Factors sustaining legitimacy of smoking in Vocational Education and Training (VET) schools: a qualitative needs assessment.

BACKGROUND: Most adult smokers started smoking in their teenage years, which increases the risk of nicotine dependence. In Denmark, there is a high prevalence of youth smoking among students in Vocational Education and Training (VET). However, reducing and preventing smoking in this group is a major challenge. This article presents a needs assessment aimed to explore factors sustaining legitimacy of smoking in VET schools and consider the measures needed to prepare VET schools' implementation of smoking reduction and prevention interventions. METHODS: Participant observations were conducted in four VET classes representing three VET schools in Denmark with a duration of four days each. Individual, semi-structured interviews were conducted with teachers, managers, and a student advisor, as well as four focus groups with a total of 20 students. Interviews were audio-taped, transcribed, and the data material was analyzed following Malterud's systematic text condensation. FINDINGS: Factors that helped sustain legitimacy of smoking in VET schools included a positive and normalized attitude towards smoking at home and among friends, an understanding of smoking as an integral and expected practice in VET professions and schools, a perceived reliance on smoking as an icebreaker in new social relations and as a pedagogical tool, and smoking as a habit and a means to deal with boredom and stress relief. CONCLUSIONS: The factors sustaining legitimacy of smoking in VET schools are reciprocal and call for smoking reduction and prevention intervention efforts which consider and address social influence, habitual behavior, and psychological needs, as well as changes at the policy level.

The association between shift work and treatment-seeking migraine in Denmark.

In Europe, the one-year prevalence of migraine is 14.9% and migraine is on the top-10 list of leading causes of years lost to disability. Sleep disturbances and irregular daily routines are considered triggers of migraine and these factors are well-known consequences of shift work. We studied the association between treatment-seeking migraine and shift work, categorised as fixed evening work, fixed night work and variable working hours with and without night work in a Danish working population of 5872 participants. When compared with fixed day workers, only participants with fixed evening work were found to have significantly increased odds of reporting treatment-seeking migraine after adjustment for socio-demographic and behavioural covariates (OR = 1.56; 95% CI 1.05-2.32). Participants with seniority of 10 years or more notably accounted for this association. Due to the cross-sectional design, selection mechanisms may have biased the results. Practitioner Summary: The study showed higher odds of treatment-seeking migraine among evening workers even when taking a range of potential confounders into account. Due to the cross-sectional design, we cannot draw any causal inferences, but potential mechanisms underlying the present study are discussed, with an emphasis on possible selection into evening work.