Tabac et alcool : Le tout est-il plus grand que la somme de ses parties?

Cette étude dresse un profil épidémiologique de la prévalence du tabagisme et de sa relation à l’usage et à l’usage épisodique excessif d’alcool dans la population canadienne et dans quelques sous-groupes de cette population. Nous avons analysé des données de l’Enquête sur la santé dans les collectivités canadiennes – cycle 2.1 (ESCC, 2003), menée auprès d’un échantillon représentatif de la population âgée de 12 ans et plus (N=134 072) avec un taux de participation combiné de 80,7 %. Les résultats révèlent que 3 % de la population rapportent un usage exclusif du tabac alors que 57 % rapportent boire sans fumer et 20 % consomment les deux substances. Les buveurs sont majoritairement des hommes de niveau économique supérieur ; les fumeurs sont, dans une plus grande proportion, des femmes de milieu économiquement défavorisé. La concomitance de l’usage des deux substances est plus élevée parmi les hommes, les personnes à faible revenu et les jeunes âgés de 20 à 29 ans. Les fumeurs réguliers et occasionnels boivent de plus grandes quantités d’alcool et sont proportionnellement plus nombreux à être des buveurs épisodiques excessifs comparativement aux anciens fumeurs et non-fumeurs. Par ailleurs, ce sont les fumeurs qui ne boivent pas qui se perçoivent en moins bonne santé alors que les buveurs non fumeurs estiment être le plus en santé. La répartition inégale des conduites à risque et de leur concomitance à travers les sous-groupes socio-économiques permet de conclure à l’importance des interventions ciblées qui tiennent compte de la concomitance des usages de l’alcool et de tabac, et ce, en santé publique comme dans la pratique clinique.This study provides an epidemiological profile of the prevalence of tobacco use and its relation to alcohol use and misuse in the Canadian population and its various subgroups. We carried secondary data analyses of the Canadian Community Health Survey – cycle 2.1 (CCHS, 2003) including 134,072 participants representative of the population aged 12 and over, for an overall response rate of 80.7%. The results indicated that 3% of the population report being mere smokers and 57% are only drinkers whereas 20% use both substances. Drinkers are mostly men with higher income whereas smokers are mostly women with lower income. The concurrent use of tobacco and alcohol is significantly higher among young men aged 20 to 29 years and low-income individuals. Regular and occasional smokers drink bigger quantities of alcohol per week compared to previous smokers and non-smokers and are more likely to be excessive drinkers. Moreover, drinkers who do not smoke provide the highest self-evaluation of their health whereas smokers who do not drink provide the lowest self-evaluation. Disparity between socioeconomic groups in the prevalence and the concurrence of risky behaviours backs the need for targeted interventions that take into account concurrent use of alcohol and tobacco both in public health and in clinical settings.Este estudio traza un perfil epidemiológico de la prevalencia del tabaquismo y de su relación con el uso y el uso episódico excesivo del alcohol en la población canadiense y en algunos subgrupos de dicha población. Hemos analizado los datos de la Encuesta sobre la salud de las colectividades canadienses – ciclo 2.1 (ESCC, 2003), llevada a cabo en una muestra representativa de la población de más de 12 años de edad (N=134.072) con un porcentaje de participación combinado de 80,7%. Los resultados revelan que el 3% de la población indica hacer uso exclusivamente del tabaco, mientras que el 57% dice beber sin fumar y el 20% consume las dos sustancias. Los bebedores son, en su mayoría, hombres de nivel económico superior; los fumadores, en una mayor proporción, son mujeres de un medio económico desfavorecido. La concomitancia del uso de las dos sustancias es más elevado entre los hombres, las personas de bajos ingresos y los jóvenes de 20 a 29 años de edad. Los fumadores regulares y ocasionales beben mayores cantidades de alcohol y, proporcionalmente, son más numerosos como bebedores episódicos excesivos de alcohol que los antiguos fumadores y no fumadores. Por otra parte, los fumadores que no beben son los que se perciben menos saludables, mientras que los bebedores que no fuman estiman ser los más sanos. La distribución desigual de las conductas a riesgo y de su concomitancia a través de los subgrupos socioeconómicos permite concluir que las intervenciones con objetivos precisos y que tienen en cuenta el consumo conjunto de alcohol y de tabaco, tanto en el medio de la salud pública como en la práctica clínica, son muy importantes

Session 1-4-A: Pathways of gambling problem severity: Follow-up from a general population survey

Study objectives Describe trajectories of change in gambling patterns and problems among a cohort of gamblers; Model change over time based on life events

Comparing problem gamblers with moderate-risk gamblers in a sample of university students

Background and aims In an effort to provide further empirical evidence of meaningful differences, this study explores, in a student population, the distinctions in gambling behavioral patterns and specific associated problems of two levels of gambling severity by comparing problem gamblers (PG) and moderate-risk gamblers (MR) as defined by the score on the Problem Gambling Severity Index (PGSI; MR: 3-7; PG: 8 and more). Methods The study sample included 2,139 undergraduate students (male = 800, mean age = 22.6) who completed the PGSI and questionnaires on associated problems. Results Results show that problem gamblers engage massively and more diversely in gambling activities, more often and in a greater variety of locations, than moderate-risk gamblers. In addition, important differences have been observed between moderate-risk and problem gamblers in terms of expenditures and accumulated debt. In regards to the associated problems, compared to moderate-risk gamblers, problem gamblers had an increased reported psychological distress, daily smoking, and possible alcohol dependence. Discussion and Conclusions The severity of gambling and associated problems found in problem gamblers is significantly different from moderate-risk gamblers, when examined in a student population, to reiterate caution against the amalgamation of these groups in future research

Mobile Free-to-Play Gaming Practices: The Entanglement of Time, Technology and Games in Everyday Life

Mobile games have become a major part of many people\u27s everyday life, especially since the rise of the Free-to-Play (F2P) model which brought mobile gaming to the fore of gaming culture. As a “new” cultural phenomenon, “playing” is now accessible anytime, in part due to the widespread availability of mobile technologies that host these games. Drawing from key concepts of the social practices theory, this study aims to explore how do mobile F2P games fit into the players’ everyday activities and occupations. Specifically, in what ways can time, mobile technologies and games shape the integration of gaming practices into the everyday life of players? Based on a thematic content analysis of 15 semi-structured qualitative interviews with players, it is possible to see how three key dimensions can shape mobiles F2P gaming practices, namely the characteristics of mobile F2P games, the use of mobile technologies, and the temporal dispositions of everyday life. These results highlight how social practices theory allows for a broader understanding of mobile F2P gaming practices by taking into account both the individual and structural aspects of this phenomenon. So what? Situating mobile F2P gaming practices within the context of everyday life can shed light on their complete embeddedness in the player’s daily routines. It highlights how time can play a major role in shaping the gaming practices and raises key questions, namely the importance of time in mobile gaming addiction

ENHJEU-Québec Survey Portrait of gambling in Quebec: Prevalence, incidence and trajectories over four years

This project is part of the collaborative funding program « Les jeux de hasard et d’argent au Québec : Portrait des joueurs adultes et prévalence des problèmes associés » of the Fonds québécois de la recherche sur la société et la culture (FQRSC). This project is conducted over a period of five years. It aims at generating data on the prevalence of gambling behaviours and associated problems among the adult population of Quebec. The project is carried out in two stages – one in 2009, the subject of this report, and another in 2012, a follow-up survey. The current report describes the problems associated with gambling by type of game, and devotes special attention to the prevalence of at-risk and probable pathological gamblers, namely, the most vulnerable groups of the population. The presentation of populational tables in the results allows for recommendations to be made for the prevention of gambling problems and the treatment of players struggling with problems. This report describes the first stage of the project

Le projet ENHJEU : Analyse contextuelle des jeux de hasard et d'argent chez les étudiants universitaires

Young adults in universities are at higher risk for excessive gambling and several associated risk behaviors such as excessive drinking and substance use. The objectives of this project are three-fold: 1) to describe the gambling habits among undergraduate university students exploring patterns of gambling on a wide variety of activities and considering the physical location and the type of gambling partners; 2) to examine the differences between non-social gamblers, at-risk gamblers and problem gamblers; and 3) to assess the relationships between severity of gambling problems and other associated problems such as hazardous drinking, illicit drug use and psychological distress. The findings are expected to provide a reliable portray of gambling habits among undergraduate students to purposively identify needs for prevention and services among this vulnerable population

How does the responsible gambling discourse shape the mind of young adult gamblers?

The responsible gambling approach is the subject of significant debate in the scientific community due to its tendency to individualize responsibility, focusing most heavily on gambler’s responsibility for gambling-related harm. In the meantime, studies have showed that young adult gamble at a higher rate than the general adult population. They are now more than ever susceptible to being drawn in to gambling due to the availability of online gambling. In this context, this study aims to explore the social representations of the concept of responsibility held by young adult gamblers. How do they perceive the concept of responsibility? Do they have an individual-centred understanding of this concept or are they able to distinguish their individual responsibility from that of the other stakeholders? The results reveal that the social representations of responsibility held by young adult gamblers fit into five categories rooted in an individual perspective of responsibility: self control, knowing the rules and making the right decision, enjoying the game, not becoming an addict, and preventing harms related to gambling. These results shed a light on how young adult gamblers internalized a discourse about responsibility that is situated at the intersection of a responsible gambling approach and neoliberal ideology. So what? The multiplicity of the involved actors in the gambling landscape requires an equitable sharing of responsibility between different stakeholders. Individual persons cannot solely bear the consequences of a social problem and the scientific community have an important role in pushing for this change to happen

Are Online Gamblers More At Risk Than Offline Gamblers?

Objectives: To characterize and compare sociodemographic profiles, game-play patterns, and level of addictive behaviors among adults who gamble online and those who do not, and to examine if, at the population level, online gambling is associated with more risky behaviors than offline gambling. Methods: Respondents were 8,456 offline gamblers and 111 online gamblers who participated in a population-based survey conducted in the province of Québec, in 2009. The study sample is representative of adult general population. Results: There is an unequal distribution of online gambling in the population. A disproportionate number of men, young people, and students say they participate in online gambling. Poker players are overrepresented among online gamblers and gambling behaviors tend to be more excessive on the Internet. Compared with offline gamblers, online gamblers report more co-occurring risky behaviors, namely alcohol and cannabis use. Conclusion: Those who gamble online appear to be more at risk for gambling-related problems, but the present findings alone cannot be used as evidence for that conclusion. Future research designs could combine longitudinal data collection and multilevel analyses to provide more insight into the causal mechanisms associated with online gambling

A life-course and time perspective on the construct validity of psychological distress in women and men. Measurement invariance of the K6 across gender

<p>Abstract</p> <p>Background</p> <p>Psychological distress is a widespread indicator of mental health and mental illness in research and clinical settings. A recurrent finding from epidemiological studies and population surveys is that women report a higher mean level and a higher prevalence of psychological distress than men. These differences may reflect, to some extent, cultural norms associated with the expression of distress in women and men. Assuming that these norms differ across age groups and that they evolve over time, one would expect gender differences in psychological distress to vary over the life-course and over time. The objective of this study was to investigate the construct validity of a psychological distress scale, the K6, across gender in different age groups and over a twelve-year period.</p> <p>Methods</p> <p>This study is based on data from the Canadian National Population Health Survey (C-NPHS). Psychological distress was assessed with the K6, a scale developed by Kessler and his colleagues. Data were examined through multi-group confirmatory factor analyses. Increasing levels of measurement and structural invariance across gender were assessed cross-sectionally with data from cycle 1 (n = 13019) of the C-NPHS and longitudinally with cycles 1 (1994-1995), 4 (2000-2001) and 7 (2006-2007).</p> <p>Results</p> <p>Higher levels of measurement and structural invariance across gender were reached only after the constraint of equivalence was relaxed for various parameters of a few items of the K6. Some items had a different pattern of gender non invariance across age groups and over the course of the study. Gender differences in the expression of psychological distress may vary over the lifespan and over a 12-year period without markedly affecting the construct validity of the K6.</p> <p>Conclusions</p> <p>This study confirms the cross-gender construct validity of psychological distress as assessed with the K6 despite differences in the expression of some symptoms in women and in men over the life-course and over time. Findings suggest that the higher mean level of psychological distress observed in women reflects a true difference in distress and is unlikely to be gender-biased. Gender differences in psychological distress are an important public health and clinical issue and further researches are needed to decipher the factors underlying these differences.</p