These results highlight the importance of addressing e-cigarette use in youth who undertake health promoting behaviours. Prevention efforts should not focus only on youth who may undertake riskier health habits; e-cigarette prevention programs should go beyond the domain of tobacco control.
The COVID-19 pandemic has disproportionately affected Canada's long-term care (LTC) sector, with residents of LTC and retirement homes accounting for 67% of all COVID-19-related deaths as of February 15, 2021. This study investigated the impact of the COVID-19 pandemic on LTC residents across Canada during the first six months of the pandemic, including how care changed for residents, using data from the Canadian Institute for Health Information's LTC and acute care databases. The results suggest that LTC residents received less medical care, with fewer physician visits and hospital transfers compared with the same period in 2019. They also had less contact with family/friends compared with the same period in 2019, which was associated with higher levels of depression. In provinces where it could be measured, the number of LTC resident deaths from all causes was higher than pre-pandemic years during the peak of the first wave, even in jurisdictions with few COVID-19related deaths in LTC.* Excess LTC resident deaths is determined by comparing the number of deaths that occurred between March 1 and June 30, 2020, with the average number of deaths that occurred during the same period in the previous five years (2015 to 2019). Deaths include death from all causes and represent the LTC residents who died in the LTC home or in a hospital.
INTRODUCTION
Electronic cigarette (e-cigarette) use among youth is common, and so efforts to regulate its use and availability are continually being made. The school environment represents an important domain for advancing health policy among youth populations. This study examines the impact of school-based e-cigarette control policies on student e-cigarette use in the context of a natural experiment.
METHODS
Using three years of longitudinal student and school level data (2013/2014 to 2015/2016), from a sample of 69 secondary schools in Ontario, Canada, a generalized estimating equation approach examined the impact of school-based e-cigarette control policy changes on the prevalence of youth e-cigarette use. The main outcome of interest was current e-cigarette use, while covariates included age, gender, ethnicity, and amount of spending money in dollars per week the student has. Tests of proportion (t-tests) were used to examine whether there were any significant differences in the changes for each intervention school relative to the sample of schools that report no changes in school-level e-cigarette control policies.
RESULTS
Estimates from the generalized estimating equation approach suggest that students had lower odds of using e-cigarettes in schools where an e-cigarette control policy was implemented. That is, the e-cigarette control policy decreased the adjusted odds of being an e-cigarette user (OR=0.68; 95% CI: 0.48–0.97). Examining school-specific impact, at four of six schools that had an e-cigarette control policy, the ban on the use of e-cigarettes may have lowered the prevalence of e-cigarette use.
CONCLUSIONS
This is the first study to use longitudinal data to study school-level e-cigarette use and the impact of e-cigarette control policy. These results provide new evidence that school-level policies banning the use of e-cigarettes on school property may be effective in reducing e-cigarette use (or preventing it) in their current form, as seen in this natural experiment.
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