Electronic cigarettes are quite a new potential source of nicotine addiction among youth. More research is needed, particularly on e-liquid use and socioeconomic factors as potential determinants. We ...studied changes from 2013 to 2015 in adolescent e-cigarette awareness and ever-use, types of e-liquids, and determinants in Finland. In 2015, we studied weekly use and reasons for ever-use. Data were from two national surveys of 12-18-year-old Finns (2013,
= 3535, response rate 38%; 2015,
= 6698, 41%). Descriptive statistics and logistic regression analysis were used. Awareness and ever-use of e-cigarettes increased significantly from 2013 to 2015 in all age and gender groups. Ever-use increased from 17.4% to 25%, with half having tried nicotine e-liquids. In 2015, weekly use was rare (1.5%). Daily cigarette smoking was the strongest determinant (OR 51.75; 95% CI 38.18-70.14) for e-cigarette ever-use, as for e-cigarette weekly use, but smoking experimentation and ever-use of snus (Swedish type moist snuff) and waterpipes alongside parental smoking and poor academic achievement also increased the odds for ever-use. The most common reason behind e-cigarette ever-use was the desire to try something new. To conclude, adolescent e-cigarette ever-use is increasing, and also among never-smokers. Tobacco-related factors are stronger determinants for e-cigarette use than socioeconomic factors.
The long-term effects of sleep on adolescent psychosocial well-being are mostly unknown, although insufficient sleep has been associated with emotional and behavioral difficulties in cross-sectional ...studies. With a five-year follow-up of Finnish adolescents (Time 1:
n
= 8834; Mean age = 13 years, 51.1% female, Time 2:
n
= 5315, Mean age = 15 years, 51.6% female, Time 3:
n
= 3712; Mean age = 17 years; 50.2% female), the purpose of this longitudinal study was to investigate the relations between self-reported sleep duration, sleep problems, and emotional and behavioral difficulties during adolescence. Emotional and behavioral difficulties were assessed using The Strengths and Difficulties Questionnaire (SDQ) measuring emotional symptoms, conduct problems, hyperactivity, peer problems and total difficulties. Sleep duration was calculated by counting the hours between self-reported bedtime and wake-up time. Sleep problems were assessed with a single question about the general sleep problems. According to the cross-lagged models for sleep and emotional and behavioral difficulties, the findings of this study indicate a developmental process during adolescence where, firstly, short sleep duration is a stronger predictor for current and prospective emotional and behavioral difficulties than vice versa. Secondly, increased emotional and behavioral difficulties expose adolescents to current and later sleep problems more strongly than reverse. Thus, the results show that short sleep duration predisposed to emotional and behavioral difficulties across adolescence, which then led to more prospective sleep problems. These findings suggest a developmental process where sleep and emotional and behavioral difficulties are intertwined in shaping adolescents’ health.
•Nicotine e-cigarette use raises the risk of daily smoking in never-smoking youth.•Nicotine e-cigarette use increases the risk of daily use of nicotine e-cigarettes.•Nicotine e-cigarettes may serve ...as a gateway to different nicotine product use.•Youths’ access to e-cigarettes should be limited to prevent nicotine addiction.
Several studies indicate an association between e-cigarette use and subsequent smoking among youth. However, most previous studies lack measures of the nicotine content of e-liquid and have not usually measured regular smoking.
We tested the association between e-cigarette use, with and without nicotine, and subsequent daily use of conventional cigarettes and nicotine e-cigarettes among study population of 3474 students. A survey was conducted in lower secondary schools of the Helsinki metropolitan area, Finland, with 15 − 16-year-olds in 2014 (baseline) and in upper secondary schools in 2016 when the cohort was 17 − 18-year-olds (follow-up). Firth logistic regression and generalized linear mixed models (GLMM) were used.
Of students, 25% had experimented with nicotine e-cigarettes at baseline and 40% at follow-up. Among baseline never-smokers, experimentation with or use of nicotine e-cigarettes predicted the uptake of daily smoking at follow-up (AOR 2.92; 95% CI 1.09–7.85), but baseline experimentation with non-nicotine e-cigarettes did not when compared with the non-e-cigarette experimenters. Nicotine e-cigarette experimentation at baseline predicted daily nicotine e-cigarette use at follow-up (AOR 2.96; 95% CI 1.22–7.22). Non-nicotine e-cigarette experimentation at baseline did not predict statistically significantly daily nicotine e-cigarette use at follow-up (AOR 3.13; 95% CI 0.98–10.02). The small number of cases may have diminished the statistical significance.
The findings suggest that experimentation with nicotine e-cigarettes serves as a gateway to subsequent use of conventional cigarettes as well as nicotine e-cigarettes. Our results support the actions to limit youths’ access to e-cigarettes in order to prevent nicotine addiction.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPUK, ZAGLJ, ZRSKP
ABSTRACT
BACKGROUND
We studied school‐level differences in academic achievement and well‐being from 2002 to 2010 in the Helsinki Metropolitan Area, as well as the connection between academic ...achievement, well‐being, and socioeconomic composition.
METHODS
The School Health Promotion Study covered 109 schools and 78% of schoolchildren (N = 100,413; aged 14 to 16 years). Depression was measured with the modified Beck Depression Scale and academic achievement with the grade‐point average. Trajectory analysis identified groups of schools that were as heterogeneous over time as possible.
RESULTS
Six school trajectories differing in academic achievement and 3 in well‐being were observed. Differences between the trajectories persisted over time. Academic achievement and well‐being were related: schools on a poor achievement trajectory were more often on a low‐well‐being trajectory. The poor socioeconomic composition of students was more common in low‐academic achievement and well‐being trajectories.
CONCLUSIONS
Academic achievement and well‐being differed between schools and are closely related to each other and to the school's socioeconomic composition. Differences between the schools did not increase over time. Educational policies aimed at reducing differences should address both academic achievement and well‐being.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
The positive association of health with education level and socioeconomic status (SES) is well-established. Two theoretical frameworks have been delineated to understand main mechanisms leading to ...socioeconomic health inequalities: social causation and health selection but how these work in adolescence is poorly known. We studied if adolescent health and health behaviours predict higher education and higher SES in adulthood and if family background and school performance in adolescence explain these associations.
Surveys on health and health behaviours were sent to representative samples of 12-18-year-old Finns in 1981-1997 every second year (response rate 77.8%, N = 55,682). The survey data were linked with the respondents' and their parents' socioeconomic data from the Finnish national registries. Both latent variables, namely, health (perceived health, health complaints, chronic disease), health-compromising behaviours (smoking status, drunkenness frequency), and family background (parents' occupation-based SES, education, family type) and variables directly measuring health-enhancing behaviours (toothbrushing, physical activity) and school performance were used to predict higher education and higher occupation-based SES at age 34. Logistic regression analysis and structural equation models (SEM) were used.
In logistic regression analyses, good health, health-enhancing behaviours, and lack of health-compromising behaviours were related to higher education and SES, also after controlling for family background and school performance. In the SEM analyses, good health, health-enhancing behaviours, and lack of health-compromising behaviours directly predicted higher SES and higher education, although the standardised coefficients were low (from 0.034 to 0.12). In all models, health, lack of health-compromising behaviours, and health-enhancing behaviours predicted school performance, which in turn, predicted the outcomes, suggesting indirect routes to these. Good socioeconomic prospects in terms of family background predicted good health, healthy behaviours, and good school performance in adolescence and higher SES and higher education in adulthood.
Health and health behaviours in adolescence predicted education and SES in adulthood. Even though the relationships were modest, they support the health selection hypotheses and emphasise the importance of adolescence for health inequalities during the life-course. Health and health behaviours were strongly associated with school performance and family background which together modified the paths from health and health behaviours to the outcomes.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Musculoskeletal symptoms among adolescents are related to the time spent using a computer, but little is known about the seriousness of the symptoms or how much they affect everyday life. The purpose ...of the present study was to examine the intensity of musculoskeletal pain and level of inconvenience to everyday life, in relation to time spent using a computer.
In a survey, 436 school children (12 to 13 and 15 to 16 years of age), answered a questionnaire on musculoskeletal and computer-associated musculoskeletal symptoms in neck-shoulder, low back, head, eyes, hands, and fingers or wrists. Pain intensity (computer-associated symptoms) and inconvenience to everyday life (musculoskeletal symptoms) were measured using a visual analogue scale. Based on the frequency and intensity, three categories were formed to classify pain at each anatomic site: none, mild, and moderate/severe. The association with time spent using the computer was analyzed by multinomial logistic regression.
Moderate/severe pain intensity was most often reported in the neck-shoulders (21%); head (20%); and eyes (14%); and moderate/severe inconvenience to everyday life was most often reported due to head (29%), neck-shoulders (21%), and low back (16%) pain. Compared with those using the computer less than 3.6 hours/week, computer use of ≥ 14 hours/week, was associated with moderate/severe increase in computer-associated musculoskeletal pain at all anatomic sites (odds ratio OR = 2.9-4.4), and moderate/severe inconvenience to everyday life due to low back (OR = 2.5) and head (OR = 2.0) pain.
Musculoskeletal symptoms causing moderate/severe pain and inconvenience to everyday life are common among adolescent computer users. Daily computer use of 2 hours or more increases the risk for pain at most anatomic sites.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The aim of the study was to examine the construct validity of the Three-Factor Eating Questionnaire -R18 (TFEQ-R18), a measure of eating behaviour, and to evaluate cognitive restraint, uncontrolled ...eating and emotional eating in a sample of adolescent and young adult females of different weights.
Subjects were 2 997 females, aged 17 to 20 years, who participated in a phase III human papillomavirus vaccination trial in Finland in 2004 - 2009.Self-administered questionnaires and weight and height measurements were used. The factor structure of the TFEQ-R18 was verified by factor analysis. Connections between measured eating behaviour and Body Mass Index (BMI) were tested using analysis of variance.
The original factor structure of the TFEQ-R18 was replicated: six of the eighteen items measured cognitive restraint, nine measured uncontrolled eating, and three measured emotional eating. On average, higher BMI was associated with higher levels of cognitive restraint (p < 0.001) and emotional eating (p < 0.001), but not with uncontrolled eating.
Structural validity of the TFEQ-R18 was good in this sample of young Finnish females with a varying range of body weights. Use of the instrument as a measure of eating behaviour was thus corroborated. Connections of restrained and emotional eating with BMI were in accordance with previous findings from young females.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Bereavement affects the health of the bereaved both emotionally and physically. Bereavement resulting from alcohol-related death of the previous generation (parents-first generation) may increase the ...risk of alcohol abuse and consequently alcohol-related mortality as well as all-cause mortality in the next generation (offspring-second generation). Furthermore, these associations can be bi-directional. However, there is no conclusive evidence of these effects, and studies exploring these intergenerational effects are rare. This study investigates these associations.
A longitudinal data were constructed by linking participants from the Adolescent Health and Lifestyle Surveys (AHLS) from 1979 to 1997 with census and registry-based data from Statistics Finland containing the socioeconomic status of the survey participants and their parents (N = 78610) to investigate these associations. Multivariate Cox proportional hazards models were used to calculate hazard ratios with 95% confidence intervals to determine the effect of bereavement with alcohol-related mortality and all-cause mortality.
The findings suggest that bereavement following the death of an offspring increases the risk of both alcohol-related and all-cause mortality among both parents. The magnitude of the risk of mortality following the death of an offspring is higher for mothers than for fathers. There were no clear associations of a parent's death with an offspring's alcohol-related or all-cause mortality. However, generally, a father's death seems to be protective of the risk of mortality among the offspring while a mother's alcohol-related death slightly increased the risk of alcohol-related mortality among their offspring.
These findings emphasise the role of bereavement, particularly resulting from the death of an offspring, on alcohol-related and all-cause mortality and therefore inequalities in mortality. Furthermore, the findings highlighting the need for alcohol abuse intervention and emotional support for bereaved persons following the death of an offspring.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: Neck–shoulder pain (NSP) and low back pain (LBP) increased among adolescents in the 1990s and the beginning of 2000. A potential risk factor for this increase is the use of information ...and communication technology. We studied how the use of computers, the Internet, and mobile phones, playing digital games and viewing television are related to NSP and LBP in adolescents. Methods: Mailed survey with nationally representative samples of 14-, 16-, and 18-year-old Finns in 2003 (n = 6003, response rate 68%). The outcome variables were weekly NSP and LBP. Results: NSP was perceived by 26% and LBP by 12%. When compared with non-users, the risk of NSP was 1.3 (adjusted odds ratios) when using computers >2–3 h/day, and 1.8 when using 4–5 h/day; 2.5 when using computers ≥42 h/week, and 1.7 when using the Internet ≥42 h/week. Compared with non-users, the risk of LBP was 2.0 when using computers >5 h/day, 1.7 when using ≥42 h/week, 1.8 when using the Internet ≥42 h/week, and 2.0 when playing digital games >5 h/day. Times spent on digital gaming, viewing television, and using mobile phones were not associated with NSP, nor were use of mobile phones and viewing television with LBP after adjusting for confounding factors. Conclusions: Frequent computer-related activities are an independent risk factor for NSP and LBP. Daily use of computers exceeding 2–3 h seems to be a threshold for NSP and exceeding 5 h for LBP. Computer-related activities may explain the increase of NSP and LBP in the 1990s and the beginning of 2000.
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NUK, OILJ, UL, UM, UPUK, VSZLJ
Little is known of the predictors of electronic cigarette (e-cigarette) use among adolescents, even though the use is increasing. We studied here the predictors for e-cigarette experimentation (tried ...and tried more than twice) and compared them with predictors for conventional smoking. A baseline school survey was conducted in the Helsinki metropolitan area, Finland, in 2011 for seventh graders (12 to 13-year-olds). Response rate was 73%. The same students were followed up in 2014 (9th grade, 15 to 16-year-olds),
= 5742. Generalized linear mixed models controlling for school clustering were used. In the follow-up, 43.3% of boys and 25.6% of girls had tried e-cigarettes and 21.9% and 8.1% correspondingly more than twice. The strongest predictors for both genders were conventional smoking, drunkenness and energy drink use. Furthermore, poor academic achievement predicted e-cigarette experimentation for both genders, and for boys, participation in team sports was a predictor. The predictors for experimenting and for experimenting more than twice were very similar, except for boys' participation in team sports. They were also similar compared to the predictors of conventional smoking but the associations were weaker. To conclude, smoking and other addictive behaviors predict adolescents' experimentation with e-cigarettes. Family's socioeconomic background had little significance.
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