Tobacco and alcohol use among Vietnamese adolescents and youth

POPULATION, FAMILY AND REPRODUCTIVE HEALTH

Johns Hopkins Bloomberg School of Public Health

Transitions into and from tobacco and alcohol use among Vietnamese

adolescents and youth

Robert Blum, MD, MPH, PhD Johns Hopkins

Huan He MS Johns Hopkins

Linh Cu Le, PhD Hanoi School of Public Health

Prepared forInternational Symposium on Cohort and

Longitudinal Studies Florence, Italy

13 October, 2014

Longitudinal Cohorts Conference Florence, Italy

Chile Lab: A DHSS focused on adolescents and youth

• Located in the Chi Linh district of Dai Duong province about half way between Hanoi and Hai Phong.

• Three modules– Health Status Behavior module collected on approximately

10,000 14-24 year olds three times: 2006, 2009, 2013.– Risk and Protective Factors module collected on

approximately 2500 14-24 year olds twice: 2007, 2014.– Parent Influences and Social Factors module collected on

approximately 2500 14-24 year olds once: 2008 (a second data collection is planned for late 2014)

13 October 2014

Longitudinal Cohorts Conference Florence, Italy

Adolescent and Youth Sample (14-24 year olds)

• Module 1, Time 1: 9,587• Module 1, Time 2: 10,123• Module 2, Time 1: 3,147• Merged sample (all three modules): 2,796

– Females: 1479– Males: 1317

13 October 2014

Longitudinal Cohorts Conference Florence, Italy

Prevalence of Ever Smoking and Having Been Drunk in Past 30 days by sex, Time 1

Behavior Engagement in Behavior

Males Females

SMOKING NO 3500 (77.7%) 4482 (99.2)

YES 1008 (22.3%) 13 (0.3%)

MISSING 20 (0.4%) 21 (0.5%)

EVER DRUNK PAST 30 DAYS

NO 2663 (58.8) 3482 (86.8%)

YES 1258 (38.8%) 488 (12.0%)

Missing 107 (2.4%) 48 (1.2%)

13 October 2014

Longitudinal Cohorts Conference Florence, Italy

Prevalence (%) for ever smoking and drunk in the past 30 days by age (Time 1, full sample)

BEHAVIOR 13 y.o. 15 y.o. 17 y.o. 19 y.o. 21 y.o.

EVER SMOKE M: 1.8% 5.9% 12.1% 24.6% 38.%

F: 0 0.3% 0.2% 0 0.7%

DRUNK IN PAST 30 DAYS

M: 11.0% 17.8% 30.7% 46.9% 62.8%

F: 2.5% 7.1% 13.2% 14.5% 17.6%

13 October 2014

Transition from Non-Smoker to smoker

Time 1Non-smoker

Time 2Non-smoker

Time 2Smoker

1081 701 (64.9%) 380 (35.15%)

Factors assoc. with transition to smoking

• Cigarettes available in the home 2.17 (p<.05)

• Family hx of violence/abuse 1.46 (p<.01)• Teacher violence/abuse 1.53 (p<.001)• Ever used internet 2.47 (p<.001)• Close friends smoke cigarettes 6.07

(p<.001)• Drunk in past 30 da 2.68 (p<.001)• Male dominance values 1.35 (p<.01)• Has girlfriend 2.23 (p<.001)• Smoking causes disease NS

Oct 13, 2014 Longitudinal Cohorts Conference Florence, Italy

Transition to Smoking among Males 2006, 2009; Analytic Sample

Transition from Smoker to Non-smoker

Time 1 Smoker

Time 2Smoker

Time 2Non-Smoker

202 150 (74.3%) 52 (25.7%)

Factors assoc. with transition to quitting smoking

• Father does not smoke cigarettes 2.10 (p<.05)

• Parents never discuss tobacco/ substances 0.20 (p<.05)

• Family member experiences adverse event .28 (p<.05)

• Almost all friends smoke .24 (p<.001)

• Self-esteem 2.48 (p<.01)• Drunk in the past 30 da NS• Knows smoking causes disease NS

Oct 13, 2014 Longitudinal Cohorts Conference Florence, Italy

Transition to Smoking Cessation (Quitting) among Males 2006, 2009; Analytic Sample

Transition from never drunk to drunk in the past 30 days

Time 1 Never Drunk

Time 2Never Drunk

Time 2Drunk past 30 da.

959 794 (82.8%) 165 (17.2%)

Factors assoc. with transition to drinking

• Family member experiences adverse event 1.88 (p<.01)

• High family conflicts 1.98 (p<.001)• Ever used internet 2.71 (p<.001)• Almost all friends have been drunk

4.16 (p<.001)• Too sick to go to school/work in

last year 1.50 (p<.01)• Depression NS• Repeated grade in School NS

Oct 13, 2014 Longitudinal Cohorts Conference Florence, Italy

Transition to Drunk in the past 30 da. among Males 2006, 2009; Analytic Sample

Transition from drunk to ever drunk in the past 30 days

Time 1 Drunk in past 30 days

Time 2Never Drunk

Time 2Drunk past 30 da.

142 73 (51.4%) 69 (48.6%)

Factors assoc. with transition to non-drunk

• Pressure from peers to smoke .26 (p<.01)

• Smokes cigarettes at time one: .37 (p<.01)

• Depression 2.05 (p<.05)• Too sick to go to school/work in

last year 2.66 (p<.01)• Repeated grade in School NS• School enrollment NS

Oct 13, 2014 Longitudinal Cohorts Conference Florence, Italy

Transition to Not Drunk in the past 30 da. among Males 2006, 2009; Analytic Sample

Longitudinal Cohorts Conference Florence, Italy

Conclusions

• Cigarette smoking is remarkably rare among female adolescents and youth in Viet Nam

• For males both alcohol and tobacco are social behaviors linked with perceived peer behaviors

• Family emotional environment appears to significantly influence substance use

• Knowledge of the effects of tobacco appear to have little effect on behavior

• Except for violent/aggressive teachers school factors appear to have little effect on substance use

October 13, 2014