Genetic variants and early cigarette smoking and nicotine dependence phenotypes in adolescents

Background: While the heritability of cigarette smoking and nicotine dependence (ND) is well-documented, the contribution of specific genetic variants to specific phenotypes has not been closely examined. The objectives of this study were to test the associations between 321 tagging single-nucleotide polymorphisms (SNPs) that capture common genetic variation in 24 genes, and early smoking and ND phenotypes in novice adolescent smokers, and to assess if genetic predictors differ across these phenotypes. Methods: In a prospective study of 1294 adolescents aged 12–13 years recruited from ten Montreal-area secondary schools, 544 participants who had smoked at least once during the 7–8 year follow-up provided DNA. 321 single-nucleotide polymorphisms (SNPs) in 24 candidate genes were tested for an association with number of cigarettes smoked in the past 3 months, and with five ND phenotypes (a modified version of the Fagerstrom Tolerance Questionnaire, the ICD-10 and three clusters of ND symptoms representing withdrawal symptoms, use of nicotine for self-medication, and a general ND/craving symptom indicator). Results: The pattern of SNP-gene associations differed across phenotypes. Sixteen SNPs in seven genes (ANKK1, CHRNA7, DDC, DRD2, COMT, OPRM1, SLC6A3 (also known as DAT1)) were associated with at least one phenotype with a p-value ,0.01 using linear mixed models. After permutation and FDR adjustment, none of the associations remained statistically significant, although the p-values for the association between rs557748 in OPRM1 and the ND/craving and selfmedication phenotypes were both 0.076. Conclusions: Because the genetic predictors differ, specific cigarette smoking and ND phenotypes should be distinguished in genetic studies in adolescents. Fifteen of the 16 top-ranked SNPs identified in this study were from loci involved in dopaminergic pathways (ANKK1/DRD2, DDC, COMT, OPRM1, and SLC6A3). Impact: Dopaminergic pathways may be salient during early smoking and the development of ND

Table_1_Assessing healthcare capacity crisis preparedness: development of an evaluation tool by a Canadian health authority.docx

IntroductionThe COVID-19 pandemic presented health systems across the globe with unparalleled socio-political, ethical, scientific, and economic challenges. Despite the necessity for a unified, innovative, and effective response, many jurisdictions were unprepared to such a profound health crisis. This study aims to outline the creation of an evaluative tool designed to measure and evaluate the Vitalité Health Network’s (New Brunswick, Canada) ability to manage health crises.MethodsThe methodology of this work was carried out in four stages: (1) construction of an evaluative framework; (2) validation of the framework; (3) construction of the evaluative tool for the Health Authority; and (4) evaluation of the capacity to manage a health crisis.ResultsThe resulting evaluative tool incorporated 8 dimensions, 74 strategies, and 109 observable elements. The dimensions included: (1) clinical care management; (2) infection prevention and control; (3) governance and leadership; (4) human and logistic resources; (5) communication and technologies; (6) health research; (7) ethics and values; and (8) training. A Canadian Health Authority implemented the tool to support its future preparedness.ConclusionThis study introduces a methodological strategy adopted by a Canadian health authority to evaluate its capacity in managing health crises. Notably, this study marks the first instance where a Canadian health authority has created a tool for emergency healthcare management, informed by literature in the field and their direct experience from handling the SARS-CoV-2 pandemic.</p

Reasons to quit smoking by social status in adolescents

Background: Recent studies report social disparities in reasons to quit smoking among adults, but it is unclear if this observation also pertains to adolescents who smoke. The objective of this study was to describe social disparities in reasons to quit smoking in adolescents. Method: Data on indicators of social status, cigarette smoking and the Adolescent Reasons For Quitting (ARFQ) scale were collected in mailed self-report questionnaires completed by 1,242 grade u students in 2010-11. The associations between each of ten social status indicators and two of the ARFQ subscales were investigated among current adolescents who smoke (n=190; 45% male; mean (sd) age =16.8(0.5)) in logistic regression analyses controlling for age, sex and number of years since first puff. Results: Sixty-three percent of adolescents who smoke rated health as an extremely or very important reason to quit smoking; only 28% endorsed social disapproval. None of the indicators of social status were associated with health as a reason to quit. Participants whose mothers were employed were less likely to endorse social disapproval as a reason to quit smoking (OR (95% CI) = 0.38 (0.15-0.96)). Conclusions: Adolescents who smoke, regardless of social status, endorse health as an important reason to quit smoking, but fewer thought that social disapproval was important. There are few social disparities in reasons to quit in adolescents

Data_Sheet_1_Assessing healthcare capacity crisis preparedness: development of an evaluation tool by a Canadian health authority.PDF

IntroductionThe COVID-19 pandemic presented health systems across the globe with unparalleled socio-political, ethical, scientific, and economic challenges. Despite the necessity for a unified, innovative, and effective response, many jurisdictions were unprepared to such a profound health crisis. This study aims to outline the creation of an evaluative tool designed to measure and evaluate the Vitalité Health Network’s (New Brunswick, Canada) ability to manage health crises.MethodsThe methodology of this work was carried out in four stages: (1) construction of an evaluative framework; (2) validation of the framework; (3) construction of the evaluative tool for the Health Authority; and (4) evaluation of the capacity to manage a health crisis.ResultsThe resulting evaluative tool incorporated 8 dimensions, 74 strategies, and 109 observable elements. The dimensions included: (1) clinical care management; (2) infection prevention and control; (3) governance and leadership; (4) human and logistic resources; (5) communication and technologies; (6) health research; (7) ethics and values; and (8) training. A Canadian Health Authority implemented the tool to support its future preparedness.ConclusionThis study introduces a methodological strategy adopted by a Canadian health authority to evaluate its capacity in managing health crises. Notably, this study marks the first instance where a Canadian health authority has created a tool for emergency healthcare management, informed by literature in the field and their direct experience from handling the SARS-CoV-2 pandemic.</p

Facteurs associés à la consommation de cannabis au début de l’adolescence

IntroductionNous avons vérifié si les facteurs connus pour être associés à la consommation de cannabis entre 14 et 16 ans sont aussi associés au fait d’avoir déjà consommé du cannabis à l’âge de 12 ans. MéthodologieLes participants à l’étude AdoQuest (n = 1 852) ont été recrutés en 2005 parmi les élèves de 5e année de 29 écoles primaires francophones à Montréal (Canada). Des données autodéclarées ont été recueillies auprès des participants en 5e année (printemps 2005) et en 6e année (automne 2005 et printemps 2006) ainsi qu’auprès de leurs parents ou personnes responsables en 2006-2007. Pour que les participants soient inclus dans l’échantillon d’analyse (n = 1 076; âge médian = 10,7 ans [écart-type : 0,5]), il fallait avoir accès aux données des questionnaires remplis par les participants et par leurs parents de même qu’aux données sur leur consommation de cannabis en 6e année (âge médian = 11,7 ans [écart-type : 0,4]). Nous avons estimé les associations possibles entre le fait d’avoir déjà consommé du cannabis à 12 ans et 33 facteurs de corrélation évalués séparément dans des modèles de régression logistique ajustés et non ajustés. RésultatsCinquante-trois participants (4,9 %) ont déclaré avoir déjà consommé du cannabis à l’âge de 12 ans. Les facteurs associés à une consommation étaient un âge plus élevé, s’identifier comme garçon, un faible revenu du ménage, une allocation hebdomadaire élevée, le fait d’avoir déjà consommé des cigarettes ou d’autres produits du tabac, le fait d’avoir déjà bu de l’alcool, le fait d’avoir déjà eu une consommation excessive d’alcool, le fait d’avoir déjà joué à des jeux de hasard, le tabagisme chez les amis ou les frères et soeurs, une dépendance accrue à la nicotine, des symptômes de dépression importants et une forte impulsivité. Les facteurs de protection étaient un niveau élevé de surveillance par les parents ou les personnes responsables des jeunes, une bonne estime de soi et un sentiment d’appartenance à l’école. ConclusionLes facteurs associés à la consommation de cannabis à des âges plus élevés sont aussi associés au fait d’avoir déjà consommé du cannabis à l’âge de 12 ans. D’après nos résultats, une surveillance et des interventions visant à prévenir la consommation de cannabis sont nécessaires chez les jeunes de moins de 12 ans

Table_3_Assessing healthcare capacity crisis preparedness: development of an evaluation tool by a Canadian health authority.docx

IntroductionThe COVID-19 pandemic presented health systems across the globe with unparalleled socio-political, ethical, scientific, and economic challenges. Despite the necessity for a unified, innovative, and effective response, many jurisdictions were unprepared to such a profound health crisis. This study aims to outline the creation of an evaluative tool designed to measure and evaluate the Vitalité Health Network’s (New Brunswick, Canada) ability to manage health crises.MethodsThe methodology of this work was carried out in four stages: (1) construction of an evaluative framework; (2) validation of the framework; (3) construction of the evaluative tool for the Health Authority; and (4) evaluation of the capacity to manage a health crisis.ResultsThe resulting evaluative tool incorporated 8 dimensions, 74 strategies, and 109 observable elements. The dimensions included: (1) clinical care management; (2) infection prevention and control; (3) governance and leadership; (4) human and logistic resources; (5) communication and technologies; (6) health research; (7) ethics and values; and (8) training. A Canadian Health Authority implemented the tool to support its future preparedness.ConclusionThis study introduces a methodological strategy adopted by a Canadian health authority to evaluate its capacity in managing health crises. Notably, this study marks the first instance where a Canadian health authority has created a tool for emergency healthcare management, informed by literature in the field and their direct experience from handling the SARS-CoV-2 pandemic.</p

Factors associated with cannabis use in early adolescence

IntroductionWe examined whether factors identified as associated with cannabis use at age 14 to 16 years are also associated with ever use at age 12. MethodsParticipants in the AdoQuest study (n = 1852) were recruited in 2005 from among Grade 5 students in 29 French-language elementary schools in Montréal, Canada. Self-report data were collected from participants in Grade 5 (spring 2005) and 6 (fall 2005 and spring 2006) and from parents/guardians in 2006/07. Inclusion in the analytic sample (n = 1076; mean age [SD] = 10.7 [0.5]) required data from participant and parental questionnaires and data on cannabis use in Grade 6 (mean age [SD] = 11.7 [0.4]). We estimated associations between ever use at age 12 with 33 potential correlates, separately in unadjusted and adjusted logistic regression models. ResultsFifty-three participants (4.9%) reported ever use at age 12. Factors associated with higher odds of ever use included older age, identifying as male, lower household income, more weekly spending money, ever tried cigarettes or other tobacco products, ever drank alcohol or binge drank, ever gambled, friends or siblings smoke cigarettes, greater nicotine dependence, higher depressive symptoms and greater impulsivity. Protective factors included higher levels of parental/guardian monitoring and greater self-esteem and school connectedness. ConclusionFactors associated with cannabis use at later ages are also associated with ever use at age 12. Our findings suggest that surveillance for and interventions to prevent cannabis use are warranted before age 12

Determinants of sustained binge drinking in young adults

BACKGROUND: Binge drinking occurs frequently among young adults, posing risks to health and safety. Little is known, however, about which drinkers continue to binge later into adulthood. We sought to identify predictors of sustained binge drinking behaviors in young adulthood. METHODS: Participants from the Nicotine Dependence in Teens (NDIT) cohort (n = 609, 53% female) completed self-report questionnaires in 20 survey cycles (SCs) during secondary school between 1999 and 2005, and in 2 postsecondary school SCs in 2007 to 2008 (SC 21; Mage = 20 years) and 2011 to 2012 (SC 22; Mage = 24 years). Participants reporting past-year binge drinking in both SCs 21 and 22 were categorized as sustainers (n = 517). Using multivariable logistic regression, we investigated 25 potential predictors of sustained binge drinking, binge-drinking frequency, and change in frequency over time among sustainers. RESULTS: Compared with stoppers, sustainers (85% of participants) were more likely to be younger, male, and to have no college/university education. Sustainers began drinking alcohol and binge drinking earlier, drank at least monthly during more secondary school grades, binged more frequently at age 20, and scored higher on impulsivity and novelty seeking in adolescence. Among sustainers, frequent binge drinkers were more likely to be male, to be nonstudents, to score higher on novelty seeking, and to have reported more depressive symptoms in adolescence. Sustainers who decelerated their binge frequency between SCs 21 and 22 were more likely to be female, to have achieved a higher level of education, and to report more depressive symptoms in SC 21. CONCLUSIONS: The determinants of sustained binge drinking are similar to predictors of binge drinking reported in the literature. Early identification of, and intervention with, youth who are impulsive, inclined toward novelty seeking, and who report higher levels of early sub clinical depressive symptoms might forestall their involvement in risky alcohol use

Gender differences in risk factors for cigarette smoking initiation in childhood

INTRODUCTION: We investigated whether established risk factors for initiating cigarette smoking during adolescence (parents, siblings, friends smoke; home smoking rules, smokers at home, exposure to smoking in cars, academic performance, susceptibility to smoking, depressive symptoms, self-esteem, school connectedness, use of other tobacco products) are associated with initiation in preadolescents, and whether the effects of these factors differ by gender. METHODS: In spring 2005, baseline data were collected in self-report questionnaires from 1801 5th grade students including 1553 never-smokers (mean age=10.7years), in the longitudinal AdoQuest I Study in Montreal, Canada. Follow-up data were collected in the fall and spring of 6th grade (2005-2006). Poisson regression analyses with robust variance estimated the effects of each risk factor on initiation and additive interactions with gender were computed to assess the excess risk of each risk factor in girls compared to boys. RESULTS: 101 of 1399 participants in the analytic sample (6.7% of boys; 7.7% of girls) initiated smoking during follow-up. After adjustment for age, gender and maternal education, all risk factors except academic performance and school connectedness were statistically significantly associated with initiation. Paternal and sibling smoking were associated with initiation in girls only, and girls with lower self-esteem had a significant excess risk of initiating smoking in 6th grade. CONCLUSIONS: Risk factors for smoking initiation in preadolescents mirror those in adolescents; their effects do not differ markedly by gender. Preventive programs targeting children should focus on reducing smoking in the social environment and the dangers of poly-tobacco use

Sustained waterpipe use among young adults

INTRODUCTION: Waterpipe smoking is increasingly popular among North American youth. However, the extent to which waterpipe use is sustained over time is not known. The objective of this study was to describe the frequency and the predictors of sustained waterpipe use over 4 years among young adults. METHODS: Data were available in a prospective cohort investigation of 1,293 seventh-grade students recruited in a convenience sample of 10 secondary schools in Montreal, Canada, in 1999. Data on past-year waterpipe use were collected from 777 participants when they were age 20 years on average (in 2007-2008) and again when they were age 24 years (in 2011-2012) in mailed self-report questionnaires. Twenty potential predictors of sustained waterpipe use were tested, each in a separate multivariable logistic regression model. RESULTS: About 51% of 182 waterpipe users at age 20 reported waterpipe use 4 years later. Most sustained users (88%) smoked a waterpipe less than once a month. Parental smoking, being currently employed, less frequent cigarette smoking, and more frequent marijuana use were associated with sustained waterpipe use. CONCLUSIONS: Half of the young adults who used waterpipe during young adulthood reported use 4 years later. Young adults who sustain waterpipe use appear to do so as an activity undertaken occasionally to socialize with others