Factors Related to Adolescent Smoking: A Nationally Representative Cross-Sectional Study in Thailand

Objective: This study aimed to explore the individual, familial, and social factors associated with different smoking status in Thai adolescents from the 2017 Cigarette Smoking and Alcohol Drinking Behavior Survey (CSAD) Methods: The nationally representative sample of 6046 adolescents aged 15-19 years who took part in the 2017 CSAD in Thailand. Multinomial logistic regression analysis was conducted to explore the associations between the individual, familial, and social factors and different smoking status. Results: The daily smoking and occasional smoking was 6.4% and 3.3%, respectively. Gender, alcohol use, substance use, attitudes toward smoking, exposure to secondhand smoke at home, anti-smoking social media campaign, and graphic warning labels were related to both daily and occasional smoking. Daily smoking was associated with exposure to secondhand smoke at school, restaurant, and public transport, and exposure to tobacco advertising. Conclusion: These findings suggest that smoking prevention intervention should particularly focus on these factors and also need to develop the anti-smoking policies for smoking prevention among adolescents.

Pengetahuan dan Sikap tentang Perilaku Merokok pada Remaja

Smoking is a health problem in Indonesia and one of the main factors of several chronic diseases that can lead to death, although many smokers are aware and admit that smoking can lead to cancer. WHO estimates that the number of smokers in Indonesia in 2025 will increase to 90 million people, or 45% of the total population. Some adolescents think that smoking is a need to relax or other reasons that make smoking commonplace. The proportion of smoking among people aged ≥10 years in Indonesia with smoking behavior every day is 24.3% and occasional smoking is 4.6%. This study aims to determine the level of knowledge, attitudes and smoking behavior in adolescents. The research method used is correlational with cross sectional approach. The population in this study were students and female students at SMKN Kota Jambi, the sampling technique with accidental sampling was 49 people. The instrument used was a questionnaire. The collected data were analyzed by univariate and bivariate and statistical tests were performed using the ch-square test. The results showed that most of the respondents had good knowledge of 57.1%, a positive attitude of 59.1% and the majority of adolescents did not smoke 63.2%. The statistical test results showed no significant relationship between knowledge and smoking behavior (P> 0.005) but there was a significant relationship between attitude and smoking behavior in adolescents (P <0.005). It is hoped that the school will implement a smoking-free area and put up a warning poster for the dangers of smoking in the school environment and carry out continuous monitoring and evaluation

Smoking tobacco, use of marijuana and other psychoactive substances by students of Silesian universities

INTRODUCTION. These days, it is observed worldwide that the number of smokers drops, however, use of e-cigarettes and other psychoactive substances becomes more popular. This survey was conducted in the years 2019 to 2020 using a group of 193 people, 124 females and 69 males, at two Silesian universities. AIM. The purpose of this survey was to estimate patterns concerning use of tobacco and psychoactive substances by students. The survey was conducted by a survey including 27 questions. RESULTS. Most of the surveyed persons (78%) were non-smokers. Among active smokers, 30% of them started smoking at the age of 12 to 15, 45% of them at 16 to 18, and 77% smoked first before 18th birthday. Among smoking subjects, 90% smokes up to 5 cigarettes a day. Most subjects replied that “curiosity” was a cause to start smoking. Students often declared so-called “occasional smoking”. Smoking in public bothered most (67%) subjects. Half of subjects declared that they never smoked marijuana. Mostly, students smoking tobacco decided to use marijuana as well. About 6% of subjects used other drugs, aside from marijuana. 3% of subjects tried amphetamine, LSD or ecstasy at least once in life. COCLUSIONS. Tobacco smoking frequency in students of Silesian universities was 22%, that is a level similar to other regions of Poland. Due to variation on the market of psychoactive substances, particularly among young people, continuous surveillance is recommended.

Increasing similarities between young adults’ smoking and snus use in Norway: a study of the trends and stages of smoking and snus epidemic from 2010 to 2018

Background The prevalence of smoking has been decreasing in Norway for decades. In contrast, the prevalence of snus use has recently increased substantially, especially among females. While there is a clear social gradient in smoking, with a higher smoking prevalence among individuals with low socioeconomic status (SES), a possible social gradient in snus use has been less studied. The aim of the current study was to investigate the trends of smoking and snus use and to examine whether ongoing changes in snus use are similar to prior smoking epidemic development. Methods The study was based on the 2010 (n = 5836), 2014 (n = 13,319) and 2018 (n = 24,515) waves from a nation-wide, cross-sectional, health survey of higher education in Norway (the SHoT study). Variables on smoking, snus use, gender, age and SES were used. Chi-square tests and logistic regression analyses were used to test significance, and Mantel–Haenszel weights were used to test the trends in stratified cross-tabulations. Results Daily smoking decreased from 5.9 to 1.5% between 2010 and 2018, while daily snus use increased from 13.4 to 19.9%. Female snus use almost doubled, from 10.9 to 19.2%. Low SES was associated with both daily smoking and snus use across all three waves. Occasional smoking was also associated with low SES at all waves, but occasional snus use was only associated with low SES in 2010. There were no significant changes over time in either the association between occasional or daily smoking and SES or the association between occasional or daily snus use and SES. Conclusions The overall smoking decrease indicated that the Norwegian smoking epidemic is in its latest stage. Steady male snus use, doubled female snus use and a clear social gradient in snus use all indicate that the snus epidemic in Norway has progressed. If this trend continues, a main implication is that snus prevalence will soon peak, first in males and then in females.

Impact of UK Tobacco Control Policies on Inequalities in Youth Smoking Uptake: A Natural Experiment Study

Introduction UK countries implemented smoke-free public places legislation and increased the legal age for tobacco purchase from 16 to 18 years between 2006 and 2008. We evaluated the immediate and long-term impacts of these UK policy changes on youth smoking uptake and inequalities therein. Aims and Methods We studied 74 960 person-years of longitudinal data from 14 992 youths (aged 11–15 years) in annual UK household surveys between 1994 and 2016. Discrete-time event history analyses examined whether changes in rates of youth smoking transitions (initiation, experimentation, and escalation to daily smoking or quitting) or their inequalities (by parental education) were associated with policy implementation. Parallel analyses examined smoke-free legislation and the change in legal age. We interpret the results as a combined effect of the two pieces of legislation as their implementation dates were too close to identify separate effects. Models were adjusted for sex, age, UK country, historical year, tobacco taxation, and e-cigarette prevalence, with multiple imputation for missing data. Results For both policies, smoking initiation reduced following implementation (change in legal age odds ratio [OR]: 0.67; 95% confidence interval [CI]: 0.55 to 0.81; smoke-free legislation OR: 0.68; 95% CI: 0.56 to 0.82), while inequalities in initiation narrowed over subsequent years. The legal age change was associated with annual increases in progression from initiation to occasional smoking (OR: 1.26; 95% CI: 1.07 to 1.50) and a reduction in quitting following implementation (OR: 0.57; 95% CI: 0.35 to 0.94). Similar effects were observed for smoke-free legislation but CIs overlapped the null. Conclusions Policies such as these may be highly effective in preventing and reducing socioeconomic inequalities in youth smoking initiation. Implications UK implementation of smoke-free legislation and an increase in the legal age for tobacco purchase from 16 to 18 years were associated with an immediate reduction in smoking initiation and a narrowing of inequalities in initiation over subsequent years. While the policies were associated with reductions in the initiation, progression to occasional smoking increased and quitting decreased following the legislation.

Smoking and lung function among adults with newly onset asthma

IntroductionSmoking increases the risk of asthma and reduces lung function among subjects with and without asthma. We assessed the effects of smoking on lung function reflecting both central and small airways among adults with newly onset asthma.MethodsIn a population-based study, 521 (response rate 86%) working-aged adults with clinically defined newly diagnosed asthma answered a questionnaire on personal smoking and other factors potentially influencing lung function, and performed spirometry. We applied multiple linear regression analysis to estimate the relations between smoking and lung function adjusting for confounding.ResultsAmong asthmatics, FEV1 level was reduced significantly, on average 208 mL, related to regular smoking (adjusted effect estimate −0.208, 95% CI −0.355 to −0.061) and 245 mL in relation to former smoking, that is, among those who quit less than a year ago (−0.245, 95% CI −0.485 to −0.004). In contrast, FEV1 was not significantly related to occasional smoking or former smoking among those who quit over a year ago. Forced expiratory flow (FEF) levels (L/s) were also significantly reduced among regular smokers (FEF25–75%: −0.372, 95% CI −0.607 to −0.137; FEF50%: −0.476, 95% CI −0.750 to −0.202). An exposure–response pattern related to both daily smoking rate and lifetime cumulative smoking was seen both among men and women.ConclusionsThis study provides new evidence that among working-aged adults with new asthma, regular smoking and former smoking reduce lung function levels with a dose–response pattern. The lung function parameters applied as outcomes reflect both larger and smaller airways.

E-cigarette adverts and children’s perceptions of tobacco smoking harms: an experimental study and meta-analysis

ObjectivesChildren exposed to electronic cigarette (e-cigarette) adverts may perceive occasional tobacco smoking as less harmful than children not exposed to e-cigarette adverts. Given the potential cross-cueing effects of e-cigarette adverts on tobacco smoking, there is an urgent need to establish whether the effect found in prior research is robust and replicable using a larger sample and a stronger control condition.DesignA between-subjects experiment with one independent factor of two levels corresponding to the advertisements to which participants were exposed: glamorous adverts for e-cigarettes, or adverts for objects unrelated to smoking or vaping.ParticipantsEnglish school children aged 11–16 (n=1449).OutcomesPerceived harm of occasional smoking of one or two tobacco cigarettes was the primary outcome. Secondary outcomes included: perceived harm of regular tobacco smoking, susceptibility to tobacco smoking and perceived prevalence of tobacco smoking in young people. Perceptions of using e-cigarettes were gauged by adapting all the outcome measures used to assess perceptions of tobacco smoking.ResultsTobacco smokers and e-cigarette users were excluded from analyses (final sample n=1057). Children exposed to glamorous e-cigarette adverts perceived the harms of occasional smoking of one or two tobacco cigarettes to be lower than those in the control group (Z=−2.13, p=0.033). An updated meta-analysis comprising three studies with 1935 children confirmed that exposure to different types of e-cigarette adverts (glamorous, healthful, flavoured, non-flavoured) lowers the perceived harm of occasional smoking of one or two tobacco cigarettes (Z=3.21, p=0.001).ConclusionsThis study adds to existing evidence that exposure to e-cigarette adverts reduces children’s perceptions of the harm of occasional tobacco smoking.

Association of occasional smoking with total mortality in the population-based Tromsø study, 2001–2015

ObjectivesThere is a shift in the smoking population from daily smokers to light or occasional smokers. The knowledge about possible adverse health effects of this new smoking pattern is limited. We investigated smoking habits with focus on occasional smoking in relation to total mortality in a follow-up study of a Norwegian general population.SettingA population study in Tromsø, Norway.MethodsWe collected smoking habits and relevant risk factors in 4020 women and 3033 men aged 30–89 years in the Tromsø Study in 2001. The subjects were followed up regarding total mortality through June 2015.ResultsAmong the participants, there were 7% occasional smokers. Occasional smokers were younger, more educated and used alcohol more frequently than other participants. A total of 766 women and 882 men died during the follow-up. After the adjustment for confounders, we found that occasional smoking significantly increased mortality by 38% (95% CI 8% to 76%) compared with never smokers. We report a dose–response relationship in the hazards of smoking (daily, occasional, former and never smoking).ConclusionsOccasional smoking is not a safe smoking alternative. There is a need for information to the general public and health workers about the health hazards of occasional smoking. More work should be done to motivate this often well-educated group to quit smoking completely.