Incidence and Determinants of Cigarette Smoking Initiation in Young Adults

PurposeTo describe the incidence and identify predictors of smoking initiation in young adults.MethodsData were collected in self-report questionnaires in 22 cycles over 13 years in a prospective cohort investigation of 1,293 students recruited in 1999–2000 from all grade 7 classes in a convenience sample of 10 high schools in Montreal, Canada. Participants were 12.7 years of age on average at cohort inception and 24.0 years of age in cycle 22. Independent predictors of smoking initiation in young adulthood (post–high school) were identified in multivariable logistic regression analysis using generalized estimating equations.ResultsOf 1,293 participants, 75% initiated smoking by cycle 22. Of these, 44%, 43%, and 14% initiated before high school, during high school, and in the 6 years after high school, respectively. The incidence density rate of initiation was .33, .13, .14, .11, and .12 initiation events per person-year in grade 7, 8, 9, 10, and 11, respectively, and .05 post–high school. Independent predictors of smoking initiation in young adults included alcohol use, higher impulsivity, and poor academic performance.ConclusionsA total of 14% of smokers who initiated smoking before age 24 years did so after high school. The predictors of initiation in young adults may provide direction for relevant preventive interventions.     

How Menthol Is Key to the Tobacco Industry's Strategy of Recruiting and Retaining Young Smokers in Singapore

Introduction

Singapore has a strong and well-established tobacco control policy, but smoking rates among young Singaporeans remain relatively high. In other countries, tobacco companies have used menthol to encourage smoking among young people. Singapore still permits the sale of menthol tobacco products and little is known about the tobacco industry's internal strategy and motivation for marketing menthol tobacco in Singapore.

个体成长模型在纵向研究中的应用--以大学新生交往主动性为例

目的介绍个体成长模型方法对大学新生适应能力中交往主动性的3次测查数据采用普通回归模型和个体成长模型进行分析。结果个体成长模型的拟合度比普通回归模型的拟合度要好,个体成长模型可在个体水平上分析个体随时间产生的变化。结论个体成长模型具有许多优点,熟悉这种重要的分析方法对纵向数据研究者是非常有益处的。     

Effect of Cocoa and Cocoa Products on Cognitive Performance in Young Adults

Increasing evidence support a beneficial role of cocoa and cocoa products on human cognition, particularly in aging populations and patients at risk. However, thorough reviews on the efficacy of cocoa on brain processes in young adults do not exist precisely due to the limited number of studies in the matter. Thus, the aim of this study was to summarize the findings on the acute and chronic effects of cocoa administration on cognitive functions and brain health in young adults. Web of Science and PubMed databases were used to search for relevant trials. Human randomized controlled studies were selected according to PRISMA guidelines. Eleven intervention studies that involved a total of 366 participants investigating the role of cocoa on cognitive performance in children and young adults (average age ≤25 years old) were finally selected. Findings from individual studies confirm that acute and chronic cocoa intake have a positive effect on several cognitive outcomes. After acute consumption, these beneficial effects seem to be accompanied with an increase in cerebral blood flow or cerebral blood oxygenation. After chronic intake of cocoa flavanols in young adults, a better cognitive performance was found together with increased levels of neurotrophins. This systematic review further supports the beneficial effect of cocoa flavanols on cognitive function and neuroplasticity and indicates that such benefits are possible in early adulthood.     

Predicted Long-Term Cardiovascular Risk Among Young Adults in the National Longitudinal Study of Adolescent Health

Objectives. We estimated the distribution of predicted long-term cardiovascular disease (CVD) risk among young adults in the United States.Methods. Our data were derived from National Longitudinal Study of Adolescent Health participants (n = 14 333; average age: 28.9 years). We used a Framingham-derived risk prediction function to calculate 30-year risks of “hard” and “general” CVD by gender and race/ethnicity.Results. Average 30-year risks for hard and general CVD were 10.4% (95% confidence interval [CI] = 10.1%, 10.7%) and 17.3% (95% CI = 17.0%, 17.7%) among men and 4.4% (95% CI = 4.3%, 4.6%) and 9.2% (95% CI = 8.9%, 9.5%) among women. Average age-adjusted risks of hard and general CVD were higher among Blacks and American Indians than among Whites and lower among Asian/Pacific Islander women than White women. American Indian men continued to have a higher risk of general CVD after adjustment for socioeconomic status. Four percent of women (95% CI = 3.6%, 5.0%) and 26.2% of men (95% CI = 24.7%, 27.8%) had a 20% or higher risk of general CVD. Racial differences were detected but were not significant after adjustment for socioeconomic status.Conclusions. Average CVD risk among young adults is high. Population-based prevention strategies and improved detection and treatment of high-risk individuals are needed to reduce the future burden of CVD.Estimated costs of cardiovascular disease (CVD) in the United States are expected to be more than $1 trillion by 2030.1 This fact, along with growing evidence of the cost effectiveness of primordial and primary prevention,2 has prompted increasing attention to the extent of CVD risk early in life. Elevated CVD risk is detectable in childhood3 and pronounced by young adulthood; among young adults 18 to 25 years of age, 34.2% report current smoking,4 and 23.8% and 16.8% are overweight and obese, respectively.5 Hypertension rates are estimated to be as high as 7.2% among those 18 to 24 years of age5 and may be as high as 20.9% among those 25 to 32 years of age.6 These individual statistics, although alarming, do not account for the co-occurrence of risk factors and the differing strength of their relationship to CVD as is done with risk prediction.The application of risk prediction functions to large epidemiological data sets could serve as a useful indicator of the burden of CVD among young adults.7 However, most functions were designed to be used with middle-aged or older adults, and they predict risk over a 5- to 10-year time period. This time frame is too short for most young adults given that incident disease will occur over decades, rather than years, after assessment. Existing research involving data from the National Health and Nutrition Examination Survey has shown that the overwhelming majority (82%) of US adults have a low 10-year risk of coronary heart disease (CHD), but nearly two thirds of these individuals have a high long-term risk of CVD.8Longer-term risk assessments are a better predictor of subclinical9,10 and clinical CVD11 than shorter-term risk prediction functions and take account of competing causes of death, thereby providing a more realistic assessment of the overall burden of CVD.7,11 Existing longer-term estimates suggest a high lifetime risk of CVD among both men (60%) and women (56%).12 However, these estimates have been made in reference to individuals 45 years of age. Although considerable data are available on levels of individual risk factors among young adults, concurrent consideration of multiple risk factors better discriminates longer-term risk than any single risk factor.13 To our knowledge, no estimates of this type currently exist for the US young adult population. Thus, estimates of CVD risk among young adults are needed to more accurately estimate the extent of risk in this population and to more accurately predict future disease burden.The 30-year Framingham risk score (30-year FRS) is the only longer-term risk prediction function designed to be used with young adults. The function was developed with the Framingham offspring cohort, and analyses of these data represent the only estimates of the extent of long-term risk among young adults. However, the participants in that study were recruited in the 1970s, and CVD risk factors have since changed significantly; there has been an increase in average body mass index (BMI)14 and in the prevalence of diabetes,15 whereas the prevalence of smoking has decreased.16 A more accurate estimate of the extent of long-term CVD risk among young adults requires an application of the 30-year risk prediction function to a contemporary sample of young adults. In this study, we began to fill this gap by using the 30-year FRS to provide the first, to our knowledge, nationally representative estimates of long-term CVD risk by gender and race/ethnicity. We also examined racial/ethnic differences in the prevalence of “high” CVD risk (a risk score of 20% or higher).     

The Moderating Role of Gender in the Relationship Between Tobacco Outlet Exposure and Tobacco Use Among African American Young Adults

Tobacco outlet exposure is a correlate of tobacco use with potential differences by gender that warrant attention. The aim of this study is to explore the moderating role of gender in the relationship between tobacco outlet exposure and past month tobacco use among African American young adults 21 to 24 years old. This cross-sectional study (n?=?283) used geospatial methods to determine the number of tobacco outlets within walking distance (i.e., a quarter mile) of participants’ homes and distance to the nearest outlet. Logistic regression models were used to test interactions between gender and tobacco outlet exposure (i.e., density and proximity). Tobacco outlets were classified based on whether or not they were licensed to sell tobacco only (TO outlets) or tobacco and alcohol (TA outlets). Neither density nor proximity was associated with past month tobacco use in the pooled models. However, gender modified the relationship between TO outlet density and tobacco use, and this relationship was significant only among women (OR?=?1.02; p?<?0.01; adjusted OR?=?1.01; p?<?0.05). This study underscores the importance of reducing tobacco outlet density in residential neighborhoods, especially TO outlets, as well as highlights potential gender differences in the relationship between tobacco outlet density and tobacco use.     

Incident obesity and cardiovascular risk factors between young adulthood and middle age by religious involvement: the Coronary Artery Risk Development in Young Adults (CARDIA) study

Background

Religious involvement has been associated with improved health outcomes but greater obesity in older adults. No longitudinal study of young adults has examined the prospective association of religious involvement with incident cardiovascular risk factors (RFs) and subclinical disease (subCVD).

Methods

We included 2433 participants of the CARDIA study, aged 20 to 32 in 1987 when religiosity was assessed, who were followed for 18 years. Multivariable-adjusted regression models were fitted to assess prospective associations of frequency of religious participation at baseline with incidence of RFs and prevalence of subCVD after 18 years’ follow up.

Results

The high frequency of religious participation was associated with a significantly greater incidence of obesity in unadjusted models (RR 1.57, 95% CI 1.14-1.73) and demographic-adjusted models (RR 1.34, 95% CI 1.09-1.65) but not after additional adjustment for baseline RFs (RR 1.17, 95% CI .97-1.41). When religious participation was treated dichotomously, any religious participation, compared with none, was associated with significantly lower subCVD.

Conclusions

Frequent religious participants are more likely to become obese between young adulthood and middle age; this association is confounded by demographic and other factors. Nonetheless, young adults with frequent participation may represent an opportunity for obesity prevention.     

北京市老年人躯体健康变化的纵向观察

目的：观察90年代北京市老年人健康=介绍人向演变的特点及增龄效应（age effect)和群组效应（cohort effect)在健康演变中的作用。方法：利用SPSS软件包分析北京市老龄化多纵纵向研究课题中1992－1997年连续调查内存活的2043例55－92岁北京城乡居民有关躯体健康的资料,以同一群体1992年1997年慢性病患病1健康自我评价、日常生活活动能力三项指标作横向和纵向分析对比。结果：①要组1997年慢性病患病率较1992年增加明显,尤其是白内障、高血压、冠心病、脑血管病,年均发病率均在1％以上,70岁以下的低龄老人中所占的比例高,占总发病的66％－75％,糖尿病的发病集中在75岁以下组的倾向更突出。②随年龄增加发生的功能活动能力下降最明显的年龄段是65岁和75岁。1997年IADL、ADL总体依赖率高于1992年主要是由于该人群年龄增加的效应。同年龄的老对比显示1997年的IADL活动能力较1992年高,显示群组效应。③1997年人群的健康自评下降主要是由两次调查的年龄差异构成。增龄对健康自评的影响在年青年人更明显。结论老年人躯体健康演变过在不同的年龄段有不同特点,增龄效应和组效应也有不同的表现,对老年保健策略有一定参考价值。     

Changes in Smoking Habits and Behaviors Following the Introduction and Spread of Heated Tobacco Products in Japan and Its Effect on FEV1 Decline: A Longitudinal Cohort Study

BackgroundHeated tobacco product (HTP) use in Japan has rapidly increased. Despite this rapid spread, little is known about the health effects of HTP use. We conducted a longitudinal cohort study to investigate the change in smoking habits following the spread of HTP use and its effect on forced expiratory volume in 1 second (FEV₁) decline.MethodsParticipants consisted of a resident population (n = 2,612; mean age, 67.7 years) with FEV₁ measurement in 2012–2014 and 2018–2019, and a worksite population (n = 722; mean age 49.3 years) without FEV₁ data. Participants were categorized as combustible cigarette-only smokers, HTP-only users, dual users, past smokers, and never smokers. The association between smoking group and the change in smoking consumption over a mean 5.6 years was examined. Differences in annual FEV₁ change between smoking groups were examined in the resident population.ResultsPrevalence of HTP-only and dual users in 2018–2019 was 0.8% and 0.6% in the resident population, and 5.0% and 1.9% in the worksite population, respectively. The overall number of tobacco products smoked/used increased in dual users compared to baseline, but not in others. Annual FEV₁ decline in dual users tended to be greater than that in cigarette-only smokers (16; 95% confidence interval, −34 to 2 mL/year after full adjustment). Participants switching to HTP-only use 1.7 years before had a similar FEV₁ decline as cigarette-only smokers.ConclusionsHTP use, including dual use, is prevalent even in a rural region of Japan. Dual users appear to smoke/use tobacco products more and have a greater FEV₁ decline. Tobacco policy should consider dual use as high-risk.Key words: heated tobacco products, electronic nicotine delivery devices, prevention, smoking caused disease     

Latent Class Analysis to Examine Patterns of Smoking and Other Tobacco Products in Young Adult Bar Patrons

Purpose

Use of multiple tobacco products is increasing, particularly among young adults. Latent class analysis of substance-use patterns provides a framework for understanding the heterogeneity of use. We sought to identify different patterns of cigarette, e-cigarette, hookah, cigarillo, and smokeless tobacco use among young adult bar patrons.

Determinants of Response in a Longitudinal Health Study Following the Firework-disaster in Enschede,The Netherlands

Very few longitudinal health studies after disasters published data on the determinants of loss to follow up. However, these determinants provide important information for future disaster studies to improve their response and reduce selection bias. For this purpose we analyzed the data of a longitudinal health survey which was performed among residents and emergency workers, at 3 weeks (n = 3662) and at 18 months (n = 2769) after a major firework disaster in The Netherlands (Enschede, May 13, 2000). The response was lower among immigrants (54%) than among native Dutch (81%). Severe damage to the house due to the disaster (OR: 1.8; 95% CI: 1.1–3.0) and being involved as an emergency workers (OR: 2.1; 95% CI: 1.2–3.4) were associated with higher response among native Dutch, while this was not the case among immigrants. Non-western immigrants with health problems in the first study were more likely to participate in the second study (for example physical symptoms OR: 2.5: 95% CI: 1.4–4.4), while the native Dutch with these symptoms were less likely to participate (OR: 0.7; 95% CI: 0.5–0.9). In conclusion, disaster-related characteristics were associated with higher response in native Dutch. Health problems were associated with higher response among non-western immigrants and with lower response among the native Dutch.     

Socioeconomic status and the development of depressive symptoms from childhood to adulthood: a longitudinal analysis across 27 years of follow-up in the Young Finns study

We examined two alternative hypotheses on the association between low socioeconomic status (SES) and depressive symptoms: social causation and health selection. The latent growth curve (LGC) approach was used to examine trajectories of change in depressive symptoms over a period of 15 years in a dataset (the Young Finns study) consisting of a nationally representative sample of adolescents and young adults (n = 1613). Depressive symptoms were examined at four examination phases between 1992 and 2007. SES was measured as parental SES childhood (baseline of the study in 1980) and as the participants own SES in 2007 when the participants had reached adulthood and were between 30 and 45 years of age. The level of depressive symptoms was associated (r = −.14) with a slower decrease in symptoms during follow-up. Lower age, male gender, higher parental occupational grade but not parental income and lower negative emotionality in childhood were associated with a lower level of depressive symptoms. Higher age was also associated with a slower decrease in depressive symptoms. A lower level of depression and faster decrease in depressive symptoms were associated with a higher socioeconomic position in adulthood. A similar pattern was found in the relationship between the level of depression and income in adulthood. We concluded that the effect of childhood SES on depressive symptoms diminishes over time, but a higher level of, and especially faster decline of, depressive symptoms predicts the adulthood occupational SES gradient.     

中华按蚊传播间日疟媒介能量的纵向观察

本文报告1975~1984年间,在山东南部一稻乡,对中华按蚊传播间日疟媒介能量的纵向观察结果,初步获得现场验证。组成因子的定量分析中,人血指数的野外捕蚊方法、沉淀试验结果与间日疟的升降相一致;叮人率的计算采用傍晚室外人帐法,用头3小时媒介按蚊数÷2.5,是符合实际的。讨论了环境和社会因素的作用、影响,包括气象条件、水稻治虫与否、抗疟技术措施等三个方面。     

Impact of the COVID-19 Pandemic on Objectively Measured Physical Activity and Sedentary Behavior Among Overweight Young Adults: Yearlong Longitudinal Analysis

BackgroundThe COVID-19 pandemic has impacted multiple aspects of daily living, including behaviors associated with occupation, transportation, and health. It is unclear how these changes to daily living have impacted physical activity and sedentary behavior.ObjectiveIn this study, we add to the growing body of research on the health impact of the COVID-19 pandemic by examining longitudinal changes in objectively measured daily physical activity and sedentary behavior among overweight or obese young adults participating in an ongoing weight loss trial in San Diego, California.MethodsData were collected from 315 overweight or obese (BMI: range 25.0-39.9 kg/m²) participants aged from 18 to 35 years between November 1, 2019, and October 30, 2020, by using the Fitbit Charge 3 (Fitbit LLC). After conducting strict filtering to find valid data on consistent wear (>10 hours per day for ≥250 days), data from 97 participants were analyzed to detect multiple structural changes in time series of physical activity and sedentary behavior. An algorithm was designed to detect multiple structural changes. This allowed for the automatic identification and dating of these changes in linear regression models with CIs. The number of breakpoints in regression models was estimated by using the Bayesian information criterion and residual sum of squares; the optimal segmentation corresponded to the lowest Bayesian information criterion and residual sum of squares. To quantify the changes in each outcome during the periods identified, linear mixed effects analyses were conducted. In terms of key demographic characteristics, the 97 participants included in our analyses did not differ from the 210 participants who were excluded.ResultsAfter the initiation of the shelter-in-place order in California on March 19, 2021, there were significant decreases in step counts (−2872 steps per day; 95% CI −2734 to −3010), light physical activity times (−41.9 minutes; 95% CI −39.5 to −44.3), and moderate-to-vigorous physical activity times (−12.2 minutes; 95% CI −10.6 to −13.8), as well as significant increases in sedentary behavior times (+52.8 minutes; 95% CI 47.0-58.5). The decreases were greater than the expected declines observed during winter holidays, and as of October 30, 2020, they have not returned to the levels observed prior to the initiation of shelter-in-place orders.ConclusionsAmong overweight or obese young adults, physical activity times decreased and sedentary behavior times increased concurrently with the implementation of COVID-19 mitigation strategies. The health conditions associated with a sedentary lifestyle may be additional, unintended results of the COVID-19 pandemic.     

Mental Health and Well-Being Trends Through the First Year-and-a-Half of the COVID-19 Pandemic: Results from a Longitudinal Study of Young Adults in the USA

Prevention Science - This study examined longitudinal trajectories of young adults’ mental health and well-being before and throughout the first year-and-a-half of the COVID-19 pandemic....     

Socioeconomic pathways to depressive symptoms in adulthood: evidence from the National Longitudinal Survey of Youth 1979

The existence of a direct effect of early socioeconomic position (SEP) on adult mental health outcomes net of adult SEP is still debated. This question demands the explicit modeling of pathways linking early SEP to adult SEP and mental health. In light of this background, we pursue two objectives in this study. First, we examine whether depressive symptoms in adulthood can be fit in a trajectory featuring both an intercept, or baseline range of depressive symptoms that varied between individuals, and a slope describing the average evolution of depressive symptoms over the years. Second, we estimate the direct and indirect pathways linking early SEP, respondents' education and adult household income, with a particular focus on whether early SEP retains a significant direct effect on the trajectory of depressive symptoms once adult SEP is entered into the pathway model. Drawing from 29 years of cohort data from the National Longitudinal Survey of Youth 1979, a survey that has been following a national probability sample of American civilian and military youth (Zagorsky and White, 1999), we used structural equation models to estimate the pathways between parents' education, respondent's education, and latent growth curves of household income and depressive symptoms. We found that the effect of parents' education was entirely mediated by respondent's education. In turn, the effect of respondent's education was largely mediated by household income. In conclusion, our findings showed that the socioeconomic attainment process that is rooted in parents' education and leads to respondent's education and then to household income is a crucial pathway for adult mental health. These results suggest that increasing educational opportunities may be an effective policy to break the intergenerational transmission of low socioeconomic status and poor mental health.     

阜阳某区高血压的防治效果及发病因素分析

目的 了解阜阳某区成人高血压的发病及防治情况。方法 对该区固定成人群体检出的2755例高血压患者进行药物或(和)非药物治疗，并就发病因素和防治情况进行1～2a(平均18个月)的随访。结果 重盐饮食、紧张环境、遗传、年龄、肥胖、吸烟等构成了高血压发病的主要因素，186例被控制，1759例有明显改善，810例得到缓解；合并脑卒中77人，心脏病56人，肾功能不全7人，死亡11人。结论 高血压病是多种原因影响的结果，其发病率高，致残率高，死亡率高，而控制率低。     

Longitudinal methods to investigate the role of health determinants in the dynamics of income-related health inequality

The usual starting point for understanding changes in income-related health inequality (IRHI) over time has been regression-based decomposition procedures for the health concentration index. However the reliance on repeated cross-sectional analysis for this purpose prevents both the appropriate specification of the health function as a dynamic model and the identification of important determinants of the transition processes underlying IRHI changes such as those relating to mortality. This paper overcomes these limitations by developing alternative longitudinal procedures to analyse the role of health determinants in driving changes in IRHI through both morbidity changes and mortality, with our dynamic modelling framework also serving to identify their contribution to long-run or structural IRHI. The approach is illustrated by an empirical analysis of the causes of the increase in IRHI in Great Britain between 1999 and 2004.