Social media and use of electronic nicotine delivery systems among school-going adolescents in a rural distressed Appalachian community.

Electronic nicotine delivery systems (ENDS) are the most used tobacco products among middle and high schoolers in the United States (U.S.). Familial relations and access play a major role in uptake among adolescents; yet the role of social media in this phenomenon in the context of communities impacted by tobacco-related health disparities is understudied. In Spring 2019, data were collected from adolescents in 8th and 9th grades in a school located in a rural distressed county in Tennessee to assess social media's role in ENDS uptake. Descriptive and multivariable statistical analyses were performed to delineate factors associated with ENDS use. Of a total of 399 respondents, 12.5 % reported current ENDS use and 22.1 % indicated having ever discussed ENDS on social media. Closed messaging platforms (Snapchat) and video platforms (Facebook/Instagram/You Tube) were the most reported form of social media used (8.31 % and 8.31 % respectively). Social media use was positively associated with both ever ENDS use (odds ratio [OR] = 2.9) and current ENDS use (OR = 3.98). Parental advice against ENDS use was positively associated with ever ENDS use. In conclusion, social media use was positively associated with both ever and current ENDS use, and Snapchat was the most popular platform among this population of students. The results indicate that youth social media engagement may lead to exposure that can influence ENDS uptake. Future studies are needed to further examine these associations among distressed communities.

Young adults' human papillomavirus-related knowledge: source of medical information matters.

OBJECTIVES: Few studies examine the influence that different sources of medical information has on human papillomavirus (HPV)-related knowledge. We examined the relationship between the primary source of medical information and knowledge about HPV in young adults aged 18-26 years. STUDY DESIGN: This study used cross-sectional data from the Health Information National Trends Survey. METHODS: Respondents (n = 404) self-reported their knowledge about HPV-related diseases and vaccinations and their sources of medical information. Sources of medical information included electronic/print media, family/friends, or a healthcare provider. Bivariate and multivariate analyses were used to examine the association between the source of information and HPV knowledge. RESULTS: Fifty-six percent of respondents used electronic or print media as their primary source of medical information. A greater proportion of Hispanic (40.0%) and black (36.0%) respondents received medical information from their family/friends than white respondents (20.0%). Respondents who received medical information from family/friends had 4.34 (95% confidence interval [CI]: 2.14, 8.79), 4.06 (95% CI: 2.05, 8.04), and 2.35 (95% CI: 1.10, 5.04) times higher odds than those who received information from healthcare providers of not knowing that HPV causes cervical cancer, knowing HPV is a sexually transmitted infection, and hearing about the HPV vaccine, respectively. CONCLUSION: Source of medical information was significantly associated with knowledge of HPV. Receiving medical information from family/friends negatively influenced young adults' HPV knowledge. These findings may guide future interventions to target peer and familial influence on medical decisions.

Mortgage possessions, spatial inequality, and obesity in large US metropolitan areas.

OBJECTIVES: As social determinants of health, mortgage possessions (primarily foreclosures in the US context) and housing instability have been associated with certain mental and physical health outcomes at the individual level. However, individual risks of foreclosure and of poor health are spatially patterned. The objective of this study is to examine the extent to which area-specific social and economic characteristics help explain the relationship between mortgage possessions and obesity prevalence in 75 of the 100 most populous US metropolitan areas. STUDY DESIGN: This is a cross-sectional study. METHODS: The study relies on three sources of data: the Selected Metropolitan/Micropolitan Area Risk Trends (SMART) project, RealtyTrac foreclosure data, and the American Community Survey. Focal social and economic characteristics include foreclosure rates, levels of racial residential segregation, and poverty. Obesity prevalence and several control measures for each metropolitan area are also used. Ordinary least squares regression, weighted using the SMART project data, is used, and statistical significance is set at 0.05. RESULTS: The results suggest that mortgage possessions are independently associated with higher obesity prevalence and that foreclosures operate through the specific channel of racial residential segregation and its tie to the racial composition of a metropolitan area. Socio-economic status of an area, and not poverty, is related to foreclosures and obesity prevalence. CONCLUSION: Mortgage possessions not only are socio-economic but also have negative health consequences, such as obesity. The findings provide an empirical base for other researchers to uncover the relationships between segregation, mortgage possessions, and obesity at the individual level of analysis. The public health community should be engaged in addressing the issue of foreclosures in the US because the failure to engage may have broad financial and health consequences across large cities.

The impact of maternal prenatal smoking on the development of childhood overweight in school-aged children.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: Maternal smoking during pregnancy likely increase the risk of childhood overweight. Childhood overweight is influenced by socioeconomic characteristics of mothers. Characteristics of child at birth determine the likelihood of overweight. WHAT THIS STUDY ADDS: Children of mothers who smoked 1 year before birth (including pregnancy) were likely to be overweight during school ages than those of mothers who never smoked. Confirmation that socioeconomic characteristics of mothers influence the likelihood of childhood overweight during school age. Smoking cessation should be targeted at mothers 1 year before birth to improve their health status and that of offspring. OBJECTIVES: To examine associations between maternal smoking and overweight among school-aged children and also identify mothers and offspring characteristics that affect children's weight. METHODS: We used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCY). Childhood overweight was defined as having Body Mass Index (BMI) of 85th percentile or above. Smoking patterns among mothers were assessed by questioning smoking behaviour 1 year before birth of the target child: never or ever smoking. Standardized procedures were used to measure height and weight. Descriptive statistics and generalized estimating equations (GEE) were used for the analysis. RESULTS: Descriptive results showed that children of mothers who smoked anytime within 1 year before birth were more likely to be overweight and have higher BMI percentile averages. GEE results showed that children of mothers who were ever smokers 1 year before birth were more likely to be overweight (OR = 1.39, 95% CI: 1.01, 1.94) and have higher BMI percentile averages (ß = 4.46, P = 0.036) from grades 1 through 6 than those of mothers who were never smokers. Additionally, the level of mother's education and birth weight were significantly associated with childhood overweight. CONCLUSIONS: Confirmed relationships between maternal smoking and overweight among school-aged children have important implications for public health policy because this evidence can be used to enhance smoking cessation 1 year before birth to improve the health status of mothers and offspring.

Civil society and the negotiation of the Framework Convention on Tobacco Control.

Tobacco control civil society organisations mobilised to influence countries during the negotiation of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) between 1999 and 2003. Tobacco control civil society organisations and coalitions around the world embraced the idea of an international tobacco control treaty and came together as the Framework Convention Alliance (FCA), becoming an important non-state actor within the international system of tobacco control. Archival documents and interviews demonstrate that the FCA successfully used strategies, including publication of a newsletter, shaming symbolism and media advocacy to influence policy positions of countries during the FCTC negotiation. The FCA became influential in the negotiation process, by mobilising tobacco control civil society organisations and resources with the help of the Internet, and framing the tobacco control discussion around global public health.