Direct healthcare costs and their relationships with age at start of drug use and current pattern of use: a cross-sectional study

ABSTRACT BACKGROUND: It is well known that early start of drug use can lead users to psychosocial problems in adulthood, but its relationship with users' direct healthcare costs has not been well established OBJECTIVES: To estimate the direct healthcare costs of drug dependency treated at a community mental health service, and to ascertain whether early start of drug use and current drug use pattern may exert influences on these costs. DESIGN AND SETTING: Retrospective cross-sectional study conducted at a community mental health service in a municipality in the state of São Paulo, Brazil. METHODS: The relationships between direct healthcare costs from the perspective of the public healthcare system, age at start of drug use and drug use pattern were investigated in a sample of 105 individuals. A gamma-distribution generalized linear model was used to identify the cost drivers of direct costs. RESULTS: The mean monthly direct healthcare costs per capita for early-start drug users in 2020 were 1,181.31 Brazilian reais (BRL) (274.72 United State dollars (USD) according to purchasing power parity (PPP)) and 1,355.78 BRL (315.29 USD PPP) for late-start users. Early start of drug use predicted greater severity of cannabis use and use of multiple drugs. The highest direct costs were due to drug dependence combined with alcohol abuse, and due to late start of drug use. CONCLUSIONS: Preventive measures should be prioritized in public policies, in terms of strengthening protective factors before an early start of drug use.

Tobacco and betel nut use among school going adolescents of South Gujarat region, India: a cross sectional study

Background: Adolescence period is very crucial in the life of an individual, when major physical, psychological and behavioral changes take place. Tobacco and Areca nut use among school going adolescent is becoming a major public health problem. Objective of this study was to determine the prevalence and pattern of smokeless tobacco and betel nut use among school going adolescents.Methods: The study was a cross sectional study. After taking the permission of principal of Government high schools of Vadodara and Surat city of Gujarat and consent of the parents of adolescents, 1107 adolescents were interviewed during March-April 2017. A self-administered questionnaire was used for data collection. Thus collected data was analyzed using SPSS 17 (Trial Version).Results: Age of the study students (total 1107) ranged from 10-19 years. (Mean age=14.61'2.85 years). Out of 1107 children 389 (35.1%) children had addiction. Prevalence of any type of addiction in girls and boys was 14.3% and 20.7% respectively. Tobacco prevalence was 13.4% and betel nut prevalence was 21.6%. Type of addiction and its association with gender was highly significant. All children addicted to tobacco using chewing form (gutkha) of tobacco. The mean age group of children who consume tobacco and betel nut was 16.13'1.32 years and 16.01'1.21 years respectively. Most common reasons among adolescents for starting addiction of tobacco and betel nut was to look mature (93.8%) followed by to look good (63.2%) and to refresh breathe (48.6%).Conclusions: High prevalence of tobacco and betel nut use among adolescents needs attention of parents, teachers and health officials.

Tobacco and areca nut use among children of primary and secondary boarding schools of Gandhinagar district: a cross sectional study.

Tobacco and Areca nut use among school children is becoming a serious problem in developing countries. Objectives of current study were to determine the prevalence and pattern of smokeless tobacco and areca nut use among residential school children and to know the reason behind sending them in boarding school. Methods: The study was a cross sectional study. After taking the permission of principal of resident schools and consent of the parents of children, 867 children from 8 boarding schools were interviewed during February-March 2011. A self-administered questionnaire was used for data collection. Results: Age of the study children (total 867) ranged from 5-19 years. (Mean age = 13.80 ± 1.96 years). Out of 867, 434 (49.9%) were boys and 433 (50.1%) were girls. Out of 867 children 311 (35.9%) children [Females: 99 (22.8%); Males: 212 (48.8%)] had addiction. Prevalence of any type of addiction in girls and boys was 22.8% and 48.8% respectively. Tobacco prevalence was 18.6% and areca nut prevalence was 17.3%. Out of 212 male children who had addiction majority of children {149 (70.3%)} consume tobacco in the form of gutkha and out of 149, 127 (85.2%) male children consume tobacco since 1 to 3 years and 22 (14.8%) children since 4 to 9 years. Among the tobacco users, the mean age at the start of any tobacco use was 12.8 years with an SD of 1.1 years. Out of 99 female children who had addiction majority of children {87 (87.9%)} consume areca nut and out of 87, 74 (85.1%) female children consume areca nut since 1 to 3 years and 13 (14.9%) children since 4 to 9 years. The mean age group of children who consume tobacco and areca nut was 14.34 ± 1.83 years and 14.03 ± 1.41 years. 63.6% children were in residential school were due to economical reason. Conclusion: High prevalence of tobacco and betel nut in children indicate that more emphasis should be given to increase their awareness regarding hazards of these substances through health education campaign with active involvement of teachers and parents.

Age at initiation & prevalence of tobacco use among school children in Noida, India: A cross-sectional questionnaire based survey.

Background & objectives: Tobacco use among school children is becoming a serious problem in developing countries. The early age of initiation underscores the urgent need to intervene and protect this vulnerable group from falling prey to this addiction. The present study was thus undertaken to assess the prevalence of tobacco habits among school children, determine the age of initiation of these habits, and compare the age of initiation between students who were more than 15 and ≤ 15 yr of age. Methods: Data on tobacco use were collected from 4786 students of class 7 to 12 (age: 11-19 yr) studying in different private and government schools of Noida city during July- December 2005, through cluster and random sampling using a self-administered questionnaire. Results: Any kind of tobacco use was found in 537 (11.2%) students; 419 (8.8%) were ‘ever smokers (including current smokers)’ 219 (4.6%) were ‘ever tobacco chewers (including current chewers)’, 179 (3.7%) were ‘exclusive smokers’ and 118 (2.5%) were ‘exclusive tobacco chewers’. The mean age of initiation of these habits was around 12.4 yr. More than 50 per cent of tobacco chewers reported use of khaini at least once. Nearly 70 per cent of boys and 80 per cent of girls ≤ 15 yr initiated the habit of tobacco before the age of 11 yr. A significant early uptake of tobacco chewing was reported from private school students as compared to government school students (P<0.05). Interpretation & conclusions: Tobacco addiction is emerging as a big threat among children. Our findings indicate a recent downward shift in the age at initiation of tobacco uptake and rising prevalence among girls. Such data need to be collected from different parts of the country to develop anti-tobacco campaigns and take policy decision.

Smokeless tobacco consumption among school children.

Background : More than one-third of the tobacco consumed regionally is of smokeless form. Aims : To determine the prevalence and pattern of smokeless tobacco use among school children. Settings and Design : This cross-sectional study was conducted among children in 5 randomly selected high schools in Kannur district, Kerala, India. Materials and Methods : This cross-sectional study was conducted among 1200 children. A self-administered questionnaire was used for data collection. Statistical Analysis : PASW 17 software was used for data analysis. Results : The mean age of the students was 14.4 years with a standard deviation (SD) of 1.2 years, and 8.5% (CI, 7.1-10.2) of the participants were tobacco users. Smokeless tobacco was used by 2% (CI, 1.2-3.4) of the participants. None of the female students used tobacco products. Among the tobacco users, the mean age at the start of any tobacco use was 12.8 years with an SD of 1.1 years. The minimum age was 12 years and the maximum was 14 years. More than 50% smokeless tobacco users started their habit at the age of 12 years; 38.5% of them started at the age of 13 years and remaining at the age of 14 years. The 84.6% smokeless tobacco users were using it 2-3 times a week and 39% of them revealed that the tobacco products were purchased from shops located near the schools. Among the users, one used to keep the quid in the mouth for more than half an hour. Conclusion : The study concludes that there is a need to educate the children regarding the hazards associated with tobacco consumption.