Correlates of and barriers to COVID-19 vaccine initiation and intention among US college students.

OBJECTIVE: To examine correlates of and barriers to COVID-19 vaccine initiation and intention among college students. PARTICIPANTS: 1,171 students attending a public university in the South. METHODS: Multivariate logistic regression was used to assess the correlates of vaccine intention and initiation. Reasons for pursuing or foregoing vaccination were analyzed qualitatively using an inductive approach. RESULTS: Among respondents, 44% had initiated vaccination, 38% intended to be vaccinated, and 18% were unsure about/unwilling to be vaccinated. Vaccine initiation and intention were both associated with 2019-2020 seasonal flu vaccination and political ideology, with conservative-leaning students having lower odds of vaccine initiation and of intention relative to liberal-leaning students. The most common reasons for vaccine initiation/intention and for vaccine hesitancy differed in frequency by political ideology. CONCLUSION: The most effective vaccine promotion strategies may be those tailored to different social groups, virus-related beliefs/perceptions, and the specific concerns of vaccine hesitant students.

Encountering Overdose: Examining the Contexts and Correlates of US College Students' Overdose Experiences.

BACKGROUND: As overdose rates increase, it is critical to better understand the causes and contexts of overdose, particularly for college students who exhibit high rates of alcohol and drug use. The purpose of this study was to examine the social contexts of U.S. college students' overdose experiences (their own, witnessed, and family'/friends'), and to assess the correlates of personal overdose. METHODS: A cross-sectional survey containing open- and closed-ended questions about overdose encounters was completed by undergraduate students at a southeastern American university (n = 1,236). Descriptive frequencies assessed prevalence, substance involvement, and fatalities associated with different encounter types. A content analysis of open-ended responses examined the social contexts of encounters. Multivariate logistic regression was used to assess the correlates of personal overdose. RESULTS: Forty-one percent of respondents reported at least one type of overdose encounter and witnessed overdose was most common. Substances involved varied across encounter type and 20-40% of respondents reported overdose-related fatalities. Students who encountered overdose often reported multiple experiences and many attributed overdoses to mixing substances. Respondents commonly encountered overdose as intervening bystanders and overdose events were often perceived to be intentional or the result of using substances to cope with stress/mental health concerns. Personal overdose was significantly associated with having ever mixed alcohol with prescription drugs, been diagnosed with a mental disorder, witnessed an overdose, and had a family member/friend overdose. CONCLUSION: Findings suggest a need for future research into the contexts and consequences of students' overdose encounters to more effectively tailor overdose prevention/response initiatives within college communities.

Applying the health belief model to examine college students' early stage adoption of non-pharmaceutical interventions in response to COVID-19.

OBJECTIVE: Amidst the COVID-19 pandemic, colleges worked to minimize transmission through non-pharmaceutical interventions (NPIs). The objective of this study was to apply the Health Belief Model to assess correlates of US college students' early stage NPI uptake. PARTICIPANTS: Sample includes 1,223 students from a medium-sized university who participated in an anonymous health survey. METHODS: Logistic regression assessed associations between HBM factors and consistent adoption of five individual NPI strategies. Multivariate linear regression assessed HBM correlates of NPI adoption overall. RESULTS: Correlates of NPI uptake varied by strategy. Only perceived NPI benefits were significantly associated with NPI adoption individually and overall. Perceived susceptibility was associated with use of hand sanitizer, facemasks, and general NPI adoption. Perceived severity was associated with avoidance of large social gatherings only. CONCLUSION: The HBM appears valuable for understanding students' NPI adoption. Results suggest university health initiatives should prioritize education on the efficacy of particular preventive behaviors.

Feasibility of a primary care patient decision aid for smoking cessation with information about e-cigarettes.

Decision aids can promote shared decision making and behavior change and may be effective in helping patients quit smoking. Patients are increasingly using e-cigarettes for smoking cessation; however, little is known about the impact of including e-cigarette information in smoking cessation decision aids. Our objective was to assess the feasibility and acceptability of a smoking cessation decision aid including e-cigarette information. This study was conducted at one family medicine clinic in the United States. We used a pre-post design. In Phase I, the decision aid presented information about approved cessation methods. In Phase II, current e-cigarette users and patients with no intention of quitting received additional information on switching to e-cigarettes. We assessed the impact of the decision aids on quit attempts and abstinence, confidence and readiness to quit, confidence and readiness to switch to e-cigarettes, and patient satisfaction. We enrolled 60 patients in each phase (N = 120). Patients reported higher confidence and readiness to quit after viewing the decision aids and consulting with their physician (p < 0.01). Patients reported the decision aid helped prepare them to make a decision about quitting smoking and expressed satisfaction with the decision aid and clinician consultation. We did not observe an impact of including e-cigarette information. Smoking cessation decision aids are acceptable to patients and may promote behavior change. Future studies should explore the impact of providing patients e-cigarette information using larger sample sizes and rigorous designs. Further research is needed to identify strategies to promote shared decision-making regarding e-cigarettes.

Evaluation of a Smoking Cessation Patient Decision Aid That Integrates Information About E-Cigarettes.

INTRODUCTION: Smokers increasingly use e-cigarettes to try to quit smoking, even more than recommended cessation methods. However, few smokers discuss the range of cessation options with their physicians. Decision aids can inform smokers about smoking cessation options, including evidence about e-cigarettes, and encourage smokers to engage in shared decision making with their physician. AIMS AND METHODS: This study aimed to evaluate a smoking cessation decision aid that included e-cigarette risks and benefits. Adult smokers were recruited from primary care clinics for two research phases: (1) usability and acceptability testing of the decision aid (n = 37); and (2) pre-post study that compared usual care (n = 90) with implementation of the decision aid in clinics (n = 90). For the latter, outcome measures included frequency of clinical discussions of readiness to quit, methods to quit in general, and of specific cessation methods, in addition to decisional conflict, communication satisfaction, and overall patient satisfaction. RESULTS: Smokers indicated high usability and acceptability of the decision aid. In the pre-post evaluation, decision aid implementation was associated with higher rates of smokers: being asked if they were ready to quit smoking (89% vs. 67%, respectively; p < .001); discussing methods for smoking cessation in general (81% vs. 48%; p < .001); and discussing specific cessation methods (NRT 55% vs. 26%, p < .001; prescription medications 26% vs. 12%, p = .022). Decision aid use was also associated with higher overall patient satisfaction with the physician visit. CONCLUSIONS: Smoking cessation decision aids that incorporate information about e-cigarettes are acceptable among smokers and can lead to evidence-based clinical discussions about smoking cessation. IMPLICATIONS: Smokers use e-cigarettes more than recommended cessation methods when they are trying to quit smoking, yet few physicians discuss the risks and benefits of e-cigarettes with their patients who smoke. This study presents preliminary findings about the feasibility and usability of a clinically based iPad-delivered smoking cessation decision aid that integrates information about e-cigarettes. Although promising, further research with randomized designs, larger samples, and longer-term follow-up is needed to determine whether this type of intervention can effectively promote cessation of all tobacco products and, for those not ready to quit smoking, the use of e-cigarettes for harm reduction.

Illicit drug use among college students: The role of social norms and risk perceptions.

PURPOSE: To examine the prevalence and correlates of college student use of illicit substances including cocaine, designer drugs, and nonmedical use of prescription stimulants and opioids, and to identify how different drug-related perceptions are related to past year use of these substances. METHODS: Data were analyzed from a cross-sectional anonymous web-based survey among a sample (n = 1345, 81% female) of students attending a mid-sized liberal arts college in the US. Logistic regression models were estimated to assess the relationships between substance-specific descriptive norms, injunctive norms, perceived availability, risk perceptions and past year use of cocaine, designer drugs, prescription stimulants, and opioids, adjusting for current marijuana use, alcohol dependence, sensation seeking, and sociodemographic factors. FINDINGS: Past year use of illicit substances ranged from 6% for nonmedical prescription opioids to 21% for nonmedical prescription stimulants. The sociodemographic correlates past year substance use differed by substance type. Descriptive norms (perceptions of peer use) and perceived risk were not consistently related to use of these substances. Current marijuana use was the strongest correlate across substances, and both injunctive norms (perceptions of peer approval) and perceived availability were consistently related to use of each substance. CONCLUSIONS: Findings suggest that future college student drug prevention efforts should more directly target current marijuana users since they are most at risk of using other illicit substances. Additionally, findings indicate that injunctive norms may be an important consideration for education-focused drug prevention programs. However, findings should be interpreted in light of limitations of the sample, which is predominantly female.

E-cigarette use frequency and motivations among current users in middle school.

INTRODUCTION: The popularity of electronic cigarettes (e-cigarettes) has increased worldwide among youth, even in countries like Mexico that ban them. This study aimed to assess the correlates of e-cigarette use frequency among Mexican students who currently use ecigarettes, as well as to describe their reasons for use. METHODS: Data were analyzed from a school-based survey of 57 public middle schools from the three largest cities in Mexico. Primary analyses were confined to those who used e-cigarettes in the prior 30 days. Censored binomial models for truncated distributions were estimated, regressing lifetime and past month frequency of use on participant sociodemographics, other substance use (smoking, alcohol, drugs), technophilia (appeal of new technologies), characteristics of e-cigarettes used, and family's and friends' use of nicotine products. RESULTS: Being male (APR = 1.93 95% CI 1.53-2.44), using drugs, (APR = 1.51 95% CI 1.03-2.20), higher technophilia (APR = 1.66 CI 1.21-2.29) and having a family member who uses e-cigarettes and cigarettes were associated with more frequent use in the last month. Students who preferred fruit and combined flavors had used e-cigarettes more often in their lifetime compared to students who preferred mint/menthol flavors. CONCLUSIONS: Some risk factors for more frequent e-cigarette use among Mexican youth are similar to those foudn in other countries (having relatives who use ecigarettes, using drugs, and use of fruit flavors). Additionally, the novel measure of technophilia was positively associated with frequency of e-cigarette use. The appeal of flavors, in particular, suggests the importance of reducing youth access to flavored products to impede product initiation and progression.

E-cigarettes and the clinical encounter: Physician perspectives on e-cigarette safety, effectiveness, and patient educational needs.

RATIONALE, AIMS, AND OBJECTIVES: There is limited research on how health care providers approach the topic of e-cigarettes in clinical encounters, especially in conjunction with other best-practice recommendations for smoking cessation. This qualitative study explored physician perceptions and recommendations involving e-cigarettes in the context of smoking cessation counselling, including their opinions about the implementation and content of patient educational materials that focus on e-cigarettes. METHODS: Semistructured interviews were conducted with 15 physicians from family medicine, internal medicine, and obstetrics/gynaecology (OB/GYN). RESULTS: Physicians did not routinely assess e-cigarette use among patients and reported that discussions were often initiated by patients. Only a minority of participants discussed e-cigarettes in conjunction with other best-practice recommendations for smoking cessation. Most others were more ambivalent about e-cigarette safety and effectiveness for cessation and did not address the topic, unless patients were already using e-cigarettes. Almost all, however, agreed that more research on e-cigarettes was needed. Physicians expressed an interest in having enhanced discussions about e-cigarettes with their patients and in using patient educational materials to accomplish this. Physicians recommended that these materials not actively promote e-cigarettes and be tailored to patients based on their demographics and motivation to quit. CONCLUSIONS: Physicians were open to improving their smoking cessation counselling and to integrating new patient educational materials that addressed e-cigarettes. Patient educational materials that provide tailored information about e-cigarettes could potentially be used initiate e-cigarette discussions and inform smokers about what is known vs unknown about e-cigarettes.

Movies promote tobacco use amongst adolescents: The need for policies to prevent this phenomenon.

Tobacco use is the primary preventable cause of death and disability in the world. To combat the tobacco epidemic, most countries have signed and ratified the World Health Organzation's Framework Convention on Tobacco Control (WHO FCTC). Article 13 of this treaty requires implementation of a comprehensive ban on tobacco advertising, promotion and sponsorship. Implementation guidelines for Article 13 recognize that the depiction of tobacco use in commercially-produced films promotes tobacco use amongst young people. In this article we review the relationship between the tobacco industry and the movie industry over the past 100 years; the cross sectional and longitudinal studies that demonstrate a causal relationship between exposure to movie smoking depictions and youth smoking initiation; and the policy interventions recommended by the WHO to limit youth exposure to tobacco in movies.

El consumo de Tabaco es la primera causa de mortalidad prevenible en el mundo. Para combatir esta epidemia, los países miembros de la Organización Mundial de la Salud han firmado, y la mayoría de ellos ratificado, el Convenio Marco para el Control del Tabaco. El articulo 13 de este tratado toda forma de publicidad, promoción y patrocinio del tabaco. Las guías para la implementación de este artículo reconocen que la presencia de tabaco en el cine es una forma de promoción de los productos del tabaco dirigida principalmente a los jóvenes.En esta revisión describimos la relación entre la industria del cine y la del tabaco en los últimos 100 año, los estudios de corte transveral y longitudinales que demiuestran como la exposición a tabaco en el cine induce a los jóvenes a iniciarse en el tabaquismo, y las políticas públicas recomendadas para evitar la presencia de tabaco en el cine, al menos en las películas para niños y adolescentes.

Sexual Scripts in Contemporary Mexican Cinema: A Quantitative Content Analysis.

While the literature on sexual scripts is substantive, with some scholarship examining the role of popular media in the production of dominant and divergent sexual practices and interactions, limited attention has been paid to the contemporary Mexican context. In this article, we share findings from a quantitative content analysis of popular Mexican films in order to explore how sexual behavior is portrayed and more specifically how relationship characteristics, condom use, and substance use interact with representations of sexual behavior. We find that more sexually explicit portrayals featured people engaged in heterosexual sexual interactions outside the context of marriage and also in age discordant relationships, where one partner was a minor. Few films featured safer sex practices or substance use in concert with sexual behavior. This research sheds light on how film as a powerful agent of socialization communicates sexual scripts in contemporary Mexican culture that may contribute to risky sexual behaviors among Mexican youth.

El cine induce a los adolescentes a consumir tabaco. es necesario implementar políticas públicas para contrarrestar este fenómeno / Cinema induces adolescents to consume tobacco. it is necessary to implement public policies to counteract this phenomenon

El consumo de tabaco es la primera causa de mortalidad prevenible en el mundo. Para combatir esta epidemia, los países miembros de la Organización Mundial de la Salud han firmado, y la mayoría de ellos ratificado, el Convenio Marco para el Control del Tabaco. El artículo 13 de este tratado regula toda forma de publicidad, promoción y patrocinio del tabaco. Las guías para la implementación de este artículo reconocen que la presencia de tabaco en el cine es una forma de promoción de los productos del tabaco dirigida principalmente a los jóvenes. En esta revisión describimos la relación entre la industria del cine y la del tabaco en los últimos 100 años, los estudios de corte transversal y longitudinales que demuestran cómo la exposición a tabaco en el cine induce a los jóvenes a iniciarse en el tabaquismo, y las políticas públicas recomendadas para evitar la presencia de tabaco en el cine, al menos en las películas para niños y adolescentes.

Tobacco use is the primary preventable cause of death and disability in the world. To combat the tobacco epidemic, most countries have signed and ratified the World Health Organzation’s Framework Convention on Tobacco Control (WHO FCTC). Article 13 of this treaty requires implementation of a comprehensive ban on tobacco advertising, promotion and sponsorship. Implementation guidelines for Article 13 recognize that the depiction of tobacco use in commercially-produced films promotes tobacco use amongst young people. In this article we review the relationship between the tobacco industry and the movie industry over the past 100 years; the cross sectional and longitudinal studies that demonstrate a causal relationship between exposure to movie smoking depictions and youth smoking initiation; and the policy interventions recommended by the WHO to limit youth exposure to tobacco in movies.

Time trends for tobacco and alcohol use in youth-rated films popular in Mexico and Argentina, from 2004-2012.

OBJECTIVE:: To examine and compare overall prevalence and time trends in tobacco and alcohol portrayals and brand appearances in youth-rated US and nationally-produced films that were the most successful in Argentina and Mexico from 2004-2012. MATERIALS AND METHODS:: Top-grossing nationally produced films from Argentina (n=73), Mexico (n=85) and the US (n=643) were content analyzed. Logistic regression was used to determine differences between Mexican, Argentine and US produced films. Linear regression models assessed significant cross-country differences in the mean number of tobacco and alcohol seconds. RESULTS:: Films from Mexico and Argentina were more likely than US films to contain tobacco, (OR=4.2; p<0.001) and (OR=7.2; p<0.001). Alcohol was present in 93% of Argentine, 83% in Mexican and 83% US films. CONCLUSIONS:: Smoking and alcohol were highly prevalent in nationally produced films. They may have a significant impact and should be targeted by policies to reduce youth exposure to portrayals of risk behaviors.

Factores de riesgo asociados al consumo de tabaco, alcohol y otras drogas en adolescentes escolarizados de tres ciudades de Argentina / Risk factors associated with tobacco, alcohol and drug use among adolescents attending secondary school in three cities from Argentina

El consumo de tabaco, alcohol y otras drogas comienza a temprana edad. Es importante identificar los factores de riesgo asociados al inicio. En 2014, se encuestaron estudiantes de primer año del secundario en Buenos Aires, Córdoba y Tucumán. Respondieron 3172 alumnos (42% de mujeres); edad media de 12,8 años. El 10% había fumado; el 32% había consumido alcohol; el 17% había tenido consumo excesivo durante el último mes, y 8% había consumido, al menos, una droga ilícita en su vida. El índice de búsqueda de emociones alto se asoció al consumo de tabaco (OR 4,25; IC 95%: 2,2-8,1), alcohol (OR 5,56; IC 95%: 3,73-8,31) y marihuana / paco / cocaína (OR 11,73; IC 95%: 5,81-23,69). Tener amigos que consumían tabaco / alcohol se asoció al consumo de tabaco (OR 12,6; IC 95%: 7,8-20,5) y alcohol (OR 5,17; IC 95%: 4,15-6,40). Tener padres que imponían pocas restricciones en el uso de medios se asoció al consumo de tabaco (OR 3,7; IC 95%: 2,1-6,5) y percibir un bajo control y soporte parental (OR 3,02; IC 95%: 1,40-6,52) se asoció al consumo de marihuana/paco/cocaína.

Tobacco, alcohol and drug use starts at an early age. It is important to identify risk factors associated with initiation. In 2014, a survey was conducted among students attending first year of secondary schools in Buenos Aires, Córdoba, and Tucumán. A total of 3172 students completed the survey (42% were girls); their mean age was 12.8 years old. Findings showed that 10% had smoked; 32% had consumed alcohol; 17% had a heavy drinking episode in the past month; and 8% had used at least one illegal drug once in their lifetime. A high sensation seeking index was associated with the use of tobacco (odds ratio [OR]: 4.25, 95% confidence interval [CI]: 2.2-8.1), alcohol (OR: 5.56, 95% CI: 3.73-8.31), and marijuana, coca paste or cocaine, (OR: 11.73, 95% CI: 5.81-23.69). Having friends who smoke or drink was associated with tobacco (OR: 12.6, 95% CI: 7.8-20.5) and alcohol use (OR: 5.17, 95% CI: 4.15-6.40). Having permissive parents in terms of media use was associated with tobacco use (OR: 3.7, 95% CI: 2.1-6.5), and perceiving a low parental support and control (OR: 3.02, 95% CI: 1.40-6.52) was associated with marijuana, coca paste and cocaine use

Risk factors associated with tobacco, alcohol and drug use among adolescents attending secondary school in three cities from Argentina. / Factores de riesgo asociados al consumo de tabaco, alcohol y otras drogas en adolescentes escolarizados de tres ciudades de Argentina.

Tobacco, alcohol and drug use starts at an early age. It is important to identify risk factors associated with initiation. In 2014, a survey was conducted among students attending first year of secondary schools in Buenos Aires, Córdoba, and Tucumán. A total of 3172 students completed the survey (42% were girls); their mean age was 12.8 years old. Findings showed that 10% had smoked; 32% had consumed alcohol; 17% had a heavy drinking episode in the past month; and 8% had used at least one illegal drug once in their lifetime. A high sensation seeking index was associated with the use of tobacco (odds ratio [OR]: 4.25, 95% confidence interval [CI]: 2.2-8.1), alcohol (OR: 5.56, 95% CI: 3.73-8.31), and marijuana, coca paste or cocaine, (OR: 11.73, 95% CI: 5.81-23.69). Having friends who smoke or drink was associated with tobacco (OR: 12.6, 95% CI: 7.8-20.5) and alcohol use (OR: 5.17, 95% CI: 4.15-6.40). Having permissive parents in terms of media use was associated with tobacco use (OR: 3.7, 95% CI: 2.1-6.5), and perceiving a low parental support and control (OR: 3.02, 95% CI: 1.40-6.52) was associated with marijuana, coca paste and cocaine use.

El consumo de tabaco, alcohol y otras drogas comienza a temprana edad. Es importante identificar los factores de riesgo asociados al inicio. En 2014, se encuestaron estudiantes de primer año del secundario en Buenos Aires, Córdoba y Tucumán. Respondieron 3172 alumnos (42% de mujeres); edad media de 12,8 años. El 10% había fumado; el 32% había consumido alcohol; el 17% había tenido consumo excesivo durante el último mes, y 8% había consumido, al menos, una droga ilícita en su vida. El índice de búsqueda de emociones alto se asoció al consumo de tabaco (OR 4,25; IC 95%: 2,2-8,1), alcohol (OR 5,56; IC 95%: 3,73-8,31) y marihuana/paco/cocaína (OR 11,73; IC 95%: 5,81-23,69). Tener amigos que consumían tabaco/alcohol se asoció al consumo de tabaco (OR 12,6; IC 95%: 7,8-20,5) y alcohol (OR 5,17; IC 95%: 4,15-6,40). Tener padres que imponían pocas restricciones en el uso de medios se asoció al consumo de tabaco (OR 3,7; IC 95%: 2,1-6,5) y percibir un bajo control y soporte parental (OR 3,02; IC 95%: 1,40-6,52) se asoció al consumo de marihuana/paco/cocaína.

Time trends for tobacco and alcohol use in youth-rated films popular in Mexico and Argentina, from 2004-2012 / Tendencias en el tiempo del uso de tabaco y alcohol en las películas para adolescentes más populares en México y Argentina: 2004 a 2012

Abstract: Objective: To examine and compare overall prevalence and time trends in tobacco and alcohol portrayals and brand appearances in youth-rated US and nationally-produced films that were the most successful in Argentina and Mexico from 2004-2012. Materials and methods: Top-grossing nationally produced films from Argentina (n=73), Mexico (n=85) and the US (n=643) were content analyzed. Logistic regression was used to determine differences between Mexican, Argentine and US produced films. Linear regression models assessed significant cross-country differences in the mean number of tobacco and alcohol seconds. Results: Films from Mexico and Argentina were more likely than US films to contain tobacco, (OR=4.2; p<0.001) and (OR=7.2; p<0.001). Alcohol was present in 93% of Argentine, 83% in Mexican and 83% US films. Conclusions: Smoking and alcohol were highly prevalent in nationally produced films. They may have a significant impact and should be targeted by policies to reduce youth exposure to portrayals of risk behaviors.

Resumen: Objetivo: Este estudio evalúa la representación en el tiempo de contenidos de tabaco y alcohol en las películas para adolescentes más populares en Argentina y México de 2004 a 2012. Material y métodos: Se analizaron las películas localmente más taquilleras producidas en Argentina (n=73), México (n=85) y EE.UU. (n=643). Se realizaron modelos de regresión logística para determinar diferencias entre películas mexicanas, argentinas y norteamericanas en variables dicotómicas, y de regresión lineal para evaluar las diferencias significativas entre países para variables continuas. Resultados: Las películas mexicanas y argentinas muestran mayor contenido de tabaco en comparación con las norteamericanas (OR=4.2; p<0.000) y (OR=7.2; p<0.000, respectivamente). El alcohol estuvo presente en 93% de películas argentinas, y en 83% tanto de las mexicanas como de las norteamericanas. Conclusión: Los resultados observados muestran tendencias que pueden tener un impacto significativo en la exposición de conductas de riesgo en jóvenes, y por ello son relevantes en la política pública.

Smoking in Movies and Adolescent Smoking Initiation: A Longitudinal Study among Argentinian Adolescents.

OBJECTIVE: To assess whether exposure to movie smoking is associated with cigarette smoking among Argentinian adolescents. STUDY DESIGN: A school-based longitudinal study involving 33 secondary schools in Argentina was performed. The sample included 2502 never smokers (average age at entry = 12.5 years), 1700 (67.9%) of whom completed follow-up surveys 17 months later. Exposure to the top 100 highest-grossing films for each year between 2009 and 2013 was assessed by content-coding films for tobacco and then by asking adolescents whether they had seen each of 50 titles, randomly selected from the larger pool, then parsing exposure into tertiles. Logistic regression models estimated aOR for the following transitions: nonsusceptible to susceptible never smoker, never smoker to ever smoker, and never smoker to current smoking (last 30 days). RESULTS: At follow-up, 34.4% of nonsusceptible never smokers became susceptible, 24.1% reported having tried smoking, and 9.4% were current smokers. Most exposure to movie smoking was from US-produced films (average 60.3 minutes compared with only 3.4 minutes from Argentine films). Greater exposure to smoking in movies was significantly associated with increased odds of becoming susceptible (aORfirst vs third tertile 1.77, 95% CI 1.30-2.41), of trying smoking (aORfirst vs third tertile 1.54, 1.14-2.08), and marginally associated with current smoking (AORfirst vs third tertile 1.54, 0.99-2.40). Exposure to smoking in US- or Argentine-produced films had similar associations. CONCLUSION: In Argentina, exposure to smoking in the movies predicted future smoking transitions among early adolescents, with most exposure coming from viewing US movies.

Parental Style and Its Association With Substance Use in Argentinean Youth.

BACKGROUND: In Europe and the United States, family relationships and parenting behavior can influence youth substance use, but less is known about their influence in Latin American countries. OBJECTIVE: To explore whether parenting behavior is associated with substance use among Latin American youth. METHODS: A cross-sectional, school-based survey of middle-school youth (n = 3172) in three Argentinian cities queried tobacco, alcohol, and drug use using items adapted from global youth surveys. Parenting behavior was assessed with previously validated items that tapped into demandingness and responsiveness, separately for mothers and fathers. Multilevel logistic regression models assessed associations between parenting behavior and substance use after adjusting for student characteristics, socioeconomic indicators, sensation seeking, and smoking amongst peers and family members. RESULTS: Substance use prevalence was 10% for current smoking, 32% for current drinking alcohol, 17% for past 30-day binge drinking (≥5 drinks), and 8% for previous year illicit drug use (marijuana or cocaine). Greater maternal demandingness was independently associated with lower likelihood of current smoking (adjusted odds ratio [AOR] = 0.77; 95% confidence interval (CI): 0.64-0.92), current drinking (AOR = 0.81; 95% CI: 0.71-0.92), binge drinking (AOR = 0.77; 95% CI: 0.66-0.99, and drug use (AOR = 0.71; 95% CI: 0.61-0.83). No other parenting behavior were independently associated with substance use, except for paternal demandingness and binge drinking (AOR = 0.84; 95% CI: 0.74-0.97). For all outcomes, no interactions were found between parenting behavior and student gender. CONCLUSIONS: Among Argentine adolescents, maternal demandingness was the strongest and most consistent correlate of substance use, regardless of adolescent substance use behavior or gender.

Evaluating the perceived effectiveness of pregnancy-related cigarette package health warning labels among different gender/age groups.

INTRODUCTION: The impact of pregnancy-related health warning labels (HWLs) appearing on cigarette packages on women of reproductive age and other socio-demographic groups is not well understood. The current study analyzes how different age/gender groups respond to pregnancy-related HWLs as compared to non-pregnancy HWLs. METHODS: Data were analyzed from four waves of an online longitudinal study with adult smokers aged 18-64 in Australia, Canada, Mexico, and the US. Participants were classified into four age\gender groups: women 40 and under; men 40 and under; women over 40; men over 40. Participants rated one pregnancy-related and several non-pregnancy related labels on worry, believability, and motivation to quit. Country-specific adjusted linear GEE were estimated regressing ratings for each of the three key outcomes for 1) pregnancy-related HWLs and 2) a rating difference score that subtracted the average ratings of the non-pregnancy warning from the rating of the pregnancy warning. All models adjusted for socio-demographics and smoking related variables. RESULTS: In Mexico and Australia, where graphic pregnancy-related HWL imagery is used (i.e., premature infant), women of reproductive age reported stronger believability, worry, and quit motivation than all other groups. Results were similar in the US, where text only HWLs are used. In contrast in Canada, where the pregnancy-related HWL imagery features a pregnant woman, ratings were unassociated with gender/age groups. Stronger effects among women of reproductive age were limited to pregnancy HWLs in each country, except Canada. CONCLUSIONS: HWLs that depict graphic effects to illustrate smoking-related pregnancy risks appear to be perceived as particularly effective among women of reproductive age.

Portrayals of character smoking and drinking in Argentine-, Mexican- and US-produced films.

The aim of this study was to assess film character portrayals of tobacco and alcohol use in US and nationally-produced films that were popular in Argentina and Mexico from 2004-2012. We performed a content analysis of these films (n=82 Argentine, 91 Mexican, and 908 US films, respectively). Chi-squares and t-tests were used to compare characteristics of characters who smoked or drank by country of movie production. Then data from all countries were pooled, and generalized estimating equation (GEE) models were used to determine independent correlates of character smoking or drinking. There were 480 major characters for Argentine-, 364 for Mexican-, and 4962 for US-produced films. Smoking prevalence among movie characters was similar to population smoking prevalence in Mexico (21%) and Argentina (26%), but about half in the US (11%), where movie product placements are restricted. Movie smoking declined over the period in all three countries. Movie alcohol prevalence was 40-50% across all countries and did not change with time. Demographic predictors of character smoking included: being male, 18 and older, having negative character valence. Movie smoking was not associated with lower SES. Predictors of character drinking included: being age 18 and older and positive character valence. Smoking and drinking predicted each other, illicit drug use, and higher scores for other risk behaviors. This suggests that policy development in Mexico and Argentina may be necessary to reduce the amount of character tobacco and alcohol use in films.

Recall, appeal and willingness to try cigarettes with flavour capsules: assessing the impact of a tobacco product innovation among early adolescents.

BACKGROUND: Use of flavour capsule varieties (FCVs) of cigarettes has rapidly increased in many countries. Adolescents are attracted to flavours; yet, surprisingly, no quantitative study has explored adolescents' perceptions of these products. OBJECTIVE: To characterise the appeal of FCVs for young adolescents in Mexico. METHODS: In 2015, surveys were conducted with a representative sample of Mexican middle school students (n=10 124; ages 11-16 years; mean 12.4 years). Students viewed and rated packs for FCVs and non-FCVs from major brands (Marlboro, Camel, Pall Mall), with brand names removed. For each pack, students were asked to write the brand name (ie, brand recall), to evaluate pack attractiveness, and to indicate the pack they were most interested in trying (including a 'none' option). Logistic generalised estimating equation (GEE) models regressed brand recall, pack attractiveness and interest in trying on brand and FCV (yes vs no), controlling for sociodemographics and smoking risk factors. RESULTS: Marlboro regular, Camel regular, Camel light and Pall Mall FCVs were most often recalled (25%, 17%, 9%, 8%). Packs for Pall Mall FCVs and Camel FCVs were most often rated as very attractive (13%, 9%, respectively) and of interest for trial (22%, 13%) along with Marlboro regular (14%). In GEE models, FCVs were independently associated with greater attractiveness (adjusted OR (AOR)=1.83, 95% CI 1.72 to 1.94) and interest in trying (AOR=1.74, 95% CI 1.54 to 1.96). Perceived pack attractiveness was also independently associated with greater interest in trying (AOR=5.63, 95% CI 4.74 to 6.68). CONCLUSIONS: FCVs appear to be generating even greater appeal among young adolescents than established non-FCVs in dominant brand families.