Body mass index associated with elevated blood pressure in Mexican school-aged adolescents.

OBJECTIVE: To evaluate the relationship between blood pressure and body mass index among adolescents. METHODS: A 14-month period cross-sectional study was carried out among 2387 adolescents attending public schools in the state of Morelos, Mexico between 2005 and 2007. We measured blood pressure during four visits, obtaining elevated blood pressure prevalence according to the guidelines for children and adolescents of the United States National Educational Program on High Blood Pressure (at least three visits needed to assess elevated blood pressure on the basis of 95th percentile specific for gender, age and height). We used specific body mass index percentiles for age and gender. We employed multiple linear and Cox proportional hazards models to identify factors related to elevated blood pressure. RESULTS: The overall prevalence of elevated blood pressure was 3.9%. Multiple linear models showed that overweight subjects had systolic and diastolic blood pressures that were 5.1 and 2.5 mmHg higher, respectively, compared with adolescents with a normal body mass index, while obese subjects had 11.3 and 6.2 mmHg higher levels, respectively. Cox proportional hazards models indicated high risk of elevated blood pressure among overweight (RR, 3.6; 95%CI, 1.5-8.5) and obese subjects (RR, 14.2; 95%CI, 7.2-27.75) compared with adolescents with a normal body mass index. CONCLUSION: Our results suggest that a higher body mass index is associated with elevated systolic and diastolic blood pressure levels, indicating the importance of incorporating strategies for ongoing screening and for promoting educational programs on healthy lifestyles to prevent hypertension in adolescents.

Estimating the impact of different cigarette package warning label policies: the auction method.

The study estimated the reduction in demand associated with implementing cigarette package warning labels that contain imagery illustrating the consequences of smoking. The experimental auction method was used, wherein adult smokers in Mexico (n=89) placed separate bids on two packs of cigarettes: one with a text-only warning label and the other with a warning label that included text and a graphic image. Differences in the values attributed to each pack were assessed using t-tests and multivariate regression. The pack with the graphic image had a mean attributed value which was 17% lower ($3.21 pesos) than the pack with the text-only warning, and this difference remained statistically significant within subgroups defined by sociodemographics, amount of smoking, number of quit attempts, and levels of perceived smoking risks. In the multivariate model, the difference in attributed values was greater among females than males, but no such differences were found for other sociodemographic or smoking-related variables. The consistently lower value that smokers attributed to cigarette packages with the graphic warning label indicates that these labels are likely to reduce cigarette demand.

[Poor school performance associated with tobacco persistence among Mexican students]. / Bajo desempeño escolar relacionado con la persistencia del tabaquismo en una cohorte de estudiantes en México.

OBJECTIVE: To evaluate the independent effect of poor school performance and tobacco persistence using a prospective population study of students who remained on school grounds during the follow-up period. Two measurements were taken over a period of three years. MATERIAL AND METHODS: A cohort study conducted within school confines was developed over the period 1998 to 1999 and 2000 to 2001, with 2,568 students, including both tobacco persistent students and non-consumers. Multiple logistic regression models were designed and structured according to educational performance using two standards: students who maintained and/or improved performance and those with poor performance, based on the first and second measurements. RESULTS: In the reference cohort, 5.2% of the students reported to have persisted with tobacco consumption during the study period, while 64.2% remained unexposed. Poor school performance was associated with tobacco persistence for the total population (OR 2.27, 95%CI 1.4-3.6), as well as for females (OR 3.0 95%CI 1.4-6.7) and males (OR 2.2 95%CI 1.1-4.1). Poor school performance has an excess risk of tobacco persistence, independently of other co-variables. The greatest difference in prevalence, using poor school performance as a reference, was observed in those subjects having depressive symptomolgy, with an excessive tobacco persistence of 21.3%. CONCLUSIONS: Interventions that foster healthy lifestyles within school environments should be adopted in a comprehensive manner. In addition, students who perform poorly should be considered vulnerable to unhealthy lifestyles. It will therefore be necessary to identify them as high risk subjects and implement interventions among this population, particularly with regard to combatting addictions.

Prevalencia del uso de drogas ilegales en función del consumo de tabaco en una muestra de estudiantes en México / Prevalence of illicit use in function of tobacco smoking in Mexican students sample

OBJETIVO: Evaluar el uso de drogas ilegales y su interacción con el consumo de tabaco en jóvenes estudiantes de un estado de la región central de México, 2005-2007. MATERIAL Y MÉTODOS: Se realizó un estudio de cohorte en el ámbito escolar en el estado de Morelos. La población fue de 4 625 alumnos. Se efectuó el análisis de la medición basal describiendo el consumo de tabaco, alcohol y drogas ilegales; se evaluó la diferencia del consumo de estas últimas mediante modelos de regresión logística y se estratificó por el antecedente de fumar. RESULTADOS: El promedio de edad fue 13.8 (DE 2.03). La proporción de mujeres fue de 51.9 por ciento; 11.9 por ciento notificó el antecedente de consumo de tabaco (13.5 por ciento hombres y 10.4 por ciento mujeres). El uso de drogas ilegales fue de 3.3 por ciento (3.7 por ciento hombres y 2.8 por ciento mujeres), su distribución según el consumo de tabaco fue de 2.0 por ciento en los no fumadores y 12.4 por ciento en los que tenían antecedente de consumo de tabaco. En el grupo de no fumadores, el consumo de drogas ilegales por parte de los padres incrementó 4.5 veces (IC95 por ciento 1.9-11.0) la posibilidad de que un adolescente usara drogas ilegales en relación con aquellos cuyos padres no consumen drogas ilegales, relación no significativa en el grupo de fumadores. Para este último grupo, el consumo de alcohol se asoció con el uso de drogas ilegales (OR = 2.6; IC95 por ciento 1.2-5.9). CONCLUSIONES: El control y prevención del consumo de tabaco y otras sustancias adictivas debe realizarse de manera integral, ya que vistas en su contexto tales conductas se encuentran relacionadas.

OBJECTIVE: To evaluate the use of the illicit drugs and its interaction with smoking in young students in a state of Central Mexico, 2005-2007. MATERIAL AND METHODS: A population cohort study with 4 625 students was carried out in different public schools in Morelos State. Baseline measurement analysis was carried out describing tobacco, alcohol and illegal drugs consumption. Drug abuse according to tobacco onsumption was assessed through logistic regression models, stratified by smoking habit. RESULTS: Mean age was 13.8 (SD 2.03); 51.9 percent were female students and 11.9 percent of total population informed having smoked (13.5 percent men and 10.4 percent women). Illicit drug use was 3.3 percent; 3.7 percent in men and 2.8 percent in women and its distribution according tobacco smoking was 2.0 percent for non smokers and 12.4 percent for those who had smoked. In non smokers group, parentÆs drug use was 4.5 times (CI95 percent 1.9-11.0) higher compared to those students whose parents do not do drug use. The effect was not significant in smokers group. Alcohol intake was associated to drug abuse in smokers group (OR=2.5; CI95 percent 1.2-5.9). CONCLUSIONS: The control and prevention of tobacco consumption and other addictive substances should be carried out since in a comprehensive way, because contextual antecedent these behaviors are related.

Bajo desempeño escolar relacionado con la persistencia del tabaquismo en una cohorte de estudiantes en México / Poor school perfomance associated with tobacco persistence among Mexican students

OBEJETIVO: Evaluar el efecto independiente de la persistencia del tabaquismo en el bajo desempeño escolar en un estudio poblacional prospectivo; para ello se utilizaron dos mediciones en un periodo de tres años aplicadas a sujetos que permanecieron en el ámbito escolar durante el lapso de seguimiento. MATERIAL Y MÉTODOS: Se desarrolló un estudio de cohorte en el ámbito escolar en los periodos 1998-1999 y 2000-2001. En este artículo sólo se incluyó a 2 568 estudiantes (persistentes en el tabaquismo y no consumidores). Se construyeron modelos de regresión logística múltiple a partir de dos estratos: estudiantes con mantenimiento o mejoría del desempeño escolar e individuos con bajo rendimiento. Se consideraron dos mediciones. Se evaluó la diferencia de riesgos de persistencia del tabaquismo en función del desempeño escolar y covariables relacionadas. RESULTADOS: En la cohorte de referencia, 5.2 por ciento de los estudiantes continuó el consumo de tabaco durante el periodo de estudio, mientras que 64.2 por ciento permaneció al margen de la exposición. El bajo desempeño escolar se vinculó con la persistencia del tabaquismo en la población total (RM= 2.27; IC95 por ciento 1.4-3.6), así como en mujeres (RM= 3.0; IC95 por ciento 1.4-6.7) y hombres (RM= 2.2; IC95 por ciento 1.1-4.1). El bajo rendimiento escolar tiene un exceso de riesgo de continuación del tabaquismo, independiente de otras covariables. La mayor diferencia en términos de prevalencia, respecto del bajo desempeño escolar, se reconoció en los sujetos con síntomas depresivos con un exceso de persistencia del tabaquismo (21.3 por ciento). CONCLUSIONES: Deben plantearse en forma integral intervenciones que fomenten estilos de vida saludables en el ámbito escolar. Asimismo, los estudiantes con bajo rendimiento escolar deben considerarse sujetos vulnerables a estilos de vida no saludables, por lo que es necesario identificarlos como individuos de alto riesgo e instituir intervenciones en este grupo poblacional, en particular en el combate a las adicciones.