A systematic review of second-hand smoking mass media campaigns (2002-2022).

BACKGROUND: Second-hand smoking (SHS) increases the risk of chronic disease in adults and poses a serious health threat to children. Mass media campaigns are instrumental in raising awareness and reducing SHS exposure. There is a need to identify recent SHS mass media campaigns and assess their sustainability in terms of knowledge, attitudes, and behavioural changes. This systematic review summarises the characteristics and outcomes of mass media campaigns on SHS prevention. METHODS: PubMed, Embase, Web of Science, and grey literature were searched in November 2022 for SHS campaigns implemented between 2016 and 2022. The eligibility criteria included campaigns on the dangers or effects of SHS with any target group, dissemination medium, study design, or language. The database search identified 1,413 peer-reviewed titles, of which 82 full-texts were screened, with 14 meeting the eligibility criteria. The grey literature search identified 9,807 sources, of which 61 were included. We extracted data on the campaign characteristics, metrics, and smoking-related outcomes. The JBI critical appraisal tool was used to assess the risk of bias of the included studies. RESULTS: We found 73 SHS campaigns conducted between 2002 and 2022, across 50 countries. The campaigns reached 378 million people. The reported recall rates range from 8 to 76%. Of the 11 studies that reported smoking-related outcomes, 10 reported increased knowledge in understanding SHS risks (73-85%), five reported an increased prevalence of smoke-free homes, and two reported an increase in number of participants persuading others to quit smoking. Two studies reported a decrease in overall smoking, whereas three studies observed a reduction in smoking in the presence of children. CONCLUSION: The available data provide some support for the effectiveness of SHS campaigns in reducing smoking behaviours in homes and around children. However, the certainty of evidence was low due to the lack of a control group and the substantial heterogeneity in the outcomes assessed. Future campaigns need comprehensive evaluation and reporting to reduce publication bias.

Adolescent Exposure to Online Advertisements and Promotions for Tobacco Products on the Internet-A Cross-Sectional Analysis of the Global Youth Tobacco Surveys.

PURPOSE: Although many countries have banned tobacco advertising on traditional media platforms, the tobacco industry actively promotes their products via online channels. Adolescents are at high risk of exposure due to spending substantial time online. We examined the prevalence of adolescent exposure to online tobacco advertisements and promotions. METHODS: We analyzed data from the Global Youth Tobacco Surveys (GYTS; 2013-2018; average response rate = 76.8%). We included 15 countries in four regions that measured self-reported exposure to tobacco advertising on the internet in the past month (N = 111,356, adolescents aged 11-18): Region of the Americas (Argentina, Costa Rica, Cuba, Ecuador, Panama, Paraguay, Peru), African (Mauritius, Zimbabwe), European (Czech Republic, Turkey), and the Western Pacific (Micronesia, Macao, Papua New Guinea, Samoa). We calculated the prevalence of online exposure to tobacco advertising by past-month cigarette use. RESULTS: Prevalence of adolescent exposure to online advertisements for tobacco products ranged from 18.2%-34.3% and 12.3%-34.4% for tobacco advertisements that "looked fun or cool". Exposure to online tobacco product advertisements was prevalent across countries, including those with advertising bans in place, and included adolescents who have never smoked (14.4%-28.4% exposed to any, 9.1%-31.0% exposed to fun or cool advertisements). Reporting seeing tobacco advertising online that looked fun or cool was positively associated with the prevalence of past-month smoking (r = 0.64, p = .010). DISCUSSION: A substantial proportion of adolescents in countries that have banned tobacco advertising are still exposed to advertisements for tobacco products online. Internet tobacco advertising needs better enforcement to prevent adolescent tobacco use and uptake worldwide.

Perceived Loneliness, Peer, and Parental Relationship With Smoking: A Cross-Sectional Analysis of Adolescents Across South-East Asia.

Tobacco use among youth in the South-East Asian region is quite prevalent. This study aims to examine if psychosocial factors (perceived loneliness, peer, and parental relationships) were associated with adolescent smoking, and whether the effects were different according to sex and age. Data came from the Global School-based Student Health Surveys collected between 2012 and 2015 in Brunei, Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand, Timor-Leste, and Vietnam. 64 578 (males = 48.5%) adolescents aged 13-18 completed the survey. Prevalence of past-month cigarette use was 10.6%. Adolescent smoking was associated with loneliness (OR = 1.75), lack of close friends (OR = 1.43), and lack of parental understanding (OR = 1.35). There was significant interactions between sex with loneliness, close friends, and parental understanding (p < .001). Interactions indicated having no close friends is associated with smoking and is stronger for females than males. Conversely, loneliness was associated with smoking more strongly in males than females. Results indicate that psychosocial factors are linked to adolescent smoking in South-East Asia, suggesting a further need for research on the relation of psychosocial factors with smoking, and their underlying factors.

Gender differences and the correlates of violent behaviors among high school students in a post-conflict area in Indonesia.

INTRODUCTION: Adolescent violence is a public health problem worldwide. Studies show that challenging environments, such as poverty and war, increase the risk of adolescent violence. This paper aims to assess gender differences in violent behaviors among adolescents in a post-conflict area in Indonesia. The other aim of this study is to investigate the correlates of adolescents' violent behaviors using the socio-ecological framework. METHODS: This is a school-based study involving 511 students from six randomly selected high schools in Kotamadya Ambon. Active and verbal violent behaviors and the potential correlates were measured and assessed using backward linear regression analyses. RESULTS: Boys were involved in more violent behaviors than girls. However, some of the boys and girls reported being involved in all types of violent behaviors. The most significant correlates of violent behaviors across genders were community violence exposure and some types of behavioral problems. DISCUSSION: This study highlighted the interconnectedness between community violence exposure and violent behaviors among adolescents living in a post-conflict area. The study also emphasizes the association between problem behaviors and violent behaviors. The results demonstrate the importance of both reducing community violence exposure and identifying adolescents with behavioral problems in the prevention of violent behaviors.

Community violence exposure and determinants of adolescent mental health: A school-based study of a post-conflict area in Indonesia.

INTRODUCTION: Studies have shown the adverse impact of exposure to community violence on adolescent health. However, most of the studies were conducted in high-income countries. This study aimed at assessing the community violence exposure and the determinants of mental health problems among adolescents in Ambon, a post-conflict area in Indonesia. MATERIAL AND METHODS: We conducted a cross-sectional, school-based study involving 511 of 10th-graders from six randomly selected high schools in Kotamadya Ambon. Our participants were assessed using a set of questionnaires including the Strength Difficulties Questionnaire (SDQ) to measure mental health problems, and the child version of the Screen for Adolescent Violence Exposure (KID-SAVE) to measure community violence exposure. The hierarchical regression analyses were used to explore the determinants of mental health problems. RESULTS: In this study, boys reported more exposure to community violence (both in frequency and severity) than girls. Meanwhile, the girls reported higher emotional problems than boys. The hierarchical regression analyses revealed that in the total sample and among boys, the community violence exposure was associated with mental health problems. However, it was the perceived impact of community violence exposure which showed an association with mental health problems among girls. CONCLUSIONS: This study revealed the high community violence exposure among adolescents living in a post-conflict setting in Indonesia. The study also found gender differences in the determinants of mental health problems among adolescents who were exposed to CVE.