Youth tobacco use in Latin America: What is the real extent of the problem?

INTRODUCTION: Cigarette consumption among teenagers is one of the most critical health-related risk behaviors. METHOD: Prospective study carried out in seven sites of five Latin American countries (Argentina [Cordoba, N=958, Corrientes, N=1013], Brazil [Curitiba, N=650; Uruguaiana, N=997], Cuba [Havana, N=1004], Mexico [Veracruz, N=991] and Paraguay [Ciudad del Este, N=868]) with public-school adolescents (aged 12-19 years). Respondents were asked to answer the California Student Tobacco Survey. RESULTS: 6550 adolescents took part in the survey (average age: 14 years). 38.5% (N=2517) "tried smoking" and 37.5% started smoking before the age of 12. Sixty-one percent of adolescents think that cigarettes are easily accessible; 41.7% considered that smokers have more friends; 88% indicated knowledge of the harms of smoking one to five cigarettes per day; 58.9% would smoke new cigarette types with less harmful substances; 27.8% have already used e-cigarettes; 28% have smoked hookah. Fifty-seven point five percent have been, in the past seven days, in the same room with someone who was smoking a cigarette; and 30.5% indicated that there were not any no-smoking rules inside their homes. Identifiable risk factors were (logistic regression analysis): smoking cigarettes offered by friends, smoking cigarettes with less harmful substances, knowing what a hookah is, being in the same room with a smoker in the past week. Identifiable protective factors against tobacco use were: knowing the health risks caused by smoking hookah and to have their own room. CONCLUSION: Youth tobacco use in Latin America is a major public health concern, and tobacco control measures are highly needed.

Sleep disorders in Latin-American children with asthma and/or allergic rhinitis and normal controls.

BACKGROUND: Asthma and/or allergic rhinitis have been associated with sleep disorders. The aim of this study was to evaluate sleep disorders in Latin-American children (4-10 years) from nine countries, with persistent asthma (A) and/or allergic rhinitis (AR) and in normal controls (C). METHODS: Parents from 454 C children and 700 A and/or AR children followed up in allergy reference clinics completed the Children's Sleep Habits Questionnaire (CSHQ) which is a retrospective one-week questionnaire composed of 33 questions composed of seven subscales (bedtime resistance, sleep duration, sleep anxiety, night wakings, parasomnias, sleep-disordered breathing and daytime sleepiness). The total scale of CSHQ and the subscales were compared between groups C and A+AR, A (n=285) vs. AR (n=390), and between controlled A (CA, n=103) vs. partially controlled/uncontrolled A (UA, n=182). RESULTS: The comparison between C and A+AR showed no significant differences in age (6.7 years vs. 7.0 years, respectively), mean Body Mass Index and total scale of CSHQ (53.3 vs. 63.2, respectively) and the subscales were significantly higher in the A+AR group. Comparison between groups A and AR, except for sleep anxiety, showed significantly higher values for CSHQ total scale (66.9 vs. 61.0, respectively) and subscales for group A. The UA group showed significantly higher values for total CSHQ scale and subscales in comparison to CA (71.1 vs. 59.4, respectively). CONCLUSIONS: Latin-American children with asthma and/or allergic rhinitis showed sleep disorders identified by the CSHQ when compared to normal controls. Despite being treated, asthma causes sleep impairment, especially when uncontrolled.

Sleep-related disorders in Latin-American children with atopic dermatitis: A case control study.

BACKGROUND: Atopic dermatitis (AD) has been associated with impairment of sleep. The aim of this study was to evaluate sleep disorders in AD Latin-American children (4-10 years) from nine countries, and in normal controls (C). METHODS: Parents from 454 C and 340 AD children from referral clinics answered the Children Sleep Habits Questionnaire (CSHQ), a one-week retrospective 33 questions survey under seven items (bedtime resistance, sleep duration, sleep anxiety, night awakening, parasomnias, sleep-disordered breathing and daytime sleepiness). Total CSHQ score and items were analysed in both C and AD groups. Spearman's correlation coefficient between SCORAD (Scoring atopic dermatitis), all subscales and total CSHQ were also obtained. RESULTS: C and AD groups were similar regarding age, however, significantly higher values for total CSHQ (62.2±16.1 vs 53.3±12.7, respectively) and items were observed among AD children in comparison to C, and they were higher among those with moderate (54.8%) or severe (4.3%) AD. Except for sleep duration (r=-0.02, p=0.698), there was a significant Spearman's correlation index for bedtime resistance (0.24, p<0.0001), sleep anxiety (0.29, p<0.0001), night awakening (0.36, p<0.0001), parasomnias (0.54, p<0.0001), sleep-disordered breathing (0.42, p<0.0001), daytime sleepiness (0.26, p<0.0001) and total CSHQ (0.46, p<0.0001). AD patients had significantly higher elevated body mass index. CONCLUSION: Latin-American children with AD have sleep disorders despite treatment, and those with moderate to severe forms had marked changes in CSHQ.