Is the Australian smoking population hardening?

BACKGROUND: The hardening hypothesis proposes that as smoking rates decline, the remaining smokers will become hardcore and resistant to quitting. This group of highly resistant quitters will potentially require more individualistic approaches to cessation and harm reduction. The harm reduction approach (specifically e-cigarettes) has been proposed as an option to address hardened Australian smokers. We tested the hardening hypothesis by analysing the rates of hardcore smoking in the Australian smoking population between 2010 and 2016. METHODS: Data were drawn from three waves of the National Drug Strategy Household Survey (NDSHS) in 2010, 2013 and 2016. Two different definitions were used to assess hardcore smoking to arrive at an upper and lower rate. Logistic regression models assessed hardcore smoker characteristics for both definitions of hardcore smoking. RESULTS: The most inclusive definition of hardcore smoking (i.e., a smoker with no plan to quit) showed a significant decline in hardcore smoking between 2010 and 2016 (5.49%-4.85%) In contrast, the prevalence of hardcore smoking using the most stringent definition (i.e., a current daily smoker of at least 15 cigarettes per day, aged 26 years or over, with no intention to quit, a lifetime consumption of at least 100 cigarettes, and no quit attempt in the past 12 months) did not change significantly between 2010 and 2016. CONCLUSION: The observed trends in the prevalence of hardcore smokers (i.e., either stable or declining depending on the definition) suggest that the Australian smoking population is not hardening. These results do not support claims that remaining smokers are becoming hardcore.

Complex Trauma and Ecological Vulnerability: Development of a Resources Perspective Framework to Inform Longitudinal Examination.

Translation and application of current complex trauma knowledge for high-risk groups such as the homeless is needed. Existing research in this area has been limited by lack of a cohesive theoretical framework that captures the dynamic and heterogeneous nature of complex trauma within the context of ecological vulnerability (e.g. homelessness). This paper aims to address these gaps by proposing an integrated resources perspective framework situating Layne and colleagues' (Layne et al. 2009, 2010) concept of 'risk factor caravans' as central focus. We demonstrate how the 'risk factor caravan' representation captures current theoretical and clinical insights into the pervasive and enduring consequences of complex trauma exposure. Personal resources are highlighted as key for understanding resource loss and gain in the current context. Longitudinal person-centered approaches as integral methodological considerations for future application of this proposed framework are examined. Implications for reducing barriers to access of available support services are discussed.

Tobacco harm reduction: are smokers becoming more hardcore?

We undertook a systematic review to identify and summarise studies on hardcore smoking and hardening to: determine the degree of variability in definitions of hardcore smoking and hardening; assess the evidence for claims that smokers are becoming increasingly hardened within the context of harm reduction as a policy initiative; and identify the determining characteristics of a hardcore smoker. We searched five electronic databases from 1970 to mid-April 2018 using the search term "smok* AND hard* AND (tobacco OR cigar* OR nicotin*)". We included studies if they included a definition of hardcore smokers and/or hardening, and provided a prevalence rate for hard core smokers or empirical evidence for hardening. Definitions of hardcore smoker varied substantially across studies. Hardening was not evident in the general smoking population and we found mounting evidence of softening occurring in smoking populations. These results indicate that hardening of smokers is not occurring and that calls for policy interventions on this basis should be challenged.

Sleep Timing During Adolescence: A Latent Transition Analysis Approach.

Objective/Background: This paper utilized a person-centered approach to examine individual differences in sleep timing cross-sectionally and prospectively in adolescents. Participants: Data from Waves 5 and 6 of the Longitudinal Study of Australian Children were used. At Wave 5, the sample included 3,552 Australian adolescents aged 12-13 years (51% males, 49% females); 84% provided data at two-year follow-up (Wave 6). Methods: Through structured interviews, adolescents provided information on sleep timing (bedtimes, sleep-onset times, and wake times) on weekends and weekdays, and relevant covariates. Latent profile analysis identified sleep profiles at Waves 5 and 6 separately; latent transition analysis examined stability and change in profiles across time. Results: Six sleep timing profiles were identified at age 12-13 years: Early Larks (n = 228; 6.4%); Larks (n = 1257; 35.4%); Intermediate (n = 1311; 36.9%); Owls (n = 351; 9.9%); Variable Owls (n = 308; 8.7%); and, Late Owls (n = 97; 2.7%). Six similar profiles were identified at age 14-15 years. The latent transition analysis indicated that the Early Larks, Larks, and Intermediate profiles were more stable over time compared with the Owls, Variable Owls, and Late Owls profiles. Higher body mass index (BMI) and longer screen time predicted transitions from Larks and Early Larks to the Owls, Variable Owls, and Late Owls profiles. Conclusions: Many adolescents showed healthy sleep timing, which continued with age. However, the Variable Owls, Owls, and Late Owls profiles reflected less healthy and more variable sleep patterns that may require targeted interventions.

Trajectories of Psychological Distress in Australians Living in Urban Poverty: The Impact of Interpersonal Trauma.

Childhood maltreatment and interpersonal trauma experience is an important factor underpinning the apparent perpetuation of the cycle of social disadvantage experienced by homeless adults. This paper aimed to examine longitudinal patterns of psychological distress in a sample of 1,504 socially disadvantaged adult participants from the Journeys Home Study in Australia. The current paper utilized the "conservation of resources" theory and the concept of "risk factor caravans" to investigate the nature and implications of childhood trauma in the context of homelessness. Growth mixture modeling revealed four distinct trajectories of psychological distress as measured by the Kessler 6 across six time points (covering a period of 2.5 years): chronic, escalating, attenuating, and resistant. Our results also indicated that experiences of different types of trauma during childhood were associated with these psychological distress trajectories. In particular, adults experiencing chronic psychological distress were significantly more likely than those exhibiting distress resistance to have experienced multiple and varied childhood maltreatment, adjusted odds ratio (AOR) = 3.30, 95% CI [0.37, 6.05], p = .002. Furthermore, adult experiences of assault were found to be associated with psychological distress. These findings have important implications for mental health, as well as interventions aimed at breaking the cycle of urban poverty. Specific focus on interpersonal trauma vulnerabilities is important. Prioritizing socioecological stability, with mental health needs assessed on an individual level, may be most appropriate. This work also highlights the need to direct future attention to barriers to access and facilitation of social support services.

The Work-Family Interface and Sleep Quality.

OBJECTIVE: This article investigated whether work-to-family conflict (WFC) and work-to-family enrichment (WFE) were associated with employee sleep quality. WFC and WFE reflect the potential for experiences at work to negatively and positively influence nonworking life respectively, and may have implications for sleep quality. In this article, we examined whether WFC and WFE were linked with sleep quality via hedonic balance (i.e., positive affect relative to negative affect). PARTICIPANTS: The sample included 3,170 employed Australian parents involved in the Household Income and Labour Dynamics in Australia (HILDA) Survey. METHODS: Information on WFC, WFE, hedonic balance, sleep quality, and relevant covariates was collected through a structured interview and self-completion questionnaire. RESULTS: WFC was associated with poorer sleep quality (ß = .27, p < .001), and this relationship was stronger in males than females and in dual parent-single income families. WFC was also found to be indirectly associated with poor sleep quality via a lower hedonic balance (ß = .17, 99% confidence interval [.14, .20]). WFE was not directly associated with sleep quality, but was indirectly associated with better sleep quality via a higher hedonic balance (ß = -.04 [-.07, -.02]). CONCLUSIONS: These results indicate that aspects of the work-family interface are associated with employee sleep quality. Furthermore, affective experiences were found to link WFC and WFE with sleep quality. Workplace interventions that target WFC and WFE may have implications for employee sleep.

Enjoyment and Behavioral Intention Predict Organized Youth Sport Participation and Dropout.

BACKGROUND: Dropout from organized youth sport has significant adverse health implications. Enjoyment and behavioral intentions have consistently been linked with participation and dropout; however, few studies have investigated these links using a prospective design. This study explored whether enjoyment and intentions to continue predicted dropout behavior at 1-year follow-up. METHODS: Questionnaires were completed by 327 regular sport participants (mean age = 13.01 y at baseline). After 1 year, 247 individuals (75.5%) continued participating in their main sport and 26 individuals (8%) dropped out. A hierarchical logistic regression model estimated the probability of dropout. In step 1, the following covariates were included: age, sex, competition level, perceived competence, parental support, coach-athlete relationship, friendship quality, and peer acceptance. In step 2, enjoyment and intentions to continue were included. RESULTS: Step 1 indicated that age, parental support, coach-athlete relationship quality, and peer acceptance were significantly associated with dropout. Step 2 explained further variance in dropout, with both enjoyment and intentions inversely associated with dropout. Peer acceptance was the only covariate to remain significantly associated with dropout in step 2. CONCLUSIONS: Findings support the use of enjoyment and behavioral intentions as indicators of sport participation/dropout behavior and may aid the development of interventions aimed at preventing future dropout.

Sleep quality subtypes predict health-related quality of life in children.

OBJECTIVE: This paper aimed to investigate whether distinct sleep quality subtypes predicted health-related quality of life in a nonclinical sample of children. METHODS: This paper utilized data from two waves of the Longitudinal Study of Australian Children, a cohort study that follows a representative population of children in Australia. This paper examined data from Waves 4 and 5 of the LSAC (covering the period 2010-2012) and included 3974 children aged 10-11 years at Wave 4 (51.4% male). Multiple dimensions of sleep quality were assessed using a combination of child- and parent-reported measures. Health-related quality of life (HRQOL) was assessed through the Pediatric Quality of Life Inventory. RESULTS: Latent class analysis indicated six distinct sleep quality classes in children, namely good sleep, moderate sleep quality, mild sleep disturbances, short sleep, long sleep, and disordered sleep. In general, the disordered sleep and minor sleep disturbance classes had poorer HRQOL, which worsened over time. The long sleep and moderate sleep quality classes also showed some decreases in HRQOL over time. CONCLUSIONS: This study demonstrates that there are distinct sleep quality subtypes in children that could have implications for HRQOL. These findings may inform future strategies to promote improved sleep and HRQOL in children.

Bidirectional Associations between Sport Involvement and Mental Health in Adolescence.

PURPOSE: This study aimed to investigate potential bidirectional relationships between sport participation and mental health during early adolescence. METHODS: Data were taken from wave 5 (2012) and wave 6 (2014) of the K cohort of the Longitudinal Study of Australian Children. In total, there were 4023 participants (mean age = 12.41 yr, SD = 0.49 yr, at baseline), and this sample was followed up 24 months later. Cross-lagged panel models were used to examine bidirectional relationships between sport participation (hours per week for team, individual, and total sport participation) and mental health (total psychological difficulties, internalizing problems, and externalizing problems) as measured by the parent-report version of the Strengths and Difficulties Questionnaire (SDQ). RESULTS: Bidirectional relationships were evident between time involved in sport and overall mental health (Sport12→SDQ14: ß = -0.048; SDQ12→Sport14: ß = -0.062). Bidirectional relationships were also evident between time involved in sport participation and internalizing (social and emotional) problems (Sport12→SDQ14: ß = -0.068; SDQ12→Sport14: ß = -0.067). The relationship between time in organized sport and externalizing problems (conduct problems and inattention/hyperactivity problems) was not bidirectional. Externalizing problems predicted later sports participation (ß = -0.039), but not vice versa. CONCLUSION: Findings demonstrate bidirectional relationships between sport participation and adolescent mental health. The design and implementation of youth sport programs should maximize mental health benefits, and programs should be designed, implemented, and marketed to be attractive to participants with poor psychosocial health.

Bidirectional associations between personality and physical activity in adulthood.

OBJECTIVE: Personality and physical activity are important for critical life outcomes. This study tested the hypothesis that there is a bidirectional association between personality and physical activity. METHOD: A nationally representative sample of 10,227 Australian adults (5,422 women; 4,805 men) completed self-report measures of physical activity and personality in 2006 (Time 1), 2010 (Time 2), and 2014 (Time 3). A latent change score modeling approach was used to test bidirectional associations, controlling for age, sex, education, physical health, and mental health. RESULTS: Conscientiousness and openness predicted subsequent increases in physical activity, whereas agreeableness predicted subsequent decreases in physical activity. Physical activity was associated with increases in openness (and conscientiousness for women) at Time 1-Time 2, but was unrelated to change in personality between Time 2-Time 3. In addition, there was some evidence that temporal associations between personality and physical activity were moderated by participant age. CONCLUSIONS: These findings indicate that personality is important for change in physical activity, but physical activity is relatively unimportant for change in personality. (PsycINFO Database Record

Is there Complex Trauma Experience typology for Australian's experiencing extreme social disadvantage and low housing stability?

Traumatic childhood experiences predict many adverse outcomes in adulthood including Complex-PTSD. Understanding complex trauma within socially disadvantaged populations has important implications for policy development and intervention implementation. This paper examined the nature of complex trauma experienced by disadvantaged individuals using a latent class analysis (LCA) approach. Data were collected through the large-scale Journeys Home Study (N=1682), utilising a representative sample of individuals experiencing low housing stability. Data on adverse childhood experiences, adulthood interpersonal trauma and relevant covariates were collected through interviews at baseline (Wave 1). Latent class analysis (LCA) was conducted to identify distinct classes of childhood trauma history, which included physical assault, neglect, and sexual abuse. Multinomial logistic regression investigated childhood relevant factors associated with class membership such as biological relationship of primary carer at age 14 years and number of times in foster care. Of the total sample (N=1682), 99% reported traumatic adverse childhood experiences. The most common included witnessing of violence, threat/experience of physical abuse, and sexual assault. LCA identified six distinct childhood trauma history classes including high violence and multiple traumas. Significant covariate differences between classes included: gender, biological relationship of primary carer at age 14 years, and time in foster care. Identification of six distinct childhood trauma history profiles suggests there might be unique treatment implications for individuals living in extreme social disadvantage. Further research is required to examine the relationship between these classes of experience, consequent impact on adulthood engagement, and future transitions though homelessness.

Social climate profiles in adolescent sports: Associations with enjoyment and intention to continue.

This study explored whether adolescent sports participants' perceptions of the social climate fall into distinct profiles, and whether these profiles are related to enjoyment and intention to continue. A Latent Profile Analysis using 313 Australian sports participants (Mage = 13.03 years) revealed four distinct profiles: positive social climate (45.1%), diminished social climate (19.8%), positive coach relationship quality (19.8%), and positive friendship quality (15.3%). Individuals within the positive social climate and the positive coach relationship quality profiles reported relatively higher levels of enjoyment and intention to continue than individuals in the diminished social climate and the positive friendship quality profiles. Indirect path analyses found the social climate profiles were linked with intention to continue through enjoyment. Results highlight the value of investigating multiple dimensions of the social climate and suggest that the coach may be of particular importance in this age group. Findings have implications for understanding youth sports participation and preventing dropout.

Exploration of Sedentary Behavior in Residential Substance Abuse Populations: Results From an Intervention Study.

BACKGROUND: There is a growing body of research linking sedentary behavior with increased risk of chronic disease and all-cause mortality. It is increasingly recommended that service providers address the multiple behavioral risk factors associated with these chronic diseases as part of routine substance abuse treatment. OBJECTIVES: The study objective was to investigate rates of physical activity and sedentary behavior in a residential substance abuse population. In addition, efficacy of a sedentary behavior intervention, "Sit Switch," was examined for feasibility in this context. METHODS: Participants (n = 54) were residents of The Salvation Army Recovery Service Centres located in Canberra and on the Gold Coast, Australia. Actigraph GT3X+ accelerometers were used to measure rates and patterns of sedentariness and physical activity. A nonrandomized controlled study of a single-session group intervention aimed at decreasing prolonged sitting ("Sit Switch") was conducted. Education, motivational-interviewing, and goal setting components underpinned the "Sit Switch" intervention. RESULTS: Individuals were highly sedentary, spending 73% of daily activity at sedentary intensity engaged in inadequate levels of moderate physical activity (6.6%/day). The single session educational program did not lead to any significant changes in sedentary behavior. Conclusion/Importance: High levels of sedentariness and low levels of physical activity engagement are evident in residents in substance abuse treatment programs. It is strongly recommended that sedentariness, a modifiable risk behavior with independent consequences for cardiovascular disease and cancer, be addressed within residential programs.

Sleep quality subtypes and obesity.

OBJECTIVE: Poor sleep quality could be a risk factor for obesity. This article utilized a person-centered approach to investigate whether distinct sleep quality subtypes were associated with obesity directly, and indirectly via physical activity. METHOD: The sample included 8,932 Australian employees who participated in the Household, Income and Labor Dynamics in Australia Survey. Structured interviews and self-report questionnaires collected information on sleep quality, obesity, and relevant demographic, health, and work-related variables. Latent class analysis identified distinct subtypes of sleep quality. General linear modeling examined the associations of sleep quality subtypes with body mass index (BMI) and waist circumference. Multicategorical mediation models examined indirect paths linking sleep quality classes with obesity via physical activity. RESULTS: Five distinct sleep quality subtypes were identified: Poor Sleepers (20.0%), Frequent Sleep Disturbances (19.2%), Minor Sleep Disturbances (24.5%), Long Sleepers (9.6%), and Good Sleepers (26.7%). BMI, waist circumference, and physical activity differed among the sleep quality subtypes, with similar results observed for males and females. For example, Poor Sleepers had the highest BMIs, followed by Frequent Sleep Disturbances and Minor Sleep Disturbances; Long Sleepers and Good Sleepers had the lowest BMIs. Mediation analyses indicated that low levels of physical activity linked the Poor Sleep, Frequent Sleep Disturbance, and Long Sleep classes with higher BMI. CONCLUSIONS: These results provide new insights into the nature of sleep quality in employees. In particular, distinct sleep quality patterns had differing associations with measures of obesity, suggesting the need for tailored workplace interventions. (PsycINFO Database Record

Personality, hedonic balance and the quality and quantity of sleep in adulthood.

OBJECTIVE: Sufficient and good-quality sleep is important for individual functioning. This study explored associations between personality and sleep duration and sleep quality in adulthood. The mediating role of hedonic balance and the moderating roles of age and sex were also explored. METHOD: A nationally representative sample of Australian adults (n = 14,065; Mage = 44.4 years; 53.1% women) completed self-report measures of personality, sleep, hedonic balance and demographic variables (e.g. health status, employment status) in late 2013. RESULTS: After controlling for demographic variables, we found that high neuroticism was associated with poorer sleep quality, and both long and short sleep durations (a curvilinear relationship). Small effects were also observed relating high extraversion and low openness to better sleep quality. Hedonic balance mediated all linear and non-linear associations between personality and sleep. Additional moderator analyses showed that high openness was more strongly related to poor sleep quality among men and young adults. High neuroticism was more strongly related to poor sleep quality among men. CONCLUSION: Findings indicate that personality is important for sleep in adulthood and that hedonic balance features a prominent role in this association.

Distinct longitudinal patterns of absenteeism and their antecedents in full-time Australian employees.

This paper investigated distinct longitudinal trajectories of absenteeism over time, and underlying demographic, work, and health antecedents. Data from the Household, Income, and Labor Dynamics in Australia Survey were used; this is a panel study of a representative sample of Australian households. This paper focused on 2,481 full-time employees across a 5-year period. Information on annual sick leave and relevant sociodemographic, work, and health-related factors was collected through interviews and self-completed surveys. Growth mixture modeling indicated 4 distinct longitudinal patterns of absenteeism over time. The moderate absenteeism trajectory (34.8%) of the sample had 4-5 days of sick leave per year and was used as the reference group. The low absenteeism trajectory (33.5%) had 1-2 days of absenteeism per year, while the no absenteeism trajectory (23.6%) had very low rates of absenteeism (<1 day per year). Finally, a smaller trajectory accounting for 8.1% of the sample had high levels of absenteeism (>11 days per year). Compared with the moderate absenteeism trajectory, the high absenteeism trajectory was characterized by poor health; the no absenteeism and low absenteeism trajectories had better health but may also reflect processes relating to presenteeism. These results provide important insights into the nature of absenteeism in Australian employees, and suggest that different patterns of absenteeism over time could reflect a range of demographic, work, and health related factors.

Trajectories and Predictors of Health-Related Quality of Life during Childhood.

OBJECTIVE: To identify distinct trajectories of health-related quality of life (HRQOL) during childhood, along with their predictors. STUDY DESIGN: A nationally representative sample of 2700 children aged 4-5 years at baseline was followed up every 24 months through to age 12-13 years. Parents reported the children's HRQOL and data on potential predictors at each wave (5 in total) as part of the Longitudinal Study of Australian Children. RESULTS: Growth mixture modeling identified 5 distinct trajectories of HRQOL during childhood. Eighty-five percent of children had consistently high levels of HRQOL from age 4-5 years to 12-13 years (healthy); 8% of children had a significant and continuous decrease in HRQOL over time (high risk); and a further 5.3% of children had decreases in HRQOL from age 4-5 years to 8-9 years, followed by increases through to 12-13 years (rebound). Finally, a small percentage (1.6%) of children had extremely low levels of HRQOL at age 4-5 years that increased over time (recovery). Maternal smoking, lower household income, living in a non-English speaking household, and nonparticipation in organized sports were predictive of poorer HRQOL trajectories when compared with children in the healthy trajectory. CONCLUSION: There are distinct trajectories of HRQOL during childhood. Most children (85%) have a healthy, stable pattern, but the remaining children have trajectories indicative of poor HRQOL. Participation in sports, maternal smoking, lower family income, and language spoken at home distinguish among these trajectories. Of these, participation in organized sports has received relatively little attention as a preventative health priority.

Childhood trauma and risky alcohol consumption: a study of Australian adults with low housing stability.

INTRODUCTION AND AIMS: This paper examined whether recall of childhood trauma was associated with adult alcohol consumption in a sample of Australians with low housing security. The secondary aim was to examine whether risky alcohol consumption predicted subsequent housing instability. Sociodemographic factors were examined as potential moderators of these associations. DESIGN AND METHODS: This paper utilised data collected through the Journeys Home Study, a longitudinal study of a representative sample of individuals who were homeless or at risk of homelessness. This paper focused on 1224 participants aged 18 years and over. Data on alcohol use, childhood trauma and sociodemographic characteristics were collected through interviews at baseline. Homeless status at 6- to 12-month follow-up was assessed via interview. Logistic regression modelling was used to examine associations of alcohol consumption with childhood abuse, sociodemographic factors and changes in homelessness status. RESULTS: Self-reported recall of childhood experiences of violence was more likely among current drinkers, risky or not, than among abstainers. Recall of childhood neglect was more common among abstainers than among risky drinkers. DISCUSSION AND CONCLUSIONS: The relationships between recall of childhood trauma and adult alcohol consumption are likely to be complex. Risky consumption may contribute to continuing homelessness among adults with unstable housing. [Correction added on 29 December 2014, after first online publication: The Results, and Discussion and Conclusion sections in the abstract have been replaced.].