Engagement in Health Risk Behaviours before and during the COVID-19 Pandemic in German University Students: Results of a Cross-Sectional Study.

Tobacco and cannabis use, alcohol consumption and inactivity are health risk behaviors (HRB) of crucial importance for health and wellbeing. The impact of the COVID-19 pandemic on university students' engagement in HRB has yet received limited attention. We investigated whether HRB changed during the COVID-19 pandemic, assessed factors associated with change and profiles of HRB changes in university students. A web-based survey was conducted in May 2020, including 5021 students of four German universities (69% female, the mean age of 24.4 years (SD = 5.1)). Sixty-one percent of students reported consuming alcohol, 45.8% binge drinking, 44% inactivity, 19.4% smoking and 10.8% cannabis use. While smoking and cannabis use remained unchanged during the COVID-19 pandemic, 24.4% reported a decrease in binge drinking while 5.4% reported an increase. Changes to physical activity were most frequently reported, with 30.6% reporting an increase and 19.3% reporting a decrease in vigorous physical activity. Being female, younger age, being bored, not having a trusted person and depressive symptoms were factors associated with a change in HRB. Five substance use behavior profiles were identified, which also remained fairly unchanged. Efforts to promote student health and wellbeing continue to be required, also in times of the COVID-19 pandemic.

Behavioral risk factor clusters among university students at nine universities in Libya.

OBJECTIVES: This study identifies and describes the clustering of 5 behavioral risk factors (BRFs) among university students. We also investigated whether cluster membership is associated with the students' self-rated academic performance and self-rated health. MATERIAL AND METHODS: A sample of 1300 undergraduates at 6 universities and 3 colleges in Libya completed a self-administered questionnaire that assessed BRFs (nutrition, physical activity, alcohol consumption, smoking, illicit drug use, inadequate sleep). A two-step cluster analysis generated student clusters with similar lifestyles. RESULTS: Two contrasting clusters of almost even size emerged (after exclusion of alcohol and illicit drug use due to very low prevalence). Cluster 1 comprised students with higher engagement in all forms of physical activity, higher levels of health consciousness, greater daily fruit/vegetable intake and better sleep patterns than students in cluster 2. Only as regards the consumption of sweets, cluster 1 students had less favorable practices than cluster 2 students. The prevalence of smoking was equally low in both clusters. Students in cluster 2, depicting a less healthy lifestyle, were characterized by a higher proportion of women, of students with less income and of higher years of study. Belonging to cluster 2 was associated with lower self-rated health (OR: 0.46, p < 0.001) and with lower self-rated academic performance (OR: 0.66, p < 0.001). CONCLUSION: Preventive programs should not address BRFs in isolation and should particularly target students with clustering of BRFs using specifically tailored approaches.

Behavioral Health Risk Profiles of Undergraduate University Students in England, Wales, and Northern Ireland: A Cluster Analysis.

BACKGROUND: Limited research has explored clustering of lifestyle behavioral risk factors (BRFs) among university students. This study aimed to explore clustering of BRFs, composition of clusters, and the association of the clusters with self-rated health and perceived academic performance. METHOD: We assessed (BRFs), namely tobacco smoking, physical inactivity, alcohol consumption, illicit drug use, unhealthy nutrition, and inadequate sleep, using a self-administered general Student Health Survey among 3,706 undergraduates at seven UK universities. RESULTS: A two-step cluster analysis generated: Cluster 1 (the high physically active and health conscious) with very high health awareness/consciousness, good nutrition, and physical activity (PA), and relatively low alcohol, tobacco, and other drug (ATOD) use. Cluster 2 (the abstinent) had very low ATOD use, high health awareness, good nutrition, and medium high PA. Cluster 3 (the moderately health conscious) included the highest regard for healthy eating, second highest fruit/vegetable consumption, and moderately high ATOD use. Cluster 4 (the risk taking) showed the highest ATOD use, were the least health conscious, least fruit consuming, and attached the least importance on eating healthy. Compared to the healthy cluster (Cluster 1), students in other clusters had lower self-rated health, and particularly, students in the risk taking cluster (Cluster 4) reported lower academic performance. These associations were stronger for men than for women. Of the four clusters, Cluster 4 had the youngest students. CONCLUSION: Our results suggested that prevention among university students should address multiple BRFs simultaneously, with particular focus on the younger students.

Are perceptions of social norms regarding peer alcohol and other drug use associated with personal use in Danish adolescents?

AIMS: This study aims to describe norm perceptions among Danish pupils aged 13-17 years related to the prevalence of personal lifetime use of alcohol and other drugs (AODs). Further we examined if norm perceptions were associated with personal lifetime AOD use. METHOD: The data were collected as baseline data in the trial The GOOD Life. A total of 2601 pupils from 42 public schools in the Region of Southern Denmark completed an online questionnaire measuring personal lifetime AOD use and personal approval of use. Additionally the perceived frequency of AOD use and approval of use among peers of their own grade were measured. Lifetime AOD outcome variables were alcohol consumption (at least one drink, being drunk and had five or more drinks on one occasion), smoking, and cannabis use. RESULTS: Pupils' perceptions of peer approval were significantly higher than pupils' personal approval of AOD use among adolescents for all outcomes. With the exception of cannabis use the estimated AOD prevalence among peers (median) were higher than the actual prevalence of personal lifetime use. Multilevel logistic regression models showed a significantly increased risk of personal AOD use for pupils that overestimated their peers' AOD use and also for pupils that perceived peers to approve of AOD use. CONCLUSIONS: The findings highlight that pupils' exaggerated perceptions regarding their peers' use and approval of AOD use are related to personal experience with AODs.

Trends in Tobacco Smoking among Czech School-aged Children from 1994 to 2014.

OBJECTIVE: The aim of the article is to examine trends in tobacco consumption among the Czech school-age population. METHODS: For the analysis, data from the Czech Health Behaviour in School-aged Children project, conducted between 1994 and 2014 were used. Trends in tobacco smoking were determined separately for boys and girls, applying the binary logistic regression with survey period as an independent variable for the smoking status. RESULTS: The analysis showed that there have been significant changes in adolescent tobacco smoking for the recent 20 years. While the share of current school-aged smokers was continuously increasing since the mid-1990s, the trend reached its peak in the mid-2000s. CONCLUSION: In recent years, the prevalence of adolescent smokers has significantly declined in the Czech Republic. Despite this recent decline, adolescent smoking remains a major challenge for the national health policy.

Normative Perceptions of Cannabis Use Among European University Students: Associations of Perceived Peer Use and Peer Attitudes With Personal Use and Attitudes.

OBJECTIVE: Perceptions of peer behavior and attitudes exert considerable social pressure on young adults to use substances. This study investigated whether European students perceive their peers' cannabis use and approval of cannabis use to be higher than their own personal behaviors and attitudes, and whether estimations of peer use and attitudes are associated with personal use and attitudes. METHOD: University students (n = 4,131) from Belgium, Denmark, Germany, the Slovak Republic, Spain, Turkey, and the United Kingdom completed an online survey as part of the Social Norms Intervention for Polysubstance usE in students (SNIPE) Project, a feasibility study of a web-based normative feedback intervention for substance use. The survey assessed students' (a) personal substance use and attitudes and (b) perceptions of their peers' cannabis use (descriptive norms) and attitudes (injunctive norms). RESULTS: Although most respondents (92%) did not personally use cannabis in the past 2 months, the majority of students thought that the majority of their peers were using cannabis and that their peers had more permissive attitudes toward cannabis than they did. When we controlled for students' age, sex, study year, and religious beliefs, perceived peer descriptive norms were associated with personal cannabis use (odds ratio [OR] = 1.42; 95% CI [1.22, 1.64]) and perceived injunctive norms were associated with personal attitudes toward cannabis use (OR = 1.46; 95% CI [1.09, 1.94]). CONCLUSIONS: European students appear to possess similar discrepancies between personal and perceived peer norms for cannabis use and attitudes as found in North American students. Interventions that address such discrepancies may be effective in reducing cannabis use.

The GOOD life: Study protocol for a social norms intervention to reduce alcohol and other drug use among Danish adolescents.

BACKGROUND: It is currently unknown if school-based social norms interventions are effective in preventing harmful alcohol consumption and other drug use among adolescents in Denmark. This paper describes the social norms-based programme The GOOD life and the design of a cluster-randomized controlled trial to test its effectiveness. METHODS/DESIGN: The intervention The GOOD life is composed of three social norms components representing three different communication channels, namely face-to-face communication (normative feedback session), print communication (posters) and interactive media (web application). The intervention period of 8 weeks is preceded and followed by data collection, with the follow-up taking place 3 months after baseline. Public schools in the Region of Southern Denmark with grades 8 and 9 are invited to participate in the study and participating schools are randomly allocated to either intervention or control schools. The aim is to recruit a total of 39 schools and a sample of 1.400 pupils for the trial. An online questionnaire is conducted to examine the use of alcohol, tobacco and marijuana as well as the perceived frequency of use among peers of their own grade, which is measured before and after the intervention. Baseline data is used to develop social norms messages which are included in the three intervention components. Primary outcomes are binge drinking (more than 5 units at one occasion) and perceived frequency of binge drinking among peers, while smoking, marijuana use and alcohol-related harm will be assessed as secondary outcomes. DISCUSSION: The GOOD life study will provide necessary insights on descriptive and injunctive norms regarding alcohol and other drug use among Danish adolescents. In addition, it will provide new knowledge and insight on the feasibility, implementation context and effectiveness of a newly developed social norms intervention in the Danish school context. TRIAL REGISTRATION: Date of registration: 17 February 2016 (retrospectively registered) at Current Controlled Trials with study ID ISRCTN27491960.

Effects of a settings-based intervention to promote student wellbeing and reduce smoking in vocational schools: A non-randomized controlled study.

RATIONALE: School dropout and health risk behavior such as cigarette smoking represent major problems among students attending upper secondary vocational education. Modifications to the social environment may promote educational attainment as well as health and wellbeing of young people. However, there is a need for more evidence-based intervention programs. OBJECTIVE: The aim of this study was to assess the effectiveness of an intervention targeting the socio-environmental setting at vocational schools on student wellbeing and smoking. METHODS: We conducted a non-randomized controlled trial of 5794 students (mean age 21 years; 81% male) in 10 (four intervention and six comparison) large vocational schools in Denmark. The intervention involved changes in everyday school practices focusing on four themes: (i) introduction activities, (ii) daily class meetings, (iii) scheduled breaks and (iv) pleasant non-smoking environment. Outcomes were student wellbeing (four subscales: school connectedness, student support, teacher relatedness, positive valuing of the profession) and daily smoking measured at 10-week follow-up. RESULTS: We found statistically significant between-group difference in school connectedness, but not in student support, teacher relatedness and valuing the profession. The intervention had no effect on daily smoking. However, we found a statistically significant interaction between baseline smoking status and condition. This interaction suggested that baseline occasional smokers in the intervention group had significantly reduced odds ratio (OR) of becoming a daily smoker compared to baseline occasional smokers in the control group (8% versus 16%; OR = 0.44). CONCLUSION: The positive effects on school connectedness and in preventing occasional smokers becoming daily smokers indicate that it is possible to tackle school-related wellbeing and smoking in a high risk population through settings-based interventions.

Shaping the Social: design of a settings-based intervention study to improve well-being and reduce smoking and dropout in Danish vocational schools.

BACKGROUND: The social environment at schools is an important setting to promote educational attainment, and health and well-being of young people. However, within upper secondary education there is a need for evidence-based school intervention programmes. The Shaping the Social intervention is a comprehensive programme integrating social and educational activities to promote student well-being and reduce smoking and dropout in upper secondary vocational education. The evaluation design is reported here. METHODS/DESIGN: The evaluation employed a non-randomised cluster controlled design, and schools were selected to either implement the intervention or continue with normal practice for comparison. In the baseline survey conducted 2011-2012, 2,329 students from four intervention schools and 3,371 students from six comparison schools answered a computer-based questionnaire during class, representing 73% and 81% of eligible students, and 22% of all technical/agricultural vocational schools in Denmark. Follow-up assessment was conducted 10 weeks after baseline and at the same time teachers of the intervention classes answered a questionnaire about implementation. School dropout rates will be tracked via national education registers through a 2-year follow-up period. DISCUSSION: Shaping the Social was designed to address that students at Danish vocational schools constitute a high risk population concerning health behaviour as well as school dropout by modifying the school environment, alongside developing appropriate evaluation strategies. To address difficulties in implementing settings-based interventions, as highlighted in prior research, the strategy was to involve intervention schools in the development of the intervention. Baseline differences will be included in the effectiveness analysis, so will the impact of likely mediators and moderators of the intervention. TRIALS REGISTRATION: ISRCTN57822968. Date of registration: 16/01/2013.

How can we strengthen students' social relations in order to reduce school dropout? An intervention development study within four Danish vocational schools.

BACKGROUND: This article describes the rationale and contents of an intervention program aimed at strengthening students' social relations in order to reduce dropout from vocational schools in Denmark. Taking its theoretical cue from the concept of 'social participation', a qualitative study was performed to investigate the specific relationships between the social environment within the schools and the institutional structures in order to analyse reasons for school dropout and their relation to well-being, cigarette smoking and substance use. METHODS: The development study was based on ethnographic methods, including 22 qualitative interviews with students 17-19 years old and fieldwork with participant observations at four vocational schools over 40 days, including informal interviews and discussion meetings with managers, teachers, counselors and students. As part of the fieldwork, four additional qualitative interviews and four group interviews were conducted with students 16-25 years old. RESULTS: The qualitative data collection resulted in seven major themes to be addressed in the intervention: social relations, sole focus on professional skills, institutionalized individualization, importance of the introduction period, physical surroundings and schedules, tobacco and cannabis use and communication about drug use. The program addressing these themes incorporates suggestions that are meant to improve how teachers welcome new students, to enable greater integration of social and educational activities and to enhance the capacity of teachers and counselors to deal with drug use problems among students. CONCLUSION: The development of new intervention programs might benefit from adopting a theoretical and methodological perspective that enables a closer exploration of the everyday social practices in which interventions are embedded. Thus, we aimed to create a comprehensive intervention that worked through organizational changes in everyday school practices. Intervention programs must be planned in dialogue and collaboration with practitioners in the field to ensure the pertinence and usability of the program.

Cambios en el consumo de tabaco de los estudiantes de la Universidad Pública de Navarra, España, durante el periodo universitario / Changes in the Tobacco Consumption of Students in Navarre, Spain, during their College Life / Análise do consumo de tabaco dos estudantes em Navarra, Espanha, durante o período acadêmico

Objetivo: Analizar los cambios que se producen en el patrón de consumo de tabaco de estudiantes de la Universidad Pública de Navarra, en el tercer curso de titulación versus el primero. Metodología: Estudio de cohorte descriptivo-observacional. Se autoaplicó un cuestionario, con preguntas sobre el consumo de tabaco. La utilización de una clave elaborada por el propio estudiante permitió enlazar los cuestionarios en los dos momentos del estudio, para asegurar la confidencialidad de los datos. Para el análisis estadístico de los datos se utilizó el paquete estadístico SPSS v21.0. Resultados: La cohorte la constituyeron 245 estudiantes: el 64,1% eran mujeres (n = 157), y el 35,9%, hombres (n = 88). El porcentaje de fumadores a diario descendió de un 24,5% en primer curso a un 23,7% en tercero, así como el porcentaje de fumadores ocasionales (de 21,6% a 20,8%). Sin embargo, el consumo medio de cigarrillos diario entre los fumadores aumentó de 10,30% a 11,02%. En las mujeres se observó la misma tendencia de cambio que en la media general: 2,8% el descenso de las fumadoras a diario y 1% las fumadoras ocasionales. Entre tanto, en los hombres aumentó el porcentaje de fumadores a diario (1,2%) y el de fumadores ocasionales (1,10%), así como el número medio de cigarrillos consumidos al día que se aumenta en 2,6. Conclusiones: Un alto porcentaje de estudiantes mantiene la frecuencia de consumo de tabaco durante la vida universitaria, que resultan porcentajes similares entre los que modifican su hábito aumentando o disminuyendo la frecuencia de consumo.

Objective: To analyze the change in the tobacco consumption of the university students during their university studies. Methodology: A descriptive cohort study of university students followed from the first to third year. An anonymous questionnaire was administered to the students. The use of a key generated by the student questionnaires allowed linking the two stages of the study, ensuring the confidentiality of data. A statistical package SPSS v210 was used for the statistical analysis of data. Results: The cohort consisting of 245 students, with 64.1% of female (n=157) and 35.9% male (n=88). The percentage of daily smokers decreased from 24.5% in the first year to 23.7% in the third, and the percentage of occasional smokers (from 21.6% to 20.8%). However, the average daily consumption of cigarettes among smokers increased from 10.30% to 11.02%. In women, the same trend of change in the overall average being 2.8% declining daily smokers and 1.0% the casual smokers was observed. However in men the percentage of daily smokers increased (1.2%) and occasional smokers (1.10%) and the average number of cigarettes smoked per day increases by 2.6. Conclusions: A high percentage of students support the frequency of consumption of tobacco during the university life, turning out to be similar percentages between those who modify smoking increasing or decreasing the frequency of consumption.

Objetivo: O objetivo deste estudo foi analisar as mudanças que ocorrem no padrão de consumo de tabaco por estudantes universitários no terceiro ano de estudo em relação ao primeiro ano. Metodologia: Estudo de coorte descritivo de uma coorte de estudantes universitários seguiu para o primeiro e terceiro ano os alunos. Autocuplimentación questionário com perguntas sobre o consumo de tabaco foi aprovada. O uso de uma chave gerada pelos questionários dos alunos autorizados a ligar as duas etapas do estudo, garantindo a confidencialidade dos dados. Para a análise estatística do pacote estatístico SPSSS dados v21.0 foi usado. Resultado: A coorte constituída 245 alunos, com 64,1% de participantes do sexo feminino (n = 157) e 35,9% do sexo masculino (n = 88). O percentual de fumantes diários diminuiu de 24,5% no primeiro ano para 23,7% no terceiro, eo percentual de fumantes ocasionais (de 21,6% para 20,8%). No entanto, o consumo médio diário de cigarros entre os fumantes aumentou 10,30%- 11,02%. Nas mulheres, a mesma tendência de mudança na média geral sendo 2,8% de declínio fumantes diários e 1% dos fumantes ocasionais foi observada. No entanto, em homens, aumentou o percentual de fumantes diários (1,2%) e fumantes ocasionais (1,10%) e do número médio de cigarros fumados por dia aumenta em 2.6. Conclusões: Uma elevada percentagem de estudantes mantém a frequência de consumo de tabaco durante a vida da faculdade, resultando em taxas similares entre aqueles que mudam de hábito, aumentando ou diminuindo a frequência de consumo.

Body image concern and its correlates among male and female undergraduate students at Assuit University in Egypt.

INTRODUCTION: This cross-sectional study examined variables associated with body image concern (BIC) and whether these associations differed between female and male students in Egypt. During the period 2009-2010, 3271 undergraduate students (1663 females, 1504 males) at Assuit University in Egypt completed a self-administered questionnaire that assessed BIC and other socio-demographic and health related variables. METHODS: Based on Cooper et al.'s Body Shape Questionnaire the authors categorized BIC into 'no BIC'; 'mild BIC'; and 'moderate/marked BIC'. Multifactorial linear regression analysis examined the association between BIC and BMI, body image perception, lifestyle (physical activity, nutrition, smoking) and mental well-being variables (quality of life, finances-related stress, perceived stress, perceived health, depressive symptoms). RESULTS: About 40% of the female students and 25.6% of male students reported having mild to marked BIC. The correlates of BIC did not exhibit striking differences between male and female students. For both genders, BIC was positively associated with BMI, body image perception as being too fat and with depressive symptoms. Self-rated health was inversely associated with BIC. CONCLUSION: These findings suggest that health promoting strategies should address the co-occurrence of depressive symptoms and BIC, and should furthermore pay due attention to higher prevalence of BIC among female students.

Predictors of illicit drug/s use among university students in Northern Ireland, Wales and England.

INTRODUCTION: The use of illicit drug/s among university students is a public health concern. Nevertheless, many UK studies investigated a narrow spectrum of variables to explore their association/s with illicit drug/s use. METHODS: We assessed the associations between a wide range of socio-demographic, health and wellbeing variables (independent variables) and having used illicit drug/s regularly, occasionally or never in life (dependent variables). Data (3706 students) were collected from seven universities in England, Wales, and Northern Ireland, using a self-administered questionnaire. RESULTS: About 5% of the sample had regularly used illicit drug/s, 25% occasionally, and 70% never. Regular drug use (RDU) was significantly more likely among males aged 21-29 years, daily smokers, those with heavy episodic drinking or possible alcohol dependency (CAGE test), and those who perceived their academic performance better than their peers. RDU was less likely among students with high health awareness and those living with parents. The predictors of occasional drug use (ODU) were similar to those of RDU. However, in addition, students with higher perceived stress were less likely, and students who felt financial burden/s were more likely to report ODU, while no association with academic performance was found. Never use of illicit drug/s was inversely associated with most of the variables listed above, and was positively associated with religiosity. Illicit drug/s use goes along with other substance use (alcohol and smoking). The finding that illicit drug/s use was higher among students reporting good academic performance was surprising and raises the question of whether illicit drug/s may be used as performance enhancing drugs. CONCLUSION: The factors identified with illicit drug/s use in this study could be utilized to develop appropriate public health policies and preventive measures for the health of students. Multilevel, value based, comprehensive, and strategic long-term intervention plans are required. This could include social interventions aimed at generating recreations alternatives and opportunities for youth, and a critical review for current authorities' interventions and services. Suggestions for coping with problems of campus illicit drug use/abuse also need to be offered.

A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students.

BACKGROUND: Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students. METHODS/DESIGN: An online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site. DISCUSSION: This project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students. FINAL TRIAL REGISTRATION NUMBER: DRKS00004375 on the 'German Clinical Trials Register'.

Correlates of smoking, quit attempts and attitudes towards total smoking bans at university: findings from eleven faculties in Egypt.

OBJECTIVES: Smoking among university students represents a formidable and global public health challenge. We assessed the associations between socio-demographic, health and wellbeing variables as independent variables, with daily smoking, attempts to quit smoking, and agreement with smoking ban as dependent variables. METHODS: A sample of 3258 undergraduate students from eleven faculties at Assiut University, Assiut, Egypt, completed a general health questionnaire. RESULTS: Overall daily or occasional smoking in last three months prior to the survey was about 9% (8% occasional and 1% daily smokers), and smoking was generally more prevalent among males (male=17%, female=0.6%, P < 0.001). After adjustment for confounders, not having normal BMI and having a mother who completed at least bachelor's degree education was positively associated with daily smoking, and conversely, no history of illicit drug use was a protective factor. About 76% of smokers had attempted to quit smoking within the last 12 months prior to the survey. Although a large proportion of students agreed/ strongly agreed with the banning of smoking at university altogether (87%), such agreement was less likely among smokers. CONCLUSION: There is need for implementation of non-smoking policies on university premises, as well as regular up-to-date information on, and the periodic/yearly monitoring of tobacco use by university students employing standardised data collection instruments and reference periods. In addition, it would be valuable to develop campus-based educational/ awareness campaigns designed to counteract tobacco advertisement directed towards young people in Middle East countries. Otherwise, the danger could be that the current relatively low smoking prevalence among university students may escalate in the future.

Factors associated with smoking, quit attempts and attitudes towards total smoking bans at university: a survey of seven universities in England, Wales and Northern Ireland.

OBJECTIVES: This study assessed the associations between socio-demographic, health and wellbeing variables (independent variables) and daily smoking, attempts to quit smoking, and agreement with smoking ban (dependent variables). METHODS: Data from 3,706 undergraduate students were collected from seven universities in England, Wales, and Northern Ireland using a standardised questionnaire. RESULTS: About 15.8% of the whole sample reported daily smoking, while 12% were occasional smokers. Smoking was significantly more prevalent among males, but the difference was due to a higher rate of occasional smokers. About every second smoker (55%) had attempted to quit smoking. Almost 45% of the whole sample agreed or strongly agreed with implementing a total smoking ban on campus. Daily smoking was more likely among students with not sufficient income, students whose fathers had at least a bachelor degree; and, students who reported binge drinking. Conversely, daily smoking was less likely among students who rated their health as very good/excellent, those who ate ≥5 portions of fruit or vegetables, and those who had never taken illicit drugs. Previous attempt/s to quit smoking were more likely among students who have never taken illicit drugs and those who agreed with a total smoking ban; and less likely among those with not sufficient income. Daily smokers were less likely to report quit attempts as compared to occasional smokers. An agreement with smoking ban was more likely among students who rated their health as very good/excellent, those who ate ≥5 portions of fruit or vegetables daily, and those who had never taken illicit drugs, but less likely among daily smokers. CONCLUSION: Favourable health practices and positive attitudes towards smoking ban were associated with each other. Interventions would need to comprise multi-component programmes that do not solely focus on smoking prevention/cessation, but also on other health promoting practices as well.

Relationships between food consumption and living arrangements among university students in four European countries - a cross-sectional study.

BACKGROUND: The transition of young people from school to university has many health implications. Food choice at the university can differ because of childhood food consumption patterns, sex and the living arrangements. Food consumption may change especially if students are living away from home. We aimed to assess food consumption patterns among university students from four European countries and how they differ by their living arrangements. METHODS: We analysed data from a cross-country survey assessing health and health behaviours of students. The sample comprised a total of 2402 first year undergraduate students from one university in each of the countries of Germany, Denmark, Poland and Bulgaria. Food consumption was assessed by means of a food frequency questionnaire with 9 food groups (indicators). RESULTS: Students' food consumption patterns differed across the countries. Frequent consumption of unhealthy items was common. Bulgarian students reported most often frequent consumption of sweets and cakes and snacks (e.g. chips and fast food). Polish students reported the least frequent consumption of vegetables and a low consumption of fruits. Across all countries except Bulgaria, men reported substantially more often frequent consumption of snacks than women. Students living at parental home consumed more fruit, vegetables, and meat than those who resided outside of their family home in all studied countries. There was more variation with regard to cakes and salads with more frequent consumption of cakes among Bulgarian female students and Danish male students and more frequent consumption of salads among Danish female students not living at parental home, compared to students from other countries. CONCLUSIONS: Nutrition habits of university students differed across countries and by sex. Students living at parental home displayed more healthy nutrition habits, with some exceptions.

Health promoting behaviours and lifestyle characteristics of students at seven universities in the UK.

AIMS: University students' wellbeing and health promoting and damaging behaviours are important and comprise many parameters. The purpose of this study was to assess a range of health behaviours and lifestyle characteristics of 3,706 undergraduate students from seven universities in England, Wales and Northern Ireland. We compared differences in these parameters between males and females, and across the participating universities. METHODS: A self-administered questionnaire assessed socio-demographic information (e.g., gender, age), nutrition, dietary intake and food consumption patterns, as well as the importance of healthy eating, three levels of physical activity, restful sleep, tobacco smoking, use of illicit substance (recreational drugs), frequency of binge drinking and problem drinking. The data was collected in 2007-2008. RESULTS: While females generally reported lower use of tobacco, illicit substances and alcohol (binge drinking/problem drinking) and consumed more fruits and vegetables, male students had a higher level of physical activity, consumed less sweets and had more restful sleep. When lifestyle characteristics of students were compared between the different universities we observed some 'clustering' of the parameters under study, whereby favourable health practices would be exhibited at some universities; and conversely, the clustering of less favourable practices exhibited at other participating sites. CONCLUSIONS: We conclude that only a minority of students exhibited positive health practices above recommended levels and the level of binge drinking and problem drinking was high. This calls for increased awareness of university administrators, leaders and policy makers to the risky health habits of their students. The observed clustering effects also indicate the need for local (university-specific) health profiles as basis and guidance for relevant health promotion programmes at universities.

Municipalities collaborating in public health: the Danish Smoking Prevention and Cessation Partnership.

This study explored the Smoking Prevention and Cessation Partnership (SPCP) which builds upon a collaboration between two Danish municipalities targeted at the prevention of tobacco smoking. The aim of the study was to describe the processes of SPCP, to examine the difficulties this collaboration faced, and to assess how these experiences could be used to improve future partnership collaboration. We employed qualitative methodology comprising 12 semi-structured one-to-one interviews with SPCP's stakeholders and an analysis of the partnership documents and reports. The findings suggested that the main potentials of the partnership were the personal relations between the members and stakeholders with the possibilities of the creation of new connections with other actors. Barriers to successful partnership building were the implementation of the new Local Government Reform as a competing task, and that the two municipalities were heterogenic in respect to organizational issues and working methods. Other impediments included the lack of continuity in leadership, the lack of clarity regarding the form of collaboration and roles, as well as different expectations of the stakeholders. We conclude that four factors remain critical for partnerships. The first is the clarity of the collaborative effort. Second, partnerships need to take into account the structural circumstances and culture/value systems of all stakeholders. Third is the impact of contextual factors on the development of the partnership; and the fourth factor is the bearing of personal/individual factors on the partnership e.g., personal engagement in the project. Early attention to these four factors could contribute to more effective partnership working.

[The lifestyles of university students and their interest in campus health promotion. A cross-sectional study]. / Universitetsstuderendes livsstil og interesse for sundhedsfremme. En tvaersnitsundersøgelse.

INTRODUCTION: Universities are increasingly interested in providing a learning and living environment conducive to the health and well-being of students and staff. In Denmark, however, little is known about the determinants of health in the student population. The purpose of this survey was to study students' lifestyles and their well-being and to identify their health promotion needs with respect to the university environment. MATERIALS AND METHODS: Students of the University of Southern Denmark (N=548, response rate 92.3%) were surveyed using a standardized self-administered questionnaire containing questions on socio-demographic issues, health awareness, use of health services, health behaviours, well-being at the university and interest in health promotion programmes and policies. RESULTS: The majority of students reported a high level of health awareness (79.8%), had not visited a doctor during the previous six months (70.8%) and had never had psychotherapy (84.3%). The rate of daily smokers was comparatively low (16.7%), only 7.1% of respondents were physically inactive and the vast majority (93.7%) had a good social network. However, 29.1% reported frequent alcohol consumption. Students showed overall high satisfaction with the study environment. Their interest in health promotion was highest with regard to non-smoking policies. CONCLUSIONS: Danish university students are highly satisfied with their study conditions and lead a relatively healthy lifestyle. However, campus policies and programmes should target the high level of alcohol consumption among students.