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IntroductionTobacco packaging design is conceived to be attractive. Plain packaging of tobacco products reduces this attractiveness by standardising their shape, size, font and colours.MethodsTo evaluate the effect of applying plain packaging to tobacco products on cardiovascular events and mortality in Argentina, we used the Cardiovascular Disease Policy Model–Argentina, a local adaptation of a well-established computer simulation model that projects cardiovascular and mortality events for the population 35–94 years old using local demographic and consumption data, during the period 2015–2024. After a literature review, we estimated that the implementation of plain packaging of tobacco products would result in an absolute decrease in tobacco prevalence of 0.55% (base-case scenario) and performed a sensitivity analysis assuming a higher and lower decrease of 1.01% and 0.095%, respectively.ResultsOver the 2015–2024 period, the decrease in smoking prevalence associated with plain packaging (0.55%) is projected to avert 1880 myocardial infarctions (MI), 820 strokes and 4320 total deaths in Argentina. The higher estimate of smoking prevalence reduction (1.01%) would translate into 3450 fewer MIs, 1490 fewer strokes and 7920 fewer deaths, while the lower estimate of smoking prevalence reduction (0.095%) would result in 330 fewer MIs, 140 fewer strokes and 750 fewer deaths.ConclusionsThe implementation of plain packaging of tobacco products could reduce cardiovascular events in Argentina, even in the absence of other tobacco control measures. Actual health benefits are likely higher than those presented here, since plain packaging may be most impactful by preventing young people from initiating smoking.

espanolObjetivo. Evaluar la escala de afluencia familiar (EAF), que consiste en el autorreporte sobre numero de computadoras y automoviles del hogar, dormitorio propio y vacaciones, como indicador de nivel socioeconomico (NSE) familiar en adolescentes escolarizados de tres paises latinoamericanos.Material y metodos. Fueron encuestados 14 717 estu-diantes de secundaria de Argentina, Mexico y Guatemala. Se evaluo la asociacion de la EAF con otros indicadores de NSE a nivel familiar (nivel educativo parental, posesion de bienes y servicios tecnologicos) y de entorno escolar (indice de marginacion, escuela publica o privada y matricula escolar).Resultados. La EAF mostro menos datos faltantes que los otros indicadores familiares de NSE. Ademas, mostro asocia-ciones en la direccion esperada con los otros indicadores de NSE. Conclusiones. La EAF parece constituir un indicador valido tanto de la riqueza material familiar como del NSE a nivel de la escuela, util para estudios sobre inequidades en salud en adolescentes latinoamericanos. EnglishObjective. To assess the family affluence scale (FAS), which consists of self-reported number of computers and cars in the home, having one’s own bedroom and holidays, as a fam-ily socioeconomic status (SES) indicator for adolescents in three Latin American countries. Materials and methods.14 717 secondary students from Argentina, Mexico and Guatemala were surveyed. The association between FAS and other SES indicators at familiar level (parent education and owning of technological goods and services) and school level (marginalization index, public or private school, and school fee) were evaluated. Results. The FAS was associ-ated in the expected direction with all other NSE indicators. Conclusions. The FAS seems to be a valid indicator of the material wealth of adolescent families, as well as of school SES, and it can be used in studies on health inequities in Latin American adolescents.

Objective: To systematically review published articles reporting the use of smoking cessation mobile health (mHealth) interventions in Latin America. Methods: Five different databases were searched from database inception to 2020. Criteria: (1) the research was a smoking cessation randomized controlled trial (RCT), quasi-experimental research, or single-arm study; (2) the intervention used at least one type of mHealth intervention; (3) the research was conducted in Latin American; and (4) the research reported the cessation rate. Results: Of the seven selected studies, four were conducted in Brazil, two in Mexico, and one in Peru. Only one study was an adequately powered RCT. Interventions relied on text messages ( n = 3), web-based tools ( n = 2), and telephone calls ( n = 3). Some studies ( n = 4) provided pharmacotherapy support. Smoking cessation outcomes included self-reported ( n = 5) and biochemically verified ( n = 2) abstinence. Follow-ups were conducted at Month 6 ( n = 2), Week 12 ( n = 4), and Day 30 ( n = 1). Cessation rates varied from 9.4% at Week 12 to 55.5% at Day 30. Conclusion: Despite the promising cessation rates of mHealth interventions in Brazil, Mexico, and Peru, there is a need to rigorously evaluate these interventions in different Latin American countries with RCTs that are long-term, adequately powered, and use biochemical verification of cessation.

OBJECTIVE: This study assesses the association between exposure to alcohol in movies and alcohol use transitions among Latin American adolescents. METHOD: A school-based longitudinal study involving 33 secondary schools in Argentina and 57 in Mexico was performed. The baseline sample included 1,504 never drinker adolescents in Argentina and 5,264 in Mexico (mean age = 12.5 years), of whom 1,055 and 3,540, respectively, completed a follow-up survey a year and a half later. Exposure to the 500 popular contemporary films was assessed by querying adolescents on 50 randomly selected titles. Films were content-coded for alcohol and exposure estimated from films seen. Logistic regression models estimated adjusted relative risk (aRR) for the following outcomes, net covariates, at follow-up: use of alcohol (having ever drank), current drinking (drinking in the past 30 days), ever binge drinking (≥ 4 drinks [females] or 5 for males). RESULTS: At follow-up, respective adolescent drinking rates for Mexico and Argentina were 31% and 36% for use of alcohol, 18% and 27% for current drinking, and 8% and 19% for ever binge drinking. Greater exposure to alcohol in movies was independently associated with trying alcohol (aRR = 1.30, 95% CI [1.17, 1.43]), current drinking (aRR = 1.22, 95% CI [1.03, 1.44]), and binge drinking (aRR = 1.71, 95% CI [1.30, 2.25]) in Mexican adolescents, whereas in Argentina, movie alcohol exposure was associated only with trying alcohol (aRR = 1.25, 95% CI [1.02, 1.53]). CONCLUSIONS: Exposure to alcohol in movies predicted underage drinking transitions in these Latin American adolescents, replicating prior results for U.S. and European cohorts.

Background Sugar-sweetened beverage (SSB) consumption is associated with obesity, diabetes, and hypertension. Argentina is one of the major consumers of SSBs per capita worldwide. Determining the impact of SSB reduction on health will inform policy debates. Methods and findings We used the Cardiovascular Disease Policy Model-Argentina (CVD Policy Model-Argentina), a local adaptation of a well-established computer simulation model that projects cardiovascular and mortality events for the population 35–94 years old, to estimate the impact of reducing SSB consumption on diabetes incidence, cardiovascular events, and mortality in Argentina during the period 2015–2024, using local demographic and consumption data. Given uncertainty regarding the exact amount of SSBs consumed by different age groups, we modeled 2 estimates of baseline consumption (low and high) under 2 different scenarios: a 10% and a 20% decrease in SSB consumption. We also included a range of caloric compensation in the model (0%, 39%, and 100%). We used Monte Carlo simulations to generate 95% uncertainty intervals (UIs) around our primary outcome measures for each intervention scenario. Over the 2015–2024 period, a 10% reduction in SSBs with a caloric compensation of 39% is projected to reduce incident diabetes cases by 13,300 (95% UI 10,800–15,600 [low SSB consumption estimate]) to 27,700 cases (95% UI 22,400–32,400 [high SSB consumption estimate]), i.e., 1.7% and 3.6% fewer cases, respectively, compared to a scenario of no change in SSB consumption. It would also reduce myocardial infarctions by 2,500 (95% UI 2,200–2,800) to 5,100 (95% UI 4,500–5,700) events and all-cause deaths by 2,700 (95% UI 2,200–3,200) to 5,600 (95% UI 4,600–6,600) for “low” and “high” estimates of SSB intake, respectively. A 20% reduction in SSB consumption with 39% caloric compensation is projected to result in 26,200 (95% UI 21,200–30,600) to 53,800 (95% UI 43,900–62,700) fewer cases of diabetes, 4,800 (95% UI 4,200–5,300) to 10,000 (95% UI 8,800–11,200) fewer myocardial infarctions, and 5,200 (95% UI 4,300–6,200) to 11,000 (95% UI 9,100–13,100) fewer deaths. The largest reductions in diabetes and cardiovascular events were observed in the youngest age group modeled (35–44 years) for both men and women; additionally, more events could be avoided in men compared to women in all age groups. The main limitations of our study are the limited availability of SSB consumption data in Argentina and the fact that we were only able to model the possible benefits of the interventions for the population older than 34 years. Conclusions Our study finds that, even under conservative assumptions, a relatively small reduction in SSB consumption could lead to a substantial decrease in diabetes incidence, cardiovascular events, and mortality in Argentina., Victoria Salgado and colleagues model the benefits of reduced sugar-sweetened beverage consumption in Argentina., Author summary Why was this study done? Sugar-sweetened beverages (SSBs) are associated with obesity, hypertension, and diabetes. Argentina is one of the largest consumers of SSBs, particularly sodas, in the world. When considering measures aimed at reducing SSB consumption, such as a soda tax, policy makers need evidence-based estimates of potential health benefits. What did the researchers do and find? We first developed and updated an Argentinian version of the Cardiovascular Disease Policy Model (CVD Policy Model), a well-established computer simulation model already used in the United States and Mexico to estimate cardiovascular health outcomes. We used the CVD Policy Model-Argentina to determine the potential impact of a reduction in soda consumption on diabetes, cardiovascular diseases (CVDs), and mortality among adults 35–94 years of age over a 10-year period (2015–2024). A 10% reduction in soda consumption is projected to avert between 13,300 to 27,700 diabetes cases, 2,500 to 5,100 myocardial infarctions, and 2,700 to 5,600 all-cause deaths over a 10-year period. The largest reductions in diabetes and cardiovascular events were observed in the youngest age group modeled (35–44 years) for both men and women; additionally, more events could be avoided in men compared to women in all age groups. What do these findings mean? A relatively small reduction in SSB consumption could lead to a substantial decrease in diabetes incidence, cardiovascular events, and mortality in Argentina. These results support the implementation of policies to reduce SSB consumption, such as a soda tax. Use of taxation as a health policy tool would have the additional advantage of providing a new source of public funds to support healthy lifestyles.

BackgroundOur objective was to assess whether exposure to tobacco in video games is associated with smoking among adolescent gamers from Argentina.MethodsCross-sectional data were analysed from students in public and private middle schools in Argentina. Tobacco content in video games was estimated using previously validated methods and adolescents’ tobacco exposure was assessed by multiplying tobacco content in the top three video games they play by the hours played per day. The primary outcome was current smoking. Multilevel logistic regression models adjusted for clustering within schools, regressing current smoking on tobacco exposure in video games (ie, none, low, high) after controlling for age, sex, parental education, parenting style, parental rules about the use of video games, rebelliousness, sensation seeking and ‘technophilia’.ResultsOf the 3114 students who participated, 92% of boys (1685/1802) and 56% of girls (737/1312) played video games and were included in the analytical sample. The prevalence of smoking was 13.8% among boys and 22.0% among girls; 74.5% of boys played video games more than 1 hour per day compared with 47.7% of girls. High exposure to tobacco content in video games compared with no exposure was independently associated with current smoking among girls (OR 1.78; 95% CI 1.02 to 3.09) but not among boys (OR 0.98; 95% CI 0.64 to 1.51).ConclusionsGreater exposure to tobacco content in video games was associated with higher likelihood of smoking among Argentine girls who play video games, suggesting the need for policies that limit these exposures.

Objective. To assess the validity of a standard measure of smoking susceptibility for predicting cigarette and e-cigarette use in a sample of early adolescents in Argentina and Mexico. Materials and methods. A school-based longitudinal survey was conducted in 2014-16 among secondary students. We analyzed students who were never smokers of regular cigarettes or e-cigarettes at baseline and who completed both surveys. The main independent variable was smoking susceptibility. Multilevel logistic regression models were used, adjusting for sociodemographic and personal variables, social network use of cigarettes and exposure to advertising. Results. In the adjusted analysis, smoking susceptibility independently predicted cigarette initiation (Argentina: AOR 2.28; 95%CI 1.66-3.14; Mexico: AOR 2.07; 95%CI 1.74-2.45) and current smoking (Argentina: AOR 3.61; 95%CI 2.48-5.24; Mexico: AOR 1.69; 95%CI 1.29-2.22); however, it only predicted e-cigarette initiation in Mexico (Mexico: AOR 1.29; 95%CI 1.02-1.63). Conclusion. Smoking susceptibility was a valid measure to predict future cigarette smoking in this sample.

Background: Cultivation of tobacco raises concerns about detrimental health and social consequences for youth, but tobacco producing countries only highlight economic benefits. We compared sociodemographic and health-related characteristics of school-age youth who worked and did not work in tobacco farming and assessed the effects on smoking behavior and health at 1 year. Methods: We used existing data collected in the province of Jujuy, Argentina where 3188 youth 13 to 17 years of age from a random middle school sample responded to longitudinal questionnaires in 2005 and 2006. Multivariate logistic regression models predicted association of tobacco farming work with health status and smoking behavior at 1 year. Results: 22.8% of youth in the tobacco growing areas of the province were involved in tobacco farming. The mean age of initiation to tobacco farming was 12.6 years. Youth working in farming had higher rates of fair or poor versus good or excellent self-perceived health (30.3% vs. 19.0%), having a serious injury (48.5% vs. 38.5%), being injured accidentally by someone else (7.5% vs. 4.6%), being assaulted (5.5% vs. 2.6%), and being poisoned by exposure to chemicals (2.5% vs. 0.7%). Youth working in tobacco farming also had higher prevalence of ever (67.9% vs. 55.2%), current (48.0% vs. 32.6%) and established smoking (17.8% vs. 9.9%). In multivariate logistic regression models tobacco farming in 2005 was associated with significant increased reporting of serious injury (OR = 1.4; 95%CI 1.1-2.0), accidental injury by someone else (OR = 1.5; 95% 1.0-2.1), assault (OR = 2.2; 95% CI 1.3-3.8), and poisoning by exposure to chemicals (OR = 2.5; 95% CI 1.2-5.4). Tobacco farming in 2005 predicted established smoking 1 year later (OR = 1.5; 95% CI 1.1-2.0). Conclusion: Youth who work in tobacco faming face a challenging burden of adversities that increase their vulnerability. Risk assessments should guide public policies to protect underage youth working in tobacco farming. (298 words). Fil: Alderete, Ethel del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Unidad Ejecutora en Ciencias Sociales Regionales y Humanidades. Universidad Nacional de Jujuy. Unidad Ejecutora en Ciencias Sociales Regionales y Humanidades; Argentina Fil: Livaudais Toman, Jennifer. University of California; Estados Unidos Fil: Kaplan, Celia. University of California; Estados Unidos Fil: Gregorich, Steven E.. University of California; Estados Unidos Fil: Mejía, Raúl. Centro de Estudios de Estado y Sociedad; Argentina Fil: Pérez Stable, Eliseo J.. National Institutes of Health; Estados Unidos

Objective: To examine and compare overall prevalence and time trends in tobacco and alcohol portrayals and brand appearances in youth-rated US and nationally-produced films that were the most successful in Argentina and Mexico from 2004-2012. Materials and methods: Top-grossing nationally produced films from Argentina (n=73), Mexico (n=85) and the US (n=643) were content analyzed. Logistic regression was used to determine differences between Mexican, Argentine and US produced films. Linear regression models assessed significant cross-country differences in the mean number of tobacco and alcohol seconds. Results: Films from Mexico and Argentina were more likely than US films to contain tobacco, (OR=4.2; p

Background: In Europe and the United States, family relationships and parenting behavior can influence youth substance use, but less is known about their influence in Latin American countries. Objective: To explore whether parenting behavior is associated with substance use among Latin American youth. Methods: A cross-sectional, school-based survey of middle-school youth (n = 3172) in three Argentinian cities queried tobacco, alcohol, and drug use using items adapted from global youth surveys. Parenting behavior was assessed with previously validated items that tapped into demandingness and responsiveness, separately for mothers and fathers. Multilevel logistic regression models assessed associations between parenting behavior and substance use after adjusting for student characteristics, socioeconomic indicators, sensation seeking, and smoking amongst peers and family members. Results: Substance use prevalence was 10% for current smoking, 32% for current drinking alcohol, 17% for past 30-day bing...

In Argentina, the national guidelines for lipid control emphasize the use of relatively inexpensive low- or moderate-potency statins by patients at high risk (>20 %) of a cardiovascular event. The objective of this study was to compare the impact and costs of the current national CVD prevention guidelines with regard to morbidity and mortality in Argentina with the impact and costs of three strategies that incorporate high-potency statins. We used the CVD Policy Model–Argentina to model the proposed interventions. This model is a national-scale, state-transition (Markov) computer simulation model of the CVD incidence, prevalence, mortality, and costs in adults 35–84 years of age. We modeled three scenarios: scenario 1 lowers the risk threshold for treatment to >10 % according the Framingham Risk Score (FRS); scenario 2 intensifies statin potency under current treatment thresholds; and scenario 3 combines both scenarios by lowering the treatment threshold to ≥10 % FRS and intensifying statin potency. Scenario 1 would translate into 1400 fewer MIs and 500 fewer CHD deaths every year, a 3 % and 2 % reduction, respectively. Scenario 2 would lead to 2000 fewer MIs and 1000 fewer CHD deaths every year. Scenario 3 would result in the greatest reduction in MIs and CHD deaths, with 3400 fewer MIs and 1400 fewer CHD deaths every year, which translates to a 7 % and 6 % reduction, respectively. All scenarios were cost-effective if the cost of a high-potency statin pill was under US$0.25. Incorporating those individuals with greater than 10 % cardiovascular risk and the use of high-potency statins into Argentina’s national lipid guidelines could result in fewer CHD deaths and events at a reasonable cost.

The aim of this study was to assess film character portrayals of tobacco and alcohol use in US and nationally-produced films that were popular in Argentina and Mexico from 2004–2012. We performed a content analysis of these films (n = 82 Argentine, 91 Mexican, and 908 US films, respectively). Chi-squares and t-tests were used to compare characteristics of characters who smoked or drank by country of movie production. Then data from all countries were pooled, and generalized estimating equation (GEE) models were used to determine independent correlates of character smoking or drinking. There were 480 major characters for Argentine-, 364 for Mexican-, and 4962 for US-produced films. Smoking prevalence among movie characters was similar to population smoking prevalence in Mexico (21%) and Argentina (26%), but about half in the US (11%), where movie product placements are restricted. Movie smoking declined over the period in all three countries. Movie alcohol prevalence was 40–50% across all countries and did not change with time. Demographic predictors of character smoking included: being male, 18 and older, having negative character valence. Movie smoking was not associated with lower SES. Predictors of character drinking included: being age 18 and older and positive character valence. Smoking and drinking predicted each other, illicit drug use, and higher scores for other risk behaviors. This suggests that policy development in Mexico and Argentina may be necessary to reduce the amount of character tobacco and alcohol use in films.

Background Use of flavour capsule varieties (FCVs) of cigarettes has rapidly increased in many countries. Adolescents are attracted to flavours; yet, surprisingly, no quantitative study has explored adolescents9 perceptions of these products. Objective To characterise the appeal of FCVs for young adolescents in Mexico. Methods In 2015, surveys were conducted with a representative sample of Mexican middle school students (n=10 124; ages 11–16 years; mean 12.4 years). Students viewed and rated packs for FCVs and non-FCVs from major brands (Marlboro, Camel, Pall Mall), with brand names removed. For each pack, students were asked to write the brand name (ie, brand recall), to evaluate pack attractiveness, and to indicate the pack they were most interested in trying (including a ‘none’ option). Logistic generalised estimating equation (GEE) models regressed brand recall, pack attractiveness and interest in trying on brand and FCV (yes vs no), controlling for sociodemographics and smoking risk factors. Results Marlboro regular, Camel regular, Camel light and Pall Mall FCVs were most often recalled (25%, 17%, 9%, 8%). Packs for Pall Mall FCVs and Camel FCVs were most often rated as very attractive (13%, 9%, respectively) and of interest for trial (22%, 13%) along with Marlboro regular (14%). In GEE models, FCVs were independently associated with greater attractiveness (adjusted OR (AOR)=1.83, 95% CI 1.72 to 1.94) and interest in trying (AOR=1.74, 95% CI 1.54 to 1.96). Perceived pack attractiveness was also independently associated with greater interest in trying (AOR=5.63, 95% CI 4.74 to 6.68). Conclusions FCVs appear to be generating even greater appeal among young adolescents than established non-FCVs in dominant brand families.

espanolIntroduccion: el tabaquismo en peliculas promueve el inicio de tabaquismo en adolescentes Objetivo: estimar el nivel de exposicion a imagenes de tabaco contenidas en peliculas vistas por adolescentes de Argentina y Mexico Metodos: Se realizo una encuesta a alumnos de primer ano del secundario de Argentina y Mexico. Se analizaron las 100 peliculas con mayor recaudacion en cada ano del periodo 2009-2013 (Argentina) y 2010-2014 (Mexico). A cada participante se le asigno una muestra aleatoria de 50 de estas peliculas, preguntandosele si la habia visto. Se estimo el numero total de adolescentes que habian visto cada pelicula en cada pais, y se multiplico por el numero de escenas que contenian tabaco (ocurrencias) en cada pelicula para asi obtener el numero de impresiones crudas de tabaco vista por los adolescentes escolarizados de cada pais. Resultados: Se analizaron 422 films en Argentina y 433 en Mexico. Mas de 500 millones de imagenes de tabaco fueron vistas por la poblacion joven de cada pais, lo que promedia 128 y 121 minutos de escenas con tabaquismo por cada adolescente en Argentina y Mexico respectivamente. Si bien los films calificados para mayores de 15/16/18 anos tenian mayor promedio por pelicula de escenas de tabaco, las peliculas calificadas para menores de esta edad fueron responsables de la mayor cantidad de escenas de tabaquismo vistas por adolescentes (67,3% en Argentina y 54,4% en Mexico) debido a su mayor audiencia. Conclusiones: A nivel poblacional son las peliculas para ninos las maximas responsables de la carga de tabaco vista por adolescentes. EnglishBackground: Smoking scenes in movies promote adolescent smoking onset; thus, the analysis of the number of smoking images inmovies really reaching adolescents has become a subject of increasing interest.Objective: The aim of this study was to estimate the level of exposure to images of smoking in movies watched by adolescents in Argentina and Mexico.Methods: First-year secondary school students from Argentina and Mexico were surveyed. One hundred highest-grossing films from each year of the period 2009-2013 (Argentina) and 2010-2014 (Mexico) were analyzed. Each participant was assigned a random sampleof 50 of these movies and was asked if he/she had watched them. The total number of adolescents who had watched each movie ineach country was estimated and was multiplied by the number of smoking scenes (occurrences) in each movie to obtain the numberof gross smoking impressions seen by secondary school adolescents from each country.Results: Four-hundred and twenty-two movies were analyzed in Argentina and 433 in Mexico. Exposure to more than 500 million smoking impressions was estimated for adolescents in each country, averaging 128 and 121 minutes of smoking scenes seen by each Argentine and Mexican adolescent, respectively. Although 15, 16 and 18-rated movies had more smoking scenes in average, moviesrated for younger teenagers were responsible for the highest number of smoking scenes watched by students (67.3% in Argentinaand 54.4% in Mexico) due to their larger audience.Conclusion: At the population level, movies aimed at children are responsible for the highest tobacco burden seen by adolescents.

Objective To assess the independent relation between parental restrictions on mature-rated media (M-RM) and substance use among South American adolescents. Methods Cross-sectional school-based youth survey of 3,172 students (mean age, 12.8 years; 57.6% boys) in 3 large Argentinean cities. The anonymous survey queried tobacco, alcohol, and drug use using items adapted from global youth surveys. Adolescents reported M-RM restriction for internet and video game use, television programming, and movies rated for adults. Multivariate logistic regression models were used to assess the association between parental M-RM restriction and substance use after adjustment for hourly media use, measures of authoritative parenting style, sociodemographic characteristics, and sensation-seeking. Results Substance use rates were 10% for current smoking, 32% for current drinking alcohol, 17% for past 30-day binge drinking, and 8% for illicit drug use (marijuana or cocaine). Half of the respondents reported parental M-RM restriction (internet 52%, TV 43%, adult movies 34%, video game 25%). Parental M-RM restriction was only modestly correlated with authoritative parenting measures. In multivariate analyses M-RM restriction on all 4 venues was strongly protective for all substance use outcomes. Compared with no restriction, odds ratios for substance use for full restrictions were 0.32 (0.18–0.59), 0.53 (0.38–0.07), 0.36 (0.22–0.59), and 0.49 (0.26–0.92) for current smoking, drinking, binge drinking, and illicit drug use, respectively. The most important single M-RM venue was movies. Conclusions Results of this study confirmed the protective association between parental M-RM restriction during adolescence and multiple substance use outcomes, including illicit drugs. M-RM restriction is independent of traditional parenting measures. The preponderance of the evidence supports intervention development.

Purpose Assess the prevalence and correlates of e-cigarette perceptions and trial among adolescents in Mexico, where e-cigarettes are banned. Methods Cross-sectional data were collected in 2015 from a representative sample of middle-school students (n = 10,146). Prevalence of e-cigarette awareness, relative harm, and trial were estimated, adjusting for sampling weights and school-level clustering. Multilevel logistic regression models adjusted for school-level clustering to assess correlates of e-cigarette awareness and trial. Finally, students who had tried only e-cigarettes were compared with students who had tried: (1) conventional cigarettes only; (2) both e-cigarettes and conventional cigarettes (dual triers); and (3) neither cigarette type (never triers). Results Fifty-one percent of students had heard about e-cigarettes, 19% believed e-cigarettes were less harmful than conventional cigarettes, and 10% had tried them. Independent correlates of e-cigarette awareness and trial included established risk factors for smoking, as well as technophilia (i.e., use of more media technologies) and greater Internet tobacco advertising exposure. Exclusive e-cigarette triers (4%) had significantly higher technophilia, bedroom Internet access, and Internet tobacco advertising exposure compared to conventional cigarette triers (19%) and never triers (71%) but not compared to dual triers (6%), although dual triers had significantly stronger conventional cigarette risk factors. Conclusions This study suggests that adolescent e-cigarette awareness and use is high in Mexico, in spite of its e-cigarette ban. A significant number of medium-risk youth have tried e-cigarettes only, suggesting that e-cigarettes could lead to more intensive substance use. Strategies to reduce e-cigarette use should consider reducing exposures to Internet marketing.

Tobacco use is the primary preventable cause of death and disability in the world. To combat the tobacco epidemic, most countries have signed and ratified the World Health Organzation's Framework Convention on Tobacco Control (WHO FCTC). Article 13 of this treaty requires implementation of a comprehensive ban on tobacco advertising, promotion and sponsorship. Implementation guidelines for Article 13 recognize that the depiction of tobacco use in commercially-produced films promotes tobacco use amongst young people. In this article we review the relationship between the tobacco industry and the movie industry over the past 100 years; the cross sectional and longitudinal studies that demonstrate a causal relationship between exposure to movie smoking depictions and youth smoking initiation; and the policy interventions recommended by the WHO to limit youth exposure to tobacco in movies.El consumo de Tabaco es la primera causa de mortalidad prevenible en el mundo. Para combatir esta epidemia, los países miembros de la Organización Mundial de la Salud han firmado, y la mayoría de ellos ratificado, el Convenio Marco para el Control del Tabaco. El articulo 13 de este tratado toda forma de publicidad, promoción y patrocinio del tabaco. Las guías para la implementación de este artículo reconocen que la presencia de tabaco en el cine es una forma de promoción de los productos del tabaco dirigida principalmente a los jóvenes.En esta revisión describimos la relación entre la industria del cine y la del tabaco en los últimos 100 año, los estudios de corte transveral y longitudinales que demiuestran como la exposición a tabaco en el cine induce a los jóvenes a iniciarse en el tabaquismo, y las políticas públicas recomendadas para evitar la presencia de tabaco en el cine, al menos en las películas para niños y adolescentes.

Purpose Develop and validate a scale that measures Technophilia (positive orientation toward new technology) and use it to address orientation toward new technologies to explain e-cigarette trial and adoption, especially in relatively low risk adolescents. Methods Survey data were obtained from students of the three largest cities in Mexico (n = 8123). We developed eight questions involving access, use and pleasure from different electronic media to measure technophilia. Exploratory factor analysis (EFA) was conducted. Linear GEE models were used when regressing technophilia on covariates. When regressing e-cigarette and conventional cigarette trial and use, logistic GEE models were used. Finally, we used multinomial logistic regression to evaluate the associations between technophilia and e-cigarettes as the first tobacco product. Results Technophilia were correlated with theoretically-related variables. Unadjusted and adjusted models regressing e-cigarette trial and use indicated that students in the highest quartile for technophilia were more likely to have tried e-cigarettes compared with the lowest quartile (AORQ4 vs Q1 = 1.36, 95% CI 1.14–1.62). Technophilia was not independently associated with current e-cigarette use in adjusted models. Students with higher technophilia were more likely to have first tried e-cigarettes in both crude and adjusted models (AORQ4vQ1 = 1.66, 95% CI 1.20–2.31; AORQ3vQ1 = 1.43, 95% CI 1.02–2.01). Technophilia did not have a statistically significant, independent association with first use of other tobacco products. Conclusion This study suggests that technophilia is associated with trial of e-cigarettes among youth. The measure we developed appears useful for understanding why some youth are open to trying novel, technologically oriented ways to consume nicotine.

International and cross-cultural research is critical for understanding multilevel influences on health, health behaviors, and disease. A particularly relevant area of need for such research is tobacco control. The tobacco epidemic is one of the biggest public health threats globally, killing over 7 million people a year. Research critical to addressing this public health problem has leveraged variability in tobacco use, history, product market, and policies across different countries, settings, and populations, particularly in low- and middle-income countries (LMICs) where the tobacco burden is increasing. These efforts are needed in order to advance the science and inform practice and policy in various settings, including the US. Several funding agencies provide support for international research focused on tobacco control in LMICs because of the importance and implications of such research. This paper provides some concrete examples of how such research has advanced our knowledge-base and informed practice and policy globally, particularly in high-income countries including the US. Some prominent themes emphasized in this manuscript include: the development of knowledge regarding the diverse tobacco products on the market; better understanding of tobacco use and its impact among different populations; generating knowledge about the impacts including unintended consequences of tobacco control policy interventions; and better understanding tobacco industry strategies and informing advocacy efforts. In summary, international tobacco control research, particularly in LMICs, is critical in effectively and efficiently building the evidence base to advance tobacco control research, policy, and practice globally, including the US, with the ultimate goal of curbing the tobacco epidemic.

OBJECTIVE: To examine the relationship between parent education, at individual- and school-level, and substance use behaviors (smoking, alcohol drinking, binge drinking, and illicit drug use) among young adolescents from Argentina and Mexico. METHODS: A cross-sectional, school-based survey of middle-school early adolescents from Mexico (N=10,123) and Argentina (N=3,172) queried substance use. RESULTS: After adjusting for age, sex and individual-level parent education, students from Mexican schools with lower parent education had higher likelihood of current smoking and drug use than those from schools with higher parent education. In Argentina, lower parent education at school-level was positively associated with all outcomes. CONCLUSION: Disadvantageous contextual school characteristics contributes to substance use among early adolescents in Mexico and Argentina.

Background Several researches have demonstrated a strong association between exposure tobacco advertising at point of sale (PoS) and tobacco susceptibility, experimentation and adolescent uptake. However, there are no local studies demonstrating this association.Our objective was to explore the association between exposure to tobacco advertising in PoS located near secondary schools and smoking in early adolescents in 3 Argentinean cities: Córdoba, Tucumán and Buenos Aires Methods This is a cross-sectional study with two descriptive sources: information about tobacco consumption was obtained through a survey of adolescents from 33 secondary schools in Buenos Aires, Córdoba and Tucumán. In addition, data on cigarette advertising in the PoS were relayed within 300 meters of each selected school. An exposition index was derived by multiplying the frequency of going to tobacco shops and a marketing index of each PoS (obtained by adding the number of signs, visibility from outside and displaying tobacco less than 1m from children's products). We explored the association between exposure to PoS advertising and smoking at individual and school level through multilevel logistic regression, adjusting for sociodemographics, social network smoking, and sensation seeking. Results The questionnaire was completed by 1680 students, 158 (9.4%) smokers, 895 (53%) no susceptible non-smokers, 389 (23%) susceptible non-smokers and 274 (16.3%) experimenters. We surveyed 340 PoS, 88 (25.88%) in Tucumán, 80 (23.53%) in Córdoba and 170 (50%) in Buenos Aires. Exposure to PoS advertising was significantly associated with being an experimenter (OR = 1.58, 95% CI 1.16-2.14) and susceptible (OR = 1.65, 95% CI 1.2-2.25) in the highest quartile of exposure. Smokers OR (95% IC) Experimenters OR (95% IC) Susceptibles OR (95% IC) Quartile 2 1.19 (0.838 - 1.685) 1.16 (0.873 - 1.534) 1.33 (0.983 - 1.792) Quartile 3 1.32 (0.930 - 1.874) 1.32 (0.996 - 1.754) 1.15 (0.839 - 1.584) Quartile 4 1.22 (0.848 - 1.758) 1.58 (1.160 - 2.147)§ 1.65 (1.207 - 2.250)§ OR= Odds Ratio § p

Background Since 2011, tobacco marketing in Argentina is banned through traditional channels. However, marketing at the point of sale (PoS) is allowed with only few limitations. PoS are currently the primary venue where youth are exposed to marketing of tobacco products. Our objective was to assess the compliance with the PoS legislation among retailers located near assess secondary schools in Buenos Aires, Córdoba and Tucumán. Methods During 2016 a survey was conducted among all the retailers within 300 m of a convenience sample of 33 secondary schools in Buenos Aires, Córdoba and Tucumán. We assessed the compliance with the seven points imposed by the Tobacco Control National Law regarding PoS. An index was created with these seven items and dichotomized into low compliance (4 or more violations) and high (3 violations or less). Store type, distance from the school, city, marketing of flavoured cigarettes and alcoholic beverages were also evaluated. The association between potential predictors of noncompliance was investigated by calculating crude and adjusted OR using a logistic regression controlled by covariates. Results Of the 340 stores surveyed, 190 (55.88%) were kiosks, 84 (24.71%) were small convenience stores, 46 (13.53%) supermarket and 20 (5.88%) others. Overall, 217 (63.82%) of the PoS had low compliance. Most, 87.35%, had at least one infraction. The three most common were the failure to display a "prohibition of sale to minors"sign, 290 (85.29%), to have more than one advertising sign, 208 (61.18%) and the sale single cigarette 167 (49.12%). Buenos Aires (the capital city) was the place with more violations, 48.82%. The strongest predictors of low compliance were marketing of flavoured cigarettes (OR=3.78, 95%IC 1.97-7.24) and alcohols beverages (OR=1.25, 95%IC 1.12- 1.51). OR 95% IC AOR 95% IC City: Bs. Aires Córdoba Tucumán 9.52 0.31 0.23 5.57 - 16.28 0.18 - 0.52 0.14 - 0.39 1 0.13* 0.28* 0.06 - 0.25 0.14 - 0.58 Alcohol marketing 1.16 1.09 - 1.29 1.25* 1.12 - 1.51 Flavored cigarette marketing 3.93 2.39 - 6.45 3.78* 1.97 - 7.24 *

Background The contradictory findings about the role of the socioeconomic status (SES) in accounting for substance use in adolescence can be explained by the lack of consensus on how best to conceptualize and measure SES. Based on Coleman's social theory, this study examines the association of family and school SES with tobacco and e-cigarette use. Methods Data came from a cross-sectional, school-based survey of middle-school early adolescents attending 33 schools in three Argentinian cities (n=3,110). Family SES was evaluated using: 1) family affluence scale (FAS) for material capital, 2) parent education for human capital, and 3) nuclear family and parent-adolescent communication for social capital. A school SES index was computed aggregating FAS and parent education from students. Multilevel logistic regression models regressed current tobacco use (in the past 30 days) and ever e-cigarette use on family and school-level SES, controlling for sex and age. Results 17.7% students were current tobacco smokers and 7.7% have ever used e-cigarette. At family level, material capital was unassociated with tobacco smoking, but positively associated with e-cigarette use; human capital was unassociated with both tobacco smoking and e-cigarette use; and social capital was inversely associated with both tobacco smoking and e-cigarette use. After adjusting for family SES, students from schools with higher SES had lower likelihood of tobacco smoking (OR=0.25, 95%CI 0.09-0.74) and higher likelihood of e-cigarette use (OR=4.36, 95%CI 1.25-15.23) than those from schools with lower SES. Conclusions Family capital measures are differentially related to student substance use, pointing out that SES indicators are not interchangeable. School SES has an independent effect on substance use above and beyond that of family SES. These findings emphasize the need for SES conceptualization and consistent selection of indicators in order to study the effect of SES on health research and its role in identifying students at-risk of substance use.

Background Our objective was to assess whether exposure to tobacco in videogames is associated with smoking in adolescents from Argentina. Methods We performed a cross-sectional study with 3,646 s middle school students from public and private schools in Argentina. Tobacco content in video games was estimated using previously validated methods and adolescent´s tobacco exposure was assessed by multiplying tobacco content by the hours per day played (range 0 to 5). Outcome measure was current smoking among video game players. Logistic regression models with random intercepts for school were used to regress current smoking on tobacco exposure and study variables multivariate models were adjusted for age, sex, parental education, rebelliouness, sensation seeking, parenting style of mother and father, tecnophilia and rules about the use of video games. Results 3113 students responded to the survey (response rate 85.4%), 1802 boys and 1312 girls; 1658 (92%) boys and 737 (56.2%) girls were gamers and were included in the analytic sample (n = 2442). Mean age was 14.3 years (SD = 1.1), and the prevalence of smoking was 13.8 among boys and 22.0% among girls; 74.5% of boys played more than 1 hour per day compared with 47.7% of girls. High exposure to tobacco as compared to no exposure to tobacco in video games was independently associated with current smoking among girls (OR = 1.78; 95%CI = 1,02 - 3,09) but not among boys ( OR = 0.98; 95%CI = 0,64 - 1,51). Conclusions Higher levels of exposure to tobacco in videogames were associated with higher likelihood of smoking in girls from Argentina.

Background E-cigarette use is spreading in Latin America both in adults and adolescents. However, little is known about how interest in them varies over time and across different countries. Countries have adopted different policies for e-cigarettes. When banned, consumers tend to use the Internet to search for and buy them. Google Trends is a publically available index of Internet search activity that has been used for generating public health insights. This study uses Google Trends analyses to assess variations in e-cigarette searches across 5 large Spanish-speaking Latin-American countries over the past five years. Methods We used Google Trends to assess the topic "electronic cigarette" in Argentina, Chile, Colombia, México and Perú; from June 2012 through June 2017. We selected these countries based on population size, tobacco use prevalence and legislation regarding e-cigarettes. We also searched for terms of specific brands among the top 25 e-cigarette related searches in the five countries. Results Searches regarding e-cigarettes have increased over the last five years in all 5 countries. There are clear differences between countries. Argentina and Mexico, the two countries where e-cigarettes are banned have the highest frequency of searches, together with Chile that has the highest prevalence of tobacco use in the Region. It is noticeable a peak in searches in Argentina during May 2016, which is explained by national press coverage of the weak enforcement of the e-cigarette ban during this time period. Popular brands appeared in the top 25 related search terms and included general e-commerce sites, e-cigarette specific marketplace sites, and product manufacturer specific sites. Conclusions Identifying search trends around e-cigarettes can enhance the evidence base for the changes in the public perceptions of e-cigarettes in Latin America. Comparisons across countries with different tobacco control strategies could be important for understanding how to regulate this emerging product.

Background E-cigarettes have had a strong growth in Mexico, especially among adolescents. These products are advertised as technology advanced products and their increased use may reflect a tendency to adopt new technologies. The concept of "technophilia" draws attention to the "pleasure, affection, and emotional qualities" that accompanies new technology. The aim of this study is to explore and validate a technophilia index among a cohort of Mexican youth, and to evaluate the association with e-cigarette trial and use. Methods We analyzed cross-sectional data from 8747 students from the three largest cities in Mexico. To develop the technophilia index we evaluated eight questions related to internet use. To validate this scale, we used an explanatory factor analysis on the overall item set. We used linear and multinomial logistic regressions to evaluate the association between the technophilia index and e-cigarette trial/use, and having used e-cigarette as the first tobacco product. Results Study results showed a dose-response association between technophilia index and e-cigarette trial (OR=1.48, 95% CI 1.26-1.75, Quartile 4 vs. Quartile 1). Moreover, Mexican adolescents with high levels of technophilia were more likely to have used e-cigarettes as their first tobacco product (OR=1.78, 95% CI 1.31-2.42, Quartile 4 vs. Quartile 1). Conclusions Results from this study suggest that e-cigarette trial is characterized by greater technophilia among youth. This study highlights the need for research in this area, so that effective strategies may be developed to address these risk factors.

Background In a previous cross-sectional study, we developed a marketing receptivity index (MRI), which had independent, positive associations with positive smoking expectancies, smoking susceptibility and current smoking behavior in a sample of early adolescents in Argentina. The current study aimed to assess the predictive validity of the MRI. Methods Data come from a longitudinal, school-based survey conducted in 33 secondary schools in Argentina. We included students who had never smoked at baseline and were successfully followed up approximately 17 months later (n=1700). Marketing receptivity was assessed with questions in three domains: frequency of going to stores that sell tobacco; cued recall of brand names for 3 cigarette packages with brand name removed; and ownership of branded merchandise. A four-level MRI was derived (low PoS marketing exposure only; high PoS exposure or recall of 1 brand; recall of 2 or more brands; and ownership of branded merchandise). Self-report of having tried to smoke at follow-up (i.e., initiation) was the primary outcome assessed. Logistic models regressed smoking initiation on the MRI, the MRI components (considered separately), and willingness to try one of the brands shown in the cued recall task, adjusting for sociodemographics, social influences and sensation seeking. Results The 4 level MRI had independent positive associations with smoking initiation (AOR 2 vs. 1 =1.42, 95% CI=1.12-1.79; AOR 3 vs 1 =2.04, 95% CI=1.38-3.00; AOR 4 vs. 1 =2.16, 95% CI=1.21-3.82). The index components, analyzed separately, were associated with outcomes except for ownership of branded merchandise. Willingness to try one of the brands shown in the recall task was also associated with initiation (AOR=1.73, 95% CI=1.31 - 2.28). Marketing Receptivity Index (MRI) OR (95% CI) p AOR (95% CI) p 1-Low PoS, 0 brands recalled 1 2-High PoS exposure or 1 brand recalled 1.12 (0.91 - 1.39) NS 1.42 (1.12 - 1.79)

Background As countries prohibit tobacco marketing through traditional channels, marketing at point of sale (PoS) and through tobacco packaging is increasingly important for promoting tobacco consumption. Objectives Assess the validity of a novel marketing receptivity index that considers frequency of PoS exposures, tobacco brand recall and ownership of branded merchandise. Methods Data come from a cross-sectional survey of 3172 secondary school students in Argentina. Questions assessed frequency of going to stores where tobacco is often sold; cued recall of brand names for 3 cigarette packages with brand name removed and ownership of branded merchandise. A four-level marketing receptivity index was derived: low PoS exposure only; high PoS exposure or recall of 1 brand; recall of 2 or more brands; and ownership of branded merchandise. Indicators of marketing receptivity and smoking involvement were regressed on the index, including in adjusted models that controlled for sociodemographics, social influences and sensation seeking. Findings Among never-smokers, the index had independent positive associations with smoking susceptibility (ie, adjusted OR (AOR) 2v1 =1.66; AOR 3v1 =1.64; AOR 4v1 =2.95), willingness to try a specific brand (ie, AOR 2v1 =1.45; AOR 3v1 =2.38; AOR 4v1 =2.20) and positive smoking expectancies (ie, B adj 2v1 =0.09; B adj 3v1 =0.18; B adj 4v1 =0.34). A more marked dose–response independent association was found with current smoking behaviour (ie, AOR 2v1 =2.47; AOR 3v1 =3.16; AOR 4v1 =3.62). Conclusions The marketing receptivity index was associated with important variation in smoking-related perceptions, intentions and behaviour among Argentine adolescents. Future research should determine the predictive validity and generalisability of this measure to other contexts, including the explanatory power gained by integrating cigarette package brand recognition tasks.

Background: Following cessation interventions, self-reported smoking abstinence with biochemical verification is the “gold standard” for defining outcomes. Because obtaining biochemical verification is challenging in community studies, we compared self-reported cessation among smokers completing treatment to the smoking status reported by each participant's spouse or proxy.Method: Participants were smokers who had reported quitting 12 months after a cessation intervention. Participants had either attended a smoking cessation clinic or they were patients seen by physicians who had recently participated in a cessation-training program. Proxies living with these participants were interviewed by telephone to ask about their partner's smoking status. We compared the participants' responses to those from their spouses.Results: At 12 months, 346 of 1423 baseline smokers had quit; 161/346 reported non-smokers were called and 140 proxies were interviewed. The participants averaged 51 years of age, 69% were women. At baseline, the mean number of cigarettes smoked per day was 20.1 (SD = 9.9) and the average number of quit attempts was 2.4 (SD = 1.2). Cessation methods used were medical advice (21%) and/or pharmacotherapy (79%). Of the 140 spouses interviewed, only 10 (7.1%) reported that their partners were currently smoking.Conclusions: Proxy-reported data on smoking status could be used to validate self-report.

This article presents the analysis of the influence of environmental variables on the received signal power from a point to point wireless link (f = 5.52 GHz) in a tropical urban environment, in the cities of Guayaquil and Duran, of Ecuador. The study included data of five variables such as relative humidity (HR), atmospheric temperature (T), solar radiation (RS), rainfall (Pr) and signal power (P) for three days of measurements, during the rainy season of 2016. A graphical and correlational analysis was performed for each climatic variable with the received signal power, and three regression models were developed. The first is linear, the second is quadratic, and finally, the third is non-linear based on a logistic function with four parameters using statistics packages of the software SPSS Statistics. From the data analysis, it can be concluded that the rainfall event modulated the influence of the atmospheric temperature on the power signal response, being temperature the variable that presents the higher correlation with the power signal data.

Purpose This study evaluated whether e-cigarette trial among Mexican adolescents increased the likelihood of trial and use of conventional cigarettes or marijuana use at follow-up. Method A school-based longitudinal survey was conducted in 60 public middle schools from the three largest cities in Mexico. Students (12–13 years old) were surveyed in 2015 and followed up 20 months later (n = 6574). Generalized estimating equations models were used to evaluate the association between e-cigarette trial at baseline and conventional cigarettes smoking and marijuana use at follow-up. Result Adolescents who had tried e-cigarettes (but not cigarettes) at baseline were more likely to have tried conventional cigarettes at followup compared to adolescents who had tried neither e-cigarettes nor cigarettes (43% vs. 24%, respectively; RR 1.41, 95% CI 1.18-1.70). We also found that adolescents who had tried both conventional cigarettes and e-cigarettes at baseline were more likely to have tried marijuana at follow-up compared to adolescents who had tried neither tobacco product (20% vs. 4%, respectively; RR 2.67, 95% CI 1.78–4.02). Trial of only e-cigarettes was not independently associated with marijuana use at followup. Conclusions Adolescents who had tried e-cigarettes were more likely to have tried conventional cigarettes and marijuana 20 months later. Although e-cigarettes have been banned in Mexico, it is likely that additional policies and public health campaigns are needed to reduce adolescent use of e-cigarettes and its consequences.

Introduction In a previous cross-sectional study of early adolescents, we developed a marketing receptivity index (MRI) that integrates point-of-sale (PoS) marketing exposures, brand recall, and ownership of branded merchandise. The MRI had independent, positive associations with smoking susceptibility among never smokers and with current smoking behavior. The current longitudinal study assessed the MRI's predictive validity among adolescents who have never smoked cigarettes Methods Data come from a longitudinal, school-based survey of 33 secondary schools in Argentina. Students who had never smoked at baseline were followed up approximately 17 months later (n = 1700). Questions assessed: PoS marketing exposure by querying frequency of going to stores where tobacco is commonly sold; cued recall of brand names for 3 cigarette packages from dominant brands but with the brand name removed; and ownership of branded merchandise. A four-level MRI was derived: 1.low PoS marketing exposure only; 2. high PoS exposure or recall of 1 brand; 3. recall of 2 or more brands; and 4. ownership of branded merchandise. Logistic regression models regressed smoking initiation by follow up survey on the MRI, each of its components, and students' willingness to try a brand, adjusting for sociodemographics, social network smoking, and sensation seeking. Results The MRI had an independent positive association with smoking initiation. When analyzed separately, each MRI component was associated with outcomes except branded merchandise ownership. Conclusions The MRI and its components were associated with smoking initiation, except for branded merchandise ownership, which may better predict smoking progression than initiation. The MRI appears valid and useful for future studies.

Background: Physician-implemented interventions for smoking cessation are effective but infrequently used. We evaluated smoking cessation practices among physicians in Argentina.Methods: A self-administered survey of physicians from six clinical systems asked about smoking cessation counselling practices, barriers to tobacco use counselling and perceived quality of training received in smoking cessation practices.Results: Of 254 physicians, 52.3% were women, 11.8% were current smokers and 52% never smoked. Perceived quality of training in tobacco cessation counselling was rated as very good or good by 41.8% and as poor/very poor by 58.2%. Most physicians (90%) reported asking and recording smoking status, 89% advised patients to quit smoking but only 37% asked them to set a quit date and 44% prescribed medications. Multivariate analyses showed that Physicians' perceived quality of their training in smoking cessation methods was associated with greater use of evidence-based cessation interventions. (OR = 6.5; 95% CI = 2.2–19.1); motivating patients to quit (OR: 7.9 CI 3.44–18.5), assisting patients to quit (OR = 9.9; 95% CI = 4.0–24.2) prescribing medications (OR = 9.6; 95% CI = 3.5–26.7), and setting up follow-up (OR = 13.0; 95% CI = 4.4–38.5).Conclusions: Perceived quality of training in smoking cessation was associated with using evidence-based interventions and among physicians from Argentina. Medical training programs should enhance the quality of this curriculum.

Objective To assess whether exposure to movie smoking is associated with cigarette smoking among Argentinian adolescents. Study design A school-based longitudinal study involving 33 secondary schools in Argentina was performed. The sample included 2502 never smokers (average age at entry = 12.5 years), 1700 (67.9%) of whom completed follow-up surveys 17 months later. Exposure to the top 100 highest-grossing films for each year between 2009 and 2013 was assessed by content-coding films for tobacco and then by asking adolescents whether they had seen each of 50 titles, randomly selected from the larger pool, then parsing exposure into tertiles. Logistic regression models estimated aOR for the following transitions: nonsusceptible to susceptible never smoker, never smoker to ever smoker, and never smoker to current smoking (last 30 days). Results At follow-up, 34.4% of nonsusceptible never smokers became susceptible, 24.1% reported having tried smoking, and 9.4% were current smokers. Most exposure to movie smoking was from US-produced films (average 60.3 minutes compared with only 3.4 minutes from Argentine films). Greater exposure to smoking in movies was significantly associated with increased odds of becoming susceptible (aOR first vs third tertile 1.77, 95% CI 1.30-2.41), of trying smoking (aOR first vs third tertile 1.54, 1.14-2.08), and marginally associated with current smoking (AOR first vs third tertile 1.54, 0.99-2.40). Exposure to smoking in US- or Argentine-produced films had similar associations. Conclusion In Argentina, exposure to smoking in the movies predicted future smoking transitions among early adolescents, with most exposure coming from viewing US movies.

OBJECTIVES:This study evaluated the effect of factors reflecting appreciation of Indigenous culture and racial insults on alcohol and drug use initiation among multi-ethnic youth in Jujuy, Argentina.METHODS:Students were surveyed from 27 secondary schools that were randomly selected to represent the province. A total of 3040 eligible students in 10th grade, age 14 to 18years were surveyed in 2006 and 2660 of these same students completed surveys in 11th grade in 2007. Multivariate logistic regression models assessed the effect of appreciation for Indigenous cultures and reported exposure to racial insults in 10th grade on incident current alcohol drinking in previous 30days, binge drinking (≥5 drinks at one sitting), and lifetime drug use (marijuana, inhalants or cocaine) in 11th grade among students not reporting these behaviors in 2006.RESULTS:In 2006, 63% of respondents reported high appreciation for Indigenous cultures and 39% had ever experienced racial insults. In 2007, incident current drinking was 24.4%, binge drinking 14.8%, and any drug use initiation was 4.1%. Exposure to racial insults increased the likelihood of binge drinking (OR=1.6; 95% CI 1.2-2.1) but was not significant for any drug use. Appreciation for Indigenous cultures reduced the risk of any drug use initiation (OR=0.5, 95% CI 0.3-0.7) but had no effect for alcohol drinking outcomes. These effects were independent of Indigenous ethnicity.CONCLUSIONS:Enhancing appreciation for Indigenous cultures and decreasing racial insults are achievable goals that can be incorporated into programs to prevent youth substance use. Fil: Alderete, Ethel del Carmen. Instituto de Ciencia y Tecnología Regional; Argentina. Universidad Nacional de Jujuy; Argentina Fil: Grerorich, Steven. University of California; Estados Unidos Fil: Monteban, Madalena. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. University of Georgia; Estados Unidos Fil: Kaplan, Celia. University of California; Estados Unidos. Helen Diller Family Comprehensive Cancer Center; Estados Unidos Fil: Mejia, Raul Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudio de Estado y Sociedad; Argentina. Universidad de Buenos Aires; Argentina Fil: Jennifer Livaudais, Toman. University of California; Estados Unidos Fil: Pérez Stable, Eliseo. University of California; Estados Unidos. Centro de Estudio de Estado y Sociedad; Argentina

Introduction: We evaluated an intervention to teach physicians how to help their smoking patients quit compared to usual care in Argentina. Methods: Physicians were recruited from six clinical systems and randomized to intervention (didactic curriculum in two 3-hour sessions) or usual care. Smoking patients who saw participating physicians within 30 days of the intervention (index clinical visit) were randomly sampled and interviewed by telephone with follow-up surveys at months 6 and 12 after the index clinical visit. Outcomes were tobacco abstinence (main), quit attempt in the past month, use of medications to quit smoking, and cigarettes per day. Repeated measures on the same participants were accommodated via generalized linear mixed models. Results: Two hundred fifty-four physicians were randomized; average age 44.5 years, 53% women and 12% smoked. Of 1378 smoking patients surveyed, 81% were women and 45% had more than 12 years of education. At 1 month, most patients (77%) reported daily smoking, 20% smoked some days and 3% had quit. Mean cigarettes smoked per day was 12.9 (SD = 8.8) and 49% were ready to quit within the year. Intention-to-treat analyses did not show significant group differences in quit rates at 12 months when assuming outcome response was missing at random (23% vs. 24.1%, P = .435). Using missing=smoking imputation rule, quit rates were not different at 12 months (15.6% vs. 16.4% P = .729). Motivated smokers were more likely to quit at 6 months (17.7% vs. 9.6%, P = .03). Conclusions: Training in tobacco cessation for physicians did not improve abstinence among their unselected smoking patients. Fil: Mejia, Raul Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina. Universidad de Buenos Aires; Argentina Fil: Stable, Eliseo J. Pérez. Universidad de California en San Francisco; Estados Unidos Fil: Kaplan, Celia P.. Universidad de California en San Francisco; Estados Unidos Fil: Gregorich, Steven E.. Universidad de California en San Francisco; Estados Unidos Fil: Livaudais Toman, Jennifer. Universidad de California en San Francisco; Estados Unidos Fil: Peña, Lorena. Centro de Estudios de Estado y Sociedad; Argentina Fil: Alderete, Mariela del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundacion Interamericana del Corazón Argentina; Argentina Fil: Schoj, Veronica. Fundacion Interamericana del Corazón Argentina; Argentina Fil: Alderete, Ethel del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

Tobacco, alcohol and drug use starts at an early age. It is important to identify risk factors associated with initiation. In 2014, a survey was conducted among students attending first year of secondary schools in Buenos Aires, Córdoba, and Tucumán. A total of 3172 students completed the survey (42% were girls); their mean age was 12.8 years old. Findings showed that 10% had smoked; 32% had consumed alcohol; 17% had a heavy drinking episode in the past month; and 8% had used at least one illegal drug once in their lifetime. A high sensation seeking index was associated with the use of tobacco (odds ratio [OR]: 4.25, 95% confidence interval [CI]: 2.2-8.1), alcohol (OR: 5.56, 95% CI: 3.73-8.31), and marijuana, coca paste or cocaine, (OR: 11.73, 95% CI: 5.81-23.69). Having friends who smoke or drink was associated with tobacco (OR: 12.6, 95% CI: 7.8-20.5) and alcohol use (OR: 5.17, 95% CI: 4.15-6.40). Having permissive parents in terms of media use was associated with tobacco use (OR: 3.7, 95% CI: 2.1-6.5), and perceiving a low parental support and control (OR: 3.02, 95% CI: 1.40-6.52) was associated with marijuana, coca paste and cocaine use.El consumo de tabaco, alcohol y otras drogas comienza a temprana edad. Es importante identificar los factores de riesgo asociados al inicio. En 2014, se encuestaron estudiantes de primer año del secundario en Buenos Aires, Córdoba y Tucumán. Respondieron 3172 alumnos (42% de mujeres); edad media de 12,8 años. El 10% había fumado; el 32% había consumido alcohol; el 17% había tenido consumo excesivo durante el último mes, y 8% había consumido, al menos, una droga ilícita en su vida. El índice de búsqueda de emociones alto se asoció al consumo de tabaco (OR 4,25; IC 95%: 2,2-8,1), alcohol (OR 5,56; IC 95%: 3,73-8,31) y marihuana/paco/cocaína (OR 11,73; IC 95%: 5,81-23,69). Tener amigos que consumían tabaco/alcohol se asoció al consumo de tabaco (OR 12,6; IC 95%: 7,8-20,5) y alcohol (OR 5,17; IC 95%: 4,15-6,40). Tener padres que imponían pocas restricciones en el uso de medios se asoció al consumo de tabaco (OR 3,7; IC 95%: 2,1-6,5) y percibir un bajo control y soporte parental (OR 3,02; IC 95%: 1,40-6,52) se asoció al consumo de marihuana/paco/cocaína.

Flavour capsules in cigarette filters are a product design innovation that allows consumers to crush a liquid-filled capsule that flavours the cigarette smoke. Most capsules include menthol flavourings, with chemosensory properties including a cooling, anaesthetic effect that makes it easier to inhale cigarette smoke, promotes misperceptions of harm and increases the appeal of smoking for youth.1–3 Industry pretesting revealed the attractiveness of choosing if and when to crush the capsule for the flavour, but cautioned that this novelty may wear off.4 Nevertheless, since the initial introduction of flavour capsule cigarettes in the Japanese market in 2007, capsule brand variants have been introduced worldwide. Industry reports and independent research indicate a number of countries where market share for flavour capsule cigarettes has grown exponentially.5–7 According to 2014 Euromonitor data,6 the top five countries with the highest market share for flavour capsule cigarettes are in the Latin American region: Chile, Peru, Guatemala, Mexico and Argentina (figure 1). For example, flavour capsule cigarette sales are estimated to account for more than a quarter of the cigarette market share in Chile, where flavour bans have been considered but effectively defeated by the industry. It is noteworthy that …