Ethnic and gender differences in drinking and smoking among London adolescents

Objectives. The study examines stages of drinking and smoking careers and transitions from initiation to regular use among adolescents, as a function of ethnic status and gender. Design. The data were collected using a confidential, self-completion questionnaire assessing onset and frequency of drinking and smoking. The sample consisted of 1777 adolescents, between the ages of 11 and 14, drawn from eight secondary schools in south-west London. Results. For both smoking and drinking, white children were more likely to have ever smoked tobacco and drunk alcohol, and were also more likely to progress from initiation to regular use than were either black or Asian children. Asian children reported the latest onset and the lowest prevalence rates for both drinking and smoking. Males reported experimenting with both cigarettes and alcohol at an earlier age than females, although a lower proportion of males report regular and lifetime involvement with both alcohol and tobacco. Furthermore, a significantly higher proportion of females who try smoking go on to do so regularly. Discussion. The importance of sociocultural factors in relation to race and gender in predicting onset and escalation of substance use is discussed. The fact that age of onset does not appear to be a significant determinant of transition rate from initiation to regular use is also explored.     

江苏省青少年吸烟和二手烟暴露状况调查

目的了解江苏省青少年吸烟及二手烟暴露情况。方法采用多阶段分层整群随机抽样的方法,在14个监测点随机抽取5 697名初中学生进行问卷调查,对吸烟和二手烟暴露情况进行加权分析估计率及其95%CI。结果青少年尝试和现在吸烟率分别为9.2%(7.3%~11.5%)和1.0%(0.6%~1.7%),学生在家、室内和室外公共场所二手烟暴露比例为分别为40.0%(34.7%~45.6%)、50.7%(45.0%~56.4%)、52.6%(45.9%~59.2%),在过去30d内,40.7%(35.8%~45.8%)的学生看到有人在学校的室内外场所吸烟。认为"二手烟肯定有害健康"的比例为76.2%(73.5%~78.8%),赞同室内和室外公共场所禁烟的比例分别为62.6%(60.2%~64.9%)和64.5%(62.7%~66.2%)结论江苏省青少年存在尝试吸烟和现在吸烟现象,二手烟暴露率较高,应大力开展综合性的控烟干预。     

Living race together: the role of partner's race in racial/ethnic differences in smoking

ABSTRACT

Objective: Crossing racial lines provides a unique context for understanding racial patterns in smoking. This research explores whether adults whose unions cross racial lines behave more similarly to their own group or their partner's

Design: Using a sample of respondents from the National Health Interview Survey (2001–2011), we compare the likelihood of current smoking and quitting smoking among adults in mixed-race unions to adults in same-race unions.

Results: Adults with different-race partners generally mirror their partner's group; people of color with White partners have a higher likelihood of being current smokers, similar to Whites, while Whites partnered with Asians and Latina/os are, like other Asians and Latino/as, less likely to smoke. There are fewer differences in the likelihood of quitting smoking.     

Cigarette smoking among San Francisco Hispanics: the role of acculturation and gender.

We conducted a phone survey of 1,669 San Francisco Hispanics ages 15 to 64 years. The age-adjusted overall smoking prevalence was 25.4 per cent (95% CI = 23.3, 27.5) with more men (32.4 per cent) smoking than women (16.8 per cent). Age-adjusted smoking rates were higher among the less acculturated males (37.5 vs 26.7 per cent) and among the more acculturated females (22.6 vs 13.6 per cent). The more acculturated, however, smoked a greater number of cigarettes per day independent of gender. Community-based smoking cessation interventions, adapted to local conditions, may have a greater potential for success among Hispanics.     

Cigarette smoking among adolescents: Is the rate declining?

Recent reports have indicated that adolescent cigarette smoking is declining. This report presents new data which point to sharply higher smoking levels than those reported elsewhere. These findings raise questions about whether adolescent smoking levels are truly declining and suggest that the traditional methods for measuring adolescent smoking may be inadequate.     

Developmental trajectories of substance use from early adolescence to young adulthood: gender and racial/ethnic differences

PurposeThe current study examined gender and racial/ethnic (Hispanics, non-Hispanic Caucasians, non-Hispanic African Americans, and non-Hispanic Asians) differences in developmental trajectories of alcohol use, heavy drinking, smoking, and marijuana use from early adolescence to young adulthood using a nationally representative sample.MethodsParticipants from the National Longitudinal Study of Adolescent Health (N = 20,160) reported rates of alcohol use, heavy drinking, smoking, and marijuana use between the ages of 12 and 34 years. Data analyses were completed using longitudinal multilevel modeling analyses.ResultsLevels of substance use increased from early adolescence to mid-20s, and then declined thereafter. Females showed higher levels of substance use in early adolescence, although males exhibited greater changes overtime and higher levels of use in mid-adolescence and early adulthood. Overall, Hispanic youth had higher initial rates of substance use, whereas Caucasian adolescents showed higher rates of change and had the highest levels of substance use from mid-adolescence through the early 30s. Racial/ethnic differences largely disappeared after age 30, except that African Americans showed higher final levels of smoking and marijuana use than the other racial/ethnic groups. Results provide evidence for both similarities and differences in general patterns of development and in gender and racial/ethnic differences across different forms of substance use.ConclusionsFindings from the current study suggest that the critical periods for intervention and prevention of substance use may differ across gender and race/ethnicity, and that future research needs to identify common and unique mechanisms underlying developmental patterns of different forms of substance use.     

The relationship between body weight perceptions,weight control behaviours and smoking status among adolescents

OBJECTIVES: This paper examines the relation between body weight perceptions, weight control behaviours and smoking status among a representative sample of Ontario students. METHODS: Bivariate and multivariate logistic regression analysis was used to evaluate the association between smoking status and perception of being overweight, and between smoking status and specific weight control behaviours. RESULTS: Among females, the odds of being a smoker were significantly higher among those who perceived themselves to be overweight and who had employed weight control behaviours in the last 12 months. Among males, the adjusted odds of being a smoker was higher only among those who skipped meals in the past 12 months. CONCLUSIONS: Body weight perceptions and the use of weight control behaviours were significantly associated with predictors of smoking among adolescent females. This suggests a need to incorporate discussion on body weight perception and body image in smoking prevention and cessation programs targeted toward adolescent females.     

Identifying adolescents at risk for hard drug use: racial/ethnic variations

Purpose: To examine early risk factors for initiation of hard drug use by 10th grade in a sample of adolescents drawn from diverse high schools and communities, compares the results across different racial/ethnic groups, and to evaluate the predictive performance of a user-friendly risk scale against the more complex logistic model.

Methods: Using longitudinal data from 4347 adolescents from California and Oregon, we developed and cross-validated logistic and additive prediction models for non-Hispanic white students (the largest group) and assessed how well each model worked for black, Hispanic, and Asian adolescents. We also developed a best logistic model for each group. Predictor variables were measured at Grade 7; the hard drug use outcome was measured at Grade 10.

Results: Major risk factors for initiation of hard drug use included early marijuana and cigarette use, deviant behavior, poor parent–child communication, being offered drugs, and prodrug attitudes and intentions. White adolescents had the most risk factors, followed by Hispanics, Asians, and Blacks. Specific risk factors played more important roles for some groups than others. Early marijuana use provided the strongest warning signal for all groups except Blacks, while exposure to drug offers increased the risk for all but Hispanic youth. Poor communication with parents was particularly important for Hispanic and Asian adolescents, whereas doing poorly in school was a key predictor only for Asians. Social influences to use drugs and intentions to use them were the only predictors for Blacks. Although family disruption and limited parental education were associated with an increase in risk for white adolescents, the latter had the opposite effect for Hispanics and Blacks. The simple additive model worked almost as well as the most complicated logistic model in predicting hard drug use for each group except Blacks.

Conclusions: These results suggest that curbing early initiation of marijuana and cigarettes and reducing prodrug influences and attitudes may dampen initiation of other substances for most youth. They also suggest that drug prevention programs need to be sensitive to differences across racial/ethnic groups and that using social background characteristics as indicators of risk can be very misleading. Carefully constructed risk scales based on simple additive models could help guide program development and provide clinicians with useful information about a troubled adolescent’s likely trajectory.     

Maternal obesity and diabetes as risk factors for adverse pregnancy outcomes: differences among 4 racial/ethnic groups

OBJECTIVES: We examined associations between obesity, diabetes, and 3 adverse pregnancy outcomes--primary cesarean delivery, preterm birth, and low birth-weight (LBW)--by racial/ethnic group. Our goal was to better understand how these associations differentially impact birth outcomes by group in order to develop more focused interventions. METHODS: Data were collected from the 1999, 2000, and 2001 New York City birth files for 329,988 singleton births containing information on prepregnancy weight and prenatal weight gain. Separate logistic regressions for 4 racial/ethnic groups predicted the adverse pregnancy outcomes associated with diabetes. Other variables in the regressions included obesity, excess weight gain, hypertension, preeclampsia, and substance use during pregnancy (e.g., smoking). RESULTS: Chronic and gestational diabetes were significant risks for a primary cesarean and for preterm birth in all women. Diabetes as a risk for LBW varied by group. For example, whereas chronic diabetes increased the risk for LBW among Asians, Hispanics, and Whites (adjusted odds ratios=2.28, 1.69, and 1.59), respectively, it was not a significant predictor of LBW among Blacks. CONCLUSIONS: In this large, population-based study, obesity and diabetes were independently associated with adverse pregnancy outcomes, highlighting the need for women to undergo lifestyle changes to help them control their weight during the childbearing years and beyond.     

Influenza and pneumococcal vaccination of adults aged > or = 65: racial/ethnic differences

BACKGROUND: Influenza and pneumococcal polysaccharide vaccination (PPV) rates among persons aged > or = 65 years are significantly below national objectives of 90%, particularly among blacks and Hispanics. This study of the 2002-2003 influenza season examines factors that may be associated with low coverage. METHODS: A national sample of 1839 community-dwelling adults aged > or = 65 years was surveyed by telephone during January-May 2003. Outcomes analyzed in 2004-2005 included self-reported influenza vaccination and PPV; place of vaccination; and among the unvaccinated, main reasons for nonvaccination, awareness of vaccination, and receipt of provider recommendation for vaccination. RESULTS: Influenza vaccine coverage was 67.8%, and PPV coverage was 60%. Coverage among blacks and Hispanics was > or = 15 percentage points below that of whites. Half (52%) of persons who had not received PPV were aware it was recommended for persons their age, and < 10% had received a recent physician recommendation for PPV. Concern about side effects and not thinking that they needed the vaccine were the most frequently cited reasons for not receiving an influenza vaccination. In each racial/ethnic group, prevalence of potential missed opportunities (recent doctor visit, but no vaccine recommendation from provider and no influenza vaccination) was higher than prevalence of potential vaccine refusal (recent doctor visit and vaccine recommendation from provider, but no vaccine): blacks, 26.9% versus 7.9%; Hispanics, 19.9% versus 12.1%; and white non-Hispanics, 16.2% versus 6.1%. CONCLUSIONS: Improved adherence to vaccination guidelines by healthcare providers could substantially raise coverage in all racial/ethnic groups. Multiple factors contribute to racial/ethnic disparities, and their relative contributions should be further quantified.     

From adolescence to young adulthood: racial/ethnic disparities in smoking

OBJECTIVES: We used data gathered from 6259 youths between the ages of 13 and 23 years to compare trends in smoking among 4 racial/ethnic groups. METHODS: We weighted trend data to represent baseline respondent characteristics and evaluated these data with linear contrasts derived from multiple regression analyses. RESULTS: Although African Americans exhibited higher initiation rates than Whites, they exhibited consistently lower rates of regular smoking than both Whites and Hispanics. This seeming anomaly was explained by African Americans' lower rates of transition to regular smoking and greater tendency to quit. Racial/ethnic disparities were accounted for by differences in pro-smoking influences. CONCLUSIONS: Reducing racial/ethnic disparities in smoking may require reducing differences in the psychosocial factors that encourage smoking.     

Activity, inactivity, and obesity: racial, ethnic, and age differences among schoolgirls.

Physical activity, inactivity, and obesity were assessed by questionnaire among a multiethnic sample of 552 girls in grades 5 through 12. Hispanics and Asians reported lower activity levels than other racial groups. Only 36% of the entire sample and less than one fifth of either Asians or Hispanics met the year 2000 goal for strenuous physical activity. Physical activity was inversely associated with age and age-adjusted body mass index. Obesity was unrelated to inactivity.     

Childbearing in cohabiting unions: racial and ethnic differences

CONTEXT: Cohabitation provides a two-parent family union in which to have and raise children outside of marriage. Little is known, however, about the conditions under which cohabiting couples conceive and decide to have children. METHODS: The National Survey of Family Growth provides detailed data on the cohabitation and fertility histories of American women. Life-table techniques, event-history analyses and logistic regression were employed to understand the racial and ethnic differences in the timing of childbearing within cohabiting unions and whether childbearing within cohabiting unions is more acceptable to members of minorities than to whites. RESULTS: In multivariate models, Hispanic women were found to be 77% more likely than white women to conceive a child in cohabitation and black women were 69% more likely than white women to do so. Among women who became pregnant while cohabiting, Hispanic women were almost twice as likely and black women were three times as likely as white women to remain cohabiting with their partner when their child was born. In addition, children born to Hispanic women in cohabiting unions were found to be 70% more likely to be intended than were those born to cohabiting white women. CONCLUSIONS: In terms of fertility, cohabitation does not maintain the same place in the American family system for all racial and ethnic groups. These racial and ethnic differences in fertility-related behavior are not explained by socioeconomic differences. Based on levels of childbearing during cohabitation, relationship status at time of birth and intention status of children, it appears that cohabitation is a more acceptable arena for family building among Hispanic women than among whites or blacks.     

Sex/gender differences in smoking cessation: A review

Data from treatment studies tends to show women are less likely to quit smoking than men, but these findings have been disputed, typically based on contradictory evidence from epidemiological investigations. The purpose of this review was to shed light on this conflict. We conducted a qualitative review in January 2016 to examine sources of variation in sex/gender differences for smoking cessation. We identified 214 sex/gender difference tests from 190 studies through Medline and studies were categorized into efficacy trials (k = 37), effectiveness trials (k = 77), prospective observational studies of cessation (k = 40; current smokers transitioning to former smokers), prospective observational studies of relapse (k = 6; former smokers transitioning to current smokers), cross-sectional investigations of former smoker prevalence (k = 32), and community-based interventions (k = 4). We also summarized evidence across time periods, countries, outcome assessments, study sample, and treatment. Evidence from efficacy and effectiveness trials, as well as prospective observational studies of relapse, demonstrated that women have more difficulty maintaining long-term abstinence than men. Findings from prospective observational studies and cross-sectional investigations were mixed and demonstrated that bio-psycho-social variation in samples across place and time may determine whether or not women or men are less likely to quit smoking. Based on these findings, we consider whether sex/gender differences in quitting meet criteria for a disparity and outline directions for further research.     

Further evidence of ethnic and gender differences for Helicobacter pylori infection among endoscoped patients

HeIicobacter pylori infection rate was determined in 697 consecutive patients with ulcer, gastritis, duodenitis and non-ulcer dyspepsia by endoscopy at a Malaysian hospital in 1999-2002. Biopsies of the gastric antrum and body were subjected to the urease test, Gram staining of impression smears and culture examination. Infection was defined as a positive result in at least one test. The infection rates were 32.1, 10.4, 20.0 and 16.2% in ulcer, gastritis, duodenitis and non-ulcer dyspepsia patients, respectively. Overall, the prevalence of H. pylori infection was 14.6%, with the rate among the Indian (21.7%), Chinese (19.2%) and Bangladeshi foreign worker (23.1%) groups significantly higher (P<0.05) than that of the Malays (5.8%). Generally, the prevalence rate among males (18.9%) was significantly higher (P<0.001) than that among females (9.0%), but for a particular ethnic group, such trend and significant differences (P<0.05) were observed only among the Malays. In terms of gender, the prevalence rates of Malay males and females were also significantly lower (P<0.05) than those of Chinese and Indians. In conclusion, there is a significant difference in H. pylori infection prevalence rates among ethnic groups (highest in Indians, then Chinese and unusually low in Malays) and gender groups (highest in males) in Malaysia.