Regional French evolution of tobacco and e-cigarette experimentation and use among adolescents aged 15-16 years: A cross-sectional observational study conducted in the Loire department from 2018 to 2020.

Background: We assessed/compared the evolution of tobacco and e-cigarette experimentation and use among French adolescents of the Loire department aged 15-16 years. Methods: A descriptive, cross-sectional/observational study conducted in 2018-2020 among 7,950 Year 11 pupils attending 27 public secondary schools of the Loire department, France. Results: From 2018 to 2020, 66.18% of adolescents were "non-vapers and non-smokers", 19.76% were "vapers and smokers", 7.90% were "non-vapers and smokers" and 6.15% were "vapers and non-smokers". E-cigarette experimentation was more prevalent than tobacco experimentation (44.92% vs 41.67%), and daily vaping was less prevalent than daily smoking (5.40% vs 10.24%). More boys than girls were daily vapers or daily smokers. A decrease was observed in tobacco experimentation (from 41.22% in 2018 to 39.73% in 2020) and e-cigarette experimentation (from 50.28% in 2018 to 41.25% in 2020). Current vaping remained stable, with an increase in daily vaping. French adolescent vapers frequently use e-liquids with little or no nicotine or with fruit or sweet flavours. Conclusions: Adolescents used e-cigarettes mainly for experimental and/or recreational purposes, with no intention of progression to daily smoking. Although the design of this study is not longitudinal and caution must be exercised, from our cross-sectional observational study data, it appears that the proportion of "non-vapers and non-smokers" tended to increase. "Smokers" tended to progress to the dual use of vaping and smoked tobacco, with the likely intention to reduce or quit smoking.

Impact of e-cigarette experimentation and use on smoking behavior among adolescents aged 15-16 years in the Loire department, France.

INTRODUCTION: We describe the vaping and smoking habits of French adolescents aged 15-16 years in the Loire department with a view to assess the impact of e-cigarette experimentation and use on their smoking behavior. METHODS: This quantitative, cross-sectional, single-center and observational study conducted from January to July 2019 targeted 6622 students aged 15-16 years attending public high school in the Loire department, France. RESULTS: A total of 4937 (74.6%) adolescents were included. Of these, 73.2% were non-vapers and 72.2% non-smokers; 66.0% of adolescents were non-vapers and non-smokers. Slightly less than half of adolescents had experimented with e-cigarettes (44.6%), more than half of whom (26.8%) continued to use vaping products, with 6.02% vaping daily. Likewise, a little less than half of adolescents had experimented with smoked tobacco (42.4%), more than half of whom (27.8%) continued to use smoking products, with 10.3% smoking daily. Vapers and smokers (20.6%) tended to begin with the use of smoked tobacco and to progress to the dual use of vaping and smoked tobacco products. Vaping had a positive effect, as 71.8% of vapers who smoked tobacco before initiating vaping stopped or reduced smoking following their progression to this double use. More than half of tobacco users are daily users while this daily use affects only 1/3 boys and 1/6 girls for vape. Finally, nearly 80.7% of adolescents who had never smoked before vaping did not smoke at the time of the study. CONCLUSIONS: Our data suggest that vaping has a rather marginal impact on smoking initiation among French adolescents aged 15-16 years in the Loire department. They therefore neither confirm nor completely disprove the gateway effect theory, relating to use of tobacco subsequent to vaping.

Évolution des comportements tabagique et de vapotage d'adolescents français de 15 à 18 ans (2018-2020).

Introduction : Longitudinal studies make it possible to study the evolution of a class of individuals over time. However, they are rarely used in France to observe the same population of young adolescents according to their grade level over the course of several years.Purpose of research : Based on the longitudinal monitoring of repeated annual cross-sectional studies on young adolescents (from 15 to 18 years old) conducted at the Honoré d’Urfé public high school (Saint-Étienne, Loire, France) involving 336 10th grade pupils in 2018, 360 11th grade pupils in 2019 and 273 12th grade pupils in 2020, we observed and studied students’ smoking and vaping behavior over a period of three years.Results : Between the ages of 15 and 18 years, the prevalence of tobacco experimentation increased almost linearly (39.10%, 47.50%, and 53.11%), while the prevalence of ‘non-smoking’ decreased by 4.5%. In addition, the prevalence of e-cigarette experimentation was stable (46.38%, 49.44%, 47.62%), whereas the prevalence of daily vaping increased by 5.0%.Conclusions : The prevalence of tobacco experimentation tends to increase with age and to catch up with that of e-cigarette experimentation, which remains stable at this stage of adolescence. Introductions to these two products seem to be rather recreational, playful, and experimental in nature, and do not have a significant connection with the development of their daily use or propensity to addiction.

Social Networking Sites and Perceived Content Influence: An Exploratory Analysis from Focus Groups with French Adolescents.

Social networking sites (SNSs) are invested in heavily by marketers aiming to reach a growing number of consumers. Concerns regarding the influence of posts displayed on SNSs in relation to behaviour were raised, in particular the promotion of ill-health behaviour directed to adolescents who may be at risk from suggestible practices. Although adolescents tend to be critical towards traditional forms of advertising, little is known about their perception of influencing strategies developed online, especially where sponsor- and user-generated content coexist. This exploratory study aims to gather information directly from adolescents about their use of SNSs their awareness of the influence that SNS content may have, particularly when it comes to tobacco and alcohol messages. Ten focus groups were conducted with 39 adolescents (11-16 years old; 56.4% male). Qualitative analysis documents the differences associated with adolescents' favourite SNSs. The different parameters linked to each SNS and the expectation to find entertaining content and values associated with friendship may decrease adolescents' perception of potential risk for health associated with SNS use. Authors advocate for the development of educational programs based on eHealth literacy and the use of social marketing techniques to facilitate and motivate adolescents to develop their competences.

The impact of social inequalities on children's knowledge and representation of health and cancer.

Reducing inequalities in the field of cancer involves studying the knowledge and mental representations of cancer among children. A qualitative study was conducted on 191 children aged 9 to 12 using the "write and draw" technique to get spontaneous mental representations of "healthy things", "unhealthy things" and "cancer". We grouped the voluntary schools according to two deprivation levels. In response to the request to "write or draw anything you think keeps you healthy", the main responses categories were physical activity, healthy food and basic needs. Smoking, drinking alcohol, sedentary lifestyles/lack of sport were identified as "unhealthy". The first theme associated with "cancer" is the "cancer site" implying children have a segmented perception of cancer. Deprived children have radically different views about the key items representing cancer: they are more likely to believe the illness is systematically deadly. They are less likely to believe it is a treatable illness. They are less likely to associate cancer with risky behaviors, particularly alcohol consumption. CONCLUSION: Social inequalities affect representations of cancer and health literacy from early childhood. Prevention programs taking into account these representations need to be introduced at school. What is Known: • Social inequalities for cancer mortality are observed in all European countries and are particularly pronounced in France. • Reducing these inequalities in prevention programs implies studying the knowledge and mental representations of cancer among children. What is New: • This study identified representations of cancer in young children according to social level. • At age 9, children living in deprived areas are less able to produce content in discussions about cancer and have narrower mental representations and a more fatalistic view.

[School nurses in France's Éducation nationale: A mixed study on education and health promotion practices]. / Les infirmières de l'Éducation nationale en France : une étude mixte sur les pratiques en éducation et promotion de la santé.

School nurses in France's Éducation nationale are a specific community within the education sector, entrusted with the mission of education and health promotion, thus requiring an adaptation of their role, their status, and their professional practices. The literature emphasizes the link between knowledge, systems of social representation, and standards of practices that revolve around individual conceptions. Based on a mixed methodology, the study focuses on the analysis of the results of a qualitative study through interviews with a sample of the population, followed by a national survey using questionnaires. These conceptions are strongly influenced by professional practice in the Éducation nationale. The role of school nurses in health education evolves according to the duration of professional practice: from health concepts that need to be taught, to a holistic approach to health education, through to advice and support to schools and teachers. This study advances lines of thought in the organization of initial or in-service training, with the aim of constructing the specific role of the school nurse as "a specialized practice in professional nursing."

[School nurses: representations and practices in health education]. / Infirmiers scolaires: représentations et pratiques d'éducation à la santé.

A survey of nurses (n = 188) from the National Education for the Academies of Lyon and Clermont-Ferrand highlights the heterogeneity of their representations and professional practices. These results underline the link between individual conceptions and the nature of the practices being used, and they show the impact of training and experience acquired in the school setting with respect to various practices and the difficulties they encounter in the fulfillment of their objectives as school nurses. The specificity of the school nurse profession is not necessarily solely related to the provision of care, but rather it is more accurately articulated around a set of educational tasks and goals, without of course being in a competitive position with the educational disciplines. This radical change in the fundamental core of the professional mission underlies the need to define a new professionalism and develop specific training tailored to the school setting and its distinctive features.