中国青少年吸烟危险因素的Meta分析

目的 探讨我国青少年吸烟的主要危险因素，为今后的研究和干预措施提供依据。方法 利用Meta分析方法综合定量分析国内26篇关于青少年吸烟的危险因素的研究文献。结果 合并OR值(95％CI)有统计学意义的前六位主要危险因素分别为：性别7．23(4．62，11．30)、老师吸烟5.82(1．44，23．56)、同伴吸烟5．51(3．29，9．21)、违纪行为3．53(2．82，4．41)、父母态度3．04(1．00，9．25)、吸烟正向态度2．41(1．61，3．61)。结论 我国青少年吸烟的主要危险因素是性别、老师吸烟、同伴吸烟、违纪行为等。     

The myth of peer influence in adolescent smoking initiation.

The widespread belief that peer influence is the primary cause of adolescent smoking initiation is examined and called into question. Correlational and longitudinal studies purporting to demonstrate peer influence are analyzed, and their limitations described. Qualitative interview studies of adolescent smoking initiation are presented as depicting the more complex role of the peer context. Finally, a new model of the role of peers in smoking initiation is offered, with an emphasis on how adolescents' characteristics lead to the selection of their friends, who then provide a peer context that may or may not support smoking.     

Prospective social-psychological factors of adolescent smoking progression

Purpose: To evaluate the ability of social-psychological risk factors to predict adolescent smoking behavior.Methods: Nonsmoking adolescents (n = 4032) who participated in the 1989 and 1993 Teenage Attitudes and Practices Surveys (TAPS I) were selected for analyses. Four multivariate logistic models were used to examine (a) adolescents’ smoking initiation, (b) adults’ smoking initiation, (c) adolescents’ progression to regular smoking, and (d) adults’ progression to regular smoking. A series of social-psychological variables were measured.Results: All four models were significant. However, no social-psychological factors were consistently significant in all four models, except white ethnicity. Data showed that social-psychological factors are less able to predict the transition from nonsmoking to experimental smoking than that from nonsmoking to regular smoking.Conclusions: Future prospective studies should measure both social-psychological and smoking acquisition factors at closer intervals to more accurately examine potential relationships.     

The protective effect of parental expectations against early adolescent smoking initiation

Substantial research and theory suggests that smoking initiation is socially mediated, with both peers and parents playing important roles. To learn more about how parenting behaviors influence smoking initiation, students (n=1002) from four middle schools were surveyed at the beginning of the sixth grade (T1), and the end of the sixth (T2) and seventh (T3) grades. T1 and T2-T1 predictors were regressed on smoking initiation at the end of seventh grade. In bivariate logistic regression analyses, association with friends who smoke, attitudes toward deviance, outcome expectations for smoking, perceived school climate, parental expectations, parental involvement at T1 and increases in these variables (T2-T1) were associated with smoking initiation at T3, but only the T1 measures of social competence, academic engagement, school adjustment, perceived prevalence, parental monitoring and parental involvement were associated with smoking initiation at T3. In multivariate logistic regression analyses, parental expectations were negatively associated, and increases in attitudes accepting of deviance and affiliation with friends who smoke were positively associated with smoking initiation. Analysis of interactions indicated that parental expectations and monitoring did not mediate the effect on smoking initiation of attitudes toward deviance or the number of friends who smoke. These findings provide evidence that parental expectations may protect early adolescents against smoking even in the context of increases in favorable attitudes and friends who smoking.     

The effect of local tobacco sales laws on adolescent smoking initiation

BACKGROUND: More than 700 communities have en acted laws prohibiting the sale of tobacco to minors, but little is known about the impact of such laws on youth smoking behavior. The objective of this study was to determine whether local tobacco sales laws de crease the rate of progression to established smoking among adolescents. METHODS: We conducted a prospective cohort study of 592 Massachusetts youths who did not smoke and were ages 12-15 years at the time of a baseline, random-digit-dial, telephone survey in 1993 and who were reinterviewed in 1997. RESULTS: Youths living in towns with a local tobacco sales ordinance at baseline were significantly less likely to progress to established smoking (defined as having smoked at least 100 cigarettes in one's life) than youths living in a town without an ordinance (odds ratio = 0.60; 95% confidence interval 0. 37, 0.97). The magnitude of this effect was unchanged after control ling for potential confounding variables. However, there was no relationship between living in a town with an ordinance and youths' perceived access to tobacco. CONCLUSIONS: Local tobacco sales laws are associated with reduced rates of adolescent smoking initiation, but in this setting, this effect did not appear to be mediated through reduced access to cigarettes.     

安徽省中学生谋害他人心理行为流行特征分析

了解安徽省中学生谋害他人心理行为的流行特征及其影响因素,为中学生心理行为干预提供科学依据.方法 从安徽省皖南、皖北、皖中每个片区随机选取1个城市,再从各个城市选取1所普通初级中学和1所普通高级中学,每所学校每个年级各调查约320人,共对5 726名初一~高三学生使用自编问卷进行调查,内容主要包括青少年一般情况、青少年谋害他人心理行为等.结果 5 726名中学生最近6个月有过谋害意念、谋害计划、谋害准备、谋害未遂的报告率分别为9.9%,2.8%,1.3%,0.6%.多因素Logistic回归分析显示,男生、初三年级、自评学习成绩偏差、自评家庭经济状况偏差、与父亲关系偏差、朋友数量<3人、自评相貌偏差、自评相貌偏好均是中学生谋害他人意念的危险因素(OR值分别为1.604,1.353,1.289,1.361,1.647,1.406,1.466,1.593,P值均<0.05);而初一年级、母亲受教育程度为初中及以下均是中学生谋害他人意念的保护因素(OR值分别为0.566,0.995,0.757,P值均<0.05).男生、初三年级.高二年级、自评学习成绩偏差、朋友数量<3人、自评相貌偏差或偏好均是中学生谋害他人计划的危险因素(OR值分别为2.335,3.248,2.526,1.779,1.523,1.645,1.895,P值均<0.05).男生、初三年级、自评相貌偏好是中学生谋害他人准备的危险因素(OR值分别为3.261,2.623,2.131,P值均<0.05);而自评学习成绩偏好是中学生谋害他人准备的保护因素(OR=0.258,P<0.05).男生、初三年级、自评相貌偏好是中学生谋害他人未遂的危险因素(OR值分别为6.295,4.919,2.268,P值均<0.05).结论 中学生谋害他人心理行为现象较为严重,不同人口特征中学生谋害他人心理行为存在一定差别,应有针对性地采取相应干预措施.     

Identifying perinatal risk factors for infant maltreatment: an ecological approach

Background  

Child maltreatment and its consequences are a persistent problem throughout the world. Public health workers, human services officials, and others are interested in new and efficient ways to determine which geographic areas to target for intervention programs and resources. To improve assessment efforts, selected perinatal factors were examined, both individually and in various combinations, to determine if they are associated with increased risk of infant maltreatment. State of Georgia birth records and abuse and neglect data were analyzed using an area-based, ecological approach with the census tract as a surrogate for the community. Cartographic visualization suggested some correlation exists between risk factors and child maltreatment, so bivariate and multivariate regression were performed. The presence of spatial autocorrelation precluded the use of traditional ordinary least squares regression, therefore a spatial regression model coupled with maximum likelihood estimation was employed.     

Dieting and smoking initiation in early adolescent girls and boys: a prospective study

OBJECTIVES: This analysis tested the relation between dieting frequency and risk of smoking initiation in a longitudinal sample of adolescents. METHODS: From 1995 to 1997, 1295 middle school girls and boys participated in a nutrition and physical activity intervention study. The prospective association between dieting frequency at baseline and smoking initiation 2 years later was tested. RESULTS: Compared with girls who reported no dieting at baseline, girls who dieted up to once per week had 2 times the adjusted odds of becoming smokers (odds ratio = 2.0; 95% confidence interval = 1.1, 3.5), and girls who dieted more often had 4 times the adjusted odds of becoming smokers (odds ratio = 3.9; 95% confidence interval = 1.5, 10.4). CONCLUSIONS: Dieting among girls may exacerbate risk of initiating smoking, with increasing risk with greater dieting frequency.     

Eating behaviors are risk factors for the development of overweight

This research aimed to characterize eating behavior in a sample of Chilean adults according to their gender and body mass index and to analyze the possible links between these variables and abnormal eating behaviors. We hypothesized that there would be significant differences in the eating behavior of normal-weight and overweight people, and also between men and women. Further, we hypothesized that overweight participants would show more abnormal eating behaviors than their normal-weight counterparts. Two hundred ninety-two participants (205 women and 87 men, age range 18-64 years) were evaluated with a battery of self-administered questionnaires. Mean body mass index was 26.58 kg/m² (women 26.22 kg/m², men 27.41 kg/m²), that is, within the overweight range. Participants with overweight (BMI ≥25 kg/m²) tended to eat faster and in greater quantities, selected more hyper-calorie foods, and engaged in a greater number of abnormal eating behaviors of various kinds. The results suggest that, in addition to what people eat, the question of how people eat may also contribute to the rapid increase in the levels of overweight and obesity in the Chilean population.     

Prevalence and risk factors for smoking among adolescents

OBJECTIVE: Tobacco smoking is one of the main causes of preventable disease and premature disability. The study was aimed at measuring smoking prevalence and related risk factors among adolescents. METHODS: A population-based cross-sectional study was carried out in a representative sample of 1,187 adolescents aged 10 to 19 years living in the urban area of Pelotas, southern Brazil. All adolescents were interviewed separately using a confidential coded questionnaire. Kaplan-Meier test was performed for survival curve analysis. RESULTS: The overall smoking prevalence rate in the sample was 12.1% (95% CI 10.3%-14%). Boys and girls had similar prevalence rates. The following were the risk factors for smoking found in the multivariate logistic regression analysis: older age (OR=28.7; 95% CI 11.5-71.4), older smoking siblings (OR=2.4; 95% CI 1.5-3.8), three or more smoking friends (OR=17.5; 95% CI 8.8-34.8) and low schooling (OR=3.5; 95% CI 1.5-8.0). CONCLUSIONS: The prevalence of smoking among adolescents in the city of Pelotas was high. Campaigns against tobacco use should be aimed at the community and families, targeting adolescents. The government must adopt legal actions in order to prevent adolescents to have access to to smoking.     

Health risk behaviors of adolescent participants in organized sports

Purpose: To assess differences in health-related behaviors between athletes and nonathletes.

Methods: In Grades 9-12 in seven high schools during the 1991-1992 academic year, 7179 (82%) students were asked to complete a survey with six categories of health-related behaviors associated with adolescent morbidity and mortality. Of the 6849 students who completed the survey, 4036 (56%) were classified as athletes. Analyses of differences were controlled for age, race, and gender.

Results: Athletes and nonathletes differed in specific health-risk behaviors. Nonathletes were more likely than athletes ever to have smoked cigarettes (15% vs. 10%) or used marijuana (24% vs. 23%), and fewer ate breakfast daily (34% vs. 45%), never added salt to food (18% vs. 22%), consumed calcium (56% vs. 64%), or consumed fruit or vegetables (40% vs. 47%) daily. More nonathletes reported frequent feelings of hopelessness (15% vs. 10%) and rarely or never using seatbelts (24% vs. 20%), but more athletes reported exceeding the speed limit by 10 mph (39% vs. 35%) and riding bicycles (40% vs. 28%) and/or motorcycles (13% vs. 8%) without helmets. These differences were statistically significant.

Conclusions: Because of their behaviors, adolescent athletes put themselves at significant risk for accidental injuries. However, athletes appear less likely to smoke cigarettes or marijuana, more likely to engage in healthy dietary behaviors, and less likely to feel bored or hopeless.     

State tobacco excise taxes and adolescent smoking behaviors in the United States.

The objective of the study described in this article was to examine the association between state cigarette excise taxes and smoking behaviors among youth in the United States. A survey was nationally mailed to adolescents in the Growing Up Today Study, an ongoing cohort of offspring of participants in the Nurses' Health Study II. A volunteer sample of 10,981 adolescent boy and girl participated in the Growing Up Today Study, who were 12 to 18 years old in 1999. Logistic regression was used to examine the relationship between state cigarette excise taxes (in quartiles) and experimentation (ever smoked) and established smoking (smoked at least 100 cigarettes in a lifetime). State tax levels in 1999 ranged from 2.5 to 100 cents. In a model that adjusted for age, gender, peer smoking, parental smoking, state clustering, state poverty level, and possession of tobacco promotional items, higher tax rates were associated with decreased odds of experimentation (test for trend p < 0.01). The highest quartile of tax (60-100 cents) was significantly associated with lower odds of experimentation (OR = 0.79; 95% CI, 0.64-0.98) and appeared protective against established smoking (OR = 0.80; 95% CI, 0.49-1.29). This study provides recent evidence that higher state cigarette excise taxes are associated with decreased experimental smoking among adolescent boys and girls. Higher state cigarette taxes may also be associated with lower odds of established smoking in this age group, although the association appears to be attenuated by peer and parental smoking. These results support the inclusion of tobacco taxes in state tobacco control programs.     

Analysis of factors related to smoking initiation and continued smoking in young adolescents

OBJECTIVE: To analyse the determining of the acquisition and later consolidation of the tobacco consumption in young adolescents. MATERIAL AND METHOD: Longitudinal study of three years of duration (2000-2002). Subjects were students of secondary education between 13 and 14 years old at the beginning of the study. The research was performed in Gran Canaria Island with a final sample of 745 subjects. Models of conditional binary election were considered for longitudinal data where the dependent variable reflects decisions of the adolescents through time, with regard to the probability of beginning to smoke, "beginning model", and the probability of being occasional or habitual smoker, "experimentation model". RESULTS: In the last year, 57% of the young teenagers surveyed use tobacco, a 25% more than in the first year, some of them, 9% on a daily basis. In the "beginning model" the determining of the tobacco consumption are interest in studies (odds ratio [OR] = 0.27; 95% confidence interval (CI), 0.08-0.87 and OR = 0.14; 95% CI, 0.03-0.58 for the students having enough and much interest in studies, respectively), to have a smoker as the best friend (OR = 7.44; 95% CI, 2.59-21.4), the alcohol consumption (OR = 11.82; 95% CI, 4.96-28.2 and OR=15.42; 95% CI, 4.68-50.7 for youngs who drink alcohol occasionally or frequently) and having more pocket money (euros per week) (OR = 1.13; 95% CI, 1.07-1.19). For the "experimentation model", to have a smoker as the best friend (OR = 7.01; 95% CI, 2.96-16.5), the alcohol consumption (OR = 5.71; 95% CI, 1.98-16.4 and OR = 5.22; 95% CI, the 1.56-17.5 for youngs who drink alcohol occasionally or frequently) and the number of years since the student started smoking (OR = 1.44; 95% IC, 1.11-1.86). CONCLUSIONS: Our study emphasizes, peer group effect, drinking alcoholic beverages and lack of interest in studies as factors associated to the tobacco consumption.     

Gender and ethnic differences in the co-occurrence of adolescent risk behaviors

Design

Results

Conclusion

We consider gender and ethnic differences in the co-occurrence of adolescent behaviors related to health and well-being.

Using a nationally representative sample of adolescents in the National Longitudinal Survey of Youth (1997–2000), we examine behavior among students as well as school drop-outs. We use latent class models (LCMs) to identify subpopulations of adolescents with similar patterns of co-occurring behaviors. The generalizability of the findings for African American adolescents in the 1970s is considered using a sample of inner-city youth from the Pathways to Adulthood Survey.

For all ethnic groups, we find a subpopulation with ‘problem behavior’ characteristics (in which early sexual initiation, alcohol use, smoking, marijuana use, and truancy are all highly prevalent). This cluster is most common among European American adolescents and among young men. A subpopulation characterized by behaviors often leading to poor social outcomes (e.g. truancy, early sexual initiation and fighting) is most common for African American adolescents, especially young African American men.

Our findings suggest that multi-factorial interventions which address the interrelationships between all of the behaviors are relevant regardless of gender or ethnicity. However, the ethnic and gender differences in the likelihood of specific patterns of interrelationships highlight the importance of considering the ethnic and gender composition of a population when developing future research and interventions.     

Identifying environmental risk factors for endemic cholera: a raster GIS approach

The bacteria that cause cholera are known to be normal inhabitants of surface water, however, the environmental risk factors for different biotypes of cholera are not well understood. This study identifies environmental risk factors for cholera in an endemic area of Bangladesh using a geographic information systems (GIS) approach. The study data were collected from a longitudinal health and demographic surveillance system and the data were integrated within a geographic information system database of the research area. Two study periods were chosen because they had different dominant biotypes of the disease. From 1992 to 1996 El Tor cholera was dominant and from 1983 to 1987 classical cholera was dominant. The study found the same three risk factors for the two biotypes of cholera including proximity to surface water, high population density, and poor educational level. The GIS database was used to measure the risk factors and spatial filtering techniques were employed. These robust spatial methods are offered as an example for future epidemiological research efforts that define environmental risk factors for infectious diseases.     

Long-term consequences of adolescent health behaviors: implications for adolescent health services

The authors discuss the evidence supporting the effectiveness of adolescent preventive services to influence health outcomes, the magnitude of the long-term consequences of adolescent health-compromising behaviors, and their implications for health policies. Particular attention is given to the contribution that behaviors participated in or begun during adolescence have on long-term health, including cancer and heart disease. They postulate the health benefits that might accrue from the widespread implementation of comprehensive adolescent preventive services, assuming a conservative estimate of effectiveness, could be significant.     

Adolescent alcohol initiation: A review of psychosocial risk factors

Longitudinal research studies focused on alcohol use initiation in adolescence were reviewed to determine which variables function as antecedent predictors or risk factors. Only studies that focused on time-1 abstainers were included. Classes of risk factors examined include sociodemographic, family, peer, personality, and behavioral variables. The most consistent antecedent risk factors for starting to drink in adolescence were parental and peer approval and models for drinking and drug use as well as adolescents’ own prior involvement in delinquent behavior. There was little evidence for gender differences in risk factors for alcohol use initiation. Secondary analyses of existing longitudinal data sets are encouraged to examine whether there are ethnic/racial differences in the risk factors for starting to drink and to establish those factors that serve a protective or buffering function, delaying onset of alcohol use in adolescence.