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Introduction: This study evaluated the effect of the COVID-19 pandemic on temporal trends in mental health and addiction--related inpatient hospitalization rates among youth (aged 10--17 years) in Canadian provinces and territories (excluding Quebec) from 1 April 2018 to 5 March 2022. Methods: We conducted an interrupted time series analysis across three periods: T0 (pre-pandemic: 1 April 2018 to 15 March 2020); T1 (early pandemic: 15 March 2020 to 5 July 2020); and T2 (later pandemic: 6 July 2020 to 5 March 2022). Results: Pre-pandemic mental health and addiction--related hospitalization rates had significant regional variability, with weekly rates from 6.27 to 85.59 events per 100 000 persons in Manitoba and the territories combined, respectively. During T1, the national (excluding Quebec) weekly hospitalization rate decreased from a pre-pandemic level of 12.82 (95% CI: 12.14 to 13.50) to 5.11 (95% CI: 3.80 to 6.41) events per 100 000 persons. There was no statistically significant change in the mental health and addiction--related hospitalization rate across provinces and territories in T2 compared to T0. However, there was a significant increase in the rate of self-harm--related hospitalizations among females Canada-wide and in most provinces during this period. Conclusion: Although several Canadian studies have reported increases in mental health and addiction--related outpatient and emergency department visits among youth during the COVID-19 pandemic, this did not correspond to an increase in the inpatient hospital burden, with the notable exception of self-harm among young females. [ABSTRACT FROM AUTHOR]

Objective: To identify multilevel correlates of former smoking in patients with cerebrovascular disease. Design: Secondary data analysis of the Canadian Community Health Survey. Methods: We used data from the 2007-2008 Canadian Community Health Survey (CCHS). Smoking status (former smoking vs smoker) was described by multilevel correlates of former smoking. A multilevel approach for variable selection for this study was used to understand how multiple levels in society can have an impact on former smoking. The study sample was selected from those respondents of the CCHS that reported they suffered from stroke symptoms. Logistic regression was used to predict former smoking in patients with cerebrovascular disease while controlling for multilevel confounders. Proportions were weighted to reflect the Canadian population. Results: There were 172 355 respondents who reporte to suffer from stroke. From this sample, 36.5% were smokers and 63.5% were former smokers. Age groups 55-69 and 70-80 and higher education (secondary education +) were positively related to former smoking. Household and vehicle smoking restrictions significantly predicted former smoking. Counselling advice from a physician and having access to a general practitioner were correlates of former smoking. Finally, the use of buproprion was positively related to former smoking. Conclusions: There are multilevel correlates of former smoking in smokers with reported stroke symptoms. These correlates include older age groups, higher education, household and vehicle smoking restrictions, pharmacotherapy use (bupropion), access to a general practitioner and counselling advice from a physician. [ABSTRACT FROM AUTHOR]

Background: Tobacco use is a major risk factor for recurrent stroke. The provision of cost-free quit smoking medications has been shown to be efficacious in increasing smoking abstinence in the general population. Objective: The objective of this pilot study was to assess the feasibility and obtain preliminary data on the effectiveness of providing cost-free quit smoking pharmacotherapy and counselling to smokers identified in a stroke prevention clinic. Trial design: Cluster randomised controlled trial. Methods: All patients seen at the Ottawa Hospital Stroke Prevention Clinic who smoked more five or more cigarettes per day, were ready to quit smoking in the next 30 days, and were willing to use pharmacotherapy were invited to participate in the study. All participants were advised to quit smoking and treated using a standardised protocol including counselling and pharmacotherapy. Participants were randomly assigned to either a prescription only usual care group or an experimental group who received a 4-week supply of cost-free quit smoking medications and a prescription for medication renewal. All patients received follow-up counselling. The primary outcome was biochemically validated quit rates at 26 weeks. The research coordinator conducting outcome assessment was blind to group allocation. Results: Of 219 smokers screened, 73 were eligible, 28 consented and were randomised, and 25 completed the 26-week follow-up assessment. All 28 patients randomised were included in the analysis. The biochemically validated 7-day point prevalence abstinence rate in the experimental group compared to the usual care group was 26.6% vs 15.4% (adjusted OR 2.00, 95% CI 0.33 to 13.26; p=0.20). Conclusions: It would be feasible to definitively evaluate this intervention in a large multi-site trial. Trial registration number: http://ClinicalTrials.gov # UOHI2010-1. [ABSTRACT FROM AUTHOR]