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      Combined Associations of Smoking and Bullying Victimization With Binge Drinking Among Adolescents in Beijing, China

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          Abstract

          Background: Binge drinking and smoking among adolescents are serious public concerns. However, very few studies have explored the reinforcement of bullying victimization by such behavior. Our study aimed at examining the individual and combined associations of smoking and bullying victimization with binge drinking among adolescents in Beijing, China.

          Methods: A total of 33,694 students aged 13–17 years old in Beijing, China were anonymously investigated via the cross-sectional Chinese Youth Risk Behavior Surveillance Survey from April to May 2014. A three-stage stratified sampling was used to select participants. Factors such as sociodemographic variables and indicators of smoking, bullying victimization, and binge drinking were analyzed with multiple logistic regressions, and joint and additive interaction effects were tested.

          Results: Overall, ever-drinking prevalence was 59.1% (boys: 64.4%; girls: 53.7%). Past 30-day binge drinking was 11.5% (boys: 15.6%; girls: 7.4%) and frequent binge drinking was 2.3% (boys: 3.3%; girls: 1.0%). Past 30-day smoking was 10.7% (boys: 16.4%; girls: 5.0%) and past 30-day bullying victimization was 48.7% (boys: 57.3%; girls: 40.1%). The combined effects of smoking and bullying victimization on occasional binge drinking (OR = 6.49, 95% CI = 5.60–7.52) and frequent binge drinking (OR = 10.32, 95% CI = 7.52–14.14) were significant, and the additive interaction effect was significant for current smoking and bullying victimization on frequent binge drinking (OR = 10.22, 95% CI = 9.43–11.07). The additive interaction effect for current smoking and bullying victimization on frequent binge drinking was significant among boys.

          Conclusion: Bullying victimization reinforced the association of smoking with frequent binge drinking, especially with findings specific to boys. Programs to prevent smoking or bullying or both may reduce binge drinking among adolescents in China.

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          Most cited references51

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          Bullying at school--an indicator of adolescents at risk for mental disorders.

          A number of 14-16 year old Finnish adolescents taking part in the School Health Promotion Study (n=8787 in 1995, n=17643 in 1997) were surveyed about bullying and victimization in relation to psychosomatic symptoms, depression, anxiety, eating disorders and substance use. A total of 9 per cent of girls and 17 per cent of boys were involved in bullying on a weekly basis. Anxiety, depression and psychosomatic symptoms were most frequent among bully-victims and equally common among bullies and victims. Frequent excessive drinking and use of any other substance were most common among bullies and thereafter among bully-victims. Among girls, eating disorders were associated with involvement in bullying in any role, among boys with being bully-victims. Bullying should be seen as an indicator of risk of various mental disorders in adolescence. Copyright 2000 The Association for Professionals in Services for Adolescents.
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            Estimating measures of interaction on an additive scale for preventive exposures

            Measures of interaction on an additive scale (relative excess risk due to interaction [RERI], attributable proportion [AP], synergy index [S]), were developed for risk factors rather than preventive factors. It has been suggested that preventive factors should be recoded to risk factors before calculating these measures. We aimed to show that these measures are problematic with preventive factors prior to recoding, and to clarify the recoding method to be used to circumvent these problems. Recoding of preventive factors should be done such that the stratum with the lowest risk becomes the reference category when both factors are considered jointly (rather than one at a time). We used data from a case-control study on the interaction between ACE inhibitors and the ACE gene on incident diabetes. Use of ACE inhibitors was a preventive factor and DD ACE genotype was a risk factor. Before recoding, the RERI, AP and S showed inconsistent results (RERI = 0.26 [95%CI: −0.30; 0.82], AP = 0.30 [95%CI: −0.28; 0.88], S = 0.35 [95%CI: 0.02; 7.38]), with the first two measures suggesting positive interaction and the third negative interaction. After recoding the use of ACE inhibitors, they showed consistent results (RERI = −0.37 [95%CI: −1.23; 0.49], AP = −0.29 [95%CI: −0.98; 0.40], S = 0.43 [95%CI: 0.07; 2.60]), all indicating negative interaction. Preventive factors should not be used to calculate measures of interaction on an additive scale without recoding.
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              Methodology of the Youth Risk Behavior Surveillance System--2013.

              Priority health-risk behaviors (i.e., interrelated and preventable behaviors that contribute to the leading causes of morbidity and mortality among youths and adults) often are established during childhood and adolescence and extend into adulthood. The Youth Risk Behavior Surveillance System (YRBSS), established in 1991, monitors six categories of priority health-risk behaviors among youths and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) sexual behaviors that contribute to human immunodeficiency virus (HIV) infection, other sexually transmitted diseases, and unintended pregnancy; 3) tobacco use; 4) alcohol and other drug use; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma among this population. YRBSS data are obtained from multiple sources including a national school-based survey conducted by CDC as well as schoolbased state, territorial, tribal, and large urban school district surveys conducted by education and health agencies. These surveys have been conducted biennially since 1991 and include representative samples of students in grades 9-12. In 2004, a description of the YRBSS methodology was published (CDC. Methodology of the Youth Risk Behavior Surveillance System. MMWR 2004;53 [No RR-12]). Since 2004, improvements have been made to YRBSS, including increases in coverage and expanded technical assistance.This report describes these changes and updates earlier descriptions of the system, including questionnaire content; operational procedures; sampling, weighting, and response rates; data-collection protocols; data-processing procedures; reports and publications; and data quality. This report also includes results of methods studies that systematically examined how different survey procedures affect prevalence estimates. YRBSS continues to evolve to meet the needs of CDC and other data users through the ongoing revision of the questionnaire, the addition of new populations, and the development of innovative methods for data collection.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                16 September 2021
                2021
                : 12
                Affiliations
                [1] 1School of Public Health, Institute of Child and Adolescent Health, Peking University , Beijing, China
                [2] 2Beijing Center for Disease Prevention and Control , Beijing, China
                [3] 3Department of Sport, Physical Education and Health, Hong Kong Baptist University , Hong Kong, SAR China
                [4] 4Laboratory of Exercise Science and Health, BNU-HKBU United International College , Zhuhai, China
                [5] 5Department of Medicine, Stanford Prevention Research Center, Stanford University , Stanford, CA, United States
                Author notes

                Edited by: Idan Menashe, Ben-Gurion University of the Negev, Israel

                Reviewed by: Utkarsh Karki, Kanti Children's Hospital, Nepal; Ziqiang Han, Shandong University, China

                *Correspondence: Yi Song songyi@ 123456bjmu.edu.cn

                This article was submitted to Child and Adolescent Psychiatry, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2021.698562
                8481949
                5d904ea5-b75a-42bc-b4a4-704fa13ee9b0
                Copyright © 2021 Chen, Lu, Duan, Ma, Zhu, Song, Lau and Prochaska.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 2, Tables: 5, Equations: 0, References: 53, Pages: 13, Words: 8427
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                individual associations,combined associations,binge drinking,smoking,bullying victimization,adolescents

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