Lucia Maria Lotrean

Gender differences regarding the alcohol-tobacco relationship among Romanian adolescents - a longitudinal study.

BACKGROUND The objective of this study was to assess cross-sectional and prospective relations between alcohol and tobacco use among Romanian adolescents, giving special attention to possible gender differences. METHODS The data were obtained from a two-wave 1-year longitudinal study carried out among 403 Romanian high school students aged 15-17 years (mean age 15.9; SD = 0.3). Questionnaires were used to assess smoking behaviour and alcohol use. Both behaviours were classified into two categories, that of adolescents who used the substance (at least once/month) and that of those who did not use the substance or used it less than monthly. Logistic regression was used to determine which substance was the best predictor of the subsequent use of the other substance. RESULTS Alcohol and cigarette use were found to be linked reciprocally and this interrelationship differed across genders. Among girls smoking predicted alcohol use better than the converse, while for the boys it was the other way around. CONCLUSION It is important for future studies of adolescent substance use to systematically investigate the gender differences in the tobacco-alcohol relationship.

Effects of comprehensive smoke-free legislation in Europe

This paper reviews data regarding the effects of the legislation banning smoking in enclosed public places, including workplaces, restaurants and bars which entered into force in several countries of Europe starting with the year 2004. The source of data is represented by articles and short information published in peer reviewed journals or in electronic format between the years 2005 and 2008. Highlights include a consideration of the effects of these laws on the attitudes of the population regarding their implementation, exposure to passive smoking in public places as well as the scientific evidence on the public health and economic impact of these laws. The results of smoking ban in public places observed in several parts of Europe support initiatives in many countries toward implementing smoke-free legislation, particularly those who have ratified the Framework Convention on Tobacco Control, which calls for legislation to reduce tobacco smoke pollution.

Health risk behavior of Romanian adults having relatives with cancer.

This study aimed to assess body features, and alimentary and lifestyle behavior related to cancer prevention among Romanian adults having relatives with cancer. The study was performed in 2010/2011 in an oncological hospital in Cluj-Napoca, Romania. It involved 320 adults who had relatives with cancer. An anonymous questionnaire was filled in by each participants; their weights and heights were measured and body mass index (BMI) was calculated, 56.6% of the participants having a value higher than 24.9. Almost all subjects ate less than 400 g of fruits and vegetables daily and 56% of the participants consumed more than 500 g of red meat weekly. One quarter of the study sample was performing less than 30 minutes of moderate physical activity daily. Some 28.1% of the subjects were smokers. These data call for comprehensive actions to help Romanian cancer patient relatives to respect the recommendations regarding healthy lifestyle promotion and cancer prevention. Health professionals should periodically assess body composition and lifestyle components of adults who have relatives with cancer in order to identify unhealthy behavior and offer them personalized education and counseling.

The Role of Information Technology in Health Education: Strengths and Weaknesses

The present study gives an overview of the use of information technology in different phases of health education planning: analyses phase, behavioral intervention phase and continuation phase. Strengths and weaknesses of the use of information technology for health education from the perspective of Romanian context and experiences are also underlined. The data show that information technology offer valuable help for data collection, development, implementation and evaluation of health education programs. Tailored health education programs are an important and appealing innovation for health education, which increase the perceived personal relevance of health messages, which consequently, helps create ideal environments for persuasion and behavior change to occur. Romania is still at a beginning phase of using information technology for health education, especially regarding the development and use of tailored health education programs. Efforts are needed in order to develop appropriate tailored health education in Romania, based on the experience in this field from other countries.

Tobacco use among Romanian youth

This paper reviews data published between 1990 and 2006 regarding smoking prevalence as well as individual and contextual influences on the smoking behavior among Romanian young adults. Highlights include a consideration of multiple levels of influence, from intra-individual factors, such as demographic and cognitive factors, to social influences, such as families and peers, to the more macro, societal/cultural levels of influence, including advertising and tobacco-related policies The source of data is represented by articles and short information published in journals or in electronic format, legislation, statistics and are illustrated with pictures. Based on these data, recommendations for future smoking prevention and reduction actions for Romanian youth are taken.

Smoking Prevention for Adolescents in Romanian Schools

This study had two objectives. The first was to assess the frequency and content of school-based anti-smoking education received by Romanian adolescents aged 14-15. Secondly, the study aimed to evaluate to what extent the implementation of a specific 5 lessons smoking prevention program influences the quality of anti-smoking school education among Romanian adolescents. The investigation was performed in twenty schools from Cluj- Napoca, Romania, which were randomly assigned to the control and experimental conditions, resulting in 55 participating classes from the seventh grade (28 in the control group and 27 in the experimental group). The experimental group participated in a school-based smoking prevention program consisting of 5 lessons. The control group beneficiated only in the standard anti-smoking education offered by their schools. Six months after the program implementation, students from both experimental and control groups filled in a questionnaire, assessing several issues regarding their exposure to anti-smoking school education in the last year. The results showed a low exposure to anti-smoking school education among the Romanian adolescents. The implementation of the specific school-based smoking prevention program increased the exposure of Romanian adolescents to a higher number of lessons of smoking prevention and influenced positively the quality of these lessons. The study identified several gaps with respect to anti-smoking education in Romanian schools. It underlines the benefits of the implementation of a school based smoking prevention program with a clear structure, which contains appropriate educational messages and it is easy to implement.

Why do Romanian junior high school students start to smoke

BACKGROUND Adolescence is a crucial period in the development of smoking behaviour. To develop efficient prevention programmes for teenagers, it is essential to understand why adolescents start to smoke. The objective of this study was to assess the predictors of smoking onset among Romanian junior high school students aged 13-14. METHODS The data were obtained from a two-wave, 9-month longitudinal study carried out among 504 junior high school non-smokers from Cluj-Napoca, Romania. Questionnaires assessed smoking behaviour, attitudes, social influence, self-efficacy and intention regarding smoking (motivational variables), as well as different sociodemographic features. RESULTS The results from the logistic regression analysis revealed that baseline lower self-efficacy in refraining from smoking in several social situations, baseline pressures from peers to smoke and baseline intentions to smoke significantly increased the risk of non-smokers to become smokers at follow-up 9 months later. CONCLUSIONS These findings underline that reinforcing social self-efficacy to refuse smoking, resisting peer pressures and maintaining negative intentions regarding smoking are essential ingredients for smoking prevention programmes among Romanian junior high school students.

Assessment of health risk behaviours and their interrelationships among young people from two counties of Romania

AimThe first goal of this study was to assess the prevalence of different health risk behaviours among Romanian young people. Next, the interrelationship between different health risk behaviours as well as age and gender differences with respect to health risk behaviours were examined.Subjects and methodsSelf-administered questionnaires were completed by a sample of 1,598 junior high school students, senior high school students and university students from urban and rural areas of two counties of Romania.ResultsThe results showed that 31% of junior high school students, 59.7% of senior high school students and 64.8% of university students reported more than one risk behaviour. Many of the risk behaviours were likely to correlate with each other and the strongest correlation was found between smoking, alcohol-related behaviour and precocious sexual intercourse. Factor analysis revealed that among junior high school students all health risk behaviours loaded on one factor. In senior high school students and university students the risk behaviours split into two factors, based probably on their frequency and severity. Factor 1 comprised smoking, alcohol-related behaviours as well as precocious sexual intercourse, while factor 2 included less common behaviours: violence, delinquency and illicit drug use. No gender differences were observed regarding the relationship between health risk behaviours.ConclusionThe results stress the importance of developing prevention programmes among Romanian youth for the behaviours discussed. Further research is needed to identify how to best offer these programmes: as stand-alone programmes or as an integrated set of programmes and whether the same approach has to be taken for younger and older adolescents.

Depression, anxiety and panic disorders in chronic obstructive pulmonary disease patients: correlations with tobacco use, disease severity and quality of life

BackgroundThe objective of this study is to assess anxiety, depression and panic disorders among patients diagnosed with COPD and to investigate their correlation with disease severity, quality of life as well as tobacco use.MethodsAn observational study was performed between January and September 2014 among 60 patients diagnosed with COPD. COPD staging according to GOLD criteria, while anxiety and depression were assessed using Hospital Anxiety and Depression Scale and panic attacks were evaluated based on ICD 10 criteria.ResultsAlmost 40% of the sample were smokers, the medium packs-years was 34.3 and the medium Fagerstrom score was 7.5. Overall, mean Modified Medical Research Council Dyspnea Scale (mMRC) was 2.86, mean COPD Assessment Test (CAT) score was 21.75 and study participants had 1.93 COPD exacerbations/year. Mean distribution of anxiety and depression symptoms scores among COPD subjects was 10.65 ± 3.5 and 9.93 ± 3.8, respectively. Smokers and ex-smokers had similar scores with regard to anxiety, depression or the presence of panic attacks. The results of the bivariate correlations indicated associations between anxiety, depression, panic attacks and disease severity, as well as poor quality of life of patients with COPD, regardless of their current tobacco use status.ConclusionsIn conclusion, the results of this study indicate that anxiety, depression and panic attacks were constant characteristics among COPD patients- regardless of their current tobacco use.

Opinions and practices regarding electronic cigarette use among Romanian high school students

OBJECTIVE The study assessed awareness, opinions, practices regarding electronic cigarettes (e-cigarettes) and factors associated with their use among Romanian high school students. METHODS A cross-sectional study was conducted in 2013 in two major Romanian cities, distributing anonymous questionnaires to 342 high school students aged 16-18. RESULTS 52.3% of the smokers, 29.2% of the ex-smokers and 7% of the never-smokers had tried e-cigarettes at least once in their life; 7.8% of the smokers and 4.6% of the ex-smokers had used e-cigarettes in the last month. Among smokers, e-cigarette use was associated with lower participation in school health education regarding e-cigarettes and with having parents using e-cigarettes.. Among ex-smokers and never-smokers, e-cigarette use was associated with intention to use e-cigarettes in the next year and with having friends who use e-cigarettes. CONCLUSION Health education programmes and regulatory interventions addressing e-cigarettes are needed in Romania. More research is necessary on how to develop effective public health messages.