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Learn About the Predictors of the Onset of Cigarette Smoking, Impact of Televised Alcohol Advertising, the Effects of Suicide on Elementary School-Aged Children, and More

In this issue, we present studies that bring to light the predictors of the onset of cigarette smoking in youth, the effects of suicide in elementary school-aged children and early adolescents, how the amount of televised alcohol advertising exposure effects youth alcohol consumption, —and more.*

* The following text is not our own; it is pulled from the linked research articles to preserve original meaning.

Predictors of the onset of cigarette smoking: A systematic review of longitudinal population-based studies in youth 

Legislation, smoking bans, taxation, and public health tobacco control campaigns likely underpin marked declines in smoking prevalence in all age groups over the past decade. However, national surveillance data suggest that the rate of decline in cigarette smoking among adolescents and young adults has slowed considerably. Several recent reviews reinforce that the impact of school-based and other types of targeted prevention programs are often short-term and some studies suggest that such prevention efforts may have unanticipated negative effects. These observations may reflect a lack of comprehensive understanding of the factors associated with onset such that tobacco control interventions are not conceptualized optimally.

Suicide in elementary school-aged children and early adolescents

Suicide in elementary school–aged children is rare. The most recent national mortality statistics from the Centers for Disease Control and Prevention reveal a suicide rate of 0.17 per 100,000 persons in youth between the ages of 5 and 11 years, in contrast to a rate of 5.18 per 100,000 among adolescents aged 12 to 17 years. Nevertheless, suicide ranked 10th as a cause of death for US elementary school–aged children in 2014. While our understanding of suicide in children remains limited, a recent analysis of suicide trends in US children (ages 5–11 years between 1993–1997 and 2008–2012) found a significant increase in the suicide rate among black children and a significant decrease for white children. Given consistent observations that suicide rates for adolescents and young adults are higher in white subjects than in black subjects, this report of a higher rate of suicide in elementary school–aged black children raises questions about whether there are important racial and developmental differences in the underpinnings of suicide between elementary school–aged children and older youth.

Amount of televised alcohol advertising exposure and the quantity of alcohol consumed by youth

Alcohol companies, through self-regulatory guidelines, tacitly acknowledge the importance of alcohol marketing by restricting advertising on television programs where the audience is disproportionately composed of underage persons, and by limiting the content of such advertising so that it does not primarily appeal to underage youth (Beer Institute, 2011; Distilled Spirits Council of the United States, 2011; Wine Institute, 2012). Even so, the role that advertising plays in drinking behaviors is still an area of scientific controversy (Nelson, 2010).

Genetics of addiction: Where do we go from here?

We have made tremendous progress in understanding the genetic epidemiology of substance use problems. We understand a good deal about the genetic architecture of substance use disorders with respect to other psychiatric conditions, and how genetic influences change across development and as a function of the environment. We are further behind in identifying specific genes involved in substance use disorders. However, rather than blindly charging ahead with expensive gene identification efforts, our field would benefit from more thoughtful discussion about what strategies to pursue—both genetic and environmental—to have the greatest impact on reducing substance use problems.

Evaluation and management of children and adolescents with acute mental health or behavioral problems

Mental health problems are among the leading contributors to the global burden of disease. Unfortunately, pediatric populations are not spared of mental health problems. In the United States, 21% to 23% of children and adolescents have a diagnosable mental health or substance use disorder. Among patients of emergency departments (EDs), 70% screen positive for at least 1 mental health disorder, 23% meet criteria for 2 or more mental health concerns, 45% have a mental health problem resulting in impaired psychosocial functioning, and 10% of adolescents endorse significant levels of psychiatric distress at the time of their ED visit. In pediatric primary care settings, the reported prevalence of mental health and behavioral disorders is between 12% to 22% of children and adolescents.