Prevalence and predictors of tobacco, alcohol and illicit drug experimentation among Tunisian middle and high school-adolescents.

OBJECTIVES: Psychoactive substance experimentation among Tunisian adolescents remains one of the most threatening public health concerns. In spite of this, little is known about the prevalence and predictors of these behaviors in the Tunisian context. This study aims to assess the prevalence of tobacco, alcohol and illicit drug experimentation and its predictive factors among adolescents in the delegation of Nfidha, Sousse governorate, Tunisia. METHODS: We conducted a cross sectional study in middle and high schools in the delegation of Nfidha, Sousse governorate, Tunisia, during the first trimester of the 2019-2020 school year using an anonymous questionnaire self-administered to a randomly drawn representative sample of 1,352 pupils. Data collected included socio-demographic characteristics, substance experimentation among school-adolescents, academic performance as well as family and peer' factors. RESULTS: Tobacco was the most commonly experimented substance with a prevalence rate of 17.5 % (CI 95 %: 14.8-18.8 %). The prevalence of alcohol and illicit drugs use were 3.3 % [CI 95 %: (2.1-3.9 %)] and 2 % [CI 95 %: (1.1-2.6 %)] respectively. Being male (Adjusted (AOR)=4.09, p<0.001), being a high school pupil (AOR=2.81, p<0.001), having experiencing academic failure (AOR=1.60, p=0.007) and having a father and siblings who use tobacco (AOR=1.72, p=0.002; AOR=2.03, p=0.001 respectively) were the predictors of tobacco experimentation in the multivariate logistic regression analysis. Additionally, being male (AOR=8.40, p<0.001), having experienced academic failure (AOR=2.76, p=0.017) as well as having a father and siblings who use alcohol (AOR=5.90, p<0.001; AOR=3.03, p=0.045 respectively) and having experienced tobacco (AOR=4.28, p<0.001) were the determinants of alcohol experimentation. Similarly, having a history of academic failure (AOR=3.44, p=0.041), having peers who use illicit drugs (AOR=3.22, p=0.028), having a history of tobacco and alcohol experimentation (AOR=6.52, p<0.001; AOR=3.49, p=0.046 respectively) were the predictors of illicit drug experimentation among adolescents. CONCLUSIONS: A substantial number of socio-demographic and environmental factors have been identified as being involved in experimentation with psychoactive substance during adolescence. Therefore, further prevention programs targeting not only adolescents, but also all risk factors are needed.

Quality of life of Tunisian patients with lung cancer: descriptive study.

INTRODUCTION: No previous study has set as primary goal the evaluation of the quality of life (QOL) of Tunisian patients with lung cancer (LC). AIM: To evaluate the QOL of Tunisian patients with LC. METHODS: This was a cross-sectional descriptive study. QOL of 100 patients with LC (90 men) was evaluated via the QLQ-C30 and QLQ-LC13 questionnaires. QLQ-C30 data were compared with international reference values. RESULTS: 40, 38, 7 and 15% of patients had, adenocarcinoma, squamous cell carcinoma, large cell and small cell LC, respectively. 72, 20 and 8% of patients had received chemotherapy, combination of chemotherapy and surgery or radiotherapy, respectively. The means±SDs of the QLQ-C30 were 3717 (QOL), 5121 (physical activity), 3921 (life role activity), 9113 (cognitive activity), 6622 (emotional activity), 2720 (social activity), 5517 (fatigue), 5120 (pain), 820 (nausea/vomiting), 4221 (dyspnea), 6623 (insomnia), 5125 (anorexia), 4932 (constipation), 1021 (diarrhea) and 7173 (financial problems). The scores means±SDs of dyspnea, cough, hemoptysis, sore mouth and tongue, dysphagia, peripheral neuropathy, alopecia, chest pain, pain in arm or shoulder, and other pain sites were, 5116, 4523, 1319, 1819, 1017, 3430, 1522, 4720, 4534, and 1419, respectively. Comparison of QLQ-C30 data with international reference values showed an alteration of all scores except of those of emotional activity, nausea/vomiting, dyspnea and diarrhea. CONCLUSION: Tunisian patients with LC had poor QOL.

Investigation of exclusive narghile smokers: deficiency and incapacity measured by spirometry and 6-minute walk test.

BACKGROUND: Studies on the submaximal aerobic capacity of exclusive narghile smokers (ENS) seem necessary in view of effective prevention of cardiorespiratory diseases. The goal of the study was to assess, by 6-min walk test (6MWT) data, the submaximal aerobic capacity of ENS, to identify factors influencing their 6-min walk distance (6MWD), and to compare their data with those of a healthy non-smoker (HNS) group. METHODS: Seventy 20-60-y-old male ENS were included. Narghile use (narghile-years) and anthropometric, clinical, spirometric, and 6MWT data were collected. Univariate and multivariate analyses were used to identify factors influencing 6MWD. Data of a subgroup of 40-60-y-old ENS (n = 25) were compared with those of an age-matched HNS group (n = 53). RESULTS: The median (first to third quartile) for age and narghile use were 32 (26-43) and 17 (8-32) narghile-years, respectively. The profile of ENS performing the 6MWT was as follows: at the end of the 6MWT, 34% and 9% had a low heart rate (< 60% of maximum predicted) and high dyspnea scores (> 5/10, visual analog scale), respectively; 3% had an oxyhemoglobin saturation decrease of > 5 points during the test; and 20% had an abnormal 6MWD (less than the lower limit of the normal range). The factors that significantly influenced the 6MWD, explaining 38% of its variability, are included in the following equation: 6MWD (m) = 742.63 - 5.20 × body mass index (kg/m(2)) + 25.23 × FEV1 (L) - 0.44 × narghile use (narghile-years). Compared with HNS, the subgroup of ENS had a significantly lower 6MWD (98 ± 7 vs 87 ± 9% predicted, respectively). CONCLUSIONS: Narghile use may play a role in reducing submaximal aerobic capacity. The present study suggests that a program of pulmonary rehabilitation is an excellent axis to follow.