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10.1001/jamapediatrics.2021.0541

http://scihub22266oqcxt.onion/10.1001/jamapediatrics.2021.0541
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33938922!8094031!33938922
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suck abstract from ncbi


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pmid33938922      JAMA+Pediatr 2021 ; 175 (7): 715-722
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  • Adolescents Substance Use and Physical Activity Before and During the COVID-19 Pandemic #MMPMID33938922
  • Chaffee BW; Cheng J; Couch ET; Hoeft KS; Halpern-Felsher B
  • JAMA Pediatr 2021[Jul]; 175 (7): 715-722 PMID33938922show ga
  • IMPORTANCE: Stay-at-home policies related to the COVID-19 pandemic could disrupt adolescents' substance use and physical activity. OBJECTIVE: To compare adolescents' substance use and physical activity behaviors before and after stay-at-home restrictions. DESIGN, SETTING, AND PARTICIPANTS: Ongoing prospective cohort study of tobacco use behaviors among ninth- and tenth-grade students enrolled at 8 public high schools in Northern California from March 2019 to February 2020 and followed up from September 2019 to September 2020. Race/ethnicity was self-classified from investigator-provided categories and collected owing to racial/ethnic differences in tobacco and substance use. EXPOSURES: In California, a COVID-19 statewide stay-at-home order was imposed March 19, 2020. In this study, 521 six-month follow-up responses were completed before the order and 485 were completed after the order. MAIN OUTCOMES AND MEASURES: The prevalence of substance use (ie, past 30-day use of e-cigarettes, other tobacco, cannabis, and alcohol) and physical activity (active >/=5 days/week) was compared at baseline and follow-up. A difference-in-difference approach was used to assess whether changes from baseline to 6-month follow-up varied if follow-up occurred after the stay-at-home order, adjusting for baseline behaviors and characteristics. All models were weighted for losses to follow-up using the inverse probability method. Weights were derived from a logistic regression model for having a follow-up response (dependent variable), as predicted by baseline characteristics and behaviors. RESULTS: Of 1423 adolescents enrolled at baseline, 1006 completed 6-month follow-up (623 [62%] were female, and 492 [49%] were non-Hispanic White). e-Cigarette use declined from baseline to 6-month follow-up completed before the stay-at-home order (17.3% [89 of 515] to 11.3% [58 of 515]; McNemar chi2 = 13.54; exact P < .001) and 6-month follow-up completed after the stay-at-home order (19.9% [96 of 482] to 10.8% [52 of 482]; McNemar chi2 = 26.16; exact P < .001), but the extent of decline did not differ statistically between groups responding before vs after the stay-at-home order (difference-in-difference adjusted odds ratio, 0.84; 95% CI, 0.47-1.52; P = .58). In contrast, being physically active was unchanged from baseline if follow-up was before the order (53.7% [279 of 520] to 52.9% [275 of 520]; McNemar chi2 = 0.09; exact P = .82) but declined sharply from baseline if follow-up was after the order (54.0% [261 of 483] to 38.1% [184 of 483]; McNemar chi2 = 30.72; exact P < .001), indicating a pronounced difference in change from baseline after the stay-at-home order (difference-in-difference adjusted odds ratio, 0.49; 95% CI, 0.35-0.69; P < .001). Overall in the cohort, reported use of other tobacco, cannabis, and alcohol did not differ meaningfully before and after the order. CONCLUSIONS AND RELEVANCE: In this cohort, a reduction in e-cigarette use occurred independently of COVID-19 stay-at-home restrictions, but persistent cannabis and alcohol use suggest continued need for youth substance use prevention and cessation support. Declining physical activity during the pandemic is a health concern.
  • |Adolescent[MESH]
  • |Adolescent Behavior/*psychology[MESH]
  • |COVID-19/*epidemiology/psychology[MESH]
  • |Drug Users/*psychology/statistics & numerical data[MESH]
  • |Exercise/*psychology[MESH]
  • |Female[MESH]
  • |Health Behavior[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Prevalence[MESH]
  • |Prospective Studies[MESH]
  • |Risk Factors[MESH]
  • |Students/*psychology/statistics & numerical data[MESH]
  • |Substance-Related Disorders/*epidemiology/psychology[MESH]
  • |Surveys and Questionnaires[MESH]
  • |United States[MESH]


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