Objective: Few studies have investigated the association between adolescents' socio-economic status (SES) and health behaviours in developing countries. Socio-economic differences in breakfast eating, fruit and vegetable consumption and physical activity were investigated among Ghanaian adolescents. Design: A school-based survey of 12-18-year-olds (n 1195, response rate 89?7 %) was conducted in 2008. Logistic regression analyses were applied to study the associations between breakfast eating, fruit and vegetable consumption and physical activity, and SES. Setting: Southern Ghana, West Africa. Subjects: School pupils aged 12-18 years. Results: Of all adolescents, 31 % took breakfast less than 4 d/week, over half (56 %) and 48 %, respectively, rarely ate fruits and vegetables. Younger adolescents (12-15-year-olds) consumed fruits and vegetables frequently compared with older ones (16-18-year-olds). Boys were more likely to participate in physical activity than girls. The probability of frequent breakfast eating was higher in adolescents from more affluent backgrounds than in those from less affluent ones. Compared with those whose mothers were illiterate, both tertiary and primary maternal educational attainment increased the probability of frequent fruit intake. Similarly, tertiary educational attainment increased the likelihood of frequent vegetable intake. Compared with those with unemployed mothers, mothers' low employment grade was related to higher probability of frequent fruit intake. High school performance was associated with frequent fruit intake, whereas high or medium school performance increased the likelihood of vegetable intake compared with low school performance. Conclusions: Interventions are needed to improve breakfast intake, fruit and vegetable consumption and physical activity in order to prevent degenerative diseases among Ghanaian adolescents.

Our results provide support for the public health approach to gambling: harms were reported even at low gambling frequency-expenditure levels. In addition to the high-risk approach, adopting a population-level approach to preventing gambling harm could shift the population distribution of harm in a lower direction.

BackgroundStudies of the relationship between sports activity and smoking among adolescents and young adults report contradictory results. We examined the association between sports activity (intensity and type of sport) and the current use of snus (Swedish snuff), cigarette smoking, and the combined use of cigarettes and snus (dual use) among young males in Finland.MethodsData were collected from 16,746 male conscripts who completed a survey during the first days of their conscription during the years 1999-2010 (median age 19 years, response rate 95%). Main outcome measures were self-reported daily/occasional use of snus, cigarette smoking, and dual use. The association between sports activity, type of sport, and several sociodemographic background variables was assessed using logistic regression analysis.ResultsOver the study period (1999-2010), the prevalence of cigarette smoking decreased from 42% to 34%, while snus use increased from 5% to 12%, and dual use increased from 7% to 13% (p < 0.001). Compared with no physical activity, regular competitive sports activity (defined as high-intensity sports activity) was positively associated with use of snus (odds ratio [OR] 10.2; 95% confidence interval [CI]: 7.8-13.5) and negatively with cigarette smoking (OR 0.2; 95% CI: 0.1-0.3). When stratified by type of sport in multivariate models, ice hockey was most strongly associated with snus use (OR 1.6; 95% CI: 1.4-1.9) and dual use (OR 2.0; 95% CI 1.8-2.3) compared with those not playing ice-hockey, followed by other team sports for snus use (OR 1.5; 95% CI: 1.3-1.8) and dual use (OR 1.8; 95% CI: 1.6-2.0) compared with those not participating in other team-sports.ConclusionsOur results show a clear association between snus use and intensity and type of training. Team sports were associated with increased use of snus and dual use compared with no participation in team sports. These findings should be acknowledged when planning and implementing preventive strategies.

Internationally, and also in Europe, adolescent gambling is increasingly recognized as an important public health issue. Most research on adolescent gambling, however, is prevalence-focused and population-based studies are scarce. Few studies have examined gambling-related harms among adolescents. In a national sample, we examined self-experienced harms related to gambling and the relationship between reported harms and gambling behavior among Finnish adolescents. A national survey of 12-18-year-olds was conducted in Finland in 2011 (N = 4,566). Main measures were frequency of gambling and gambling-related harms reported during the past 6 months. The relationship between reported harms and gambling behavior was assessed using logistic regression analysis. Overall, 44% had gambled during the past 6 months. Of the sample, 12% were frequent gamblers (at least weekly) and 32% were occasional gamblers (monthly or less often). Compared to occasional gamblers, frequent gamblers were more likely to experience harms. The most commonly reported harms among frequent gamblers were "felt guilty or shameful due to gambling" (17%) followed by "problems with relationships" (13%) and "disruptions of daily rhythm" (10%). In age and gender-adjusted analysis, daily gamblers were significantly more likely to report all different types of harms when compared to other groups. These findings suggest that when planning and targeting youth gambling prevention and harm reduction strategies the nature and extent to which gambling may contribute to the different types of harms are important to consider.

BackgroundIn Western countries, tobacco use is most prevalent among adolescents in lower socioeconomic groups. The association between socioeconomic status (SES) and tobacco use among adolescents in developing countries is unexplored. Using multiple SES measures, we investigated this association among adolescents in Ghana.MethodA school-based survey of a representative sample of 13-18-year-old Ghanaians (N = 1,165, response rate = 89.7%) was conducted in three regions, in 2008. Logistic regression analysis was used to evaluate the relationship of smoking, tawa (smokeless tobacco) use with familial SES (parental occupation and education, material affluence scale, family structure), an adolescent's individual social position (school performance, plans after graduation) and inter-generational social mobility (predicted by the differences of familial and individual positions).ResultsSocioeconomic differences existed in tobacco use whether measured by familial SES or individual social position with higher prevalence in lower socioeconomic groups. Low father's education and living in a non-nuclear family were associated with both forms of tobacco use while low material affluence was associated with tawa use only; individual social position measured by plans after graduation was the strongest predictor of both smoking and tawa use. Inter-generational downward social mobility and particularly staying in low SES was related to both forms of tobacco use.ConclusionsSimilar to Western countries, lower SES is related to an adolescent's tobacco use also in developing countries. Cumulative socioeconomic disadvantage over generations increases the probability of tobacco use.