Waterpipe Tobacco Smoking and Associated Risk Factors among Bangladeshi University Students: An Exploratory Pilot Study

Over the past two decades, there has been a global rise in the prevalence of waterpipe tobacco smoking. Waterpipe tobacco smoking involves the inhalation of heated tobacco smoke after passing through water, and it has been associated with an identified dependence effect similar to that found with cigarette smoking. Despite the popularity of waterpipe tobacco among youth (and in particular, university students) in many countries, detailed data of its usage are lacking in Bangladesh. Therefore, the present study was conducted to explore waterpipe tobacco smoking behavior and normative beliefs among university students in Bangladesh and to assess the factors associated with waterpipe tobacco use. A quantitative cross-sectional survey was carried out among 340 Bangladeshi university students (64.4% male; mean age 21.6 years). Among participants, 13.5% reported they had ever smoked tobacco from a waterpipe and 9.4% had it in past 30 days. Among past 30-day users, 72% were categorized as having waterpipe smoking dependence (n =?23). No females in the sample had ever smoked using a waterpipe. Maternal occupation, monthly expenditure, and regular smoking status were major predominant factors associated with waterpipe smoking behavior of the students. The study is of existential value given that there are no prior studies ever carried out in Bangladesh previously. Recommendations are provided based on the study’s findings, particularly in relation to what action is needed from universities in Bangladesh.

     

Tobacco smoke exposure and inadequate sleep among U.S. school-aged children

Objective/backgroundInadequate sleep and tobacco smoke exposure (TSE) have been separately linked to adverse childhood health consequences. Our objective was to assess the association between home TSE status and inadequate sleep among U.S. school-aged children.MethodsWe analyzed 2018–2019 National Survey of Children's Health data, and included 17,851 children ages 6–11 years. Children were classified into three parent-report TSE groups: (1) did not live with a smoker (no TSE at home); (2) lived with a smoker who did not smoke inside the home (thirdhand smoke (THS) exposure only); and (3) lived with a smoker who smoked inside the home (secondhand smoke (SHS) and THS exposure). Parent-report of inadequate sleep on most weeknights was defined as <9 h, following age-specific national guidelines. We fitted a weighted multivariable logistic model to assess the association between TSE groups and inadequate sleep, adjusting for child covariates (sociodemographics, overweight status, health status, physical activity, and screen time).ResultsAbout 13% and 1% of school-aged children were exposed to home THS only and home SHS and THS, respectively; approximately 36% overall had inadequate sleep. Compared to children with no TSE at home, children who were exposed to home THS only had higher odds of inadequate sleep (AOR = 1.44, 95%CI = 1.20–1.73); those exposed to home SHS and THS had higher odds of inadequate sleep (AOR = 1.83, 95%CI = 1.20–2.78).ConclusionsTSE is associated with school-aged children having inadequate sleep, even when smokers did not smoke inside the home. Promoting parental smoking cessation is essential to fully protect children from related risks.     

Comparison of Two School-Based Smoking Prevention Programs among South African High School Students: Results of a Randomized Trial

Background  Smoking rates are projected to increase substantially in developing countries such as South Africa. Purpose  The aim of this study was to test the efficacy of two contrasting approaches to school-based smoking prevention in South African youth compared to the standard health education program. One experimental program was based on a skills training/peer resistance model and the other on a harm minimization model. Method  Thirty-six public schools from two South African provinces, KwaZulu-Natal and the Western Cape, were stratified by socioeconomic status and randomized to one of three groups. Group 1 (comparison) schools (n = 12) received usual tobacco use education. Group 2 schools (n = 12) received a harm minimization curriculum in grades 8 and 9. Group 3 schools (n = 12) received a life skills training curriculum in grades 8 and 9. The primary outcome was past month use of cigarettes based on a self-reported questionnaire. Result  Five thousand two hundred sixty-six students completed the baseline survey. Of these, 4,684 (89%) completed at least one follow-up assessment. The net change in 30-day smoking from baseline to 2-year follow-up in the control group was 6% compared to 3% in both harm minimization (HM) and life skills training (LST) schools. These differences were not statistically significant. Intervention response was significantly moderated by both gender and race. The HM intervention was more effective for males, whereas the life skills intervention was more effective for females. For black African students, the strongest effect was evident for the HM intervention, whereas the strongest intervention effect for “colored” students was evident for the LST group. Conclusion  The two experimental curricula both produced similar overall reductions in smoking prevalence that were not significantly different from each other or the control group. However, the impact differed by gender and race, suggesting a need to tailor tobacco and drug use prevention programs. More intensive intervention, in the classroom and beyond, may be needed to further impact smoking behavior.

Prevalence of depressive symptoms and predictors of treatment among U.S. adults from 2005 to 2010

Objectives

To determine nationally representative estimates of the prevalence of depressive symptoms and factors associated with treatment among those with moderate to severe symptoms.

Methods

A cross-sectional, retrospective analysis of adults age ≥ 18 years in the 2005–2010 National Health and Nutrition Examination Survey data who responded to the Patient Health Questionnaire (PHQ-9) was conducted (n= 13,320). Depressive symptoms and severity were defined by PHQ-9 scores. Depression treatment was defined as either receiving antidepressants or seeing a mental health professional. Multivariable logistic regression analyses using population weights identified factors associated with having depressive symptoms and receipt of any treatment.

Results

The prevalence of depressive symptoms increased from 20.92% to 25.66% over 6 years. Among patients with moderate to severe depression, 38.66% received treatment. Multivariable analyses found that being female, other Hispanic, younger age, having certain chronic comorbidities or previous hospitalization, no health insurance and in poverty status were associated with having depressive symptoms (P< .05). Among patients with moderate to severe depression, being female, white, younger age, having comorbidities (arthritis and hypertension) or previous hospitalization were associated with receipt of treatment (P< .05).

Conclusions

The prevalence of depressive symptoms is high, and only a small portion of patients with moderate to severe depression received treatments. Treatment disparities exist and need improvement.     

Prevalence of Anxiety and Associated Factors among University Students: A Cross-Sectional Study in Japan

Mental health difficulties can impact students’ motivation, focus, and ability to communicate with others. Students attending medical universities are more likely to experience anxiety, depression, and other mood changes for the first time. However, no study has examined their prevalence among Japanese rehabilitation students. This study investigated the prevalence of anxiety among Japanese rehabilitation students and aimed to identify its predictors. A cross-sectional study was conducted among 148 first-year physical and occupational therapy students at a private medical university in Japan in June 2022. Data on sociodemographic and personal characteristics, such as gender, age, subject major, regular exercise, place of residence, and sleeping hours, were recorded using an original questionnaire. Instruments included the State-Trait Anxiety Inventory, COVID-19 questionnaire, and Beck Depression Inventory–Second Edition (BDI-II). The results indicated that 83 (56%) and 77 (52%) students exhibited state anxiety and trait anxiety symptoms, respectively. Thirty-four (23%) students experienced mild depressive symptoms. Associations were further determined between gender, subject major, handling of stress, loneliness, satisfaction with life, satisfaction with social connections, anxiety about the future, satisfaction with school life, fulfillment of friendships, and depression. Several variables demonstrated a statistically significant association: handling stress (p < 0.05; 95% CI 0.409–2.472), satisfaction with life (p < 0.01; 95% CI 0.500–0.897), anxiety about the future (p < 0.01; 95% CI 1.397–4.087), and depression (total score of BDI-II, p < 0.01; 95% CI 1.555–100.742). Our results emphasize that universities must establish a system for early identification and support of anxiety and depression in students.     

Patterns of Tobacco Consumption among Indian Men with Schizophrenia Compared to Their Male Siblings

Objective

Tobacco consumption among patients with schizophrenia has been investigated extensively in western countries, but there is a dearth of studies in India, where socio-economic and cultural variables are different. This study aims to investigate the patterns of tobacco consumption among schizophrenia patients compared with their non-psychotic siblings.

Methods

Consenting, successive male outpatients diagnosed with schizophrenia (n=100, DSM-IV criteria), and their non-psychotic brothers (n=100) were compared. Following a structured diagnostic interview, detailed information about tobacco consumption (including smokeless tobacco) was obtained using the Fagerstrom Test for Nicotine Dependence for smoked tobacco, and FTND-smokeless tobacco. The University of Pennsylvania Computerized Neurocognitive battery (CNB) was administered to a sub-group of patients (n=48).

Results

Schizophrenia patients initiated tobacco use at a significantly earlier age than their brothers, but there was no significant difference with regard to type, quantity or frequency of tobacco use (smoke or smokeless varieties). Patients who consumed tobacco had significantly higher positive symptom scores compared with non-users (p=0.043). There were no significant differences between nicotine dependent and non-dependent patients with regard to CNB domains except attention.

Conclusion

Patterns of tobacco consumption were similar among schizophrenia patients and their non-psychotic brothers. Tobacco use was associated with increased positive symptom scores, but there were no significant differences in cognitive measures among nicotine dependent and non-dependent patients.     

Prevalence of mental illness in immigrant and non-immigrant U.S. Latino groups

OBJECTIVE: Although widely reported among Latino populations, contradictory evidence exists regarding the generalizability of the immigrant paradox, i.e., that foreign nativity protects against psychiatric disorders. The authors examined whether this paradox applies to all Latino groups by comparing estimates of lifetime psychiatric disorders among immigrant Latino subjects, U.S-born Latino subjects, and non-Latino white subjects. METHOD: The authors combined and examined data from the National Latino and Asian American Study and the National Comorbidity Survey Replication, two of the largest nationally representative samples of psychiatric information. RESULTS: In the aggregate, risk of most psychiatric disorders was lower for Latino subjects than for non-Latino white subjects. Consistent with the immigrant paradox, U.S.-born Latino subjects reported higher rates for most psychiatric disorders than Latino immigrants. However, rates varied when data were stratified by nativity and disorder and adjusted for demographic and socioeconomic differences across groups. The immigrant paradox consistently held for Mexican subjects across mood, anxiety, and substance disorders, while it was only evident among Cuban and other Latino subjects for substance disorders. No differences were found in lifetime prevalence rates between migrant and U.S.-born Puerto Rican subjects. CONCLUSIONS: Caution should be exercised in generalizing the immigrant paradox to all Latino groups and for all psychiatric disorders. Aggregating Latino subjects into a single group masks significant variability in lifetime risk of psychiatric disorders, with some subgroups, such as Puerto Rican subjects, suffering from psychiatric disorders at rates comparable to non-Latino white subjects. Our findings thus suggest that immigrants benefit from a protective context in their country of origin, possibly inoculating them against risk for substance disorders, particularly if they emigrated to the United States as adults.     

Smoking,alcohol consumption,and drug use among adolescents with psychiatric disorders compared with a population based sample

This study investigated frequencies of smoking, alcohol use, and illicit drug use by diagnostic category in 566 adolescent psychiatric patients, comparing this sample with 8173 adolescents from the general population in Norway who completed the Young-HUNT 3 survey. Frequencies of current alcohol use were high in both samples but were lower among psychiatric patients. Compared with adolescents in the general population, adolescents in the clinical sample had a higher prevalence of current smoking and over four times higher odds of having tried illicit drugs. In the clinical sample, those with mood disorders reported the highest frequencies of smoking, alcohol use, and illicit drug use, whereas those with autism spectrum disorders reported the lowest frequencies. Our results show an increased prevalence of risky health behaviors among adolescents with psychiatric disorders compared with the general population. The awareness of disorder-specific patterns of smoking and substance use may guide preventive measures.     

Assessing the reliability and validity of the Bermond-Vorst Alexithymia Questionnaire among U.S. Anglo and U.S. Hispanic samples

OBJECTIVE: The aim of this paper is to assess the psychometric properties of the Bermond-Vorst Alexithymia Questionnaire (BVAQ) in U.S. Anglo and U.S. Hispanic samples of college students. METHOD: One hundred ninety-four U.S. Hispanics and 304 U.S. Anglos participated in the study. In addition to completing the BVAQ, participants completed the 20-item Toronto Alexithymia Scale (TAS-20), the Beck Depression Inventory (BDI), and the Eysenck Neuroticism Scale (ENS). RESULTS: BVAQ and TAS-20 subscales were correlated across groups. While the identifying and verbalizing composites of the BVAQ subscales were predictive of neuroticism and depression across groups in the expected direction, the fantasizing subscale of the BVAQ was negatively predictive of depression and neuroticism across groups. CONCLUSION: Given the unexpected findings associated with some of the BVAQ subscales, future research should explore the dimensionality of alexithymia.     

Smoking, gender, and dietary influences on erythrocyte essential fatty acid composition among patients with schizophrenia or schizoaffective disorder.

BACKGROUND: Prior reports of decreased levels of essential fatty acids among schizophrenic patients have generated several hypotheses proposing inherent abnormalities in phospholipid and fatty acid metabolism and have provided the basis for treatment trials; however, these essential fatty acid aberrations may be attributable to uncontrolled factors, such as smoking, rather than abnormalities inherent to schizophrenia. METHODS: Erythrocyte fatty acid compositions were quantified in 72 medicated schizophrenic or schizoaffective patients both at baseline and after 16 weeks of supplementation with 3 g/day of either ethyl-eicosapentaenoic acid or placebo. Current smoking status, gender, dietary survey, and Montgomery Asburg Depression Rating Scale, Repeatable Battery for the Assessment of Neuropsychological Status, Abnormal Involuntary Movement Scale, and Positive and Negative Syndrome Scale scores were assessed. RESULTS: Schizophrenic patients who smoked had lower baseline erythrocyte docosahexaenoic acid percent (2.98 +/-.7 vs. 3.59 +/- 1.2, p <.005) and eicosapentaenoic acid (EPA) percent (.39 +/-.13 vs. 47 +/-.22, p <.05), compared with nonsmokers, with a significant gender interaction (p <.01) in multivariate analyses of variance. Baseline arachidonic acid did not differ. Smokers reported lower dietary intake (percent total fat) of linolenic acid (F = 10.1, p <.003) compared with nonsmokers. Nonsmoking women reported greater dietary intake of EPA compared with smoking men or nonsmokers of either gender. CONCLUSIONS: Smoking status, gender, and dietary intake significantly predicted erythrocyte polyunsaturated fatty acid status among schizophrenic patients. No evidence was found for subgroups of schizophrenia or relationships to specific symptom severity on the basis of erythrocyte fatty acids. Prior reports of abnormalities of essential fatty acid metabolism among schizophrenic patients may have been an artifact of patients' smoking behavior and differences in dietary intake of omega-3 fatty acids.     

Brief report: Associations between in-person and electronic bullying victimization and missing school because of safety concerns among U.S. high school students

Although associations between bullying and health risk behaviors are well-documented, research on bullying and education-related outcomes, including school attendance, is limited. This study examines associations between bullying victimization (in-person and electronic) and missing school because of safety concerns among a nationally representative sample of U.S. high school students. We used logistic regression analyses to analyze data from the 2013 national Youth Risk Behavior Survey of students in grades 9–12. In-person and electronic victimization were each associated with increased odds of missing school due to safety concerns compared to no bullying victimization. Having been bullied both in-person and electronically was associated with greater odds of missing school compared to electronic bullying only for female students and in-person bullying only for male students. Collaborations between health professionals and educators to prevent bullying may improve school attendance.     

Comparison of obesity among Chinese and U.S. Special Olympic athletes with intellectual disabilities

Background/objectivesObesity is a health problem in China, but there are no reports on the obesity status of Chinese citizens with intellectual disabilities (ID). Research has shown that adults with ID have higher body mass index (BMI) than adults without ID, but this information is primarily based on populations residing in North American and European countries. The purpose of this study was to compare BMI and obesity status of Chinese and U.S. Special Olympic athletes with ID.Subjects/methodsHeight, weight, BMI and self-reported physical activity (SRPA) data from the Special Olympics 2006 U.S. National Games and 2007 Shanghai World Games databases were analyzed. Linear and logistic analyses were conducted for continuous data and dichotomous variables, respectively. Predictor variables were age, gender, country, SRPA, and obesity status according to country specific criteria. Significance was set at p < 0.05.ResultsThe U.S. group had significantly higher BMI values than their Chinese counterparts. Age (p = 0.001) and country (p = <0.001) were the main predictors of BMI and obesity status, even when country-specific standards of obesity classifications were used. Holding all other factors constant, each unit increase of age was associated with increased odds for obesity by a factor of 1.04 and the odds of obesity occurring in U.S. athletes was 2.47 times greater than in Chinese athletes.ConclusionObesity is an emerging health problem for Chinese adults with ID. Participation in Special Olympics does not offset obesity in people with ID and other methods of intervention are needed to address obesity in this population segment. This is a global health concern that requires immediate attention.     

Disparities in smoking cessation among U.S. adults with a history of asthma

BACKGROUND: Socioeconomic status (SES) and racial-ethnic disparities in smoking cessation among U.S. adults with a history of asthma have received limited attention. PURPOSE: This study examined sociodemographic characteristics associated with smoking cessation in national samples of adults with a self-reported history of asthma. METHODS: Data from the National Health Interview Survey (years 2000 and 2001 combined) was used to assess the quit ratio (i.e., former smokers as a proportion of ever-smokers) by sociodemographic characteristics, and predictors of former versus current smoking status were examined with multiple logistic regression. RESULTS: Quit ratios were 53% in Hispanics, 52% in non-Hispanic Whites, and 42% in African American ever-smokers. The quit ratio reached 70% in college graduates versus 45% in those with less than 12 years of education. In multivariate analyses, education and marital status but not racially classified social groups/ethnicity were independently associated with former versus current smoking. CONCLUSIONS: Expanded smoking cessation efforts are needed among persons with a history of asthma, especially those of lower SES.     

Internet Use among University Students in South West Bank: Prevalence,Advantages and Disadvantages,and Association with Psychological Health

University students are frequently using the Internet for educational purposes and for other purposes. Recently, there is a debate on advantages and disadvantages of Internet use and its effects on the students’ psychological health. This study examines the prevalence of Internet use, its advantages and disadvantages, and its relationship with the psychological health of university students in the southern part of the West Bank. Mixed methods employing sequential exploratory design were used. Three focused groups were included to inform the development of the cross-sectional survey. Then, a convenience sample of 144 students from three universities in the south West Bank completed the survey. The results revealed that 96 % of university students reported using the Internet. Different advantages and disadvantages of using the Internet among students were emphasized. A high rate of Internet use was associated with students’ poor psychological health. Internet use has negative and positive educational, social and psychological consequences for students. However, advantages of Internet use were shown to be more than its disadvantages.