| 1. |
- Andersson, Filip, et al.
(författare)
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Prevalence of cannabis use among young adults in Sweden comparing randomized response technique with a traditional survey
- 2023
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Ingår i: Addiction. - 0965-2140 .- 1360-0443. ; 118:9, s. 1801-1810
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: The prevalence of cannabis use based on self-reports is likely to be underestimated in population surveys, especially in contexts where its use is a criminal offence. Indirect survey methods ask sensitive questions ensuring that answers cannot be identified with an individual respondent, therefore potentially resulting in more reliable estimates. We aimed to measure whether the indirect survey method ‘randomized response technique’ (RRT) increased response rate and/or increased disclosure of cannabis use among young adults compared with a traditional survey.Design: We conducted two parallel nation-wide surveys during the spring and the summer of 2021. The first survey was a traditional questionnaire-based one (focusing on substance use and gambling). The second survey applied an indirect survey method known as ‘the cross-wise model’ to questions related to cannabis use. The two surveys employed identical procedures (e.g. invitations, reminders and wording of the questions)Setting and Participants: The participants were young adults (aged 18–29 years) living in Sweden. The traditional survey had 1200 respondents (56.9% women) and the indirect survey had 2951 respondents (53.6% women).Measurements: In both surveys, cannabis use was assessed according to three time-frames: life-time use; use during the past year; and use during the past 30 days.Findings: The estimated prevalence of cannabis use was two- to threefold higher on all measures when estimated using the indirect survey method compared with the traditional survey: use during life-time (43.2 versus 27.3%); during the past year (19.2 versus 10.4%); and during the past 30 days (13.2 versus 3.7%). The discrepancy was larger among males and individuals with an education shorter than 10 years, who were unemployed, and who were born in non-European countries.Conclusions: Indirect survey methods may provide more accurate estimates than traditional surveys on prevalence of self-reported cannabis use.
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| 2. |
- Araghi, Marzieh, et al.
(författare)
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No association between moist oral snuff (snus) use and oral cancer : pooled analysis of nine prospective observational studies
- 2021
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 49:8, s. 833-840
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Worldwide, smokeless-tobacco use is a major risk factor for oral cancer. Evidence regarding the particular association between Swedish snus use and oral cancer is, however, less clear. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between snus use and oral cancer.Methods: A total of 418,369 male participants from nine cohort studies were followed up for oral cancer incidence through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors.Results: During 9,201,647 person-years of observation, 628 men developed oral cancer. Compared to never-snus use, ever-snus use was not associated with oral cancer (adjusted HR 0.90, 95% CI: 0.74, 1.09). There were no clear trends in risk with duration or intensity of snus use, although lower intensity use (<= 4 cans/week) was associated with a reduced risk (HR 0.65, 95% CI: 0.45, 0.94). Snus use was not associated with oral cancer among never smokers (HR 0.87, 95% CI: 0.57, 1.32).Conclusions: Swedish snus use does not appear to be implicated in the development of oral cancer in men.
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| 3. |
- Araghi, Marzieh, et al.
(författare)
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Smokeless tobacco (snus) use and colorectal cancer incidence and survival : Results from nine pooled cohorts
- 2017
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 45:8, s. 741-748
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Although smoking is considered to be an established risk factor for colorectal cancer, the current evidence on the association between smokeless tobacco and colorectal cancer is scant and inconclusive. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess this association.METHODS: A total of 417,872 male participants from nine cohort studies across Sweden were followed up for incidence of colorectal cancer and death. Outcomes were ascertained through linkage to health registers. We used shared frailty models with random effects at the study level to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).RESULTS: During 7,135,504 person-years of observation, 4170 men developed colorectal cancer. There was no clear association between snus use and colorectal cancer overall. Exclusive current snus users, however, had an increased risk of rectal cancer (HR 1.40: 95% CI 1.09, 1.79). There were no statistically significant associations between snus use and either all-cause or colorectal cancer-specific mortality after colorectal cancer diagnosis.CONCLUSIONS: Our findings, from a large sample, do not support any strong relationships between snus use and colorectal cancer risk and survival among men. However, the observed increased risk of rectal cancer is noteworthy, and in merit of further attention.
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| 4. |
- Araghi, Marzieh, et al.
(författare)
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Use of moist oral snuff (snus) and pancreatic cancer : Pooled analysis of nine prospective observational studies
- 2017
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 141:4, s. 687-693
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Tidskriftsartikel (refereegranskat)abstract
- While smoking is a well-established risk factor for pancreatic cancer, the effect of smokeless tobacco is less well understood. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between Swedish snus use and the risk of pancreatic cancer. A total of 424,152 male participants from nine cohort studies were followed up for risk of pancreatic cancer through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. During 9,276,054 person-years of observation, 1,447 men developed pancreatic cancer. Compared to never-snus use, current snus use was not associated with risk of pancreatic cancer (HR 0.96, 95% CI 0.83-1.11) after adjustment for smoking. Swedish snus use does not appear to be implicated in the development of pancreatic cancer in men. Tobacco smoke constituents other than nicotine or its metabolites may account for the relationship between smoking and pancreatic cancer. What's new? While smoking is a well-established risk factor for pancreatic cancer, the effect of smokeless tobacco is less well understood. Smokeless tobacco like snus yields lower exposure to tobacco carcinogens compared with smoking, because it does not undergo combustion, but delivers an equivalent dose of nicotine. Using pooled individual data from the Swedish Collaboration on Health Effects of Snus Use, here the authors show that Swedish snus use does not appear to be implicated in the development of pancreatic cancer in men. Tobacco smoke constituents other than nicotine or its metabolites may account for the relationship between smoking and pancreatic cancer.
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| 5. |
- Arefalk, Gabriel, et al.
(författare)
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Smokeless Tobacco (Snus) and Risk of Heart Failure of Ischemic and Non-Ischemic Origin: a Pooled Analysis of Eight Prospective Cohort Studies
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundSnus, a Swedish type of smokeless tobacco, has potent acute hemodynamic effects, which could provoke stress on the cardiovascular system, including the myocardium. Snus has, however, not been linked to risk of ischemic heart disease. Therefore, we hypothesized that snus use increases the risk for heart failure of non-ischemic origin.MethodsWe conducted a pooled analysis of eight Swedish prospective cohort studies involving individual participant data from 350,711 men. Shared frailty models with random effects at the cohort level, were used to estimate hazard ratios (HRs) with 95 % confidence intervals (CIs) of heart failure in relation to snus use. We investigated dose-response associations, and association with ischemic and non-ischemic heart failure in separate. For positive control purposes, we also investigated associations between smoking and risk of heart failure.ResultsDuring a median follow-up time of 16 years, 5,404 men were hospitalized for heart failure. In models adjusting for age, smoking, previous myocardial infarction and educational level, current snus use was associated with a higher risk of heart failure (HR 1.27, 95 % CI 1.07-1.50), relative to non-current snus use. A dose-response pattern was observed, with higher risk with more snus cans used per week. We observed an association of snus use with non-ischemic heart failure, HR 1.34 (95 % CI 1.11-1.63), but not with ischemic heart failure, HR 1.01 (95 % CI 0.72-1.42). Smoking was more strongly associated with heart failure, particularly of ischemic origin, than snus use.ConclusionsSnus use was associated with a modestly increased risk for heart failure of non-ischemic origin in a dose-response manner. This finding has public health implications for the risk assessment of snus use, and potentially other modes of smokeless use of nicotine.
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| 6. |
- Beeres, Dorien Tecla, et al.
(författare)
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Child–adult contract for prevention of tobacco use : "as-treated" analysis of a cluster randomized controlled trial (the TOPAS study) at 3-year follow-up
- 2024
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Ingår i: Prevention Science. - : Springer Nature. - 1389-4986 .- 1573-6695. ; 25, s. 175-192
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Tidskriftsartikel (refereegranskat)abstract
- To estimate the effect of a 3-year commitment to remain tobacco free on tobacco uptake among high school students in Sweden. The commitment is developed in the form of a contract between a child and a significant adult, constituting the core component of Tobacco-free Duo (T-Duo), a Swedish school-based tobacco prevention program. Secondary analysis of data from a cluster randomized controlled trial. Participants were 586 students in high schools assigned to the intervention arm of T-Duo. At inception, participants attended grade 7 (i.e., age 12–13). Only students who were tobacco naïve at baseline for the respective outcome and participated in all follow-ups were included. The exposure was defined as signing a 3-year contract with a significant adult, categorized as “stable contract” (3 years contract with the same contract partner), “unstable” (signed a contract sometime during follow-up but this was not sustained over time and/or with the same partner), and “no contract” at all during the intervention period. The primary outcome was having never tried cigarette smoking at the end of grade 9. Exposure and outcomes were self-reported in yearly questionnaires. Of 586 students, 321 (55%) held a stable contract, 204 (35%) an unstable contract, and 61 (10%) did not sign a contract at all. At the end of grade 9 (age 15–16), the relative risk (RR) to remain cigarette free was 1.11 (95% CI 1.00–1.22) (Number Needed to Treat = 10) among students in any type of contract compared to students that did not write a contract at all. The RRs for remaining tobacco free (secondary outcomes) ranged from 1.07 (0.98–1.16) for regular snus use to 1.16 (1.00–1.35) for any type of tobacco use. A commitment to remain tobacco free through a child–adult contract seems to exert a preventive effect on the uptake of tobacco use among Swedish adolescents over 3 school years. The current findings apply to a selected sample of both schools and students.Registration: Current Controlled Trials ISRCTN52858080 Date: January 4, 2019, retrospectively registered.
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| 7. |
- Byhamre, Marja Lisa, et al.
(författare)
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Swedish snus use is associated with mortality : a pooled analysis of eight prospective studies
- 2020
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Ingår i: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 49:6, s. 2041-2050
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The health consequences of the use of Swedish snus, including its relationship with mortality, have not been fully established. We investigated the relationship between snus use and all-cause and cause-specific mortality (death due to cardiovascular diseases, cancer diseases and all other reasons, respectively) in a nationwide collaborative pooling project.METHODS: We followed 169 103 never-smoking men from eight Swedish cohort studies, recruited in 1978-2010. Shared frailty models with random effects at the study level were used in order to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of mortality associated with snus use.RESULTS: Exclusive current snus users had an increased risk of all-cause mortality (aHR 1.28, 95% CI 1.20-1.35), cardiovascular mortality (aHR 1.27, 95% CI 1.15-1.41) and other cause mortality (aHR 1.37, 95% CI 1.24-1.52) compared with never-users of tobacco. The risk of cancer mortality was also increased (aHR 1.12, 95% CI 1.00-1.26). These mortality risks increased with duration of snus use, but not with weekly amount.CONCLUSIONS: Snus use among men is associated with increased all-cause mortality, cardiovascular mortality, with death from other causes and possibly with increased cancer mortality.
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| 8. |
- Dimitrova, Radosveta, et al.
(författare)
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Pedagogical and Social Climate in School Questionnaire : Factorial Validity and Reliability of the Teacher Version
- 2016
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Ingår i: Journal of Psychoeducational Assessment. - : SAGE Publications. - 0734-2829 .- 1557-5144. ; 34:3, s. 282-288
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated the factorial structure of the Pedagogical and Social Climate in School (PESOC) questionnaire among 307 teachers in Bulgaria. The teacher edition of PESOC consists of 11 scales (i.e., Expectations for Students, Unity Among Teachers, Approach to Students, Basic Assumptions About Students’ Ability to Learn, School–Home Relations, Teacher Cooperation, Teachers’ Professional Development, Teaching Activities, Student Valuation, Principal’s Pedagogical Leadership, and School Management). A confirmatory factor analysis conducted with structural equation modeling supported a bi-dimensional factor model (Students and Teachers; School Leadership and Management). School climate indicators were also significantly and positively correlated. PESOC is an asset to the literature on assessment of school climate with evidence for factorial validity and reliability in an underresearched international context.
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| 9. |
- Eichas, Kyle, et al.
(författare)
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Measuring Dimensions of Family Interaction in Adolescence : A Multitrait–Multimethod Analysis
- 2020
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Ingår i: European Journal of Psychological Assessment. - : Hogrefe Publishing Group. - 1015-5759 .- 2151-2426. ; 36:5, s. 901-906
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the convergent and discriminant validity of adolescent and parent ratings of family interaction. Adolescent and parent ratings of democratic parenting, parental warmth, and adolescent free disclosure were measured using a multitrait–multimethod confirmatory factor analytic approach. Participants included 3,959 Swedish youth in seventh grade (average age 13 years), with follow-up measurements in eighth and ninth grades. At each grade, findings provided support for trait discriminant validity and discriminant validity of methods. However, findings failed to provide support for convergent validity. Overall, the present findings suggest that measurement of family interactions should include the perspectives of both parents and adolescents because their perceptions of family interactions may represent different family interaction constructs.
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| 10. |
- Ferrer-Wreder, Laura, et al.
(författare)
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Ways to Measure Family-Related Factors in Swedish Families using Child and Parent Reports
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Many Swedish parents report that they tend to employ moderate control as well as frequent use of democratic parenting practices (Trost, 2012). This approach to parenting combined with policy and institutional supports for child and family welfare make the Swedish parenting context in some ways unique and in need of further investigation (e.g., Trost, El-Khouri, & Sundell, 2015). From a measurement perspective, when parents and children in the same family report on the same construct, one is faced with several questions such as are the child and parent reports reflective of the same construct? If yes, then child and parent reports can be modelled or conceptualized as indicators of the same construct. Another possibility is that adolescents’ and parents’ perceptions of a given construct are fundamentally different from one another. A number of options exist in terms of how to conceptualize measurement when parents and children report on the same construct (Bank, Dishion, Skinner, & Patterson, 1990).The results presented in this poster are from a longitudinal study of school climate and mental health (study name and citation blinded for peer review). The sample consists of a cohort of Swedish 7th graders (N=3,932, aged 13-14 years old, 51.8% =female, from 101 schools in eight Swedish regions). At grade 7, using structural equation modelling (SEM), different measurement models of family-related factors were tested, namely democratic parenting (Wray-Lake & Flanagan, 2012), parental warmth (Trost, et al, 2007; Tilton-Weaver et al., 2010), and child-parent communication (Kerr & Statin, 2000). Adolescents in the cohort and one of their parents reported on these constructs at grades 7, 8, and 9. The results presented here are for grade 7. Analyses were conducted with Mplus 7.4 (using Mplus’s robust maximum likelihood estimator, TYPE = COMPLEX in Mplus, to account for the nested nature of responses by school building, and FIML estimation for missing data). Three SEM models were tested, including (1) a three-factor model in which parallel child and parent reports were indicators of the same family factors, (2) a six-factor model in which parallel child and parent reports were indicators of separate family factors, and (3) a multi-trait multi-method model with three family factors and two method factors (parent and child report; Model 3). Two models showed good fit to the data: the six-factor model, χ2(89) = 164.873; CFI = .997; RMSEA = .015 [.011, .018], and the multi-trait multi-method model, χ2(84) = 533.735; CFI = .982. RMSEA = .037 [.034, .040]. While both models evidenced good fit, the six-factor model provided the more parsimonious solution. This result indicates that adolescents and parents in this sample may be viewing the family-related factors in different ways. In the poster, other analyses will be reported on the utility of the models identified in grade 7 at the other study time points, such as at grades 8 and 9. Study findings will also be discussed in terms of culture and parenting.
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