Does parental smoking cessation encourage their young adult children to quit smoking? A prospective study

AIMS: To investigate the extent to which parental early and late smoking cessation predicts their young adult children's smoking cessation. DESIGN: Parental early smoking cessation status was assessed when children were in 3rd grade, parental late smoking cessation was assessed when children were in 11th grade, and young adult children's smoking cessation was assessed 2 years after high school. SETTING: Forty Washington State school districts participated in the Hutchinson Smoking Prevention Project. PARTICIPANTS AND MEASUREMENTS: Participants were the 1553 families in which parents were ever regular smokers who had a young adult child smoking at least weekly at 12th grade who also reported their smoking status 2 years later. Questionnaire data were gathered on parents and their young adult children (49% female and 91% Caucasian) in a cohort with a 94% retention rate. FINDINGS: Parents who quit early had children with 1.8 (OR = 1.80; 95% CI = 1.22, 2.64) times higher odds of quitting smoking for at least 1 month in young adulthood compared to those whose parents did not quit early. In contrast, there was no association (OR = 0.84; 95% CI = 0.47, 1.51) between parents quitting late and their young adult children's smoking cessation. CONCLUSIONS: Parental early smoking cessation is associated with increased odds of their young adult children's smoking cessation. Parents who smoke should be encouraged to quit when their children are young.     

Do middle school students really have fixed images of elders?

OBJECTIVE: The purpose of this study was to determine whether combinations of characteristics, abstracted from drawings of elders made by middle school students, grouped together to form cohesive perceptions, or stereotypes, of human aging. METHODS: We abstracted 49 characteristics from drawings of elders made by 1,944 students at two middle schools in San Antonio, Texas, at the beginning of the 1998-1999 school year. Correlational and factor analyses were used to determine if there was an underlying structure or grouping to the characteristics. Logistic regression was used to determine the variables associated with the investigators' classification of the images as positive, neutral, or negative. RESULT: The standardized alpha coefficient for the 49 variables was low (alpha = 0.37). The Spearman rho correlations between the variables were also low, with 90.2% of the 1,176 comparisons being < 0.10. Exploratory factor analyses did not provide a useful grouping of characteristics drawn by the students, including analyses stratified by gender and restricted to the most common 34 characteristics. Among the 49 characteristics that emerged from the drawings, 11, 4, and 11 traits were directly associated with classifying the drawings as positive, neutral, or negative, respectively. DISCUSSION: These analyses indicate that middle school students have not formed strong images regarding aging: No clear cohesive stereotypes of elders emerged from the images drawn by these children. Absence of stereotypic views implies that middle school students may not have a built-in bias toward older people and age-associated changes. This suggests that young adolescents are at a point where instruction including gerontological content can be used to effectively teach about aging and health promotion.     

Parental mediation of adolescent media use and demographic factors as predictors of Kenyan high school students’ exposure to sexual content in television

Research in Western nations suggests that parents’ involvement in their children's media use can make a difference in how adolescents select, process and respond to sexual television messages. Little or no published research has investigated this issue in sub-Saharan Africa, even though adolescents and young adults remain among the groups at highest risk for HIV transmission. This study investigated the relationship between Kenyan adolescents’ level of exposure to sexual television content and their parents’ mediation of their television use. A cluster sample of 427 Nairobi public high school students was surveyed regarding parental mediation of their media use and their intake of sexual television content. Co-viewing with opposite sex friends was associated with higher intake of sexual TV content. This relationship was stronger among boarding school students than among day school students. Parental mediation and co-viewing variables predicted three times as much variance among boarding than among day school students.     

Does moderate alcohol use affect health‐care costs? A propensity analysis of female health‐care workers

AIMS: To determine differences in health-care costs associated with moderate alcohol consumption among female health-care workers while controlling for other risk factors that may be correlated with alcohol use. DESIGN AND SETTING: Non-randomized, prospective, observational study of health-care costs by female health-care workers in a large managed care organization recruited between 1 January 1998 and 1 July 2000. PARTICIPANTS: Six hundred and eighty-five female employees, continuously and stably employed by the managed care organization, who received health-care through the affiliated managed care organization. All women completed a health risk appraisal as part of the company's Employee Wellness Plan; 218 women were categorized as moderate drinkers and 467 as abstainers/light drinkers. MEASUREMENTS: Total costs of in-plan and out-of-plan health-care utilization, by type of service, during the 6 month period after completing the health risk survey were calculated. FINDINGS: Using 218 one-to-one matched pairs of moderate drinkers and abstainers/light drinkers, no significant differences in total, outpatient or inpatient costs were observed during the 6 month observation period. Pharmacy costs were significantly lower for moderate drinkers (-43 dollars, 95% CI = -88.82 dollars to -2.41 dollars), primarily due to differences in costs from anxiolytic (including barbiturates and benzodiazepines), hypnotic and sedative drug fills. CONCLUSIONS: Findings demonstrate the value of risk factor matching when studying the relationship between alcohol use and health-care utilization. The discovery of differential pharmacy utilization raises the possibility that alcohol consumption may reduce the use of prescribed central nervous system depressants.     

Does exposure to opioid substitution treatment at prison release reduce the risk of death? A prospective,observational study in England

BackgroundOpioid use disorders are common in the prison population. Prisoners face an acute risk of death in the first 4 weeks after release. We tested whether prison-based opioid substitution treatment (OST) reduces post-release mortality.MethodsThis was a national prospective cohort study of adult prisoners with opioid use disorders recruited from 39 prisons (and transferred to and released from 123 prisons) in England during 2010–16 linked to Prison Health, Justice Statistics Analytical Services, Office for National Statistics, and National Drug Treatment Monitoring System. We assessed the association between OST exposure at prison release and all-cause mortality using Cox proportional hazards models adjusted for demographic and behavioural confounders and community treatment.FindingsWe created a risk set of 15 141 incarcerations (12 260 individuals) with opioid use disorders (8645 exposed to OST on release, 6496 unexposed). 401 individuals died during the observation period (160 in the first year, 24 in the first month). The mortality risk in the OST-exposed group was lower than in the unexposed group in the first 4 weeks (0·93 per 100 person-years [95% CI 0·4–2·1] vs 3·67 [2·3–5·8]; unadjusted hazard ratio [HR] 0·25, 95% CI 0·10–0·64). Mortality risk did not differ from 4 weeks to 4 months (HR 1·07, 95% CI 0·57–2·00) or from 4 months to 1 year (0·97, 0·65–1·45). OST-exposed prisoners were more likely than the non-exposed group to enter community treatment (odds ratio 2·47, 95% CI 2·3–2·65). The protective effect of OST exposure was not attenuated after adjustment for demographic or behavioural confounders or for community drug treatment (adjusted HR 0·27, 95% CI 0·11–0·71). There was no evidence of an interaction between OST exposure on prison release and community treatment (ratio of HRs 0·99, 95% CI 0·12–8·11; p for likelihood ratio test=0·99).InterpretationOST at prison release lowered risk of mortality in the first month by 75% (removing the excess risk of death in people with an opioid use disorder leaving prison compared with risk of death in the community after 4 weeks) and increased the likelihood of entering drug treatment in the community.FundingDepartment of Health, NHS England, Public Health England.     

A comparison between brand-specific and traditional alcohol surveillance methods to assess underage drinkers’ reported alcohol use

Background: Adolescent alcohol consumption remains common and is associated with many negative health outcomes. Unfortunately, common alcohol surveillance methods often underestimate consumption. Improved alcohol use measures are needed to characterize the landscape of youth drinking. Objectives: We aimed to compare a standard quantity-frequency measure of youth alcohol consumption to a novel brand-specific measure. Methods: We recruited a sample of 1031 respondents across the United States to complete an online survey. Analyses included 833 male and female underage drinkers ages 13–20. Respondents reported on how many of the past 30 days they consumed alcohol, and the number of drinks consumed on an average drinking day. Using our brand-specific measure, respondents identified which brands they consumed, how many days they consumed each brand, and how many drinks per brand they usually had. Results: Youth reported consuming significantly more alcohol (on average, 11 drinks more per month) when responding to the brand-specific versus the standard measure (p?p?p?Conclusion: This study contributes to the field of alcohol and adolescent research first by investigating a potentially more accurate alcohol surveillance method, and secondly by promoting the assessment of alcohol use among adolescents vulnerable to risky alcohol use. Finally, our survey addresses the potential impact of alcohol marketing on youth and their subsequent alcohol brand preferences and consumption.     

Why target early adolescents and parents in alcohol prevention? The mediating effects of self‐control,rules and attitudes about alcohol use

Aims To examine the effects of a parent and student intervention offered separately and simultaneously (PAS) on onset of weekly drinking via its putative mediators. Design A randomized trial with four conditions; (1) parent intervention, (2) student intervention, (3) combined parent–student intervention and (4) control group. Setting High schools selected randomly, located in different areas. Participants A total of 2937 early adolescents (mean age = 12.6, standard deviation = 0.49) and their parents. Measurements Mediation effects were analysed using pretest data and two follow‐up measurements (10 and 22 months after baseline). A path model was estimated (Mplus) to examine the effect of the interventions on adolescent‐reported mediators (self‐control, perceived parental rules and attitudes about alcohol) and parent‐reported mediators (parental rules and attitudes about alcohol). Outcome was onset of weekly drinking. Findings The parent intervention modified rules and attitudes about alcohol as reported by parents. An indirect effect of the parent intervention via parental rules was found. The combined intervention affected both adolescent‐reported and parent‐reported rules and attitudes about alcohol and adolescents' perceived self‐control, yet only perceived rules and self‐efficacy, as reported by adolescents, and parental attitudes mediated the association between the combined intervention and onset of weekly drinking. No significant effects were found of the separate student intervention on the mediating factors. Conclusions The PAS programme proved to be effective as predicted by the theoretical assumptions underlying the interventions. Interventions with parents and adolescents to prevent adolescent alcohol consumption may usefully target parental rules about alcohol and adolescents' self‐confidence.     

Does extinction of responses to cigarette cues occur during smoking cessation?

Aims This study investigated whether Pavlovian extinction occurs during smoking cessation by determining whether experience abstaining from smoking in the presence of cigarette cues leads to decreased probability of lapsing and whether this effect is mediated by craving. Design Secondary analyses were carried out with data sets from two studies with correlational/observational designs. Setting Data were collected in smokers' natural environments using ecological momentary assessment techniques. Participants Sixty‐one and 207 smokers who were attempting cessation participated. Measurements Multi‐level path models were used to examine effects of prior experience abstaining in the presence of available cigarettes and while others were smoking on subsequent craving intensity and the probability of lapsing. Control variables included current cigarette availability, current exposure to others smoking, number of prior lapses and time in the study. Findings Both currently available cigarettes [odds ratios (OR) = 36.60, 11.59] and the current presence of other smoking (OR = 5.00, 1.52) were powerful predictors of smoking lapse. Repeated exposure to available cigarettes without smoking was associated with a significantly lower probability of lapse in subsequent episodes (OR = 0.44, 0.52). However, exposure to others smoking was not a reliable predictor, being significant only in the smaller study (OR = 0.30). Craving functioned as a mediator between extinction of available cigarettes and lapsing only in the smaller study and was not a mediator for extinction of others smoking in either study. Conclusions This study showed that exposure to available cigarettes is a large risk factor for lapsing, but that this risk can also be reduced over time by repeated exposures without smoking. Smoking cessation interventions should attempt to reduce cigarette exposure (by training cigarette avoidance) but recognize the potential advantage of unreinforced exposure to available cigarettes.     

Does sports participation during adolescence prevent later alcohol,tobacco and cannabis use?

Aims   To study whether participation in organized sports during adolescence predicts increased smoking of tobacco, alcohol intoxication and cannabis use from late adolescence to adulthood when controlling for potential confounders. Moreover, to study whether such increased drug use varies according to type of sport (team versus individual), main skills needed (endurance, strength or technical) and level of competition.
Design, setting and participants   Survey of national sample of Norwegian high school students (aged 13–19 years) in 1992 (T1) followed-up in 1994 (T2), 1999 (T3) and 2006 (T4) ( n  = 3251).
Measurements   Outcome measures included smoking of tobacco and 12-month prevalences of alcohol intoxication and cannabis use, respectively. Confounders included pubertal timing, friends' drug use, perceived social acceptance, grades and parental socio-economic status.
Findings   Latent growth curve analyses showed that initial level of participation in organized sports predicted growth in alcohol intoxication. Those involved initially in team sports had greater growth in alcohol intoxication, but lower growth in tobacco use and cannabis use, during the adolescent and early adult years compared to those involved in technical or strength sports. Practising endurance sports, as opposed to technical or strength sports, predicted reduced growth in alcohol intoxication and tobacco use.
Conclusions   Sports participation in adolescence, and participation in team sports in particular, may increase the growth in alcohol intoxication during late adolescent and early adult years, whereas participation in team sports and endurance sports may reduce later increase in tobacco and cannabis use.