The Scottish adolescent e-cigarette user : profiling from the Scottish Adolescent Lifestyle and Substance Use Survey (SALSUS)

Objectives: Profiling the Scottish adolescent e-cigarette user Study design: 283 state, independent and grant maintained schools participated in the Scottish Adolescent Lifestyle and Substance Use Survey (SALSUS) between September 2013 and 2014. 33,685 13 and 15-year-old pupils who had completed the cross-sectional survey SALSUS questionnaire, and answered the question based on e-cigarette use were included in the analysis. Profiling of the typical Scottish adolescent e-cigarette user through gender, age, socioeconomic status, urban/rural location, weekly alcohol consumption, current drug use and current tobacco smoking was the main outcome measured. Results: 1.1% of adolescents were current e-cigarette users with 11% having tried the devices before. Current e-cigarette users were significantly more likely to be male (OR=1.9; CI= 1.5-1.9), rural (OR= 1.4; CI=1.1-1.9), smoke tobacco (OR=21.1; CI=15.3-29.1), weekly alcohol (OR=1.4; CI=1.1-1.9) and current drug users (OR=2.3; CI=1.7-3.0). There were no significance differences observed for socioeconomic status. Similar results were observed for those using both and those who only used e-cigarettes. Only tobacco smokers differed in that they were significantly more likely to be female than male (OR=0.56; CI=0.51-0.63) and of a lower socioeconomic status (OR=1.3; CI=1.1-1.4). Conclusions: The Scottish adolescent e-cigarette user is male, lives rurally, a weekly alcohol drinker, a current drug user and a tobacco smoker. This profiling study helps to inform policy makers targeting e-cigarette use. Further research requires a longitudinal study and monitoring the changing views of this group.PostprintPeer reviewe

HBSC 2014 Survey in Scotland National Report

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Health behaviour in school-aged children : World Health Organization collaborative cross-national study (HBSC): findings from the 2010 HBSC survey in Scotland

The HBSC study in Scotland is funded by NHS Health ScotlandThe report, produced by CAHRU with funding support from NHS Health Scotland, provides a unique picture of the health of young people aged 11, 13 and 15 years in Scotland over the last two decades. Set against the social backdrop of family life, school experience, neighbourhood environment and peer relationships the report gives a comprehensive description of young people's health status. Please contact CAHRU (contact details) for further information about this research.Publisher PD

The role of school connectedness and friend contact in adolescent loneliness, and implications for physical health

JI was supported by the Medical Research Council (MC_UU_00022/1) and the Scottish Government Chief Scientist Office (SPHSU16). The HBSC 2013/14 study in Scotland was funded by NHS Health Scotland (now Public Health Scotland).The current study investigated how adolescents' loneliness relates to school connectedness, classmate support, teacher support, and offline and online communication with friends. We also examined the association between loneliness, physical health, and sleep. Data came from the Scottish Health Behavior in School-aged Children (HBSC). The total sample was 2983 adolescents (F = 1479 [49.6%]) aged 14-17 years (M = 15.66, SD = 0.39) from 117 secondary schools in Scotland. Results showed that (1) higher teacher support, classmate support, and offline contact with friends predicted lower levels of loneliness, (2) online friendship engagement predicted higher levels of loneliness, and (3) poor health and sleep were positively associated with loneliness. The study offers new findings, highlighting the role played by classmates/peers and teachers in reducing loneliness. Supporting previous research, we also found associations between loneliness, poor sleep, and worse physical health.Publisher PDFPeer reviewe

Trends in early alcohol and drunkenness initiation, by gender and subregion

In 2014, around one in four adolescents in the Region first consumed alcohol at age 13 or younger, and just under one in 10 were first drunk at this early age. • Gender differences are not present in all countries and regions, but when present, boys are more likely to report early alcohol initiation and early drunkenness. • Early alcohol initiation has declined in most countries and regions. On average, early alcohol initiation across all countries and regions declined from 46% in 2002 to 28% in 2014. Similarly, early drunkenness more than halved, from 17% to 8%, over this period. • A significant increase in alcohol use at age 13 or younger was reported in Slovenia among both boys and girls and in Greece among girls only. • The biggest changes in early initiation of alcohol and drunkenness were seen in the Nordic and Ireland/Great Britain subregions, which had the highest prevalence in 2002. Less change was seen in the southern Europe/ Mediterranean subregio

Trends in bullying victimization in Scottish adolescents (1994-2014) : changing associations with mental well-being

Objectives Bullying victimization among schoolchildren is a major public health concern. This paper aims to analyse the changing associations over two decades between bullying victimization and mental well-being in a representative Scottish schoolchildren sample. Methods Data were collected in six rounds of the cross-sectional Health Behaviour in School-aged Children study in Scotland, with 42,312 adolescents (aged 11, 13 and 15 years). Logistic and linear regression were used to examine changes in the association between bullying victimization and mental well-being. Results The prevalence of bullying victimization rates in Scotland increased between 1994 and 2014 for most age-gender groups, apart from 13-year old boys and 15-year old girls. Over time, female victims reported less confidence and happiness and more psychological complaints than their nonbullied counterparts. This worsening effect over time was not observed in boys. Conclusions Overall, our evidence indicates that the associations between bullying victimization and poor mental well-being strengthened overtime for bullied girls. This finding might partly explain the observed deterioration in mental health indicators among Scottish adolescent girls.Publisher PDFPeer reviewe

Association between tobacco control policies and current smoking across different occupational groups in the EU between 2009 and 2017

Background This study investigated the cross-national and longitudinal associations between national tobacco control policies and current smoking in 28 European Union (EU) member states between 2009 and 2017. It also examined the interaction between tobacco control policies and occupational status. Methods We used data from four waves of Eurobarometer (2009, 2012, 2014 and 2017). The total sample size was 105,231 individuals aged ≥15 years. Tobacco Control Scale scores (range 0 to 100) for years 2005, 2007, 2012 and 2014 measured the strength of country-level tobacco control policies. Logistic multilevel regression analyses with three levels (the individual, the country-year and the country) were performed with current smoker as the dependent variable. Results Across the EU, average smoking prevalence fell from 29.4% (95% CI: 28.5% to 30.2%) in 2009 to 26.3% (95% CI: 25.4% to 27.1%) in 2017. We confirmed that cross-nationally, strong national tobacco control policies are significantly associated with low probability of smoking. A one-point increase in TCS score was associated with lower odds of smoking (OR = 0.990; 95% CI = 0.963 to 0.998), but longitudinally (within-country) increases in TCS were not associated with current smoking (OR = 0.999; 95% CI = 0.994 to 1.005). Compared to those in manual occupations, the cross-national association was stronger in the upper occupational group (Conditional OR for the interaction = 0.985; 95% CI = 0.978 to 0.992) and weaker in the economically inactive group (Conditional OR for the interaction 1.009; 95% CI: 1.005 to 1.013). Conclusion Differences in tobacco control policies between countries were associated with probability of smoking but changes in TCS within countries over time were not. Differences between countries in tobacco control policies were found to be most strongly associated with likelihood of smoking in the highest occupational groups and were found to have only a weak association with smoking among the economically inactive in this sample

The association between MPOWER tobacco control policies and adolescent smoking across 36 countries : an ecological study over time (2006–2014)

Objective To examine associations over time between national tobacco control policies and adolescent smoking prevalence in Europe and Canada. Design In this ecological study, national tobacco control policies (MPOWER measures, as derived from WHO data) in 36 countries and their changes over time were related to national-level adolescent smoking rates (as derived from the Health Behaviour in School-aged Children study, 2006-2014). MPOWER measures included were: Protecting people from tobacco smoke (P), offering help to quit tobacco use (O), warning about the dangers of tobacco (W), enforcing bans on advertising, promotion and sponsorship (E) and raising taxes on tobacco (R). Results Across countries, adolescent weekly smoking decreased from 17.7% in 2006 to 11.6% in 2014. It decreased most strongly between 2010 and 2014. Although baseline MPOWER policies were not directly associated with differences in average rates of adolescent smoking between countries, countries with higher baseline smoke-free policies (P) showed faster rates of change in smoking over the time period. Moreover, countries that adopted increasingly strict policies regarding warning labels (W) over time, faced stronger declines over time in adolescent weekly smoking. Conclusion A decade after the introduction of the WHO MPOWER package, we observed that, in our sample of European countries and Canada, measures targeting social norms around smoking (i.e., smoke-free policies in public places and policies related to warning people about the dangers of tobacco) are most strongly related to declines in adolescent smoking.Publisher PDFPeer reviewe

The association between MPOWER tobacco control policies and adolescent smoking across 36 countries: An ecological study over time (2006–2014)

Objective: To examine associations over time between national tobacco control policies and adolescent smoking prevalence in Europe and Canada. Design: In this ecological study, national tobacco control policies (MPOWER measures, as derived from WHO data) in 36 countries and their changes over time were related to national-level adolescent smoking rates (as derived from the Health Behaviour in School-aged Children study, 2006-2014). MPOWER measures included were: Protecting people from tobacco smoke (P), offering help to quit tobacco use (O), warning about the dangers of tobacco (W), enforcing bans on advertising, promotion and sponsorship (E) and raising taxes on tobacco (R). Results: Across countries, adolescent weekly smoking decreased from 17.7% in 2006 to 11.6% in 2014. It decreased most strongly between 2010 and 2014. Although baseline MPOWER policies were not directly associated with differences in average rates of adolescent smoking between countries, countries with higher baseline smoke-free policies (P) showed faster rates of change in smoking over the time period. Moreover, countries that adopted increasingly strict policies regarding warning labels (W) over time, faced stronger declines over time in adolescent weekly smoking. Conclusion: A decade after the introduction of the WHO MPOWER package, we observed that, in our sample of European countries and Canada, measures targeting social norms around smoking (i.e., smoke-free policies in public places and policies related to warning people about the dangers of tobacco) are most strongly related to declines in adolescent smoking.publishedVersio

Development of an algorithm to classify Primary Care Electronic Health Records of alcohol consumption : experience using data-linkage from UK-Biobank and Primary Care electronic health data sources

Funding: AA-L received funding from an HDRUK Fellowship for some of her research time. This project was funded by a research bursary from NHS Fife R&D department. Award date 10 April 2019.Objectives Develop a novel algorithm to categorise alcohol consumption using primary care electronic health records (EHRs) and assess its reliability by comparing this classification with self-reported alcohol consumption data obtained from the UK Biobank (UKB) cohort. Design Cross-sectional study. Setting The UKB, a population-based cohort with participants aged between 40 and 69 years recruited across the UK between 2006 and 2010. Participants UKB participants from Scotland with linked primary care data. Primary and secondary outcome measures Create a rule-based multiclass algorithm to classify alcohol consumption reported by Scottish UKB participants and compare it with their classification using data present in primary care EHRs based on Read Codes. We evaluated agreement metrics (simple agreement and kappa statistic). Results Among the Scottish UKB participants, 18 838 (69%) had at least one Read Code related to alcohol consumption and were used in the classification. The agreement of alcohol consumption categories between UKB and primary care data, including assessments within 5 years was 59.6%, and kappa was 0.23 (95% CI 0.21 to 0.24). Differences in classification between the two sources were statistically significant (p<0.001); More individuals were classified as ‘sensible drinkers’ and in lower alcohol consumption levels in primary care records compared with the UKB. Agreement improved slightly when using only numerical values (k=0.29; 95% CI 0.27 to 0.31) and decreased when using qualitative descriptors only (k=0.18;95% CI 0.16 to 0.20). Conclusion Our algorithm classifies alcohol consumption recorded in Primary Care EHRs into discrete meaningful categories. These results suggest that alcohol consumption may be underestimated in primary care EHRs. Using numerical values (alcohol units) may improve classification when compared with qualitative descriptors.Publisher PDFPeer reviewe