Consequences of youth tobacco use: a review of prospective behavioural studies

Background Cigarette smoking represents a significant health problem and tobacco has been identified as causing more preventable diseases and premature deaths than any other drug. Although health consequences from smoking have been documented, there has been a surprising lack of research into behavioural consequences.

Aims To review what is known of the long-term relationship between patterns of tobacco use prior to age 18 years and behavioural consequences in adulthood.

Method A literature search of electronic abstraction services from 1980 to September 2005 was conducted. To be included in the review, studies had to have large, representative samples, be longitudinal studies with baseline age under 18 years and follow-up age 18 years or older and clarify effects due to attrition, leaving 16 articles that met the inclusion criteria. Two reviewers evaluated each paper.

Findings Adolescent tobacco use predicts a range of early adult social and health problems. Surprisingly few studies met the inclusion criteria. The limited evidence available suggests that adolescent tobacco smoking increases the likelihood of early adult tobacco use and the initiation of alcohol use or the development of alcohol-related problems. The link between adolescent tobacco use and subsequent cannabis use was not resolved convincingly from the studies summarized. The effects of tobacco use on later illicit drug use tended to fall away when adjusting for underlying risk factors. Existing studies of the effects of tobacco use on later mental health have many limitations. Nevertheless, a finding that youth tobacco use may predict subsequent mental health problems deserves further investigation. The possible effects of tobacco use on academic/social problems and sleep problems also warrant further investigation.

Conclusion This review highlights links between youth tobacco use and subsequent behavioural and mental health problems. It provides health care professionals with evidence of the possible harmful effects of youth tobacco smoking on later social, emotional, and behavioural well-being.

A review of school drug policies and their impact on youth substance use

Youth substance use is an important social and health problem in the United States, Australia and other Western nations. Schools are recognized as important sites for prevention efforts and school substance use policies are a key component of health promotion in schools. The first part of this paper reviews the known status of school policies on tobacco, alcohol and other illicit drugs in a number of Western countries and the existing evidence for the effectiveness of school drug policy in preventing drug use. The review shows that most schools in developed countries have substance use policies but that there is substantial variation in the comprehensiveness of these policies (i.e. the breadth of people, places and times of day that are explicitly subject to policy prohibitions), and the orientation of their enforcement (e.g. punitive versus remedial), both across and within schools. The few studies of policy impact focus solely on tobacco policy and provide preliminary evidence that more comprehensive and strictly enforced school policies are associated with less smoking. The second part of the paper introduces the International Youth Development Study, a new longitudinal research project aimed at comparing school policies and the developmental course of youth drug use in the United States, where drug policies are abstinence-based, with Australia, which has adopted a harm minimization approach to drug policy

Regional and urban Victorian diabetic youth: clinical and quality-of-life outcomes

Objectives: To compare groups of urban and regional Victorian diabetic children and assess their quality of life, diabetes knowledge, access to services and metabolic control.

Methods: Forty-seven children from three regional Victorian communities (Horsham, Warrnambool and Sale; n = 16, 18 and 13, respectively) were compared with 120 age-, sex- and duration of diabetes-matched children attending the Royal Children's Hospital (RCH) diabetes clinic in Melbourne. Quality of life, diabetes knowledge, use of services, and metabolic control were assessed using the child health questionnaire (CHQ PF-50/CF-80); a diabetes-knowledge questionnaire; access to a diabetes nurse educator (DNE), dietitian and complication screening; and indices of mean HbA1C (values are taken every 3 months in the 'yearly HbA1C'), respectively.

Results: Comparisons of CHQ data showed that regional diabetic youth scored significantly lower on most subscales. The greatest deficits were seen in areas of mental health, self-esteem, parent impact (emotional) and family cohesion. Diabetes knowledge and median yearly HbA1C for patients were not significantly different between the regional and urban centres (8.1%, 8.9%, 8.4% and 8.6% at RCH, Horsham, Warrnambool and Sale, respectively). Patients in regional centres had reportedly less access to team-based diabetes care.

Conclusions: Regional youth in Victoria, with similar levels of metabolic control and diabetes knowledge as their urban counterparts, have a markedly lower quality of life, implying a negative synergy between diabetes and the demands of regional lifestyles.

Longitudinal surveys of Australian youth : active citizenship and the secondary school experience : community participation rates of Australian youth

LSAY is a research program that follows young Australians as they move through secondary school, into further education or training, and into the labour market and adult life. This website provides access to the electronic full text versions of LSAY research reports, from 1996 to present.

Youth and sexualities : pleasure, subversion and insubordination in and out of schools

These cutting-edge international essays challenge dominant narratives of queer youth predicated on oppression and victimization. As school systems address the emergence of Gay-Straight Alliances and calls to provide equal educational access, researchers, educators and youth workers are paying increasing attention to sexuality, gender and schooling. Yet present discourses are limited to liberal understandings of tolerance, safety, and equity that are defined by a separation of "queer" and "normal." This text documents and offers radical interpretations of the creativity of queer youth in challenging existing practices. Interdisciplinary analyses offer multiple vantage points for reconceptualizing adolescent sexual subjectivities and institutional and cultural practices.

Occupying the crease: an exploration of youth cricket in New Zealand

Recruiting and retaining participants is a challenge that most sport administrators face. The present study examined motives for participation/discontinuation in cricket, propensity to play in the future, and the influence that various initiatives had on youths' propensities to play. A nationwide survey of 858 young New Zealand cricketers revealed six underlying motives for participating in cricket: team, competition, mastery, extrinsic rewards, fitness and being active, with the first three of these being the strongest predictors of propensity to play. Together the six motives explained 17% of the variance in propensity to play. None of the initiatives tested increased the likelihood of playing cricket for those who were currently involved. For those who had stopped playing, their reasons for ceasing were most likely to be the lure of other sports or activities. Nonetheless, initiatives that increased their chances of participating in cricket again were playing in a social competition, having better equipment, having less costly equipment, and being provided with the opportunity to meet top players. These findings have important implications for cricket administrators in terms of the management and promotion of youth cricket in New Zealand.