Cigarette smoking and cardiovascular risk factors among Aboriginal Canadian youths

Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, Ont.
Canadian Medical Association Journal (Impact Factor: 5.96). 11/2005; 173(8):885-9. DOI: 10.1503/cmaj.045159
Source: PubMed


Aboriginal populations in North America are exhibiting an increased prevalence of cardiovascular disease and associated traditional and nontraditional cardiovascular risk factors, trends believed to be due to the influence of Western lifestyle habits. Because these influences are present at an early age, we sought to study the patterns of one such habit, cigarette smoking, among Aboriginal Canadian youths and to assess the associated accrual of cardiovascular risk factors at an early age.
Patterns of cigarette smoking were assessed in a population-based, cross-sectional study involving 236 youths aged 10-19 (mean 14.9) years in the Oji-Cree community of Sandy lake, in northwestern Ontario. Participants underwent clinical and metabolic evaluation with assessment of cardiovascular risk factors.
The prevalence of cigarette smoking among the study participants was considerably higher than age-specific national averages, with fully 50% of the participants overall and 82% of the adolescent participants (aged 15-19) being current smokers. Compared with their peers, children smoking 6 or more cigarettes per day had an enhanced cardiovascular risk profile consisting of a higher mean systolic blood pressure (111 v. 107.5 mm Hg, p = 0.036), a higher mean plasma homocysteine level (8.7 v. 7.6 micromol/L, p = 0.008) and a lower mean serum folate level (4.5 v. 5.4 mmol/L, p = 0.007), after adjustment for age, sex and body mass index. In separate multiple linear regression analyses, current cigarette exposure (number of cigarettes smoked per day) emerged as an independent determinant of both systolic blood pressure and plasma homocysteine level.
In this Aboriginal community with remarkably high rates of cigarette smoking among its youth, an independent dose-response relation was found between current smoking exposure and both traditional (systolic blood pressure) and nontraditional (homocysteine level) cardiovascular risk factors. The association of cigarette smoking with an enhanced cardiovascular risk profile at an early age may be a factor contributing to the high prevalence of cardiovascular disease in this Aboriginal population.

Full-text preview

Available from:
  • Source
    • "In terms of specific health determinants, more than 75% of studies for both youth populations were related to lifestyle. In particular, physical activity (11,15), sexual behaviour (16,17) and substance abuse (18) were all equally represented in the Aboriginal youth studies at 33% each, followed by diet [20%] (19) and tobacco use [13%] (4,20). Substance abuse was the most prominent lifestyle factor for the non-Aboriginal youth population, totalling 43% followed by smoking (33%), physical activity (15%), diet (13%) and sexual behaviour (10%). "
    [Show abstract] [Hide abstract]
    ABSTRACT: To compare the current state of health research on Aboriginal and non-Aboriginal youth in Canada. A search of published academic literature on Canadian Aboriginal youth health, including a comprehensive review of both non-Aboriginal and Aboriginal youth research, was conducted using MEDLINE and summarized. A MEDLINE search was conducted for articles published over a 10-year period (2000-2010). The search was limited to research articles pertaining to Canadian youth, using various synonyms for "Canada," "youth," and "Aboriginal." Each article was coded according to 4 broad categories: Aboriginal identity, geographic location, research topic (health determinants, health status, health care), and the 12 key determinants of health proposed by the Public Health Agency of Canada (PHAC). Of the 117 articles reviewed, only 34 pertained to Aboriginal youth, while the remaining 83 pertained to non-Aboriginal youth. The results revealed major discrepancies within the current body of research with respect to the geographic representation of Aboriginal youth, with several provinces missing from the literature, including the northern territories. Furthermore, the current research is not reflective of the demographic composition of Aboriginal youth, with an under-representation of Métis and urban Aboriginal youth. Health status of Aboriginal youth has received the most attention, appearing in 79% of the studies reviewed compared with 57% of the non-Aboriginal studies. The number of studies that focus on health determinants and health care is comparable for both groups, with the former accounting for 62 and 64% and the latter comprising 26 and 19% of Aboriginal and non-Aboriginal studies, respectively. However, this review reveals several differences with respect to specific focus on health determinants between the two populations. In non-Aboriginal youth studies, all the 12 key determinants of health of PHAC are explored, whereas in Aboriginal youth studies the health profile remains incomplete and several key determinants and health indicators are neglected. The current studies are not reflective of the demographic and geographic profiles of Aboriginal youth in Canada, and they have also failed to provide a comprehensive examination of their unique health needs and concerns compared with studies on non-Aboriginal youth.
    Full-text · Article · Aug 2012
  • Source
    • "Cigarette smoking is associated with high levels of morbidity and mortality in industrialized nations (Young, 1994). Across North America, Aboriginal 1 peoples evidence elevated levels of daily smoking compared to general populations (Beauvais, Thurman, Burnside, & Plested, 2007;First Nations Information Governance Center, 2012;Janz, Seto, & Turner, 2009;Retnakaran, Hanley, Connelly, Harris, & Zinman, 2005). Currently, more than half (57%) of Aboriginal adults living in First Nations communities across Canada smoke daily or occasionally, compared to 20% of the, 2012;Reid & Hammond, 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract: The aim of the study was to determine if a culturally sensitive smoking prevention program would have short-term impacts on smoking intentions among Aboriginal children. Two schools with high Aboriginal enrollment were selected for the study. A grade 4 classroom in one school was randomly assigned to receive the culturally sensitive smoking prevention program. A grade 4 classroom in the second school received a standard smoking prevention program delivered in this jurisdiction. Children in each classroom were tested pre- and post-intervention to measure attitude changes about smoking. There was a significant reduction in intentions to smoke among Aboriginal children who received the culturally sensitive smoking prevention program. The small overall sample size precluded a direct comparison of the efficacy of the culturally sensitive and standard programs. The present findings suggest a smoking prevention program that has been culturally adapted for Aboriginal children may reduce future smoking intentions among Aboriginal grade 4 students. Further research is needed to determine the extent to which school smoking prevention programs adapted to respect the long-standing use of tobacco in Aboriginal cultural traditions may be more effective than standard programs in reaching Aboriginal youth.
    Full-text · Article · Aug 2012 · American Indian and Alaska native mental health research: journal of the National Center
  • Source
    • "Young adults (aged 18–29 years) have the highest proportion of daily smokers (54%). Smoking rates amongst Aboriginal youth tend to be higher in more remote communities (up to 82% for those aged 15–19 years) (28). In the Northwest Territories, Aboriginal youth aged 10–14 years are 5 times more likely to be current smokers than non-Aboriginal youth (although this proportion declined to 17% in 2006 from 29% in 1982) (29). "
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the benefits, limitations and ethical issues associated with conducting participatory research on tobacco use using youth to research other youth. Community-based participatory research. Methods: Research on tobacco use was conducted with students in the K'àlemì Dene School and Kaw Tay Whee School in the Northwest Territories, Canada, using PhotoVoice. The Grade 9-12 students acted as researchers. Researcher reflections and observations were assessed using "member checking," whereby students, teachers and community partners could agree or disagree with the researcher's interpretation. The students and teachers were further asked informally to share their own reflections and observations on this process. Using youth to research other youth within a participatory research framework had many benefits for the quality of the research, the youth researchers and the community. The research was perceived by the researchers and participants to be more valid and credible. The approach was more appropriate for the students, and the youth researchers gained valuable research experience and a sense of ownership of both the research process and results. Viewing smoking through their children's eyes was seen by the community to be a powerful and effective means of creating awareness of the community environment. Limitations of the approach were residual response bias of participants, the short period of time to conduct the research and failure to fully explore student motivations to smoke or not to smoke. Ethical considerations included conducting research with minors, difficulties in obtaining written parental consent, decisions on cameras (disposable versus digital) and representation of all participants in the final research product.
    Full-text · Article · May 2012
Show more