessation programs may not be necessary. The most effective quit strategy was the acquisition of information on contents of cigarettes and the health effects of smoking. Armed with these strategies, school nurses can provide leadership in the design and implementation of school based smoking cessation programs.
Publication The Journal of School Nursing
Date February 01 , 2008
URL http://jsn.sagepub.com/cgi/content/abstract/24/1/21

 


Developing a Knowledge Exchange Tool for School-Based Health Policies and Programs

Abstract Youth smoking and physical inactivity are significant public health issues, with implications for both health and education stakeholders, as school-based policies and programs have the potential to reach a broad population of youth to address these issues. Knowledge exchange tools designed around comprehensive school-level data collection systems allow for dissemination of evidence into such policies and programs. The purpose of this manuscript is to describe the process of developing knowledge exchange feedback reports for school-based health policies and programs, using the School Health Action, Planning and Evaluation System (SHAPES) data collection system. SHAPES-Ontario is a project that utilized the SHAPES research platform to collect student-level behavioural data and school-level policy and programs data on tobacco and physical activity in 81 secondary schools across Ontario, Canada. Methods used to develop the feedback reports involved categorizing and scoring survey response options based on extensive research evidence and expert feedback. Feedback report scores were aggregated into overall grades and presented in a short and long version of a feedback report for school administrators. These reports present prime examples of how to use the principles of knowledge exchange in developing a tool to bridge the gap between research and practice. (Contains 3 tables and 2 figures.)
Publication Educational Research and Reviews
Date January 00, 2008
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ893913

 


The role of national policies intended to regulate adolescent smoking in explaining the prevalence of daily smoking: a study of adolescents from 27 European countries

Abstract Aims This study seeks to examine whether contextual factors influence adolescents' daily smoking. A focus was placed on three modifiable policies operating at a national level, non-smoking policy at educational facilities, price and minimum age for buying tobacco.Design This study is based on a merged data set consisting of the 2001/02 Health Behavior in School-aged Children (HBSC) study and national-level data collected from the 2003 WHO European Tobacco Control Database and the World Development Indicators Database. HBSC is an international study including adolescents from 32 countries in Europe, Israel and North America. Data were analysed with multi-level hierarchical regression models.Findings The study found large differences in the prevalence of daily smoking among adolescents, and also large differences between boys and girls within some countries. The study found that smoking bans in schools were associated with lower odds ratios of daily smoking, which was the one positive association in the study. The study found no association between cigarette prices and adolescent daily smoking prevalence, and also the somewhat unexpected finding that having an age limit for allowing adolescents to purchase tobacco was associated with an increased risk of daily smoking.Conclusions There was an association between mandatory national bans on smoking and lower smoking prevalence. This should be confirmed by studies that examine whether mandatory bans are more rigorously implemented than voluntary bans. If this association is causal, introducing mandatory bans may reduce adolescent smoking prevalence. The findings that price was unrelated to smoking prevalence undermine findings elsewhere that adolescent smokers are more price-sensitive than adult smokers, but longitudinal studies are needed.
Publication Addiction
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2008.02161.x/abstract

 


Disparities in Smoking Behaviors Among Those With and Without Disabilities From 2001 to 2005

Abstract ABSTRACT Objectives: Past research has suggested smoking disparities among individuals with disabling conditions. We contrasted smoking behaviors of those with and without disabilities from 2001 to 2005.Design: Descriptive correlational study.Sample: Telephone interviews were conducted in all states with noninstitutionalized adults. Half were female; most were Anglo (70.5%) and had at least a high school education (90%). Their average age was 45 years. Approximately 19% of the sample reported being disabled.Measurement: We analyzed 4 years of data from the population-based Behavioral Risk Factor Surveillance System.Results: While individuals with disabilities were more likely to report ever having smoked than nondisabled respondents, current smoking behaviors were more similar in the 2 groups, and the difference was not statistically significant when demographic factors were included in the model. Smoking behavior decreased somewhat for nondisabled persons between 2001 and 2005, but remained fairly constant for those with disabilities. However, those with disabilities were more likely than those without disabilities to have attempted to quit smoking in all years.Conclusions: Findings underscore the importance of smoking cessation programs tailored to people with disabilities. The role of the public health nurse in addressing smoking cessation at the individual, system, and community level is discussed.
Publication Public Health Nursing
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1525-1446.2008.00739.x/abstract

 


Do graphic health warning labels have an impact on adolescents’ smoking-related beliefs and behaviours?

Abstract Aims To assess the impact of the introduction of graphic health warning labels on cigarette packets on adolescents at different smoking uptake stages.Design School-based surveys conducted in the year prior to (2005) and approximately 6 months after (2006) the introduction of the graphic health warnings. The 2006 survey was conducted after a TV advertising campaign promoting two new health warnings.Setting Secondary schools in greater metropolitan Melbourne, Australia.Participants Students in year levels 8–12: 2432 students in 2005, and 2050 in 2006, participated.Measures Smoking uptake stage, intention to smoke, reported exposure to cigarette packs, knowledge of health effects of smoking, cognitive processing of warning labels and perceptions of cigarette pack image.Findings At baseline, 72% of students had seen cigarette packs in the previous 6 months, while at follow-up 77% had seen packs and 88% of these had seen the new warning labels. Cognitive processing of warning labels increased, with students more frequently reading, attending to, thinking and talking about warning labels at follow-up. Experimental and established smokers thought about quitting and forgoing cigarettes more at follow-up. At follow-up intention to smoke was lower among those students who had talked about the warning labels and had forgone cigarettes.Conclusions Graphic warning labels on cigarette packs are noticed by the majority of adolescents, increase adolescents’ cognitive processing of these messages and have the potential to lower smoking intentions. Our findings suggest that the introduction of graphic warning labels may help to reduce smoking among adolescents.
Publication Addiction
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2008.02294.x/abstract

 


Factors Influencing Teachers’ Implementation of an Innovative Tobacco Prevention Curriculum for Multiethnic Youth: Project SPLASH

Abstract Background: The effectiveness of school-based tobacco use prevention programs depends on proper implementation. This study examined factors associated with teachers’ implementation of a smoking prevention curriculum in a cluster randomized trial called Project SPLASH (Smoking Prevention Launch Among Students in Hawaii).Methods: A process evaluation was conducted and a cross-condition comparison used to examine whether teacher characteristics, teacher training, external facilitators and barriers, teacher attitudes, and curriculum attributes were associated with the dose of teacher implementation in the intervention and control arms of the study. Data were collected from a total of 62 middle school teachers in 20 public schools in Hawaii, during the 2000-2001 and 2001-2002 school years. Sources included teacher questionnaires and interviews. Chi-square test and t test revealed that implementation dose was related to teachers’ disciplinary backgrounds and skills and student enjoyment of the curriculum.Results: Content analysis, within case, and cross-case analyses of qualitative data revealed that implementing the curriculum in a yearlong class schedule and high teacher self-efficacy supported implementation, while high perceived curriculum complexity was associated with less complete implementation.Conclusions: The results have implications for research, school health promotion practice, and the implementation of evidence-based youth tobacco use prevention curricula.
Publication Journal of School Health
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2008.00299.x/abstract

 


Mechanisms Through Which Adolescents Attend and Respond to Antismoking Media Campaigns

Abstract Based on H. Markus and R. B. Zajonc’s (1985) O-S-O-R model, this study explores which pre- and postorientations are associated with antismoking campaign effectiveness. Analyzing nationally representative survey data, this study finds that sensation seeking as an internal orientation and antismoking education as a learned orientation play critical roles in adolescents’ level of awareness to both antismoking campaigns (i.e., “truth”) and prosmoking media messages. In turn, exposure to both kinds of smoking-related media messages seems significantly related to adolescents’ smoking intention rather indirectly through negative attitudes toward tobacco companies and through peer smoking norms, respectively. A comparative analysis between younger and older adolescents seems to suggest that school-based antismoking education may be more effective for younger adolescents, whereas antismoking media campaigns may be more effective for older adolescents.
Publication Journal of Communication
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1460-2466.2007.00375.x/abstract

 


Relationship Between Physical Disabilities or Long-Term Health Problems and Health Risk Behaviors or Conditions Among US High School Students*

Abstract Background: This study explores the relationship between self-reported physical disabilities or long-term health problems and health risk behaviors or adverse health conditions (self-reported engagement in violent behaviors, attempted suicide, cigarette smoking, alcohol and other drug use, sexual activity, physical activity, dietary behaviors, self-reported overweight [based on height and weight], physical health, and mental health) among US high school students.Methods: Data were from the Centers for Disease Control and Prevention’s 2005 national Youth Risk Behavior Survey, a cross-sectional paper-and-pencil survey collected from a representative sample of public and private high school students (grades 9 through 12) in the United States.Results: Significantly more students with physical disabilities or long-term health problems than without described their health as fair or poor and reported being in a physical fight, being forced to have sexual intercourse, feeling sad or hopeless, seriously considering and attempting suicide, cigarette smoking, using alcohol and marijuana, engaging in sexual activity, using computers 3 or more hours per day, and being overweight (for all, p ≤ .05). For none of the health risk behaviors analyzed were the rates significantly lower among students with physical disabilities or long-term health problems than among other students.Conclusions: Young people who live with physical disabilities or long-term health problems may be at greater risk for poor health outcomes. Public health and school health programs, with guidance from health care providers, need to work with these adolescents and their families to develop and implement appropriate interventions, with particular emphasis on promoting mental health.
Publication Journal of School Health
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2008.00297.x/abstract

 


Modifiable characteristics associated with sedentary behaviours among youth

Abstract Objective. Childhood overweight and obesity is a major public health issue. A better understanding of factors associated with sedentary behaviours would provide valuable insight for tailoring interventions to prevent or reduce overweight among youth. Methods. Data were collected from 25 416 grade 9 to 12 students attending 76 secondary schools in Ontario, Canada, using the Physical Activity Module of the School Health Action, Planning and Evaluation System (SHAPES). Sex specific multivariate logistic regression analyses were then used to examine how physical activity, BMI, social influences, and smoking behaviour were associated with screen time, time spent reading, and time spent on homework. Results. The average screen time per day was 2.7 (±1.7) hours, yet 48.1% of students reported spending less than one hour reading per week and 30.2% spent less than an hour of time on homework per week. Among males, being underweight (≤5% percentile BMI, adjusted for age and sex) was associated with more screen time (OR 1.23, 95%CI 1.01–1.50) and time spent reading (OR 1.19, 95%CI 1.00–1.43), whereas being at risk of overweight (≥85% percentile BMI, adjusted for age and sex) was associated with less time spent on homework (OR 0.75, 95%CI 0.65–0.85). Conversely, among females, being at risk of overweight was associated with more screen time (OR 1.24, 95%CI 1.10–1.41), and time spent reading (OR 1.19, 95%CI 1.05–1.35). Aside from BMI, other factors associated with sedentary behaviours included physical activity, parental encouragement and support for physical activity, close friend physical activity behaviour, and smoking status. Discussion. We found that students are highly involved in screen-based sedentary behaviours, but spend a limited time on more productive sedentary behaviours, like reading and homework. Developing a better understanding of sedentary behaviours is critical for preventing and reducing obesity among youth populations.
Publication International Journal of Pediatric Obesity
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1080/17477160701830879/abstract

 


The impact of a parent-directed intervention on parent – child communication about tobacco and alcohol

Abstract Introduction and Aim. Given the likelihood of engaging in the hazardous use of tobacco and alcohol increases during teenage years, pre-adolescence is a critical time to implement prevention programmes. While social factors other than those associated with parenting play a role in determining a child's risk for initiation of tobacco and alcohol use, parents can have a significant influence on their children's decisions about these issues. The aim of this study was to assess the impact of an in-home parent-directed drug education intervention on parent – child communication about tobacco and alcohol. Design and Methods. A group randomised intervention trial was conducted in Perth, Western Australia. Schools were selected using stratified random sampling and randomised to three study conditions. A total of 1201 parents of 10–11-year-old children were recruited from 20 schools. The impact of a self-help intervention, comprised of five communication sheets containing information and activities designed to encourage parents to talk with their 10–11-year-old child about issues related to smoking cigarettes and drinking alcohol, was assessed. Results. Intervention-group parents were more likely to have spoken with their children, to have spoken more recently, to have engaged the child during the discussion and to have addressed the topics identified as being protective of children's involvement in tobacco and alcohol. In addition, the duration of talks about alcohol was longer than for parents in the comparison group. Discussion and Conclusions. Parents of 10–11-year-old children appear to be receptive to participating in a home-based drug-related educational intervention and the parent-directed intervention seems to have enhanced parent – child tobacco- and alcohol-related communication.
Publication Drug and Alcohol Review
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1080/09595230801935698/abstract

 


Linking Global Youth Tobacco Survey 2003 and 2006 Data to Tobacco Control Policy in India

Abstract Background: India made 2 important policy statements regarding tobacco control in the past decade. First, the India Tobacco Control Act (ITCA) was signed into law in 2003 with the goal to reduce tobacco consumption and protect citizens from exposure to secondhand smoke (SHS). Second, in 2005, India ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). During this same period, India conducted the Global Youth Tobacco Survey (GYTS) in 2003 and 2006 in an effort to track tobacco use among adolescents.Methods: The GYTS is a school-based survey of students aged 13-15 years. Representative national estimates for India in 2003 and 2006 were used in this study.Results: In 2006, 3.8% of students currently smoked cigarettes and 11.9% currently used other tobacco products. These rates were not significantly different than those observed in 2003. Over the same period, exposure to SHS at home and in public places significantly decreased, whereas exposure to pro-tobacco ads on billboards and the ability to purchase cigarettes in a store did not change significantly.Conclusions: The ITCA and the WHO FCTC have had mixed impacts on the tobacco control effort for adolescents in India. The positive impacts have been the reduction in exposure to SHS, both at home and in public places. The negative impacts are seen with the lack of change in pro-tobacco advertising and ability to purchase cigarettes in stores. The Government of India needs to consider new and stronger provisions of the ITCA and include strong enforcement measures.
Publication Journal of School Health
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2008.00316.x/abstract

 


Disordered eating and substance use in high-school students: Results from the Youth Risk Behavior Surveillance System

Abstract Objective:To examine the association between disordered eating (fasting, diet product use, and vomiting or laxative use) and use of 10 substances (cigarettes, alcohol, marijuana, cocaine, inhalants, heroin, methamphetamines, ecstasy, steroids, and hallucinogens) in a nationally representative adolescent sample.Method:Participants were 13,917 U.S. high-school students participating in the 2005 Youth Risk Behavior Surveillance System.Results:Disordered eating was significantly associated with the use of each substance. Using effect size estimates that take base rates into consideration, for female students, associations between substance use and disordered eating were weak for all but three forms of substance use: current smoking, binge drinking, and inhalants. Among male students, strong (marijuana, steroids, and inhalants) or moderate effects (all other substances) were observed.Conclusion:Future research needs to focus on inhalant use and methamphetamine use in males. Increased medical attention should be directed toward adolescents who practice disordered eating behaviors because they are also at elevated risk for using cigarettes, alcohol, inhalants, methamphetamines, and steroids. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008
Publication International Journal of Eating Disorders
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1002/eat.20520/abstract

 


The Impact of Child Obesity on Active Parental Consent in School-Based Survey Research on Healthy Eating and Physical Activity

Abstract Previous studies have shown that active consent procedures result in sampling bias in surveys dealing with adolescent risk behaviors such as cigarette smoking and illicit drug use. To examine sampling bias from active consent procedures when the survey topic pertains to childhood obesity and associated health behaviors, the authors pair data obtained from both active and passive consent procedures. The authors find that parents of children who are overweight or at risk for being overweight are significantly less likely to give active consent. In addition, parents of children enrolled in lower grades are more reluctant to consent to participate. (Contains 3 tables and 2 notes.)
Publication Evaluation Review
Date 2008
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ793349

 


Young People - Food and Smoking: Trends from 1983

Abstract From SHEU's work with schools within the same authority we know that smoking levels vary widely from school to school. However, when data are combined from surveys across the country general trends can be detected.
Publication Education and Health
Date 2008
URL /x/EH/eh364sheu.pdf

 


Suicidal ideation and associated factors among school-going adolescents in rural Uganda

Abstract Mental health is a neglected area of health research and practice in most of sub-Saharan African countries where the largest burden of morbidity is from infectious diseases. This even occurs despite the fact that some mental health problems may arise from infectious diseases.
Publication BMC Psychiatry
Date 2007-11-23
URL http://www.biomedcentral.com/1471-244X/7/67/abstract

 


Rationale, design and conduct of a comprehensive evaluation of a school-based peer-led anti-smoking intervention in the UK: the ASSIST cluster randomised trial [ISRCTN55572965]

Abstract In preparing the main results paper from this trial, we have noticed an important error in the study protocol paper[1]. In the paragraph headed 'Outcome measures and sample size calculations', the current text
Publication BMC Public Health
Date 2007-10-23
URL http://www.biomedcentral.com/1471-2458/7/301/abstract

 


Explanations for female excess psychosomatic symptoms in adolescence: evidence from a school-based cohort in the West of Scotland

Abstract By mid adolescence there is an excess in female physical and/or psychosomatic, as well as psychological morbidity. This paper examines the contribution of a range of factors (self-esteem, body image, gender-role orientation, body mass index, smoking and physical activity) to explaining the female excess in three psychosomatic symptoms (headaches, stomach ache/sickness, and dizziness) and depressive mood at age 15.
Publication BMC Public Health
Date 2007-10-22
URL http://www.biomedcentral.com/1471-2458/7/298/abstract

 


Coping Strategies Used by Adolescents During Smoking Cessation

Abstract The purpose of this study was to examine coping strategies used by teens as they attempted to quit smoking. The teens were attending a school-based cessation program titled Quit 2 Win that was offered in four high schools. This study examined situations in which teens were tempted to smoke. The study compares coping strategies teens reported in resisting smoking with situations where they reported lapsing. Participants were interviewed the week of their quit date and asked about their state of mind, the availability of cigarettes, and coping strategies used to resist smoking. By identifying coping strategies, school nurses can develop new interventions for teen smoking cessation.
Publication The Journal of School Nursing
Date June 01 , 2007
URL http://jsn.sagepub.com/cgi/content/abstract/23/3/177

 


School smoking bans: do they help/do they harm?

Abstract Introduction and Aims. The international evidence about the effectiveness of school smoking bans on youth smoking initiation is equivocal. The purpose of the present study was to examine the association between school smoking bans and smoking initiation as a health outcome as well as academic achievement as an educational outcome, taking into account socio-economic status. Design and Methods. This multi-level study was based on a cross-sectional self-reported anonymous data from 12 990 students who participated in the 2002 Student Drug Use Survey in the Atlantic Provinces. The main outcomes were having smoked a first whole cigarette in the year prior to the survey, and academic performance. The main independent variable at the individual- and school-levels was a school rule against smoking on school property or at school events, as reported by students. Results. Smoking initiation was predicted by individual-level demographic factors and by the contextual factor of attending a school with a high prevalence of established smoking, but failed to be predicted by a school smoking ban. The academic performance of students who indicated there was no school smoking ban was found to worsen as an increasing proportion of the student body indicated that such a rule existed. Lower socio-economic status was found to be an independent predictor of smoking initiation and poorer academic performance. Discussion and Conclusions. A school ban against smoking, in addition to not being clearly effective, might also not be entirely benign. School smoking policy should be monitored as to educational outcomes and the impact of policy on groups vulnerable to smoking.
Publication Drug and Alcohol Review
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1080/09595230701613619/abstract

 


Use of the Transtheoretical Model to Predict Stages of Smoking Cessation in Korean Adolescents

Abstract Background: Smoking is popular among Korean male high school adolescents, with the prevalence of 20.7% differing markedly with the type of school, being 16.3% and 27.6% in academic and vocational technical high schools, respectively. The purpose of this study was to identify significant variables that predict stages of smoking cessation among Korean high school students using the transtheoretical model (TTM), in order to provide an empirical basis for developing smoking cessation programs.Methods: Cross-sectional data were collected in April and May 2004 from 300 male students at 3 vocational technical high schools in Korean metropolitan areas. The survey variables comprised decisional balance, self-efficacy, stages and processes of change, nicotine dependence, and use of smoking cessation aids.Results: Current and former smokers comprised 26.3% and 22.7% of the cohort, respectively, of which 71.4% had experienced smoking cessation at least once and 55.1% utilized smoking cessation aids to help stop smoking. Nicotine-free tobacco and nicotine gum were the most common smoking cessation aids. Decisional balance, use of behavioral processes, and higher self-efficacy were significant in explaining stages of smoking cessation after controlling for nicotine dependence.Conclusions: The study results suggest that smoking cessation programs developed based on the TTM may help adolescents to progress through stages, with it being important to include information regarding the use of smoking cessation aids.
Publication Journal of School Health
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2007.00213.x/abstract

 


Does harm minimisation lead to greater experimentation? Results from a school smoking intervention trial

Abstract Introduction and Aims. Declines in adolescent smoking prevalence have slowed recently, resulting in increased interest and literature in tobacco harm minimisation. To date, harm reduction strategies have focused largely on modifying the product and alternative (safer) mechanisms of nicotine delivery. There has been little exploration of primary harm minimisation to prevent the onset of regular smoking among young people. A major concern expressed about harm reduction interventions and young people is that they may increase experimentation among non-users. Design and Methods. The Smoking Cessation for Youth Project was a 2-year school-based cluster randomised controlled trial conducted in 30 Western Australian schools. Results on the primary outcome showed a significant reduction in regular smoking among 4636 13–15-year-olds receiving a harm minimisaton versus standard intervention. This paper addresses the intervention effects on 2078 students who had not smoked at baseline. Results. At 20-month follow-up, smoking initiation was slightly lower among intervention students than comparison students (who received a largely abstinence-based intervention), although this difference did not attain statistical significance (OR = 0.86; 95% confidence interval: 0.68, 1.09). Discussion and Conclusions. This study provided limited evidence to suggest that harm minimisation is a superior approach to abstinence-based interventions for non-smokers. However, this intervention did not contribute to increased experimentation among non-smokers. Although more trials are required, these results indicate that fears of potential negative iatrogenic effects from school-based harm minimisation interventions may be unwarranted.
Publication Drug and Alcohol Review
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1080/09595230701613585/abstract

 


A latent class typology of young women smokers

Abstract Aims Despite aggressive anti-smoking campaigns, smoking rates are increasing among young women, suggesting the need for new approaches to reach this population. Segmenting audiences can facilitate targeting interventions to specific populations, based on association of smoking behaviors with other health behaviors and psychological and social antecedents. Using latent class analysis, we sought to profile patterns of behavioral, attitudinal and cognitive variables related to tobacco use among young women.Design This study is part of an ongoing Midwestern longitudinal self-report survey of the natural history of cigarette smoking.Participants Participants were 18–25-year-old women smokers (n = 443).Measurements Variables included a comprehensive range of demographic characteristics, smoking-related variables and general attitudinal variables.Findings Three distinct classes emerged with the following characteristics: (1) working women who tended to smoke daily but reported high levels of positive affect and life satisfaction (n = 212); (2) light-smoking college students who exercised regularly, began smoking after high school and quit successfully at follow-up 5 years later (n = 86); and (3) heavy smokers who were more likely to have children, report high levels of negative affect and smoke for addictive reasons, for stimulation and to control affect (n = 145). Differences in smoking cessation at a 5-year follow-up were significant across the classes (18.1%, 34.4% and 13.0% had quit for at least 6 months, respectively).Conclusions The psychosocial and behavioral profiles of these classes can potentially be used to tailor smoking interventions more effectively within this population.
Publication Addiction
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2007.01889.x/abstract

 


Genes, maternal smoking, and the offspring brain and body during adolescence: Design of the Saguenay Youth Study

Abstract The search for genes of complex traits is aided by the availability of multiple quantitative phenotypes collected in geographically isolated populations. Here we provide rationale for a large-scale study of gene-environment interactions influencing brain and behavior and cardiovascular and metabolic health in adolescence, namely the Saguenay Youth Study (SYS). The SYS is a retrospective study of long-term consequences of prenatal exposure to maternal cigarette smoking (PEMCS) in which multiple quantitative phenotypes are acquired over five sessions (telephone interview, home, hospital, laboratory, and school). To facilitate the search for genes that modify an individual's response to an in utero environment (i.e. PEMCS), the study is family-based (adolescent sibships) and is carried out in a relatively geographically isolated population of the Saguenay Lac-Saint-Jean (SLSJ) region in Quebec, Canada. DNA is acquired in both biological parents and in adolescent siblings. A genome-wide scan will be carried out with sib-pair linkage analyses, and fine mapping of identified loci will be done with family-based association analyses. Adolescent sibships (12–18 years of age; two or more siblings per family) are recruited in high schools throughout the SLSJ region; only children of French-Canadian origin are included. Based on a telephone interview, potential participants are classified as exposed or nonexposed prenatally to maternal cigarette smoking; the two groups are matched for the level of maternal education and the attended school. A total of 500 adolescent participants in each group will be recruited and phenotyped. The following types of datasets are collected in all adolescent participants: (1) magnetic resonance images of brain, abdominal fat, and kidneys, (2) standardized and computer-based neuropsychological tests, (3) hospital-based cardiovascular, body-composition and metabolic assessments, and (4) questionnaire-derived measures (e.g. life habits such as eating and physical activity; drug, alcohol use and delinquency; psychiatric symptoms; personality; home and school environment; academic and vocational attitudes). Parents complete a medical questionnaire, home-environment questionnaire, a handedness questionnaire, and a questionnaire about their current alcohol and drug use, depression, anxiety, and current and past antisocial behavior. To date, we have fully phenotyped a total of 408 adolescent participants. Here we provide the description of the SYS and, using the initial sample, we present information on ascertainment, demographics of the exposed and nonexposed adolescents and their parents, and the initial MRI-based assessment of familiality in the brain size and the volumes of grey and white matter. Hum Brain Mapp 2007. © 2007 Wiley-Liss, Inc.
Publication Human Brain Mapping
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1002/hbm.20402/abstract

 


Tobacco smoking habits among a complete cross-section of Australian nursing students

Abstract Abstract This study was undertaken as a complete cross-sectional survey of tobacco smoking habits among 270 undergraduate students at an Australian nursing school (response rate: 84.6%). An anonymous, self-reporting questionnaire survey was used to gather the data. The overall prevalence of current smoking was 15.9%, with a further 8.5% being ex-smokers. The nursing students consumed an average of 11.5 cigarettes per day, they began smoking at 20.8 years of age, and had an average smoking duration of 7.2 years. The students who had previously worked as a nurse were twice as likely to be current smokers. This study suggests that although tobacco smoking remains fairly common among Australian nursing students, its prevalence and distribution vary according to the individual demographics of the group under study. Future researchers will need to consider the changing demographic base from which the new generation of nursing students are drawn.
Publication Nursing & Health Sciences
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1442-2018.2007.00306.x/abstract

 


Risk factors for sleep-related hypoxia in primary school children

Abstract Sleep-related hypoxia has adverse effects on cognition in children. Knowledge of factors contributing to sleep-related hypoxia is sparse. We aimed to identify demographic and clinical factors associated with mild (nadir arterial oxygen saturation 91–93%), moderate (nadir arterial oxygen saturation ≤90%), and recurrent (oxygen desaturation index > 3.9) sleep-related hypoxia in children. Parental questionnaires were distributed and overnight recordings of arterial oxygen saturation performed in a population-based cross-section of primary school children (n = 995). Associations were determined using unconditional logistic regression as well as unadjusted and adjusted odds ratios (OR), and their 95% confidence intervals (95% CI) calculated. Male sex, overweight (i.e., body mass index ≥ 75th percentile), household smoking, symptoms of sleep-disordered breathing, a current respiratory tract infection, and histories of asthma and respiratory allergy were all significantly associated with sleep-related hypoxia. In multiple regression analysis, (i) overweight (OR, 95% CI: 2.7, 1.7–4.3) and a history of respiratory allergy (1.7, 1.1–2.7) were independent risk factors for mild sleep-related hypoxia, (ii) overweight (3.2, 1.7–5.8), a history of respiratory allergy (2.4, 1.4–4.4), and household smoking >10 cigarettes/day (1.8, 1.1–2.8) were independent risk factors for moderate sleep-related hypoxia, and (iii) overweight (2.3, 1.04–5.3), a history of respiratory allergy (2.5, 1.2–5.1), and a current respiratory tract infection (4.4, 2.0–9.8), were independent risk factors for recurrent sleep-related hypoxia. Our data suggest that overweight, passive smoking, respiratory allergies, and acute lung disease may independently contribute to sleep-related hypoxia in children. Pediatr Pulmonol. 2007; 42:805–812. © 2007 Wiley-Liss, Inc.
Publication Pediatric Pulmonology
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1002/ppul.20658/abstract

 


Getting it right: designing adolescent-centred smoking cessation services

Abstract Aims To demonstrate the importance of identifying adolescent preferences for smoking cessation in order to inform the design of effective adolescent cessation services.Design Structured qualitative interviews drawing on means-end theory.Setting Three youth-clubs and two secondary schools in south-east Wales.Participants Twenty-five male and female 13–18-year-olds, mainly daily smokers.Findings Interviewees did not assume immediately that a smoking cessation service is something that will be available to them, and therefore they initially encountered difficulties in identifying attributes of such support. With further prompting interviewees were able to express a preference for support attributes, but these were not attributes that traditionally form part of cessation provision. Their main preference was for support from friends and family, access to nicotine replacement therapy and non-school-based, flexible support and guidance.Conclusion The results re-emphasize the inadequacies of existing cessation provision for meeting adolescent preferences and suggest that developing more adolescent-appropriate support requires a reconceptualization of existing interventions, with service users situated at the core of intervention design. The study highlights a number of service development points for intervention planners including: rethinking the timing and location of provision; placing more emphasis on the selection of facilitators; harnessing support from friends and family; and rooting these developments in broader tobacco control strategies.
Publication Addiction
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2007.01851.x/abstract

 


Is attention-deficit/hyperactivity disorder associated with illicit substance use disorders in male adolescents? A community-based case–control study

Abstract Aims This study aims at evaluating the association between attention-deficit/hyperactivity disorder (ADHD) and illicit substance use disorders (SUD) (marijuana, cocaine and inhalants), controlling for the association with conduct disorder (CD), in a community-based sample of adolescents.Design Case–control, community-based study.Setting A delimited geographical area in the South of Brazil, served by four public health clinics.Participants A total of 968 male adolescents (15–20 years of age) were screened for SUD in their households. Of the subjects who were screened positive, we selected 61 cases with illicit SUD. For each case we selected, from the group which was screened negative, three controls without illicit or alcohol SUD, matched by age and proximity with the case's household.Measurements The screening instrument was the Alcohol Smoking and Substance Screening Test (ASSIST). SUD diagnoses were assessed by the drug section of the Mini International Neuropsychiatry Interview (MINI). Other psychiatric diagnoses were based on semistructured (Schedule for Affective Disorders and Schizophrenia for School-Age Children—epidemiological version; MINI) and clinical interviews.Findings Adolescents with ADHD presented a significantly higher odds ratio (OR) for illicit SUD than youths without ADHD, even after adjusting for potential confounders (CD, ethnicity, religion and estimated IQ) (OR = 9.12; 95% CI = 2.84–29.31, P
Publication Addiction
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2007.01850.x/abstract

 


Mental health problems, negative life events, perceived pressure and the frequency of acute infections among adolescents Results from a cross-sectional, multicultural, population-based study

Abstract Aim: To study the association between mental health problems, negative life events, perceived pressure at school and the frequency of acute infectious illnesses in an adolescent population, and to explore whether the association differs by sex and immigration status.Methods: A cross-sectional study involving all tenth grade pupils in Oslo in 2000 and 2001. Of 8316 eligible pupils, 7346 participated in the study, giving a participation rate of 88%. Twenty-four percent of participants were first- or second-generation immigrants.Results: Mental health problems and negative life events were associated with the number of acute infections in a population-based setting, even after adjustment for possible confounding factors. For girls with an immigrant background, internalised mental health problems and own serious illness or injury had the strongest association with acute infections. For adolescents with a non-immigrant background, experiencing sexual violence had the strongest association, and for native-born boys the strongest association with acute infections was externalised mental health problems. Smoking was the cofactor with the strongest association to acute infections.Conclusion: There is a relationship between acute infection, mental health problems and negative life events among adolescents in a multicultural population-based setting.
Publication Acta Pædiatrica
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1651-2227.2007.00084.x/abstract

 


Combining Cognitive Behavioral Therapy with Contingency Management for Smoking Cessation in Adolescent Smokers: A Preliminary Comparison of Two Different CBT Formats

Abstract This pilot study evaluated the optimal format of cognitive behavioral therapy (CBT) to combine with contingency management (CM) in a four-week, high school-based smoking cessation program. Thirty-four adolescent smokers received a standard weekly version of CBT or a frequent brief behavioral intervention. Results indicate a trend toward a higher seven-day point prevalence end-of-treatment abstinence rate and percent days abstinent during treatment in the CBT condition. In addition, significantly more participants in the CBT group completed treatment. These preliminary results suggest that when combined with CM, the standard weekly format of CBT is more acceptable to adolescent smokers.
Publication The American Journal on Addictions
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1080/10550490701641173/abstract

 


Using Solution-Focused Approaches in Motivational Interviewing with Young People

Abstract This article explores the theory and practice of using the solution-focused approach of motivational interviewing (MI) with young people. MI is based on the premise that people are not always at a stage of readiness to change behaviours, such as smoking, drinking or drug use, which are perceived by others to be problematic. The article explores the theoretical and research background to the approach as well as the practical application. There then follows an illustrative case study of the work with a boy approximately 12 years old. The article concludes with a critical look at the work and suggestions for its potential application in schools. The authors conclude that this is a useful approach and recommend further research in educational settings.
Publication Pastoral Care in Education
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1468-0122.2007.00405.x/abstract

 


Risk Indicators for Missing Teeth in Working-Age Pomeranians – An Evaluation of High-Risk Populations

Abstract Objective: The goal of this study was to examine whether psychosocial conditions for general health described in the public health literature are also reflected in tooth loss.Methods: The relation of psychosocial factors to missing teeth was evaluated among 2,501 individuals aged 25 to 59 years from the population-based cross-sectional Study of Health in Pomerania using logistic regression analyses. The case group included 15 percent of participants of each 5-year age group with the highest number of missing teeth.Results: Unemployment, dose-dependent current and former smoking, a poor general health status, and a longer time since the last dental appointment were significant risk indicators for missing teeth. Alcohol consumption, use of interdental cleaning products, and checkup as the reason for the last dental visit were protective. Women with low education and low income were identified as a high-risk group for missing teeth by the three-way interaction between gender, school education, and household income. The effect of marital status was modified by gender: being single was a risk indicator for men but it was protective for women.Conclusions: The study supports the hypothesis that psychosocial conditions that affect health status as described in the general public health literature also have an effect on tooth loss. Strategies to prevent tooth loss may be expeditiously implemented in combination with approaches to prevent other health-related problems.
Publication Journal of Public Health Dentistry
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1752-7325.2007.00041.x/abstract

 


Prevalence and risk factors of allergies in Turkey: Results of a multicentric cross-sectional study in children

Abstract The Prevalence And Risk Factors of Allergies in Turkey (PARFAIT) study was planned to evaluate prevalence and risk factors of asthma and allergic diseases and also to find out which geographical variables and/or climatic conditions play a role determining the prevalence of allergic diseases in Turkish school children. Study was planned as cross-sectional questionnaire-based. About 25,843 questionnaires from 14 centers were appropriate for analysis. Parental history of allergy, having an atopic sibling and other atopic disease in index case was significant risk factors for all allergic diseases. Breast feeding decreased the risk of current asthma (OR: 0.92, CI: 0.86–0.99) and wheezing (OR: 0.93, CI: 0.87–0.99) but not allergic rhinitis and eczema. Respiratory infection in the past was an important risk factor for the occurrence of allergic diseases especially for asthma which was increased 4.53-fold. Children exposed to household smoke were significantly at higher risk of asthma, wheezing, and allergic rhinitis (OR: 1.20, CI: 1.08–1.33; OR: 1.21, CI: 1.09–1.34; and OR: 1.32, CI: 1.21–1.43, respectively). All allergic diseases were increased in those children living in areas which have altitude of below 1000 m and mean yearly atmospheric pressure above 1000 mb. The study has suggested that household and country-specific environmental factors are associated with asthma, wheezing, allergic rhinitis, and eczema risk during childhood in Turkey.
Publication Pediatric Allergy and Immunology
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1399-3038.2007.00551.x/abstract

 


Taking School-Based Substance Abuse Prevention to Scale: District-Wide Implementation of Keep a Clear Mind

Abstract Public schools are under increased pressure to implement evidence-based substance abuse prevention programs. A number of model programs have been identified, but little research has examined the effectiveness of these programs when "brought to scale" or implemented district-wide. The current paper summarizes the application of the Adelman and Taylor's (1997) model for district-wide program implementation to the dissemination of an evidence-based parent-child drug education program called Keep A Clear Mind (KACM; Werch & Young, 1990). In addition to documenting the partnership process used to scale-up the program to a district-level, evaluation results are presented from 2,677 fifth graders in 43 schools who participated in the KACM program. Pre-post comparisons from two consecutive cohorts of students indicated a significant reduction in students' attitudes supporting alcohol use and a significant increase in parent/child communication about prevention, students' perceived ability to resist peer pressure, and their belief that it is "wrong" to use alcohol, tobacco, and marijuana. Focus groups conducted with a subset of the KACM teachers indicated great support for the KACM program, the partnership approach, and the dissemination model. Findings provide support for Adelman and Taylor's (1997) model as a framework for collaborative district-wide implementation of substance-abuse prevention programs.
Publication Journal of Alcohol and Drug Education
Date 2007
URL http://www.eric.ed.gov/ERICWebPortal/detail?
accno=EJ841350

 


Anti-Tobacco School-Based Programming for Deaf Youth

Abstract As part of the effort to reduce cigarette smoking--the single most preventable cause of death in the society--researchers have tried for over half a century to identify effective school-based anti-tobacco education that can discourage tobacco use among children and adolescents. Unfortunately, deaf and hard of hearing young people have been largely excluded from this effort. Prevention messages available to hearing youth are often inaccessible and inadequate, and culturally and linguistically appropriate programming has not been developed. This may leave deaf and hard of hearing young people more vulnerable to a substance that is responsible for about one in five deaths--400,000 each year--in the United States, and over four million deaths across the globe. Children and adolescents that struggle with issues of social acceptance and self-esteem, who experience communication barriers, and who face difficulties when it comes to school performance are at great risk for tobacco use and other risk-taking behaviors. In this article, the authors describe a tobacco prevention curriculum tailored to the needs of deaf and hard of hearing youth. This "Hands Off Tobacco!" curriculum is now being tested in a quasi-experimental non-equivalent control group design involving over 600 deaf and hard of hearing students at four schools in California, New Jersey, and Minnesota.
Publication Odyssey: New Directions in Deaf Education
Date 2007
URL http://www.eric.ed.gov/ERICWebPortal/contentdelivery/servlet/ERICServlet?
accno=EJ903156

 


Smoking

SHEU Literature search

http://sheu.org.uk

Thanks to Zotero and Jason Priem

SEE ALSO LINKS TO "Drugs"

Please contact David McGeorge

Last updated July 03 2012

Topics: 

Comments about SHEU

"I would like to take this opportunity to thank you for your work regarding writing and compiling the sex education survey. The survey was well executed and the schools have found their individual reports very helpful. The results of the survey have enabled the Local Campaign Group to justify the need for young men's campaigns and given us invaluable insight as to the thoughts and experiences of this target group."

Teenage Pregnancy Strategy Manager

"I really think that the HRBQ is a wonderful piece of work in terms of getting useful information for so many different organisations in one go." Healthy Children's Research and Statistics Officer

Research and Statistics Officer

Any comments on specific survey questions that may have caused difficulty?
Pupils at our primary school found the questionnaire very easy to understand and most of them completed the questions in less than 45min.

Teacher

"The system works and I find quite a lot of it useful in my work. I've also recommended it to others."

Teenage Pregnancy Manager

"I really appreciate the professional service which SHEU offers.  We have had a great experience working with Angela on the school surveys." 

Health Improvement Specialist

"One year (following the SHEU survey) responses from our Year 4 cohort caused us concern, so we put in place a number of team building, motivational projects. We then assessed their effectiveness by requesting the SHEU questionnaires for these pupils as Year 5's."

Learning Mentor

"Please send an additional copy of our report - it is the most requested and borrowed item in the whole library." Health Promotion Unit

Health Promotion Unit

"Over the last twenty years you have achieved much. The surveys and subsequent reports have painted the clearest picture we have of what young people are doing and what they think." OFSTED 1998

OFSTED

"I have never looked at myself in this way before." Pupil

Pupil

"You and the team have the evidence to show how young people's behaviour has or hasn't changed over time." 
Tribute from a Health Education Co-ordinator to John Balding, presented at his retirement lunch, May 2005

Health Education Co-ordinator

"The service you provide is of national significance." Health Development Agency

Health Development Agency

I would be extremely interested to see the results as I know how useful this information has been to the other schools in the
borough

Headteacher

"Just to say a huge thank you for all your efforts in helping us with the Health survey amongst pupils. It has provided us with significant data which will be used across the school to help us improve. It helped us to obtain a healthy schools standard as well. I hope we can make this an annual feature as we can track the changing health of our pupils." Headteacher

Headteacher

"This is an excellent way of keeping up to date belt and braces style."

School Drugs Advisor

"The data from last time were spot-on and we have done lots of work with it. We are very keen to repeat the survey." Headteacher

Headteacher

"On behalf of all the health promoters in Scotland I would like to say a big thank to you and your colleagues for your excellent work over the years. This includes not only your survey work but your role as a visiting examiner in Scotland and adviser on course development."
Tribute from a Health Commissioner to John Balding, presented at his retirement lunch, May 2005

Health Commissioner

"The Schools Health Education Unit has gained a reputation as one of the most reliable sources of information about young people's health." BBC

BBC

"It's good to talk with you again - we used so much of those data and did so much with it in schools - we really got the place buzzing!"

Consultant in Public Health

"The survey reports have been used to inform commissioning at specific commissioning groups. They are also being used within our Extended Schools Clusters and to inform The Annual Public Health and the Joint Strategic Needs Assessment." Programme Manager - Young People

"The Unit has a unique historical and contemporary archive of young people." Prof. Ted Wragg 1938-2005

Prof Ted Wragg, 1938-2005

"The Schools Health Education Unit has been a unique inspiration to all of us. For me, as I have worked in the many different areas of the NHS, the SHEU, its principles and your determination have always been a cornerstone in what a health promoting service should be about."
PCT Performance Manager paying tribute to John Balding, presented at his retirement lunch, May 2005

PCT Performance Manager

"The credit goes to you for the fabulous information the survey yields!"

Assistant Director Schools and SEN

"The (named) Children and Young People's Partnership has benefitted from the results of the SHEU survey locally for many years now, and we should like to continue to do so in future."

Consultant in Public Health Medicine

"As a Deputy Head in a large secondary school I was involved in taking part in a city wide health and wellbeing survey over a period of six years. Completing the survey every two years grew in importance year on year, with the final cycle having a major impact on our SDP, PHSE curriculum, Ofsted outcomes and governor understanding.
Over the six year period we moved from a small sample in two tutor groups filling in a paper survey to two year groups completing an online survey. The reports produced give graphical analysis of a wide range of issues. As a result of the survey we increased the number of PSHE workshop days for students to address issues such as smoking, drug and alcohol awareness, anti-bullying workshops. The surveys helped Governors make a positive informed decision to allow Brook Advisory Clinic nurses on site to support students.
As a result of taking part and using the evidence provided we were able to offer more support for students which had a direct impact on improved attendance and outcomes."

Deputy Head Secondary School

We were all very impressed with the spreadsheet and can see that an incredible amount of work has gone into creating this!

Health Improvement Specialist

I just wanted to write and tell you how much I enjoyed your talk at last week's conference.

Chief Executive, substance use charity

"The Unit is to be congratulated in preparing ... material of the highest standard and worthy of wide dissemination." National Association for Environmental Education

National Association for Environmental Education

"I have valued greatly the work I have done with the team in Exeter, it has been a highlight of my years here." Health Promotion Specialist

Health Promotion Specialist

 “The (SHEU survey) helped us to prioritise where we needed to be in terms of PSHE education. We delivered assemblies based on the evidence as well as curriculum development, and dealt with whole school issues – particularly in regard to pastoral care. The answers received to the question on the survey “Who are you most likely to approach if you needed help” worried staff as “teacher” was not a popular answer. Subsequently the staff asked themselves why this had happened and what needed to be done to address the issue. There was more emphasis on wider aspects of PSHE education delivery, which needed more attention.

To summarise, the (SHEU survey) allows the PSHE department to assess the impact of teaching and learning and modify future lessons accordingly. It allows our school to look at whole school issues such as the extent to which the pastoral care system is meeting the needs of our pupils. It helps us to do need analysis of our pupils. It helps to provide important evidence for SEF / the extent to which we are meeting wellbeing indicators / National Healthy School standards.”  

Secondary School Head

"Brilliant - thank you Angela. As always you and your team are so proficient at getting our requests dealt with so promptly - it is a real pleasure to work with such a great organisation."

Health Improvement Adviser

"The children found the survey very interesting and enjoyed doing it." Class Teacher

Class teacher

"...the only question to cause a problem was 'has everyone got a pen?" Supervisor's notes following a school survey

Supervisor's Notes

"Your work in developing the Health Related Behaviour Survey was ground breaking and has continued to evolve." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

"We were talking about (the SHEU survey) data at our recent NSCoPSE Conference, for PSHE advisers and consultants. It would be really helpful if some of this powerful data and the trends could be shared in the consultation around the PSHE Review. Colleagues shared their very positive experiences of (the SHEU survey). It provides excellent evidence of behaviour change for children and young people and of the impact of PSHE and wider interventions."

Personal and Social Development Consultant

"We use the data to inform whole school practice: Pastoral programmes for target groups of pupils; Items for discussion with School Council; Information to help us achieve the Healthy School gold standard; To develop and dicuss with pupils our Anti-Bullying Policy; Targeted whole class sessions with the Police Community Support Officers; To share pupil perceptions of all aspects of their school life with parents, staff and governers." 

Learning Mentor

"You have made a truly significant contribution to health education and health promotion of young people in, not only England, but all over the United Kingdom and beyond." Colleague from NHS Scotland paying tribute to John Balding, presented at his retirement lunch, May 2005

NHS Scotland

"Over the last twenty years you have achieved much. The surveys and subsequent reports have painted the clearest picture we have of what young people are doing and what they think." Tribute from OFSTED to John Balding, presented at his retirement lunch, May 2005

OFSTED

"We would like to take part in the next ECM survey. We have found the data produced invaluable for supporting evidence in our SEF etc."

School Vice Principal

"The data for (us) are very useful ... This is especially important when evaluating the impact of interventions regarding alcohol or other areas, as the survey data are likely to provide an earlier indication than routine data sources."

Specialist Registrar in Public Health

"SHEU data proved the best source of the kind of information we were looking for (...) to provide research support to the National Healthy Schools Programme." 

Department of Health

"I very much value the contribution the Health Related Behaviour Survey has made to the public health agenda and feel confident it will continue to do so." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

Director of Public Health

"The Unit produces an invaluable body of knowledge... providing exceptional information across time and throughout the country." Kelloggs

Kelloggs

"This week I have been working on a major strategy for service design -- it is easy to get solely focussed on hospitals, performance targets, and work force planning -- all very important; but at the same the needs of young people and how we need to work across agencies to address the health needs of today and tomorrow must be recognised. SHEU is founded to do just this."

PCT Performance Manager

"We never make a move without looking at these excellent reports." Public Health Consultant

Public Health Consultant

"We have never consulted our young people like this before. The survey makes a great contribution to our 'best value' planning." Sports Development Officer

Sports Development Officer

"Within the curriculum, we are part of the Healthy Schools programme - and the local, Director of Public Health Award. We cover many facets of health from emotional intelligence to safety education and our very strong, Anti-Bullying and Child Protection programmes. You can imagine our delight when the Local Authority and our school nurse made the following comments after we took part in the regional Schools Health Education Unit Survey: " Head Teacher.
“This was an amazing set of outcomes and really good evidence that (your school) is doing a wonderful job in prioritizing the health and well-being of its pupils … Well done to staff, governors and parents for all your work on this through the Director of Public Health award and other strategies. It is very clear that pupils feel happy, safe and involved at the school and your caring ethos shines through this data.”
Healthy Schools Coorduinator.

 

Headteacher & Healthy Schools Coordinator

"The Schools Health Education Unit is the jewel in the crown of the Health Education Authority." Major General Sir John Acland 1928 - 2006

Major General Sir John Acland

"Many thanks for all of the fantastic information that you have sent to me over the years, it has really helped me to plan relevant courses for my students to follow and to help me to focus on the needs of the students I teach."

PSHE teacher

"Thank you from my staff to you and all your staff. The speed of 'turn-around' of the questionnaires is outstanding in anyone's terms." Headteacher

Headteacher

"Many thanks for a major contribution to the health of children in the UK and elsewhere over many years and putting in place the continuation of the Unit." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

Director of Public Health

"I would like to say how much we appreciated the work you and your team have put in to this project, a big thank you for the excellent reports that you have completed on our behalf." Assistant Director of Public Health

Assistant Director of Public Health

"The Health Related Behaviour Survey is an incredibly useful resource for (us) as it provides schools, with invaluable data which can inform curriculum content, methods of lesson delivery and empower schools to better meet the needs of their pupils."

Health Education Advisor

"We're very happy to commission another survey from you. Our colleagues in School Improvement are dead keen to work with us on this. During our last LA Inspection, we were flagged from our Tellus data as having a bullying problem. We could demonstrate with our SHEU data - which had a much better sample size and coverage of the authority - that we did not have the problem they suggested. The Inspectors went away happy and we are definitely surveying again with SHEU."

Local Authority Senior Adviser

"Our use of the Health-Related Behaviour Questionnaire was commended as part of our accreditation for the National Healthy Schools Scheme." Headteacher

"Every school involved in the National Healthy School programme should start with an HRBQ survey." Health Education Co-ordinator

Health Education Co-ordinator

"I would like to say that this survey was very useful and made me realise things about PE and health that I had never realised before......Food at school is groovy, especially if your school does Jamie Olivers School Dinners. Viva apples and thanks for the survey." Female pupil, 13 yrs old

Female pupil, 13yrs

(Our) Senior team were very enthused with the rich source of data provided within the reports (and thought that the analyses including within the appendices section of the main reports were really interesting).

Health Improvement Specialist (Children, Schools and Families)

"...the most comprehensive health education survey."

Daily Telegraph

"As a result of the survey we reviewed and amended PSHE schemes of work, we are currently working on a "Green Travel Plan", a morning breakfast club was established and we further developed 6th Form mentoring."

Health Education Coordinator

"You have often stood alone against the media who were often looking for the sensational headline. I have noticed an important change: the media now look out for and report very fairly and fully on the reports from the team." 
Tributes from a Health Education Advisor to John Balding, presented at his retirement lunch, May 2005

Health Education Advisor

"Thanks for presenting the survey to local schools this morning, I just wanted to thank you for such interesting and thought-provoking information.  
I’m really glad we were able to take part - the information (particularly headline data and differences) will support us to have some really interesting questions with the Year group as a whole about the sense they’re making of this; what they think it might mean in terms of changes they might make, and what they need to support them in this."

Deputy Headteacher

"Thank you very much, David, for another excellent survey.  We look forward to receiving our reports."

Healthy Schools Co-ordinator

"We are planning next year's programmes around this information." Health Education Adviser

Health Education Adviser

"You have made a fantastic contribution to children’s health education and promotion. I am personally grateful to you for helping to kickstart my research career." Prof. Neil Armstrong tribute to John Balding, presented at his retirement lunch, May 2005

Prof Neil Armstrong

“(The SHEU survey) was very, very useful. It gave us reassurance we weren’t missing a trick. For example not many pupils in the sample year groups were taking illegal drugs, which re-enforced our opinions. But the survey also raised issues and flagged some things up. We discovered that some of our girls weren’t eating enough – the percentage of girls in our school not eating lunch the day before the survey was higher than the county average. There were other concerns too, specifically around cigarettes, alcohol and attendance.
The school used this data and took a number of actions to address it. More female peer mentors were put in place and the school asked NEXUS (the Extended Schools service) for help, so they developed a programme for girls which addressed their eating patterns, healthy eating, sex education and self-esteem issues.
We ran an anti-bullying group for Year 9 as a preventative measure, based upon data provided by our current Year 10 students.
The travel data revealed that a high number of pupils took the car to school so we involved the BIKE-IT scheme who ran assemblies, brought in their bikes (including one with a pedal-powered smoothie maker!), and raised awareness of health and green issues.
The information about how happy the students were with their lives raised some concerns as far fewer girls were as happy as the boys, so work was done around developing aspirations, role-models and self-esteem."        
 

Deputy Head, Secondary School

"Many thanks to SHEU for your excellent professional support over the years."

PSHE teacher