Tobacco and cannabis use trajectories from adolescence to young adulthood

The main objective of this longitudinal research is to answer the following question: What is the relationship between tobacco and cannabis use trajectories from adolescence to young adulthood? And more specifically we are interested in: A. If the use of one of the substances (tobacco or cannabis) decreases overtime, does the use of the other one increase to compensate? Are other substances (such as alcohol, for example) also used to compensate in these cases? B. Does the probability to become a tobacco smoker increase when cannabis use is heavier or has lasted longer? C. What are the risk and protective factors that can predict that the use of tobacco and/or cannabis will increase or decrease overtime

Is vulnerability associated with substance use? A study among youth in Switzerland.

Adolescence is a period of exploration and experimentation that includes risk behaviors such as substance use. Adolescents living in a situation of vulnerability could be more prone to using substances. In this cross-sectional study, we aimed to evaluate the association between the level of vulnerability and substance use considering explanatory factors. Data were obtained from the first wave of the GenerationFRee project (http://www.generationfree.ch), a longitudinal study based on data collected yearly between 2014 and 2019 on youth aged 15-24 years in high schools and professional schools. The sample included 5179 participants. We designated four risk behaviors: current tobacco smoking, alcohol misuse, cannabis use, and other illegal drug use. We defined vulnerability based on three criteria: the relationship with parents, school performance, and the family socioeconomic status (SES). According to this definition, participants were divided into three groups: no vulnerability, moderate vulnerability, and high vulnerability. Each substance was compared by vulnerability level and controlled with explanatory factors such as age, gender, perceived health, emotional well-being, academic track, nationality, living with parents, residence, family structure, money earned, and perceived personal financial situation. The results show that all substances except alcohol misuse are associated with vulnerability at the bivariate level. All the explanatory factors were also significant with the exception of academic track and amount of money earned per month. In the multinomial regression, for the moderate- and high-vulnerability groups, cannabis use was the only behavior that remained significant. In conclusion, this study shows the association between level of vulnerability and substance use, especially cannabis use. The results also demonstrate the complexity around vulnerability and how the interaction with social aspects influences vulnerability. Youths presenting familial, educational, or financial problems need to be especially screened for substance use by healthcare providers

From controlling to letting go : what are the psychosocial needs of parents of adolescents with a chronic illness?

While one of the main objectives of adolescence is to achieve autonomy, for the specific population of adolescents with a chronic illness (CI), the struggle for autonomy is accentuated by the limits implied by their illness. However, little is known concerning the way their parents manage and cope with their children's autonomy acquisition. Our aim was to identify the needs and preoccupations of parents of adolescents with CI in coping with their children's autonomy acquisition and to determine whether mothers and fathers coped differently. Using a qualitative approach, 30 parents of adolescents with CI participated in five focus groups. Recruitment took place in five specialized pediatric clinics from our university hospital. Thematic analysis was conducted. Transcript analyses suggested four major categories of preoccupations, those regarding autonomy acquisition, giving or taking on autonomy, shared management of treatment and child's future. Some aspects implied differences between mothers' and fathers' viewpoints and ways of experiencing this period of life. Letting go can be hard for the father, mother, adolescent or all three. Helping one or the other can in turn improve family functioning as a whole. Reported findings may help health professionals better assist parents in managing their child's acquisition of autonomy

Adolescent behavioural risk screening in primary care: physician's point of view.

Despite regular consultation between adolescents/young adults (AYA) and their physicians, they are not regularly screened for psychosocial risk behaviours. This study examines physicians' self-reported psychosocial risk behaviour screening in AYA. It aims to highlight which elements hinder or improve screening abilities. The design was a cross-sectional quantitative survey. Data were obtained through a self-reported questionnaire sent out to primary care physicians (PCP) in Switzerland in 2018. The target population consisted of 1,824 PCP (29% response rate). Participants were asked whether they screened youths from 3 age groups [10-14 y/o, 15-20 y/o, and 21-25y/o] for the HEEADSSS items during child well visits and routine checkups. Barriers to screening included primary consultation motive prioritization, insufficient time, patient compliance, reimbursement, lack of skills related to adolescent health, lack of referral options. Data were analysed first through a bivariate analysis using Chi-square tests then through a multinomial logistic regression. The majority of physicians partook in preventive screening for 3-5 psychosocial risk elements. They reported the primary consultation motive as well as a lack of available time as having a high impact on their screening habits. Physician's experience and having discussed confidentiality were related to an increase in the number of topics addressed. Confidentiality remained a significant variable throughout all analyses. Barriers such as lack of consultation time and prioritization issues were found by physicians to be critical but did not hinder screening habits. The main element impacting screening habits was assuring confidentiality and the second is self-efficacy

Une étude qualitative sur l'usage des cigarettes électroniques (e-cigarettes) chez les jeunes

La cigarette électronique (E-cigarette) est un phénomène relativement récent qui est en train de prendre une ampleur inattendue, surtout chez les jeunes. La littérature scientifique à ce sujet est encore relativement rare et surtout centrée sur les taux de prévalence. Bien que théoriquement conçues pour les adultes qui voudraient arrêter de fumer, les adolescents sont devenus un public cible pour ces produits, dont beaucoup n'ayant jamais fumé de cigarettes traditionnelles. Du point de vue de la santé publique, une des préoccupations majeures correspond au possible effet indésirable des cigarettes électroniques d'inciter les jeunes au tabagisme. Beaucoup de questions restent sans réponse quant à l'impact des cigarettes électroniques sur la santé publique. Par exemple, il n'est pas clair si les cigarettes électroniques sont juste une nouveauté que les jeunes n'essayent qu'une fois ou si elles ont le potentiel de concurrencer les cigarettes traditionnelles. Même si les cigarettes électroniques sont disponibles en Suisse depuis près de 10 ans, peu de données existent quant aux motifs de consommation des jeunes, les modalités de consommation, les effets recherchés et la perception de leur nocivité

Who Are Those Youths Who Consider Themselves as Unpopular?

Purpose: To examine the characteristics of adolescents and young adults (AYA) who perceive themselves as unpopular with peers from the same-sex, opposite-sex, or both. Methods: We used the baseline wave (2014-15; N¼5179) of the Generation FRee longitudinal study, gathering a cantonal representative sample of in-school 15-24 year-olds. The web-based in school administered questionnaire included the 2 items “Among same-sex/opposite-sex peers, I am very popular” (yes/no). Respondents were divided into 4 groups: Those who perceived themselves as popular with same-sex and opposite-sex peers (POP; N¼3’164, 61.09%); as unpopular with same-sex and opposite-sex peers (UNPOP; N¼1’228, 23.71%); as unpopular with same-sex peers only (UNPOPSame; N¼284, 5.48%), and as unpopular with opposite-sex peers only (UNPOPOther; N¼503, 9.72%). At the bivariate level, groups were compared on sociodemographic data, making same-sex and opposite-sex friends easily, emotional well-being, school performance and track, and substance use (current smoking, past 30-days e-cigarette, cannabis, and alcohol misuse, and other illegal drug use ever). All significant variables (p<.05) were included in a multinomial logistic regression using POP as the reference category. Data are presented as Relative Risk Ratios (RRR) with 95% confidence intervals

Living With a Chronic Condition and Risk Behaviors

Purpose: To assess whether living with a chronic condition (CC) is associated with risk behaviors among youths. Methods: Data were drawn from the baseline wave (2014-15; N¼5179) of the GenerationFRee survey, a longitudinal study among post-mandatory youths aged 15-24 years in Fribourg, Switzerland. Students were divided into three groups depending on whether they reported having a CC or not: healthy controls (no CC: N¼4529; 46.2% females), CC without limitation (CCWL: N¼536; 52.6% females) and CC limiting daily activities (CCLDA: N¼114; 58.9% females). At the bivariate level groups were compared on sociodemographic data and six risk behaviors (current smoking; current (at least once in the past 30 days) alcohol misuse, cannabis use and use of other illegal drugs; violent behavior and antisocial behavior at least once in the past 12 months). In a second step, a multinomial logistic regression was conducted including all variables significant at the .05 level. Results are given as Relative Risk Ratios (RRR) with 95% confidence intervals

More Important Than You Thought: Some Chronically Ill Adolescents Rely a Lot on Their Health Professional

Purpose: To assess who do chronically ill adolescents rely on in their entourage. Methods: Data were drawn from the GenerationFRee study, a cross-sectional survey including 5149 youths aged 15-24 divided into 3 groups: healthy controls (HC; N=4529), chronically ill without limitations (CI; N=517) and chronically ill with limitations (CIWL; N=103). Groups were compared on perceived health status, socio-demographic variables and whether they could rely a lot on their father, their mother, their girl/boyfriend, their best friend or their health professional in case of difficulty. All variables significant at the bivariate level were included in a multinomial logistic regression using HC as the reference category. Results are given as Relative Risk Ratios (RRR) with 95% CI

Does Doing the Right Thing Pay? Comparing Youths Who Abstain from Risk Behaviors to Their Risk-taking Peers

Purpose: To assess whether young people not engaging in risk behaviors do better than their risk-taking peers. Methods: Data were drawn from the GenerationFRee study, a cross-sectional in-school survey including 5179 youths aged 15-24. Six risk behaviors were studied: smoking, alcohol misuse, cannabis use, use of other illegal drugs, violent behavior and antisocial behavior. A score obtained after adding the behaviors permitted to divide the subjects into Abstainers (score=0; N=1920) and Risk-takers (score>0; N=3259). Groups were compared on personal, familial, academic characteristics. All variables significant at the bivariate level were included in a logistic regression using Risk-takers as the reference category. Results are given as adjusted Odds Ratios (aOR) with 95% confidence interval

Is Being Overweight or Obese Really a Problem?

Purpose: To assess whether there are individual, familial, academic or social differences between youths being overweight, obese or normal weight. Methods: Data were drawn from the GenerationFRee study, a cross-sectional survey including 5179 youths aged 15-24. Using Cole’s cut-off points of body mass index (BMI), individuals were divided into normal weight (NW; N=4291), overweight (OW; N=646), and obese (OB, N=242). Groups were compared on age, gender, emotional wellbeing, self-reported health status, family structure, relationship with father and with mother, life satisfaction, socioeconomic status, pubertal timing, popularity among peers, easiness to make friends, at risk for eating disorders, parents nationality, own nationality, and academic track. All variables at the bivariate level were included in multinomial logistic regression using NW as the reference category. Results are given as Relative Risk Ratios (RRR) with 95% confidence interval