Cross-sectional Study of Factors Associated With Suicide Ideation in Ontario Adolescents

Objective: Suicide is the second leading cause of death in Canadian adolescents. The Interpersonal Theory of Suicide attempts to explain suicide etiology and proposes that feelings of perceived burdensomeness or thwarted belongingness lead to suicide ideation, but this has not been extensively studied in adolescents. This study aimed to use the Interpersonal Theory of Suicide to examine factors that may be associated with suicide ideation in adolescents. The factors of interest were school connectedness, perceived availability of support, self-esteem, feelings of worthlessness, feelings of hopelessness, bullying and cyberbullying victimization, substance use, and social media use. Methods: Data were from the 2017 Ontario Student Drug Use and Health Survey, a survey of 7th to 12th graders enrolled in a publicly funded school in Ontario. Weighted multivariate logistic regression of suicide ideation on all exposure variables was conducted. Results: 13.6% of students in the sample endorsed having suicidal ideation in the preceding 12 months. Not knowing where to turn to for support, feeling worthless, endorsing low self-esteem, being bullied, and using cannabis were each associated with greater odds of suicide ideation. Feeling hopeless, social media use, using alcohol and tobacco, and being cyberbullied were not associated with suicide ideation in the weighted multivariate logistic regression model. Conclusions: This study is consistent with the Interpersonal Theory of Suicide as low self-esteem and feelings of worthlessness, two indicators of perceived burdensomeness, and not knowing where to turn to for support, an indicator of thwarted belongingness, were associated with greater odds of suicide ideation. These findings can help guide interventions aimed at reducing the burden of suicidality during adolescence and demonstrate the need to provide accessible mental health support for youth

Disparities in knowledge about the health effects of smoking among adolescents following the release of new pictorial health warning labels

The final publication is available at Elsevier via https://doi.org/10.1016/j.ypmed.2017.11.025 © 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/This paper examined knowledge about the health effects of smoking among health equity groups following the 2012 introduction of refreshed pictorial health warning labels (HWLs) in Canada. Data are from the 2012/2013 Youth Smoking Survey a representative school-based survey of 47,203 adolescents in Grades 6–12 in nine provinces. Regression models examined overall knowledge about eight health effects of smoking included in the HWLs. Less than one-third of adolescents (32.2%) knew that smoking causes vision loss/blindness and 33.7% knew that smoking causes bladder cancer. Whereas knowledge was high for lung cancer (93.9%), knowledge about other health effects ranged from 52.9% for chronic bronchitis/emphysema to 77.6% for gum or mouth disease. Non-smoking adolescents who were: susceptible to future smoking, male, ethnic minorities, and who had less spending money were significantly less likely to be knowledgeable of the health effects of smoking. There were fewer disparities in knowledge about the health effects of smoking among smokers. Smokers who bought loose or bagged cigarettes rather than cigarettes in packages or cartons were significantly less likely to be knowledgeable about the health effects of smoking. There are significant disparities in knowledge about the health effects of smoking by health equity groups particularly among non-smoking adolescents. Warning labels have the potential to reduce disparities in knowledge about the health effects of smoking when exposure to the warning labels is universal. Complementary strategies such as mass media campaigns are needed to address disparities in knowledge.Canadian Cancer Society grant #2011-701019 through the Propel Centre for Population Health Impac

Socioeconomic Differences in the Effectiveness of the Removal of the “Light” Descriptor on Cigarette Packs: Findings from the International Tobacco Control (ITC) Thailand Survey

Many smokers incorrectly believe that “light” cigarettes are less harmful than regular cigarettes. To address this problem, many countries have banned “light” or “mild” brand descriptors on cigarette packs. Our objective was to assess whether beliefs about “light” cigarettes changed following the 2007 removal of these brand descriptors in Thailand and, if a change occurred, the extent to which it differed by socioeconomic status. Data were from waves 2 (2006), 3 (2008), and 4 (2009) of the International Tobacco Control (ITC) Thailand Survey of adult smokers in Thailand. The results showed that, following the introduction of the ban, there was an overall decline in the two beliefs that “light” cigarettes are less harmful and smoother than regular cigarettes. The decline in the “less harmful” belief was considerably steeper in lower income and education groups. However, there was no evidence that the rate of decline in the “smoother” belief varied by income or education. Removing the “light” brand descriptor from cigarette packs should thus be viewed not only as a means to address the problem of smokers’ incorrect beliefs about “light” cigarettes, but also as a factor that can potentially reduce socioeconomic disparities in smoking-related misconceptions

Cigarettes sold in China: design, emissions and metals

Background China is the home to the world's largest cigarette maker, China National Tobacco Company (CNTC), yet little is known publicly about the design and emissions of Chinese cigarettes. CNTC is currently in the process of consolidating its brands and has ambitions to export its cigarettes. Machine-measured tar yields of many of its cigarette brands have also been reduced, similar to what occurred in Western countries from the 1970s through the 1990s with so-called 'low-tar' cigarettes introduced to address consumer concerns about health risks from smoking.Method The current study examines the design and physical characteristics, labelled smoke emissions and tobacco metals content of leading brands of Chinese cigarettes from seven cities purchased in 2005-6 and in 2007.Results Findings suggest that similar to most countries, tar levels of Chinese cigarettes are predicted primarily by tobacco weight and filter ventilation. Ventilation explained approximately 50% of variation observed in tar and 60% variation in carbon monoxide yields. We found little significant change in key design features of cigarettes purchased in both rounds. We observed significant levels of various metals, averaging 0.82 mu g/g arsenic (range 0.3-3.3), 3.21 mu g/g cadmium (range 2.0-5.4) and 2.65 mu g/g lead (range 1.2-6.5) in a subsample of 13 brands in 2005-6, substantially higher than contemporary Canadian products.Conclusion Results suggest that cigarettes in China increasingly resemble those sold in Western countries, but with tobacco containing higher levels of heavy metals. As CNTC looks to export its product around the world, independent surveillance of tobacco product characteristics, including tobacco blend characteristics, will become increasingly important.</p

Traumatic brain injuries and problem gambling in youth: Evidence from a population-based study of secondary students in Ontario, Canada

Traumatic brain injury (TBI) is characterized by a change in brain function after an external force or sudden movement to the head. TBI is associated with risk-taking, impulsivity, psychological distress, substance abuse, and violent crime. Previous studies have also linked problem gambling to TBI, but these studies have not controlled for possible confounding variables such as mental health problems and hazardous drinking which are also linked to TBI. This study examines the relationship between problem gambling and TBI among adolescents. Data were obtained from the 2011, 2013 and 2015 cycles of the OSDUHS, a biennial cross-sectional school-based study of children in grades 7 to 12 (N = 9,198). Logistic regression was used to estimate adjusted odds ratios (AOR) in controlled and uncontrolled analyses. Adjusting for sex and grade only, problem gambling was associated with a history of TBI (AOR = 2.8). This association remained significant after adjusting for hazardous drinking and suicidality (AOR = 2.0). In addition, problem gambling had a statistically significant relationship with being male (AOR = 4.7), hazardous drinking (AOR = 4.5), and suicidality (AOR = 3.1). This study provides further data to suggest a link between TBI and problem gambling. However, research is needed on the causal relationship between these variables and the potential implications for treatment and prevention