Tobacco retailer density surrounding schools and youth smoking behaviour: a multi-level analysis

<p>Abstract</p> <p>Background</p> <p>Youth smoking prevention should be a public health priority. It is not only vital to prevent youth from smoking but also to prevent non-smoking youth from becoming susceptible to smoking. Past research has examined factors associated with youth's susceptibility to become a future smoker, but research has yet to examine tobacco retailer density and susceptibility to smoking among never smokers. The objectives of this study are to examine how tobacco retailer density surrounding schools and social smoking influences are associated with smoking susceptibility among youth of never smokers, and occasional and daily smoking among youth of current smokers.</p> <p>Methods</p> <p>Data were collected in 2005-2006 from grade 9 to 12 students attending 76 secondary schools in Ontario, Canada, as part of the SHAPES-On study. A series of multi-level logistic regression analyses were performed to understand how student- and school-level factors are associated with three smoking behaviour outcomes: smoking susceptibility among never smokers, occasional smoking, and daily smoking.</p> <p>Results</p> <p>The number of tobacco retailers surrounding a school was found to be associated with the likelihood of a never smoker being susceptible to future smoking (OR 1.03, 95CI% 1.01, 1.05). We also identified that being surrounded by smoking social influences, specifically family and close friends, can substantially increase the likelihood that never smokers are at risk for future smoking or that youth are already occasional or daily smokers.</p> <p>Conclusions</p> <p>We identified that the number of tobacco retailers surrounding a school was associated with an increased odds of being susceptible to future smoking among male never smokers. Smoking social models surrounding youth also appears to have an important impact on their smoking behaviour regardless of their smoking status. It is important for youth smoking prevention programs to begin early, interrupt youths' susceptibility to future smoking, and focus on subgroups that are at higher risk of smoking. The government should consider the impact of tobacco retailer density on youth smoking behaviour, and be cautious when granting licenses for establishments to sell tobacco products.</p

The roll-your-own cigarette market in Canada: a cross-sectional exploratory study

<p>Abstract</p> <p>Background</p> <p>Even though the use and prevalence of roll-your-own cigarettes (RYO) has been declining over the past decades, RYO remains important. Given the paucity of research examining RYO use, there is a need to better understand the current and potential future context of RYO use.</p> <p>Methods</p> <p>Data from the 2002 Canadian Tobacco Use Monitoring Survey (CTUMS) were used to examine RYO tobacco use among 23,341 Canadians aged 15 and older. Logistic regression models were conducted to examine factors which differentiate smokers who smoke RYO tobacco all of the time, most of the time or sometimes from smokers who do not smoke RYO tobacco.</p> <p>Results</p> <p>We found that 17% (n = 925,000) of current smokers in Canada reported smoking RYO. When compared to manufactured cigarette (MC) smokers, RYO users were heavier smokers, more addicted to nicotine, and less likely to consider quitting smoking. Lower income smokers were more likely to smoke RYO tobacco compared to smokers with high income. Conversely, smokers who had completed secondary school or university were less likely to smoke RYO tobacco compared to smokers who had not completed secondary school.</p> <p>Conclusion</p> <p>This study demonstrates that RYO tobacco use is not a negligible problem within Canada and provides valuable new insight for developing future tobacco control initiatives for this population of smokers.</p

A multi-level examination of school programs, policies and resources associated with physical activity among elementary school youth in the PLAY-ON study

<p>Abstract</p> <p>Background</p> <p>Given the decline in physical activity (PA) levels among youth populations it is vital to understand the factors that are associated with PA in order to inform the development of new prevention programs. Many studies have examined individual characteristics associated with PA among youth yet few have studied the relationship between the school environment and PA despite knowing that there is variability in student PA levels across schools.</p> <p>Methods</p> <p>Using multi-level logistic regression analyses we explored the school- and student-level characteristics associated with PA using data from 2,379 grade 5 to 8 students attending 30 elementary schools in Ontario, Canada as part of the PLAY-Ontario study.</p> <p>Results</p> <p>Findings indicate that there was significant between-school random variation for being moderately and highly active; school-level differences accounted for 4.8% of the variability in the odds of being moderately active and 7.3% of the variability in the odds of being highly active. Students were more likely to be moderately active if they attended a school that used PA as a reward and not as discipline, and students were more likely to be highly active if they attended a school with established community partnerships. Important student characteristics included screen time sedentary behaviour, participating in team sports, and having active friends.</p> <p>Conclusion</p> <p>Future research should evaluate if the optimal population level impact for school-based PA promotion programming might be achieved most economically if intervention selectively targeted the schools that are putting students at the greatest risk for inactivity.</p

Applying systematic review search methods to the grey literature: a case study examining guidelines for school-based breakfast programs in Canada

Grey literature is an important source of information for large-scale review syntheses. However, there are many characteristics of grey literature that make it difficult to search systematically. Further, there is no ‘gold standard’ for rigorous systematic grey literature search methods and few resources on how to conduct this type of search. This paper describes systematic review search methods that were developed and applied to complete a case study systematic review of grey literature that examined guidelines for school-based breakfast programs in Canada. Methods: A grey literature search plan was developed to incorporate four different searching strategies: (1) grey literature databases, (2) customized Google search engines, (3) targeted websites, and (4) consultation with contact experts. These complementary strategies were used to minimize the risk of omitting relevant sources. Since abstracts are often unavailable in grey literature documents, items’ abstracts, executive summaries, or table of contents (whichever was available) were screened. Screening of publications’ full-text followed. Data were extracted on the organization, year published, who they were developed by, intended audience, goal/objectives of document, sources of evidence/resources cited, meals mentioned in the guidelines, and recommendations for program delivery. Results: The search strategies for identifying and screening publications for inclusion in the case study review was found to be manageable, comprehensive, and intuitive when applied in practice. The four search strategies of the grey literature search plan yielded 302 potentially relevant items for screening. Following the screening process, 15 publications that met all eligibility criteria remained and were included in the case study systematic review. The high-level findings of the case study systematic review are briefly described. Conclusions: This article demonstrated a feasible and seemingly robust method for applying systematic search strategies to identify web-based resources in the grey literature. The search strategy we developed and tested is amenable to adaptation to identify other types of grey literature from other disciplines and answering a wide range of research questions. This method should be further adapted and tested in future research syntheses

Examining the impact of timing of alcohol use initiation on changes to body weight and weight status among students in the COMPASS study

Obesity rates among Canadian youth continue to be a concern, as weight issues during adolescence can transfer into adulthood, leading to long-term health problems. Current evidence lacks a consistent relationship between alcohol consumption and weight gain, and there remains a paucity of research examining the effect of alcohol intake on body weight and BMI over time. This study seeks to examine the effect of grade when students are first classified as “current drinker” and “current binge drinker” on weight and weight status (BMI) trajectories. Two waves of 4-year linked longitudinal data (Y1:2012–13 to Y4:2015–16 and Y2:2013–14 to Y5:2016–17) collected from the COMPASS study (a large prospective cohort study examining health behaviours among Canadian high school students), were used to examine alcohol intake and weight gain among students in grade 9 at their respective baseline year (Y1, n = 1180 or Y2, n = 1612). A modest association between alcohol intake and increased body weight was seen in students who reported binge drinking and earlier onset of alcohol consumption (initiation in grade 10), compared to those who never became binge drinkers, or those who started drinking in grade 11 or grade 12. This additional increase was sustained in grade 11 in males but not females. In contrast, those categorized as “current drinkers” showed no significant increases in weight compared to non-drinkers regardless of grade of initiation. More research should investigate the association between binge drinking and weight gain in high school and beyond, specifically in relation to gender, to approach this issue comprehensively

Caffeinated energy drink consumption and predictors of use among secondary school students over time in the COMPASS cohort study

Consumption of caffeinated energy drinks (CED) by youth is a public health priority, given the lack of regulation and evidence for both short and long-term health effects of CED use. Considering the potential risks associated with excessive caffeine consumption, this paper examined CED consumption and predictors of CED use over time in a large sample of Canadian secondary school students participating in the COMPASS study. Using linked longitudinal data (n = 4949) from the first three years of the COMPASS study (2012/13 to 2014/15), three logistic Generalized Estimated Equation models were performed to examine predictors of weekday CED use, weekend CED use, and weekly CED use. The prevalence of weekly CED use remained fairly consistent across the three years of follow-up; 12.5% in year-1, 11.3% in year-2, and 11.4% in year-3. Smokers and marijuana users at follow-up were all at greater odds of weekday or weekly CED use, regardless of baseline use. Binge drinkers at baseline were at greater odds for weekday or weekly CED use, but not if they started binge drinking after their baseline year. Marijuana users at follow-up were all at greater odds of weekend CED use, regardless of baseline marijuana use. >1 in 10 youth reported consuming CEDs one or more times per week, where specific subpopulations of youth, such as marijuana users, appear to be more frequent CED users. Although CED use remained relatively constant over the three-year period examined, prevalence of CED use remains problematic among secondary school students.Canadian Institutes of Health Researc

An examination of how age of onset for alcohol, cannabis, and tobacco are associated with physical activity, screen time and BMI as students are preparing to graduate from high school

Introduction In this study we examined the co-occurrence of alcohol, cannabis, and tobacco among a large cohort of grade 12 students in Canada, and then explored if the age of initiation of these substances was associated with moderate-to-vigorous physical activity (MVPA), screen time, and BMI. Methods This cross-sectional study used student-level data from grade 12 students in years 1 to 5 (2012–2016) of the COMPASS study. Random intercept linear regression models were used to examine the impact of age of initiation of alcohol, cannabis, and tobacco use on student average daily physical activity, daily screen time and BMI. Results Twenty-eight percent of students had only tried one substance with alcohol being the most reported single substance used (25%). The most common co-occurrence was students reporting having tried all three substances (27%). Nineteen percent of students reported no substance use by grade 12. Younger age of first use of alcohol was associated with increased MVPA in grade 12. Earlier initiation of cannabis and tobacco were associated with increased screen time in grade 12. Age of first use of alcohol, cannabis and tobacco were not associated with BMI in grade 12. Conclusion While no specific cut-off age was identified this study indicates that for every year tobacco and cannabis use are delayed among children, there are subsequent reductions to screen time in grade 12. Early initiation of alcohol was associated with increased MVPA in grade 12. Early initiation of alcohol, cannabis and tobacco were not associated with BMI in grade 12.Canadian Institutes of Health Research Institute of Nutrition, Metabolism and Diabetes || CIHR Institute of Population and Public Health || Health Canad