Prospective association between dieting and smoking initiation among adolescents

PURPOSE: To examine the relation between dieting and smoking initiation among adolescents. DESIGN: Prospective data from a nationally representative study were used. SETTING: Two waves (1994 to 1996) of the National Longitudinal Study of Adolescent Health. SUBJECTS: The sample included 7795 non-Latino Caucasian and non-Latino African-American adolescents. MEASURES: Dieting status was the independent variable and trying smoking and initiation of regular smoking were the dependent variables. Covariates included age, ethnicity, overweight status, false self-perception about being overweight, and availability of cigarettes at home. ANALYSIS: Logistic regression and latent transition analyses were used. RESULTS: Females had a higher prevalence of dieting (55%) when compared with males (25%). Dieting initiation was a significant predictor for initiation of regular smoking among females (OR = 1.94, p = .010), but not among males. Inactive dieting was a significant predictor among males (OR = 1.74, p = .031), but not among females. Compared to nondieters, initiating and consistent female dieters reported a higher probability of transitioning to having tried regular smoking, although results from logistic regression suggested that the association between consistent dieting and initiation of regular smoking was not significant. CONCLUSIONS: There is a positive relation between initiating dieting and initiating regular smoking among females, but among males it is the inactive dieters who show a positive relationship. Results illustrate the importance of examining the association between dieting and the initiation of regular smoking.     

Gender and educational differences in smoking initiation rates in Spain from 1948 to 1992

BACKGROUND: The pattern of smoking initiation is of importance in understanding the prevalence of smoking and future trends in tobacco-related diseases. OBJECTIVE: To analyse trends of cigarette smoking initiation rates by sex and educational level in Spain. METHODS: Pooled data from the 1993, 1995 and 1997 Spanish National Health Interview Surveys were used (16,365 males and 17,478 females aged >15 years). The age and smoking status of each subject were reconstructed for five calendar periods (1948-1952, 1958-1962, 1968-1972, 1978-1982, 1988-1992). Age-specific (10 to 24 years old) smoking initiation rates were calculated for males and females, and according to level of education (high education: university and secondary school; low education: primary and less than primary). RESULTS: Among males, there was a trend towards earlier age at start of smoking and higher initiation rates between 1958 and 1982, and a subsequent decline in initiation rates, more apparent in males with a higher level of education. Smoking initiation among females was rare until the 1960s, and from the period 1968-1972 onwards a converging pattern with that of males was observed. Women with a higher level of education started smoking before women with low education, but this pattern changed over the period 1978-1982, with higher initiation rates among less educated women during the last period studied. CONCLUSIONS: These results help to characterize the tobacco epidemic in Spain, now at the end of stage 3. The observations are in agreement with diffusion-of-innovations theory and the social and economic changes from the 1960s onwards in Spain.     

Gender differences in smoking cessation

Men and women have traditionally consumed cigarettes very differently, demonstrating widely varying patterns of prevalence during the past eight decades. For example, though the prevalence of smoking among men increased dramatically soon after the turn of the century, an analogous though less dramatic increase among women was not observed for another 25-30 years. Similarly, when a dramatic decrease in smoking prevalence among men was observed following the 1964 Surgeon General's Report, a comparable decrease among women was not seen until 15 years later. Such differences in smoking patterns have led to the widespread belief that giving up smoking is more difficult for women than it is for men. This paper reviews various studies which address this issue and suggests areas in which further research is needed.     

Gender differences in teenage smoking

This study analyzes the patterns and correlates of gender differences in cigarette smoking in a national sample of white high school seniors in 1985. More females than males were smokers, because females had higher rates for the early stages of smoking adoption. Specifically, females were more likely to have tried smoking at least once and, among those who had tried smoking, females were more likely to have smoked more than once or twice. Gender differences in smoking varied, depending on the students' characteristics. For example, the female excess in the early stages of smoking adoption was small or absent among rural students or very religious students, apparently because traditional values inhibit smoking adoption more among females than among males. We estimated the contributions of gender differences in students' characteristics to gender differences in smoking adoption. For example, males were more involved in sports, and this appears to be one reason why males had lower rates of smoking adoption than females. On the other hand, males had more deviant behavior and attitudes, and this would be expected to contribute to greater smoking adoption by males. The findings of this study indicate important gender differences in the determinants of smoking adoption.     

Gender differences in smoking behavior

This paper investigates gender differences in smoking behavior using data from the German Socio-economic Panel (SOEP). We develop a Blinder-Oaxaca decomposition method for count data models, which allows to isolate the part of the gender differential in the number of cigarettes daily smoked that can be explained by differences in observable characteristics from the part attributable to differences in coefficients. Our results reveal that the major part of the gender smoking differential is attributable to differences in coefficients indicating substantial differences in the smoking behavior between men and women.     

Detecting emotional and behavioural problems in paediatric clinics

BACKGROUND: Children with chronic illness have increased rates of mental health problems and psychological difficulties often present as physical conditions. This prevalence survey aims to determine whether children attending general paediatric out-patient clinics are at increased risk of suffering from emotional and behavioural disturbance and whether there is an unmet need for psychiatric liaison to paediatric clinics. METHODS: Participants were 307 children aged 5-15 years attending a representative sample of paediatric out-patient clinics in one UK hospital. A national community sample of 10,438 children aged 5-15 years was used as a comparison group. Parental ratings of child behaviour were obtained using the Strengths and Difficulties Questionnaire (SDQ). Doctors rated the extent of any emotional difficulties using a modification of the SDQ 'impact supplement'. RESULTS: Children attending paediatric out-patient clinics were more than twice as likely (OR = 2.3, 95% CI 1.7-3.1) to score in the abnormal range of the SDQ. Of the 60 (20%) children with a probable psychiatric disorder only 15 had received specialist help from Child Mental Health Services. There were no gender differences in the profile of difficulties with emotional symptoms being particularly evident in both boys (OR = 2.85, 95% CI 1.97-4.11) and girls (OR = 3.04, 95% CI 1.92-4.70). The risk of psychiatric disorder was highest among those children with brain disorders attending neurological clinics (OR = 5.8, 95% CI 2.5-11.3). Clinicians only identified emotional or behaviour problems in a quarter of those children with parent-rated disorder. CONCLUSION: There is an increased prevalence of emotional and behavioural disturbance in children attending paediatric out-patient clinics. The SDQ could be added to routine paediatric assessments to aid appropriate referral of children with a possible psychiatric disorder to child mental health services.     

Gender differences in the relationship between physical activity and smoking among psychiatrically hospitalized adolescents

Physical activity has been identified as a protective factor with regard to tobacco use, such that physically active adolescents are less likely to initiate smoking, and smokers are less physically active than non-smokers. These findings, along with the well-documented benefits of exercise on mood and well-being in adults, have stimulated interest in exercise-based smoking cessation interventions. However, little research has explored the relationship between physical activity and smoking characteristics within adolescent smokers. Also, gender differences in adolescents' motives for smoking and exercise may have implications for intervention development, especially in clinical populations. The current study explored the relationship between physical activity and smoking in a sample of adolescent smokers (N = 191) and non-smokers (N = 48) receiving inpatient psychiatric treatment (61% female, mean age 15.3 years). Results indicated that smokers were less likely to be physically active than non-smokers. Additionally, there was a consistent pattern of gender differences in the relationship between smoking and physical activity within smokers. Specifically, physically active male smokers were less nicotine dependent and less prone to withdrawal symptoms, and had a trend toward greater motivation to quit, than their non-active counterparts. In contrast, physically active female smokers did not differ in dependence or withdrawal and were less motivated to quit than non-active female smokers. Taken together, these results suggest that within clinical populations of adolescent females, smoking and exercise may be used jointly as weight control strategies. Exercise-based interventions for smoking cessation for adolescent females, especially clinical populations, should address weight and body image concerns.     

Gender differences in the association between westernization and metabolic risk among Greenland Inuit

Background The Inuit have gone through an accelerated process of modernization especially since 1950. Primarily because of the dietary transition, westernisation is expected to influence the Inuit’s metabolic risk in a negative way with respect to cardiovascular risk. The aim was to analyze metabolic risk factors among Inuit in Greenland and Denmark and their relation to westernization.Methods 1173 adult Inuit participated in a health survey in Greenland and Denmark. The examination included a 75 g OGTT. BMI, waist-to-hip ratio, and blood pressure were measured. P-glucose, s-insulin, lipids and urine-albumin/creatinine ratio were analysed. Westernization was estimated by place of residence and language.Results The prevalence of the metabolic syndrome was 20.3% among men and 19.5% among women (p = 0.73). The association between the metabolic syndrome and westernization was different for men and women. For men there was an increase in prevalence of the metabolic syndrome with westernization within Greenland, but the variation was less pronounced than the difference between the migrants and the Inuit in Greenland. Age, family history of diabetes, and non-smoking were directly associated with the metabolic syndrome, whereas high physical activity was negatively associated with the metabolic syndrome. For women there was a significant negative association between westernization and the metabolic syndrome among the three population groups in Greenland, whereas the prevalence was not significantly lower among female migrants compared with Inuit women in Greenland. Age, family history of diabetes, non-smoking, and low education were associated with the metabolic syndrome.Conclusions The effect of westernization on metabolic risk was different for men and women. For men physical inactivity due to a decrease in subsistence hunting and fishing seems to increase the metabolic risk; for women higher education is associated with a more favorable risk profile.     

Gender differences in the association between morbidity and mortality among middle-aged men and women

Objectives. We examined gender differences in mortality, morbidity, and the association between the 2.Methods. We used health data from 2 studies of middle-aged men and women: the British Whitehall II cohort of employees from 20 civil service departments in London and the 1989 French GAZEL (this acronym refers to the French gas and electric companies) of employees of France''s national gas and electricity company. Participants were aged 35 to 55 years when assessed for morbidity and followed up for mortality over 17 years.Results. Male mortality was higher than female mortality in Whitehall II (hazard ratio [HR] = 1.56; 95% confidence interval [CI] = 1.28, 1.91) and the GAZEL cohort (HR = 1.99; CI = 1.66, 2.40). Female excess morbidity was observed for some measures in the Whitehall II data and for 1 measure in the GAZEL data. Only self-reported sickness absence in the Whitehall II data was more strongly associated with mortality among men (P = .01).Conclusions. Mortality was lower among women than among men, but morbidity was not consistently higher. The lack of gender differences in the association between morbidity and mortality suggests that this is not a likely explanation for the gender paradox, which refers to higher morbidity but lower mortality among women than among men.In most regions of the world, life expectancy among women is higher than among men.^1,2 Men are said to be “more vulnerable from the beginning of life,”³ with mortality rates among men being higher than those among women throughout the lifespan.^4,5 Research in the 1970s and 1980s routinely showed higher morbidity among women; this discrepancy between morbidity and mortality rates is referred to as the “gender paradox.”^5–10 However, uniformity in the pattern of gender differences for all measures of morbidity has been questioned.¹¹ At older ages, there is some evidence to suggest that there are minimal gender differences in self-assessed health,¹² as well as substantially higher levels of disability among women.^13,14 The notion of ubiquitous male vulnerability also is challenged by research showing higher mortality among women after cardiac surgery.^15–21It remains unclear whether the gender paradox discrepancy is based on inferences from ecological correlations between morbidity and mortality or whether the discrepancies hold true at the individual level. Furthermore, multiple measures of morbidity, both subjective and objective measures, have rarely been examined in the same study. We tested the hypothesis of greater morbidity among women by examining a range of objective and subjective measures of health among middle-aged men and women. For 3 of the measures included, we compared self-report with an objective measure of morbidity.One explanation for the gender paradox links it to greater stoicism among men and a greater willingness among women to use health services, report health problems,^5,22,23 and factor in less-serious ailments when assessing their own health.²⁴ Although these explanations implicate slightly different mechanisms, they all assume that a woman''s illness is less likely to kill her. More specifically, if women overreport minor health problems or report health problems at an earlier, more benign stage, then the association between morbidity and mortality ought to be smaller among women compared with men. Thus, we examined the evidence for this discrepancy in the association between morbidity and mortality by examining a range of objective and subjective measures of morbidity. We used data on employed men and women aged 30 to 55 years at baseline from 2 cohorts: the Whitehall II study and the GAZEL (this acronym refers to the French gas and electric companies) Study.     

Gender differences in relationships between social capital and individual smoking and drinking behavior in Taiwan

Despite the concept of social capital receiving great attention in the area of health research, few studies have analyzed the differential effects of social capital between genders. This article assesses gender differences in the relationships between social capital and smoking and drinking behavior in Taiwan. Data on individual sociodemographic characteristics, smoking, drinking, and social capital were obtained from the Taiwan Social Change Survey conducted in 1995 and in 2000. The overall response rate was 67%. In total, 3713 women and men aged over 20 years living in 204 neighborhoods were interviewed. Social capital indicators were aggregated at the neighborhood level, and included neighborhood closeness, political influence, social contact, social trust, and social participation. The data were analyzed with multilevel binomial regression models. Gender differences were found in some aspects of social capital. Stronger effects of social trust on smoking were found for women than for men, whereas stronger effects of neighborhood closeness on drinking were found for women than for men. Social participation was positively associated with drinking in both genders. The findings of this study provide new evidence for the differential effects of social capital by gender in Taiwan, suggesting that more studies are needed to understand social capital's effects in Asian societies and the mechanisms by which the effects may vary with gender.     

Gender differences in platelet count and its association with cigarette smoking in a large cohort in Israel.

Cigarette smoking has an effect on platelet function and aggregation although the sensitivity of platelet count in reflecting this phenomenon is not known. The association of platelet count with smoking habits was examined in a cohort of 5017 Israeli industrial workers aged 20-64 years. Males had a significantly lower age-adjusted mean platelet count than females (225,600 vs 247,800/microliters; p less than 0.001). Female smokers had lower platelet counts than non-smokers (231,000 for heavy vs 252,000 for never smokers) with a strong dose-response relationship (p less than 0.0001), whereas among males platelet count was slightly higher in smokers (224,000 for non-smokers vs 227,000 for heavy smokers; p = 0.243). The difference in platelet count between the sexes remained almost identical after controlling for smoking status and hematocrit. In multiple regression analysis, the negative association between smoking and platelet count in women remained highly significant (p less than 0.001) after controlling for ethnic origin, alcohol consumption, body mass, hematocrit, cholesterol and HDL-cholesterol, whereas for males the slight positive association was not significant. The reduced platelet count observed in males compared with females and in female smokers, suggests that platelet count may reflect sex differences in hemostasis and the effects of smoking on the hemostatic system. This may have implications for the mechanisms underlying the pathogenesis of ischemic heart disease and should be explored further.     

中学生健康素养与遭受欺凌的关联及其性别差异

目的 探讨中学生健康素养和遭受欺凌的关联及其性别间的差异,为改善青少年遭受欺凌提供依据.方法 2017年11月至2018年1月采用多阶段整群抽样方法,在安徽省合肥市、辽宁省沈阳市、广东省阳江市和重庆市抽取18 900名中学生进行问卷调查.采用自填式问卷调查研究对象的基本特征、健康素养水平和遭受欺凌情况,比较不同特征中学...     

Gender differences in the association between psychosocial factors and depressive symptoms in Japanese junior high school students

To determine psychosocial factors associated both with depressive symptoms and with gender differences in depressive symptoms among junior high school students, we conducted self-administered questionnaires using a sample of 2,660 students of 13 public junior high schools in Okinawa, Japan. Depressive symptomatology was measured by the Center for Epidemiologic Studies Depression Scale (CES-D). The psychosocial variables examined were life stresses, social support, health practices, self-esteem, and locus of control. Depressive symptoms were positively associated with life stresses and negatively associated with health practices, social support, self-esteem, and internal locus of control. In addition, female students were likely to report more depressive symptoms, life stresses, and low self-esteem and poor health practices. After controlling for the psychosocial variables differed by gender, gender differences in depressive symptoms were eliminated. In conclusion, for depressive symptoms of junior high school students, life stresses might be risk factors, but positive health practices, social support, high self-esteem, and internal locus of control might be protective factors. Gender differences in depressive symptoms could be explained by the females' elevation on these psychosocial variables.     

Gender differences in the association between functional limitation and depressive symptoms: the salience of food insecurity

ABSTRACT

The present study evaluated gender differences in the associations of functional limitation with food insecurity and depressive symptoms. Using data from 3,624 respondents ages 18to 80 years from two pooled cross-sectional cycles (2011–2012 and 2013–2014) of the National Health and Nutrition Examination Survey (NHANES), a structural equation model was estimated to assess gender differences in the association between physical limitation and food insecurity, and whether indicators of economic resources mediated an observed interaction. Results demonstrate that food insecurity accounted for about one-tenthof the association between functional limitation and depressive symptoms. Furthermore, these associations were more pronounced among women and were not explained by variation in economic resources. Food insecurity thus appears to be an indicator of psychological adversity among people with functional limitations, especially women, independent of other indicators of economic resources and hardship. Health promotion and social programs should address food insecurity as a unique dimension of adversity in efforts to improve health and well-being.     

Different perspectives on emotional and behavioural problems in unaccompanied refugee children and adolescents

Objective. This study aims, firstly, to investigate the prevalence of emotional and behavioural problems in unaccompanied refugee children and adolescents living in Belgium. Secondly, this study compares the perspectives of the adolescents with those of social workers on the adolescents’ emotional well-being.

Design. A total of 166 unaccompanied refugee children and adolescents, living in different large- and small-scale centres, in foster care or alone, participated in the study. Of them, 142 completed self-report questionnaires on emotional and behavioural problems (HSCL-37A, SDQ-self and RATS) and traumatic experiences (SLE), and for 124 refugee youths, social workers filled in two questionnaires on emotional and behavioural problems (CBCL/6-18 and SDQ-parent).

Results. Between 37 and 47% of the unaccompanied refugee youths have severe or very severe symptoms of anxiety, depression and post-traumatic stress. Girls and those having experienced many traumatic events are at even higher risk for the development of these emotional problems. Social workers also report a high prevalence of internalising problems in this population and they also report important externalising problems in unaccompanied refugee youths.

Conclusion. Being unaccompanied is an important risk factor for the emotional well-being of refugee children and adolescents. Therefore, appropriate measures on reception and care should be taken in order to support these youths.