Chi-Chen Wu

The incidence of experimental smoking in school children: an 8-year follow-up of the child and adolescent behaviors in long-term evolution (CABLE) study

BackgroundStudies have established that most regular adult smokers become addicted in their adolescent years. We investigated the incidence of and risk factors associated with initial experimental smoking among a group of school children who were followed for 8 years.MethodsWe used cohort data collected as part of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) study, which selected nine elementary schools each from an urban area (Taipei City) and a rural area (Hsingchu county) in northern Taiwan. From 2002 to 2008, children were asked annually whether they had smoked in the previous year. An accelerated lifetime model with Weibull distribution was used to examine the factors associated with experimental smoking.ResultsIn 2001, 2686 4th-graders participated in the study. For each year from 2002 to 2008, their incidences of trial smoking were 3.1%, 4.0%, 2.8%, 6.0%, 5.3%, 5.0% and 6.0%, respectively. There was an increase from 7th to 8th grade (6.0%). Children who were males, lived in rural areas, came from single-parent families, had parents who smoked, and had peers who smoked were more likely to try smoking earlier. The influence of parents and peers on experimental smoking demonstrated gradient effects.ConclusionsThis study used a cohort to examine incidence and multiple influences, including individual factors, familial factors, and community factors, on experimental smoking in adolescents. The findings fit the social ecological model, highlighting the influences of family and friends. School and community attachment were associated with experimental smoking in teenagers.

The effects of social structure and social capital on changes in smoking status from 8th to 9th grade: results of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) study.

OBJECTIVE Social structure and social capital are important variables for public health strategies seeking to prevent smoking among adolescents. The purpose of this study was to examine the relationships between social structure, social capital and changes in smoking status from the 8th to 9th grade in Taiwan. METHODS Data were obtained from the Child and Adolescent Behaviors in Long-term Evolution (CABLE) project. The study analyzed a final sample of 1937 students (50.7% female). RESULTS Each layer of social structure was associated with a particular form of social capital. Students whose parents were married and living together had higher family social capital. After controlling for background variables, the social structure variable of friends who smoke was significantly associated with changes in smoking status. Students reporting more school attachment were less likely to start smoking. Students with higher parental supervision was associated with less chance of being a consistent smoker, whereas participation of social organization outside of school was associated with continued smoking. Attending school club was associated with higher probability of smoking cessation. CONCLUSION Smoking prevention and intervention strategies aimed at junior high school students should be tailored to the particular form of social capital important for each type of smoking status.

Do parents play different roles in drinking behaviours of male and female adolescents? A longitudinal follow-up study

Objective Gender differences in the associations between adolescent drinking behaviour, and perceived parental drinking behaviours and attitudes towards underage drinking, were investigated. Methods Data were drawn from two cohorts in the Child and Adolescent Behaviours in Long-term Evolution project. We used data from 2009 to 2006, when cohorts 1 and 2, respectively, were in grade 9. No cohort effect was found, so the two cohorts were pooled; 3972 students (1999 boys and 1973 girls) participated in the study. The major variables included adolescent drinking behaviours over the last month, and perceived parental drinking behaviours and parental attitudes towards underage drinking. The effects of the combination of parental drinking behaviours, and attitudes on the drinking behaviours of male and female adolescents, were analysed by logistic regression. Results The drinking behaviour of boys was correlated with the drinking behaviours and attitudes of their fathers but not with those of their mothers. Among boys, having a non-drinking father who was against underage drinking (OR=0.27, 95% CI 0.16 to 0.46), a non-drinking father who was favourable towards underage drinking (OR=0.61, 95% CI 0.39 to 0.94), or a drinking father who was against underage drinking (OR=0.44, 95% CI 0.23 to 0.85) significantly decreased the likelihood of alcohol consumption, whereas maternal behaviour and attitude were not significant influences. Among girls, having a non-drinking father who was against underage drinking (OR=0.52, 95% CI 0.30 to 0.91) or a non-drinking father who was favourable towards underage drinking (OR=0.51, 95% CI 0.32 to 0.83) significantly decreased the likelihood of alcohol consumption, as did having a non-drinking mother who was against underage drinking (OR=0.23, 95% CI 0.09 to 0.60). Conclusions The influences of fathers and mothers on the drinking behaviour of their adolescent children differed by offspring gender.

The Effects of Sleep Problems on the Trajectory of Antisocial Behavior from Adolescence through Early Adulthood in Taiwan: Family Functioning as a Moderator

STUDY OBJECTIVES To examine the longitudinal relationship between sleep problems and development of antisocial behavior from adolescence through young adulthood, and to investigate whether family functioning moderates the association being examined. Potential sex differences were also explored. METHODS A total of 2,491 adolescents participated in a prospective study spanning 2009 through 2014 in northern Taiwan. Measures included sleep problems, family functioning (parental support, family interaction, and family conflict), antisocial behavior, and other individual characteristics (sex, age, parental education, family economic stress, depressive symptoms, and stressful life events). Random coefficient growth models were used to test study hypotheses. RESULTS Sleep problems were significantly and positively associated with antisocial behavior (B = 0.088 and 0.038 for males and females, respectively). Sex differences further emerged in the moderating effects of family functioning. Among males, those with high family interaction had a weaker association between sleep problems and antisocial behavior; among females, the examined association was weaker in those with high parental support. For both sexes, the association between sleep problems and antisocial behavior was stronger for those with high family conflict. CONCLUSIONS Our findings highlight the robust link between sleep problems and adolescent antisocial behavior over time. We also show for the first time that the association depends on family functioning. Prevention methods and treatment of sleep problems in youths that incorporate family functioning may yield significant benefits for decreasing antisocial behavior. Sex-specific intervention and prevention approaches should also be considered.

Disentangling the effects of depression on trajectories of sleep problems from adolescence through young adulthood

BACKGROUND Little is known about the differential influences of between- and within-person effects of depression as well as its long-term impacts on sleep problems in adolescents. This study aims to disentangle these differences by estimating three effects of depression (i.e., long-term, immediate, and fluctuating). METHODS The sample included 1345 males and 1283 females in Taiwan. In multilevel models, the between- (i.e., long-term and immediate) and within-person (i.e., fluctuating) effects were estimated by using the average and time-varying scores of depression, respectively. The interactions between long-term and the other effects were also tested to determine the moderating effects of long-term influences. RESULTS Significant immediate and long-term effects of depression were found for both sexes, indicating that adolescents with higher levels of depression were at increased risks for future sleep problems. For females only, the long-term effects further exacerbated the negative influences of immediate effects of depression on sleep problems. Moreover, the fluctuating effects were found to change over time in females and the influences were more pronounced in young adulthood. LIMITATIONS The self-reported measures of both depression and sleep problems may produce common method variance and bias the results. Our measurements were adapted from various existing scales to increase their applicability; therefore, the internal consistency was not high. CONCLUSIONS Our findings provide insight regarding who is at risk for sleep problems and when this risk would occur based on the effects of depression. They also highlight the importance of both immediate and long-term effects of depression on development of sleep problems.

Dual Trajectories of Sleep Duration and Cigarette Smoking during Adolescence: Relation to Subsequent Internalizing Problems

Decreasing sleep duration and increasing cigarette smoking of adolescents are major public health concerns. However, research examining connections between the developmental trajectories of the outcomes that are evolving contemporaneously and their relation to long-term outcomes is still lacking. This study examined distinct trajectories of sleep duration and cigarette smoking during adolescence, associations between these trajectories, and links with internalizing problems during young adulthood. Data were collected from 2510 adolescents who participated in a longitudinal study spanning from 2006 through 2014 in northern Taiwan. Group-based dual trajectory modeling was used to examine the dynamic relationships between sleep duration and cigarette smoking trajectories during adolescence. Multiple linear regression was used to understand the association between the distinct trajectories and subsequent internalizing problems. Three sleep duration trajectories (short decreasing, typical sleep, and long sleep) and three cigarette smoking trajectories (nonsmokers, late increasing, and escalating smokers) were identified. We found significant inter-relationships for sleep duration and cigarette smoking trajectories during adolescence; all atypical sleep duration trajectories conferred increased risks of increased cigarette smoking and vice versa. In addition, the effects of sleep duration and cigarette smoking on later internalizing problems were found to vary by sex and trajectory patterns. These results provide insight regarding the co-development of sleep duration and cigarette smoking trajectories during adolescence. We also highlight the different roles of sleep duration and cigarette smoking trajectories and their relation to internalizing problems of young adulthood.

Transitions in sleep problems from late adolescence to young adulthood: A longitudinal analysis of the effects of peer victimization

Adolescence is a developmental period with high vulnerability to sleep problems. However, research identifying distinct patterns and underlying determinants of sleep problems is scarce. This study investigated discrete subgroups of, changes in, and stability of sleep problems. We also examined whether peer victimization influenced sleep problem subgroups and transitions in patterns of sleep problems from late adolescence to young adulthood. Sex differences in the effects of peer victimization were also explored. In total, 1,455 male and 1,399 female adolescents from northern Taiwan participated in this longitudinal study. Latent transition analysis was used to examine changes in patterns of sleep problems and the effects of peer victimization on these changes. We identified three subgroups of sleep problems in males and two in females, and found that there was a certain level of instability in patterns of sleep problems during the study period. For both sexes, those with greater increases in peer victimization over time were more likely to change from being a good sleeper to a poor sleeper. The effects of peer victimization on baseline status of sleep problems, however, was only significant for males, with those exposed to higher levels of peer victimization more likely to be poor sleepers at baseline. Our findings reveal an important role of peer victimization in predicting transitions in patterns of sleep problems. Intervention programs aimed at decreasing peer victimization may help reduce the development and escalation of sleep problems among adolescents, especially in males.

Sex differences in sleep patterns and changes in 7th to 12th graders: a longitudinal follow-up study in Taiwan

Study Objectives To assess the relationship between sex and the development of sleep patterns in adolescents from grade 7 to 12. Methods We analyzed longitudinal data from annual school-based assessments of sleep habits among secondary school students in northern Taiwan. Measures of sleep patterns included sleep length on weekdays and weekends as well as weekend-weekday difference (WndD), defined as the discrepancy in the time in bed (TIB) between weekdays and weekends. Growth curve models were used to assess sex differences in sleep patterns. Associations between other covariates and sleep patterns were also explored. Results We found shorter weekday TIB in girls compared with boys at all time points. In contrast, girls had longer weekend TIB than boys over time except in the 12th grade. WndD was also longer in girls than boys. All interaction terms between sex and time were insignificant, indicating that developmental change across time was not statistically different for boys and girls. Several other factors, namely, parental education, pubertal development, self-perceived health, weight status, depressive symptoms, academic stress, infrequent exercise, and substance use, were also found to be associated with sleep patterns. Conclusions Our findings show a sex difference in TIB both on weekdays and weekends. No sex difference was found in the development of sleep patterns over time.