Mediation by coping style in the association between stressful life events and depressive symptoms in young adults.

PURPOSE: The association between stressful life events and depressive symptoms is well-established, but the role of coping style in this association is less clear. We examined whether problem-focused, emotion-focused or avoidant coping style mediated and/or moderated the association in young adults. METHODS: Data were drawn from a 20-year longitudinal study that included 1294 students' age 12-13 years recruited in 1999-2000 from ten high schools in Montreal, Canada. Herein we report an analysis that included 782 participants aged 24 years on average with data on covariates collected at age 20. Using VanderWeele's four-way decomposition approach, the total effect of stressful life events on depressive symptoms considering coping styles was decomposed into four components: moderation only, mediation only, mediated interaction, no mediation or moderation. RESULTS: We observed mediation only by emotion-focused coping ([Formula: see text](95%CI) = 0.15(0.04, 0.24)) suggestive that individuals who experienced more stressful life events also reported greater use of emotion-focused coping and higher levels of depressive symptoms. We found moderation only by problem-focused coping ([Formula: see text](95%CI) = - 1.51(- 2.40, - 0.53)) and by emotion-focused coping ([Formula: see text](95%CI) = 1.16(0.57, 1.69). These results suggest that individuals reporting more problem-focused coping experienced fewer depressive symptoms after exposure to stressful life events; those reporting more emotion-focused coping experienced more depressive symptoms. Avoidant coping did not mediate or moderate the association between stressful life events and depressive symptoms. CONCLUSION: Interventions that aim to reduce depressive symptoms in young adults who experience stressful life events may need to reinforce problem-focused coping and minimize emotion-focused coping strategies.

Do demographic and socioeconomic characteristics underpin differences in youth smoking initiation across Canadian provinces? Evidence from the Canadian Community Health Survey (2015-2018). / Les caractéristiques démographiques et socioéconomiques sous-tendent-elles les différences d'initiation à l'usage du tabac chez les jeunes entre les provinces canadiennes? Données probantes tirées de l'Enquête sur la santé dans les collectivités canadiennes (2015-2018).

INTRODUCTION: Youth initiation may drive differences in smoking prevalence across Canadian provinces. Provincial differences in initiation relate to tobacco control strategies and public health funding, but have also been attributed to population characteristics. We test this hypothesis by examining the extent to which seven characteristics-immigration, language, family structure, education, income, home ownership and at-school status-explain differences in initiation across provinces. METHODS: We used data from 16 897 youth aged 12 to 17 years in the Canadian Community Health Survey collected from 2015 to 2018. To examine the proportion of provincial differences explained by population characteristics, we compared average marginal effects (AMEs) from partially and fully adjusted models regressing "having ever initiated" on province and other characteristics. We also tested interactions to examine differences in the association between population characteristics and initiation across provinces. RESULTS: Initiation varied from 4% in British Columbia to 10% in Quebec. Being born in Canada, speaking French, not living in a two-parent household, being in the lowest household income quintile, having parents without postsecondary education, living in rented accommodation and not being in school were each associated with initiation. Taking these results into consideration, the AME of residing in another province compared with Quebec was attenuated by between 3% and 9%. Family structure and household income were more strongly associated with initiation in the Atlantic region and Manitoba, but not in Quebec. CONCLUSION: Differences in initiation between Quebec and other provinces are unlikely to be substantially explained by their demographic or socioeconomic composition. Reprioritizing tobacco control and public health funding are likely key in attaining the "tobacco endgame" across provinces.

Correlates of perceived success of health-promoting interventions in elementary school. / Corrélats du succès perçu des interventions de promotion de la santé dans les écoles primaires.

INTRODUCTION: School-based health-promoting interventions (HPIs) aim to support youth development and positively influence modifiable lifestyle behaviours. Identifying factors that contribute to or hinder the perceived success of HPIs could facilitate their adaptation, improve implementation and contribute to HPI sustainability. The objective of this study was to identify factors in three domains (school characteristics, characteristics of the HPI and factors related to planning and implementing the HPI) associated with perceived success of HPIs among school principals in elementary schools. METHODS: Data were drawn from Project PromeSS, a cross-sectional survey of school principals and/or nominated staff members in a convenience sample of 171 public elementary schools in Quebec, Canada. School board and school recruitment spanned three academic school years (2016-2019). Data on school and participant characteristics, HPI characteristics, variables related to HPI planning and implementation and perceived success of the HPI were collected in two-part, structured telephone interviews. Descriptive statistics were used to characterize schools and study participants. Twenty-eight potential correlates of perceived HPI success were investigated separately in multivariable linear regression modelling. RESULTS: Participants generally perceived HPIs as highly successful. After controlling for number of students, language of instruction, school neighbourhood and school deprivation, we identified five correlates of perceived success, including lower teacher turnover, higher scores for school physical environment, school/teacher commitment to student health, principal leadership and school being a developer (vs. adopter) of the HPI. CONCLUSION: If replicated, these factors should be considered by HPI developers and school personnel when planning and implementing HPIs in elementary schools.

Natural course of co-use of alcohol and cannabis in adolescents and young adults in Montréal, Canada.

OBJECTIVE: Little is known about changes in alcohol and cannabis co-use over time in adolescents and young adults. We sought to describe the natural course of alcohol and cannabis co-use from age 12 to 17 and 20 to 31 and to describe frequent (i.e., ≥ once/month) binge drinking (i.e., ≥ 5 drinks/occasion) and cannabis use from age 20 to 31. METHOD: Data were drawn from two longitudinal studies conducted in Montréal, Canada: AdoQuest (n = 1,852) and the Nicotine Dependence in Teens (NDIT) study (n = 1,293). Complete data on alcohol and cannabis were available for 620 12-17-year-olds (58% female) followed from 2005 to 2011 in AdoQuest, and 673 20-31-year-olds (56% female) followed from 2007 to 2020 in NDIT. We reported proportions of co-use, exclusive drinking ("drinking"), exclusive cannabis use ("cannabis use"), frequent co-use, frequent binge drinking, and frequent cannabis use by age and sex. RESULTS: Co-use rose from 2% at age 12-13 to 23% at age 17, was stable at 44% at age 20 and 24, and then decreased to 37% at age 31. Drinking rose from 20% to 51%, and cannabis use was consistently rare (< 2%). During young adulthood, frequent co-use declined from 21% at age 20 to 12% at age 31, and frequent binge drinking declined from 29% at age 20 to 22% at age 31. Frequent cannabis use increased from 6% at age 20 to 11% at age 31. CONCLUSIONS: Alcohol and cannabis use should be studied as time-varying behaviors. Co-use patterns should be monitored over time in this population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Stable physical activity patterns predominate in a longitudinal study of physical activity among young adults in Canada from before to during the COVID-19 pandemic.

We examined change in walking, moderate-to-vigorous physical activity (MVPA) and meeting MVPA guidelines from before to during the COVID-19 pandemic, and identified factors associated with newly meeting and no longer meeting MVPA guidelines during the pandemic. Complete data were available for 614 young adults participating in the ongoing Nicotine Dependence in Teens (NDIT) study pre-pandemically in 2010-12 and 2017-20, and during the pandemic in 2020-21. Change in physical activity was examined in four sub-groups (i.e., stable inactive, newly met MVPA guidelines, no longer met MVPA guidelines, stable active). Factors associated with newly and no longer met MVPA guidelines were identified in multivariable logistic regression. While walking and MVPA changed little from 2010-2 to 2017-20, both declined during the pandemic (median for both = -30 min/week). 63.3% of participants reported no change in meeting MVPA guidelines during the pandemic, 11.4% newly met MVPA guidelines and 25.2% no longer met MVPA guidelines. Male sex, not university-educated, amotivated to engage in physical activity reported pre-pandemic, and endorsing physical activity as a COVID-19 coping strategy were associated with newly met MVPA guidelines. Male sex, not university-educated, higher problem-focused coping scores and endorsing physical activity as a COVID-19 coping strategy were protective of no longer met MVPA guidelines. Increased understanding of why some participants increased or decreased MVPA during the pandemic is needed to inform physical activity-related policy during pandemics.

Symptoms of depression and anxiety increased marginally from before to during the COVID-19 pandemic among young adults in Canada.

We documented changes in depressive and anxiety symptoms from before to during the COVID-19 pandemic among young adults and investigated whether changes differed across participant characteristics. Data were available in an investigation of 1294 grade 7 students recruited in 1999-2000. For this analysis, we used data collected pre-pandemically in 2017-20 (mean (SD) age = 30.6 (1.0)) and during the pandemic in 2020-21 (mean (SD) age = 33.6 (0.6)). 673 participants with data in both cycles were retained for analysis. Symptoms were measured using the Major Depression Inventory (MDI) and the Generalized Anxiety Disorder-7 (GAD-7) scale. Standardized mean differences (SMD) of changes in MDI and GAD-7 values between cycles were calculated across participant characteristics. On average, MDI scores increased by 2.1 (95%CI 1.4, 2.8) points during the pandemic from mean 10.5; GAD-7 scores increased by 1.2 (0.8, 1.5) points from mean 4.7. The SMD was 0.24 (0.14, 0.33) for MDI, and 0.24 (0.13, 0.34) for GAD-7. No differences in MDI change scores were observed across participant characteristics. Differences in GAD-7 change scores were observed by mood/anxiety disorder (SMD - 0.31 (- 0.58, - 0.05)), household income (0.24 (0.02, 48)), living with young children (- 0.56 (- 1.23,- 0.05)), and adherence to public health recommendations 0.58 (0.19, 1.03)). Increases in depressive and anxiety symptoms were observed 10-16 months into the COVID-19 pandemic among adults age 32-36.

Associations of Quantity Smoked and Socioeconomic Status With Smoke-Free Homes and Cars Among Daily Smokers.

INTRODUCTION: An association between socioeconomic status (SES) and smoke-free private spaces among smokers could be due to heavier smoking among low SES smokers. We assessed whether quantity smoked or SES are independently associated with smoke-free homes or cars in daily smokers. METHOD: Data were drawn from a cross-sectional telephone survey (2011-2012) of 750 daily smokers age ≥18 years in Quebec, Canada (45% response). Multivariable logistic regression was used to model the independent association between (a) number of cigarettes smoked per day, and (b) each of educational attainment, annual household income, or active employment status and smoke-free homes or cars. RESULTS: Participants were 41.0 years old on average, 57% were female. Median (IQR) number of cigarettes smoked per day was 14 (10, 20). Forty-eight percent of participants reported smoke-free homes; 34% reported smoke-free cars. Quantity smoked was strongly associated with both smoke-free homes and cars. Income and education (but not actively employed) were associated with smoke-free homes. None of the SES indicators were associated with smoke-free cars. CONCLUSIONS: Interventions targeting smokers to promote smoke-free homes and cars should incorporate components to help smokers reduce quantity smoked or preferably, to quit. Interventions targeting smoke-free homes will also need to address SES inequalities by education and income. Our data suggest that reduction in quantity smoked may help smokers reduce SHS exposure in cars, but that an inequality lens may not be relevant.

A longitudinal study of change in substance use from before to during the COVID-19 pandemic in young adults.

Introduction: We assessed change in substance use from before to during the COVID-19 pandemic in young adults and identified factors associated with initiation/increase in use. Methods: The sample comprised young adults from a longitudinal investigation of 1294 youth recruited at ages 12-13 (1999-2000) in 10 Montréal-area high schools. Pre-pandemic data on use of cannabis, alcohol, combustible cigarette, e-cigarette and binge drinking were collected at ages 20.4, 24.0 and 30.6. During COVID-19, data were collected from December 2020 to June 2021 (age 33.6). We studied the prevalence of any and weekly/daily use from age 20.4 to 33.6. Individual-level change in substance use during the pandemic was estimated as differences in the frequency of use from age 30.6 to 33.6 versus from age 24.0 to 30.6. Heterogeneity in the risk of initiated/increased substance use during COVID-19 across sociodemographic subgroups was assessed using modified Poisson regression. Results: The prevalence of cannabis use increased from 17.5% to 23.1% from before to during the pandemic; e-cigarette use increased from 3.8% to 5.4%. In individual change analyses, the proportion of participants whose substance use did not change ranged from 48.9% (alcohol) to 84.0% (e-cigarettes). The incidence of initiated/increased cannabis use (22.4%), and quit/decreased alcohol (35.2%) and binge drinking (53.5%) were higher during the pandemic than between ages 24.0 to 30.6. Low education and living alone were associated with higher risks of initiated/increased use of most substances. Discussion: Most participants reported stable patterns in substance use from before to during the COVID-19 pandemic. Funding: The NDIT study was supported by the Canadian Cancer Society (grant numbers 010271, 017435, 704031) and the Canadian Institutes of Health Research (grant number 451832).

Initiation or cessation: what keeps the prevalence of smoking higher in Quebec than in the rest of Canada? / Initiation à l'usage du tabac ou arrêt du tabac : comment expliquer une prévalence supérieure du tabagisme au Québec en comparaison du reste du Canada?

INTRODUCTION: We compared smoking initiation and cessation in Quebec versus the rest of Canada as possible underpinnings of the continued higher cigarette smoking prevalence in Quebec. METHODS: Data were drawn from the Canadian Community Health Survey (CCHS). We compared average and sex-stratified prevalence estimates of (1) current cigarette smoking in persons aged 15 years and older; (2) past-year initiation of cigarette smoking in those aged 12 to 17 and 18 to 24 years; and (3) past-year cessation in adults aged 25 years and older in Quebec versus the other nine Canadian provinces in each two-year CCHS cycle from 2007/08 to 2017/18. RESULTS: The prevalence of current smoking decreased from 25% to 18% among adults aged 15 years and older in Quebec from 2007/08 to 2017/18, and from 22% to 16% in the rest of Canada. Initiation among those aged 12 to 17 years decreased from 9% to 5% in Quebec, and from 7% to 3% in the rest of Canada. Neither initiation among people aged 18 to 24 (at 6% and 7%, respectively) nor cessation among adults aged 25 and older (approximately 8%) changed over time in Quebec or in the rest of Canada. In each two-year CCHS cycle, past-year initiation among those 12 to 17 years of age was consistently higher in Quebec than in the rest of Canada, but there were no substantial or sustained differences in initiation among people aged 18 to 24 or in past-year cessation. Findings were similar when stratified by sex. CONCLUSION: Higher levels of smoking initiation among youth aged 12 to 17 years could be a proximal underpinning of the continuing higher prevalence of smoking in Quebec versus the rest of Canada.