Parents' and friends' smoking status as predictors of smoking onset: findings from six European countries.
ABSTRACT This study assessed the relationship between the smoking behavior of adolescents and the smoking status of their parents and friends among adolescents from six European countries. A longitudinal study collected data from 15 705 adolescents on their own smoking status, and that of their parents, best friend and friends in general. Cross-sectional regression analysis showed that adolescent smoking was most strongly associated with friends' smoking and best friend's smoking, explaining 38% of the variance in the total sample. Longitudinal regression analysis, however, showed that the beta coefficients of the smoking status of the best friend and friends in general were comparable to that of parental smoking. Parental smoking behavior was found to be as predictive of smoking onset after 1 year as friends' smoking status.
Article: Evaluation of a Dutch school-based depression prevention program for youths in highrisk neighborhoods: study protocol of a two-armed randomized controlled trial.[show abstract] [hide abstract]
ABSTRACT: Research has indicated that depression prevention programs attenuate the development of symptoms of depression in adolescents. To implement these programs on a large scale, implementation in a school setting with teachers providing the programs is needed. In the present study, the effectiveness of the Dutch depression prevention program Op Volle Kracht (OVK) provided by school teachers during school hours with adolescents from high risk neighborhoods will be tested. The mediating effects of cognitive distortions and alexithymia will be evaluated as well. We hypothesize that the OVK program will prevent or decrease reported depressive symptoms, and that this association will be mediated by cognitive distortions and alexithymia. Schools with at least 30% of their pupils living in low income areas in the Netherlands are invited to participate in the study. Classes from vocational training up to pre-university level are eligible and 1324 adolescents (11-14 years) will be participating in the study. Randomisation will be done at class level, randomly assigning participants to an intervention group (OVK) and a control group (care as usual), stratifying by school level (high versus low). Trained school teachers will be delivering the program, which covers cognitive-behavioral and social problem-solving skills. Longitudinal data will be collected with self-report measurements administered in the school setting at baseline, post intervention and at two follow ups (at 6 and 12 months). Primary outcome is the level of depressive symptoms, and secondary outcomes include: cognitive errors, response style, attributional style, alexithymia, stressful life events, substance use, happiness, and school grades. If the OVK program proves to be effective when it is provided by school teachers, a structural implementation of the program in the school curriculum will enhance the quality of the lives of adolescents and their families and will reduce costs in health care. In addition, the results of the study advances current knowledge on the underlying mechanisms of the development of depression and may aid the improvement of depression prevention programs in general. Dutch Trial Register NTR3110.BMC Public Health 03/2012; 12:212. · 2.00 Impact Factor
Article: The Impact of Smoking in Adolescence on Early Adult Anxiety Symptoms and the Relationship between Infant Vulnerability Factors for Anxiety and Early Adult Anxiety Symptoms: The TOPP Study[show abstract] [hide abstract]
ABSTRACT: Cigarette smoking is increased in people with trait anxiety and anxiety disorders, however no longitudinal data exist illuminating whether smoking in adolescence can influence the developmental trajectory of anxiety symptoms from early vulnerability in infancy to adult anxiety expression. Using The Tracing Opportunities and Problems in Childhood and Adolescence (TOPP) Study, a community-based cohort of children and adolescents from Norway who were observed from the age of 18months to age 18–19years, we explored the relationship between adolescent smoking, early vulnerability for anxiety in infancy (e.g. shyness, internalizing behaviors, emotional temperaments) and reported early adult anxiety. Structural equation modeling demonstrated that adolescent active smoking was positively associated with increased early adulthood anxiety (b = 0.17, p,0.05), after controlling for maternal education (proxy for socioeconomic status). Adolescent anxiety did not predict early adult smoking. Adolescent active smoking was a significant effect modifier in the relationship between some infant vulnerability factors and later anxiety; smoking during adolescence moderated the relationship between infant internalizing behaviors (total sample: active smokers: b = 0.85,p,0.01, non-active smokers: ns) and highly emotional temperament (total sample: active smokers: b = 0.55,p,0.01,non-active smokers: ns), but not shyness, and anxiety in early adulthood. The results support a model where smoking acts as an exogenous risk factor in the development of anxiety, and smoking may alter the developmental trajectory of anxiety from infant vulnerability to early adult anxiety symptom expression. Although alternative non-mutually exclusive models may explain these findings, the results suggest that adolescent smoking may be a risk factor for adult anxiety, potentially by influencing anxiety developmental trajectories. Given the known adverse health effects of cigarette smoking and significant health burden imposed by anxiety disorders, this study supports the importance of smoking prevention and cessation programs targeting children and adolescence.PLoS ONE 05/2013; 8(5):e63252. · 4.09 Impact Factor
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ABSTRACT: EinleitungNach aktuellen repräsentativen Erhebungen rauchen ca. 20% der 11 bis 17-Jährigen. Die Prävalenzen steigen von <2% bei den 11- und 12-Jährigen auf >40% bei den 17-Jährigen. Weniger als 2,1% der 11- bis 13-Jährigen greift regelmäßig zur Zigarette – 1,4% täglich. Das Ziel der Untersuchung ist eine Vollerhebung des Rauchverhaltens und möglicher assoziierter Faktoren für Mädchen und Jungen in 5. Klassen einer Region Vorpommerns. Die Klassenstufe 5 gilt im Allgemeinen als die Klassenstufe, in der Präventionsmaßnahmen zur Verschiebung des Raucheinstiegs beginnen sollten. MethodeDiese Arbeit ist Teil der Evaluation des schulbezogenen Präventionsprogramms GeKoKidS, einer randomisierten Kontrollgruppenstudie in Schulen. An dem Programm beteiligen sich Schulen, die im Schuljahr 2007/2008 über eine 5. Jahrgangsstufe verfügten. Die Datenerhebungen zum Rauchverhalten fanden zu Beginn des Schuljahres 2007/2008 mit 852Schülern statt. ErgebnisGenerell bezeichnen sich 98,5% der Schüler der 5. Klassen als Nichtraucher. Die Rauchprävalenz beträgt 0,1% tägliche und 1,3% gelegentliche Raucher. Mehr als 80% der Schüler geben an, noch nie das Zigarettenrauchen probiert zu haben. Es zeigen sich signifikante Geschlechterunterschiede in der Motivation Nichtraucher zu bleiben und in der Beantwortung der Frage, wie viele der Freunde rauchen. Die Unterschiede zwischen Nierauchern und Probierern sind signifikant in nahezu allen erhobenen Variablen. Nieraucher zeigen eine signifikant niedrigere Motivation mit dem Rauchen anzufangen, sind sich sicher, am Ende des Schuljahres immer noch Nichtraucher zu sein, haben weniger beste Freunde/Freundinnen, die rauchen, haben weniger Personen im Freundeskreis und zu Hause, die rauchen und spüren eine geringere situative Versuchung rauchen zu müssen. DiskussionDie Ergebnisse der Vollerhebung unterstützen die Notwendigkeit präventiver Maßnahmen mit dem Ziel, das Probieren zu verhindern und den Einstieg in das Rauchen zu verzögern. Die Gruppe der Schüler der Jahrgangsstufe 5 besteht nahezu ausschließlich aus Nichtrauchern und zu einem überwiegenden Teil aus Nierauchern. Geschlechterunterschiede im Rauchverhalten legen Präventionsmaßnahmen z.B. außerhalb des Schulsettings nahe. Der Zusammenhang zwischen einem rauchendem Umfeld und dem eigenen Rauchverhalten konnte bestätigt werden, wobei längsschnittliche Studien notwendig sind, um zu klären, in welche Richtung dieser Zusammenhang besteht. IntroductionThe prevalence of smoking increases from 2% in 11–12-year-olds to more than 40% in 17-year-olds. Less than 2.1% of the 11–13-year-olds smoke regularly, and 1.4% smoke daily. The aim of this study was to fully assess smoking behaviour and associated factors in 5th-graders in the entire region of Western Pomerania, Germany. The 5th grade is generally when preventive measures to delay smoking acquisition are initiated. MethodsThis study is part of a randomized controlled trial in schools. All schools with a 5th-grade class in the 2007/2008 school year in Western Pomerania were asked to participate. Data for 852 pupils were assessed. ResultsIn all, 98.5% of the 5th-graders considered themselves nonsmokers. The prevalence was 0.1% for daily smoking and 1.3% for occasional smoking. More than 80% indicated they had never smoked. There were significant differences between boys and girls in their motivation to remain nonsmokers and in the number of their friends who smoked. In nearly all the variables assessed, there were significant differences between“never-smokers” and children who had at least tried smoking. Never-smokers were significantly less motivated to start smoking, were more confident about remaining nonsmokers during 5th grade, had fewer best friends who smoked, had fewer friends who smoked, were more likely to come from smokeless households, and experienced a lesser urge to smoke. DiscussionThe results of the total assessment support the necessity of preventive measures aiming at delaying the onset of both experiencing smoking and smoking regularly. The group of 5th-graders mainly consisted of nonsmokers, with the majority being never-smokers. Differences between boys and girls imply that preventive measures should be established outside of school. An association exists between a smoking environment and smoking behaviour; however, longitudinal studies need to be conducted to examine the direction of this association.Prävention und Gesundheitsförderung 04/2012; 4(4):259-264.