The relationship between body weight perceptions, weight control behaviours and smoking status among adolescents

Disentangling the aetiological pathways between body mass index and site-specific cancer risk using tissue-partitioned Mendelian randomisation

BACKGROUND

Body mass index (BMI) is known to influence the risk of various site-specific cancers, however, dissecting which subcomponents of this heterogenous risk factor are predominantly responsible for driving disease effects has proven difficult to establish. We have leveraged tissue-specific gene expression to separate the effects of distinct phenotypes underlying BMI on the risk of seven site-specific cancers.

METHODS

SNP-exposure estimates were weighted in a multivariable Mendelian randomisation analysis by their evidence for colocalization with subcutaneous adipose- and brain-tissue-derived gene expression using a recently developed methodology.

RESULTS

Our results provide evidence that brain-tissue-derived BMI variants are predominantly responsible for driving the genetically predicted effect of BMI on lung cancer (OR: 1.17; 95% CI: 1.01-1.36; P = 0.03). Similar findings were identified when analysing cigarettes per day as an outcome (Beta = 0.44; 95% CI: 0.26-0.61; P = 1.62 × 10-6), highlighting a possible shared aetiology or mediator effect between brain-tissue BMI, smoking and lung cancer. Our results additionally suggest that adipose-tissue-derived BMI variants may predominantly drive the effect of BMI and increased risk for endometrial cancer (OR: 1.71; 95% CI: 1.07-2.74; P = 0.02), highlighting a putatively important role in the aetiology of endometrial cancer.

CONCLUSIONS

The study provides valuable insight into the divergent underlying pathways between BMI and the risk of site-specific cancers.

Body image dissatisfaction and associated factors in adolescents

This study aimed to examine the factors associated with body dissatisfaction in adolescents. This is a cross-sectional study with students from two public and four private schools in the metropolitan region of Rio de Janeiro. Body dissatisfaction was evaluated using the Body Silhouette Scale, by the difference between the image they perceive as their current image and the one they would like to have. The association was assessed by hierarchical logistic regression multinomial model, by estimating odds ratios (OR) and 95% confidence intervals (95%CI). Among the 1,019 adolescents evaluated (13-19 years), 75% showed body dissatisfaction, 41.4% wishing for a smaller silhouette and 33.7% wishing for larger silhouettes. The wish for a smaller silhouette was more significant in girls, overweight adolescents, those with an unsatisfactory meal pattern, and with higher waist circumference. Adolescents that had been exposed to teasing due to their body shape increased the probability of wishing for both smaller and larger silhouettes. Strategies are required for a more positive perception of body image, especially for girls and for overweight adolescents, which provide guidance on adequate meal consumption and prevent exposure to peer teasing, valuing coexistence and well-being in the face of existing bodily differences.

Body esteem, weight-control outcome expectancies, and e-cigarette use among young adults

INTRODUCTION

Evidence is still scarce regarding the use of e-cigarettes by young people for weight-control reasons. This study aimed to test a model in which the prospective association between negative body esteem and e-cigarette use is mediated by weight-control outcome expectancies for e-cigarette use. The model was tested across genders.

METHODS

Data were collected at three time points, 6 months apart, from 2327 young adults (mean age = 21.2; SD = 2.2; 54% women). Self-reported data were collected on demographics, body mass index, body esteem, weight-control outcome expectancies for e-cigarette use, and current e-cigarette use and cigarette smoking.

RESULTS

Among women, we found a significant indirect effect of lower body esteem on higher likelihood of current e-cigarette use 1 year later, mediated by higher weight-control outcome expectancies at 6-month follow-up, adjusting for demographics, body mass index, and baseline e-cigarette use and cigarette smoking. Among men, body esteem was not found to have significant effect on either weight-control expectancies or e-cigarette use.

CONCLUSIONS

Based on the current findings, young adult women who have higher negative body esteem are at increased risk for using e-cigarettes for weight-control motives.

IMPLICATIONS

The current findings are some of the first to show prospective associations among weight-control motives and e-cigarette use among young adults. These findings suggest that a group of vulnerable young women may be using e-cigarettes to lose or control weight. More research is needed to understand their choice of flavors, nicotine concentration, and device type. In addition, research is needed to understand whether e-cigarettes are being marketed, directly or indirectly, as being useful for weight loss or control. There may be a need for health promotion strategies that provide healthier alternatives to young women struggling with low body esteem who use e-cigarettes for weight loss or control.

Ketogenic Diet-Induced Diabetic Ketoacidosis in a Young Adult with Unrecognized Type 1 Diabetes

Ketogenic diet, a very low-carbohydrate diet and high-fat diet, has emerged as a popular approach for weight reduction, particularly in young adults. However, a serious but rare complication of the ketogenic diet is ketoacidosis associated with low carbohydrate intake, which should be cautiously monitored in people with a predisposition to the condition. We report a 22-year-old Thai woman with an unremarkable past medical history who presented with an acute onset of dyspnea of 2 days' duration. Diabetic ketoacidosis was diagnosed by elevated capillary blood glucose, significant metabolic acidosis, and a high serum beta-hydroxybutyrate level. Low C-peptide level and positive islet autoantibodies confirmed the new diagnosis of type 1 diabetes in this patient. After her conditions were stabilized, the patient revealed that she began a ketogenic diet for weight reduction 4 days before her illness. Other precipitating factors were not identified. This highlights that ketogenic diet may increase diabetic ketoacidosis risk at the presentation of previously unrecognized type 1 diabetes.

Frequency of Trying to Lose Weight and Its Association with Children's Weight Perception and Dietary Intake (NHANES 2011-2012)

Weight loss practices and frequency among children and adolescents can impact overall diet quality. We used cross-sectional U.S. National Health and Nutrition Examination Survey data (NHANES) 2011-2012 from 1303 children and adolescents (8-15 years) to examine associations between frequency of trying to lose weight (never vs. sometimes/a lot) and sociodemographic characteristics, self-perception of weight, and dietary intake. A greater frequency of trying to lose weight was reported by participants with overweight/obesity, those from households with lower annual income and those who perceived they were overweight or obese compared to their counterparts. A high proportion of participants with overweight and obesity considered themselves to be "about the right weight" (76.7 and 42.8%, respectively). Intake data based on one 24-h dietary recall were examined using multivariable regression models adjusted for child and parent/family characteristics. In adjusted analyses, energy and total fat intakes were lower among those trying to lose weight compared to those never trying to lose weight. Intakes of cholesterol, sodium, and refined grains were not different by frequency of trying to lose weight (all p = 0.059-0.074). Weight loss efforts may be related to better nutritional profiles for some children and adolescents.

Weight underestimation and body size dissatisfaction among black African adults with obesity: Implications for health promotion

BACKGROUND

Body image perception has an impact on modifiable cardiovascular disease (CVD) risk, lifestyle and psychological health in many populations.

AIM

To assess weight discordance (underestimating own weight) and body size dissatisfaction (perceiving body size as either 'too small' or 'too large') among overweight and obese South Africans, the associated factors and the implications for health promotion.

SETTING

A rural community and an urban township in two provinces of South Africa.

METHODS

An ancillary study within a prospective cohort involving 920 adults aged 35-78 years. Information on body image perception, anthropometry, risk factors and weight change were obtained on year 4 follow-up. Obesity was described as having a body mass index (BMI) 25 kg/m2. Descriptive and multivariate analyses were undertaken.

RESULTS

Most obese and overweight adults, respectively, underestimated their own weight (85% vs. 79%) and considered their body sizes as either 'too large' (59%) or 'too small' (57%). Those who perceived CVD threat, compared with those who did not, were 3.0 times more likely to be dissatisfied with their body sizes (p 0.0001) and 1.6 times more likely to underestimate their own weight (p 0.001). Those who indicated their willingness to lose weight were seven times more likely to be dissatisfied with their body sizes and unlikely to have discordant weight status (p = 0.0002).

CONCLUSION

Body size dissatisfaction and weight underestimation were influenced by perceived threat of CVD and the willingness to lose weight. Obesity prevention should leverage on perceived CVD threat messaging and self-motivation for attaining a healthy weight.

The effect of body mass index on smoking behaviour and nicotine metabolism: a Mendelian randomization study

Given clear evidence that smoking lowers weight, it is possible that individuals with higher body mass index (BMI) smoke in order to lose or maintain their weight. We performed Mendelian randomization (MR) analyses of the effects of BMI on smoking behaviour in UK Biobank and the Tobacco and Genetics Consortium genome-wide association study (GWAS), on cotinine levels and nicotine metabolite ratio (NMR) in published GWAS and on DNA methylation in the Avon Longitudinal Study of Parents and Children. Our results indicate that higher BMI causally influences lifetime smoking, smoking initiation, smoking heaviness and also DNA methylation at the aryl-hydrocarbon receptor repressor (AHRR) locus, but we do not see evidence for an effect on smoking cessation. While there is no strong evidence that BMI causally influences cotinine levels, suggestive evidence for a negative causal influence on NMR may explain this. There is a causal effect of BMI on smoking, but the relationship is likely to be complex due to opposing effects on behaviour and metabolism.

Adolescent smoking: The relationship between cigarette consumption and BMI

Background

Studies relating cigarette smoking and body weight yield conflicting results. Weight-lowering effects in women and men have been associated with smoking, however, no effects on weight have been proven. This study examined the association between cigarette smoking and relative weight in adolescent males and females as they age into young adults.

Methods

Data from the National Longitudinal Survey of Youth—a nationally representative survey conducted annually—was used for this analysis. The sample consists of 4225 males and females observed annually from 1997 at age 12 to 17 through 2011 at age 27 to 31. Hierarchical generalized models (HGM) assess the impact of smoking on the likelihood of having higher BMI controlling for demographic, household and environmental impacts. The second estimation considers the possibility that smoking is endogenous and utilizes a multinomial instrument (IV) for smoking level.

Results

HGM models reveal a negative association between cigarette smoking and BMI for both males and females. Individuals who smoke more have lower BMI compared to infrequent or non-smokers. General health rating, region of residence and income were used instrument for smoking in a linear two-stage IV specification. The instrument is highly correlated with BMI and results mirror the HGM. Finally, models run on early, middle and advanced adolescents show that the relationship diminishes over time. The relationship between BMI and smoking decreases as females age but increases for males.

Conclusions

Empirical models confirm an association cigarette consumption and BMI in both males and females. This negative relationship varies with age. It is important to identify health risks—obesity—and modifiable risk factors—smoking—that contribute to health disparities among adolescents. However, the increase in one risky behavior leading to the decrease in the prevalence of the other, complicates the issue. The higher prevalence of frequent cigarette uses among both adolescents and young adults of lower BMI suggest that smoking could be used curb or suppress appetite.

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The weight impact of tobacco use by adolescents, unlike adults, has not been conclusively determined.

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This study examines the relationship between cigarette use and the body weight (BMI) of high school aged youth.

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Since smoking can be considered endogeneous in weight studies, smoking is instrumented in a two-stage process.

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Cigarette use is associated with higher BMI, but magnitudes vary by age.

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Models run on early, middle and older adolescents show that the relationship diminishes over time.

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The relationship between BMI and smoking decreases as females age but increases for males.

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Overweight and obese adolescents were more frequent tobacco users.

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Results suggest that electronic and conventional tobacco has similar BMI associations when used independently.

Body weight perception, disordered weight control behaviors, and depressive symptoms among Korean adults: The Korea National Health and Nutrition Examination Survey 2014

BACKGROUND/ PURPOSE

Despite emerging evidence suggesting harmful influences of accurate weight perception on psychological health among individuals with obesity, little is known about the association in Asian populations. The aim of this study was investigate the association between body weight perception and depressive symptoms among Korean adults, and potential differential associations across gender.

METHODS

We used data from the sixth Korea National Health and Nutrition Examination Survey in 2014, comprising 3,318 female (n = 1,876) and male (n = 1,442) participants, aged 19-65 years, with no history of depression and a body-mass index (BMI)> = 18.5kg/m2. Depressive symptoms were measured by the Patient Health Questionnaire-9 Korean version. Weight perception patterns were categorized by comparing self-perceived and objectively measured weight status. Gender-stratified four-level multilevel linear models adjusted for age, BMI, menopause, education, income, marital status, urbanicity, chronic conditions, exercise, smoking, and alcohol use. Subgroup analyses were performed across BMI category.

RESULTS

Among women with obesity, those who underperceived their weight status reported fewer depressive symptoms compared to those who accurately perceived their weight status (β = -1.25, p<0.05). Among women with normal weight, those who overperceived their weight status reported more depressive symptoms compared to those who accurately perceived their weight status (β = 1.00, p<0.05). The same associations were not found in men.

CONCLUSION

Awareness-oriented strategies for obesity prevention and weight management focused on providing information on weight status may need to consider unintended consequences of accurate weight perception on mental health among individuals with obesity, particularly among women.

Body mass index, body dissatisfaction and adolescent smoking initiation

BACKGROUND

Smoking influences body weight, but there is little evidence as to whether body mass index (BMI) and body dissatisfaction increase smoking initiation in adolescents.

METHODS

We evaluated the association between measured BMI, body dissatisfaction and latent classes of smoking initiation (never smokers, experimenters, late onset regular smokers, early onset regular smokers) in the Avon Longitudinal Study of Parents and Children. In observational analyses we used BMI (N=3754) and body dissatisfaction at age 10.5 years (N=3349). In Mendelian randomisation (MR) analysis, we used a BMI genetic risk score of 76 single nucleotide polymorphisms (N=4017).

RESULTS

In females, higher BMI was associated with increased odds of early onset regular smoking (OR: 1.11, 95% CI: 1.04, 1.18) compared to being a never smoker, but not clearly associated with experimenting with smoking (OR: 1.04, 95% CI: 0.99, 1.10) or late onset regular smoking (OR: 1.01, 95% CI: 0.94, 1.09). No clear evidence was found for associations between BMI and smoking initiation classes in males (p-value for sex interaction≤0.001). Body dissatisfaction was associated with increased odds of late-onset regular smoking (OR: 1.71, 95% CI: 1.32, 1.99) in males and females combined (P-value for sex interaction=0.32). There was no clear evidence for an association between the BMI genetic risk score and smoking latent classes in males or females but estimates were imprecise.

CONCLUSIONS

BMI in females and body dissatisfaction in males and females are associated with increased odds of smoking initiation, highlighting these as potentially important factors for consideration in smoking prevention strategies.

Trends in Adolescent Overweight Perception and Its Association With Psychosomatic Health 2002-2014: Evidence From 33 Countries

PURPOSE

Perceiving oneself as overweight is common and strongly associated with adolescents' subjective well-being. The prevalence of overweight perceptions and their impact on well-being may have increased over the past decade due to an increase in the salience of weight-related issues. This study examines trends (2002-2014) in the prevalence of adolescent overweight perceptions and their association with psychosomatic complaints.

METHODS

Data from 15-year-old adolescents were obtained between 2002 and 2014 in four rounds of the Health Behaviour in School-aged Children study in 33 countries in Europe and North America (N = 187,511). Design-adjusted logistic regressions were used to quantify changes in overweight perceptions over time. Linear modeling was used to assess change in the association between perceived overweight and self-reported psychosomatic complaint burden, adjusting for overweight status.

RESULTS

Among boys, 10 of 33 countries saw an increase in overweight perceptions between 2002 and 2014, with Russia, Estonia, and Latvia showing the most pronounced year-on-year increases. Only England, France, Germany, and Norway saw an increase in the positive association between overweight perceptions and psychosomatic complaints among boys. Among girls, most countries (28/33) saw no change in the prevalence of overweight perceptions, with the prevalence over 40% in most nations. However, in 12 countries, the association between overweight perceptions and psychosomatic complaints increased among girls, with particularly strong changes seen in Scotland and Norway.

CONCLUSIONS

Evidence is presented which suggests that for adolescent girls in 12 Northern and Western European countries and for boys in four perceiving oneself as overweight may be increasingly deleterious for psychosomatic health.

Body image emotions, perceptions, and cognitions distinguish physically active and inactive smokers

Objectives

To determine if body image emotions (body-related shame and guilt, weight-related stress), perceptions (self-perceived overweight), or cognitions (trying to change weight) differ between adolescents characterized by smoking and physical activity (PA) behavior.

Methods

Data for this cross-sectional analysis were collected in 2010–11 and were available for 1017 participants (mean (SD) age = 16.8 (0.5) years). Participants were categorized according to smoking and PA status into four groups: inactive smokers, inactive non-smokers, active smokers and active non-smokers. Associations between body image emotions, perceptions and cognitions, and group membership were estimated in multinomial logistic regression.

Results

Participants who reported body-related shame were less likely (OR (95% CI) = 0.52 (0.29–0.94)) to be in the active smoker group than the inactive smoker group; those who reported body-related guilt and those trying to gain weight were more likely (2.14 (1.32–3.48) and 2.49 (1.22–5.08), respectively) to be in the active smoker group than the inactive smoker group; those who were stressed about weight and those perceiving themselves as overweight were less likely to be in the active non-smoker group than the inactive smoker group (0.79 (0.64–0.97) and 0.41 (0.19–0.89), respectively).

Conclusion

Body image emotions and cognitions differentiated the active smoker group from the other three groups.

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We examined body image in physically active adolescent smokers.

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Body-related shame and guilt were related to being a physically active smoker.

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Trying to gain weight was also associated with being a physically active smoker.

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Body image emotions and cognitions differentiate physically active smokers.

Between-school variation and student characteristics associated with the accuracy of weight status perception among students: does the school a student attends impact his/her weight status perception?

Research has identified that perceived weight status is a better predictor of weight control behavior than actual weight status. The purpose of this study was to examine whether the accuracy of weight status perception varies across schools, and to identify the student-level characteristics associated with inaccurate weight status perception among 25,060 grade 9 to 12 students attending 76 schools in Ontario, Canada. Although the majority of adolescents (60.4%) had accurate weight status perceptions, multi-level logistic regression analyses revealed significant between-school variability in the accuracy of weight status perceptions for both males and females. School location and school-level socioeconomic status were the school-level variables analyzed. We identified that males attending urban or suburban schools were more likely to overestimate their weight status compared with males attending rural schools. Important student-level characteristics included grade, weight status, sports participation and social influences. Additional research is required to better understand both the school- and student-level characteristics associated with the accuracy of weight status perceptions among adolescents.

Factors associated with tobacco smoking and the belief about weight control effect of smoking among Hungarian adolescents

INTRODUCTION

The relationship between body weight and smoking has been well-documented among adult populations, but the data among youth are inconsistent. This study explores the relationship among social, behavioural, body weight-related factors and adolescent smoking while identifying factors associated with the belief that smoking controls weight.

MATERIALS AND METHODS

Baseline data from a three-year, prospective cohort study started in 2009 in Hungary's six metropolitan cities. Randomly selected 6th and 9th grade students completed a self-administered questionnaire during the 2009-2010 school year (n = 1445; 45% boys, mean age of 6th graders: 12.06 years, SD = 0.63; mean age of 9th graders: 15.06 years, SD = 0.63). Calculations of Body Mass Index (BMI) were based on objectively measured weight and height data of participants. Appetite-Weight Control Scale of the Short Form of Smoking Consequences Questionnaire was used to measure the belief that smoking supports weight control. Bivariate and multivariate logistic regression analyses were performed to examine the association between the perception of weight control and smoking, while controlling for potential confounding variables (e.g., gender).

RESULTS

24.8% of participants smoked cigarettes within the past 30 days. The odds of smoking were increased among students who were older, had smoking friends, were exposed to parental smoking, and had poorer academic performance. BMI showed positive association with smoking (increases in BMI were associated with higher odds of smoking), and the belief that smoking controls weight mediated this association. There was no difference in smoking prevalence among those motivated either to lose or gain weight (approximately 30%), but was considerably lower among adolescents satisfied with their body weight (19%). The belief that smoking supports weight control was more common for girls, older students, and those who perceived themselves as overweight.

CONCLUSIONS

Dissatisfaction with body weight and the belief that smoking has weight controlling effects are associated with an increased likelihood of adolescent smoking, therefore they must be considered in smoking prevention programmes among youth.

Gender specific factors associated with having stopped smoking among in-school adolescents in Ukraine: results from the Global Youth Tobacco Survey 2005

Background

The prevalence of cigarette smoking in Ukraine is different between genders and is among the highest in the world. There is need to identify gender-specific factors that are associated with having stopped smoking among adolescents.

Findings

We used data from the Ukraine Global Youth Tobacco Survey 2005. We carried out a backward stepwise logistic regression analysis with having stopped smoking as the outcome.

Altogether, 2800 adolescents reported having ever smoked cigarettes. Overall 64.1% (63.4% male, and 65.5% female) adolescents reported having stopped smoking. Male adolescents who stated that smoking decreases body weight were 25% more likely, while female adolescents were 9% less likely to stop smoking. While male adolescents who received support on how to stop smoking from a family member were 7% less likely, female adolescents were 60% more likely to stop smoking. Furthermore, while male adolescents who received a lecture on the harmful effects of smoking were 10% less likely, female adolescents were 9% more likely to stop smoking. Finally both male and female adolescents who were sure or most probably that they would not smoke a cigarette offered to them by their best friends were more likely, and those adolescents who were sure that smoking is harmful to health were less likely to stop smoking.

Conclusions

Our study has identified some factors that are associated with having quit smoking that are gender-specific. We believe public health programs targeting adolescent smoking should consider these factors in their design and implementation of gender sensitive interventions.

Neighbourhood influences on narghile smoking among youth in Beirut

BACKGROUND

Increasingly neighbourhoods are identified as influencing health. Neighbourhood characteristics have been linked to cigarette use. In Lebanon, the water pipe (narghile) use is most frequent among youth. The current study is aimed at identifying differential neighbourhood influences on smoking narghile among youth.

METHODS

A quantitative interview was completed with 1294 adolescents, 13-20 years, in three urban disadvantaged neighbourhoods of Beirut. Individual and social factors, suggested by the literature, were associated with smoking narghile. The neighbourhood variation in the influence of these factors was then explored. Bivariate and stratified logistic regression analysis were conducted, neighbourhood being the stratification variable.

RESULTS

About 60% of respondents had ever tried a narghile, about one-fifth continued to smoke. Several individual-level and social variables predicted narghile smoking bivariately. The influences on narghile smoking varied by neighbourhood. Neighbourhood differences persisted at the multivariate level. Consistently across neighbourhoods, the influence of friends was the predominant predictor of narghile smoking. In one neighbourhood, maternal smoking was a risk factor for narghile smoking of youth, in another paternal smoking. Being female seems to be protective in two of the three neighbourhoods. Other factors also differentially influence narghile use by neighbourhood.

CONCLUSIONS

The mechanisms of influence of neighbourhoods on health are not clearly understood, but a transactional paradigm seems most fitting with the results found in this research. Interventions to prevent the narghile smoking should address multiple levels of influence; and must be tailored to the particular aspects of neighbourhoods which are influential in the uptake of this behaviour.

Do researcher-derived classifications of youths' smoking behavior correspond with youths' characterizations of their behavior?

AIMS

To describe the categories employed by researchers to describe adolescents' smoking behavior and to determine how these various categorizations compare with youths' self-defined smoking status.

STUDY SELECTION

A search of the PubMed and Science Direct databases, limited to articles in the English language, published between January 2002 and November 2007.

DATA EXTRACTION

Employing a mixed methods approach, several categories of youths' smoking status were obtained from a literature review and subsequently reproduced by using responses to detailed questionnaire items. Associations between the researcher-derived smoking categories (from the literature review) and the youths' self-reported smoking status, from survey data, were determined.

RESULTS

The categories of smoking status, from the literature review, varied in definition and in the number of categories. The associations between the literature-based categories and the youths' self-reported smoking status were modest.

CONCLUSIONS

Researcher-derived categories of youths' smoking status may not adequately encapsulate youths' perceptions of their own smoking behavior. There is a need to better describe adolescents' smoking behavior with special consideration of the ways in which adolescents characterize their own smoking behavior.

Associations of trying to lose weight, weight control behaviors, and current cigarette use among US high school students

BACKGROUND

Approximately one-quarter of high school students currently use cigarettes. Previous research has suggested some youth use smoking as a method for losing weight. The purpose of this study was to describe the association of current cigarette use with specific healthy and unhealthy weight control practices among 9th-12th grade students in the United States.

METHODS

Youth Risk Behavior Survey data (2005) were analyzed. Behaviors included current cigarette use, trying to lose weight, and current use of 2 healthy and 3 unhealthy behaviors to lose weight or to keep from gaining weight. Separate logistic regression models calculated adjusted odds ratios (AORs) for associations of current cigarette use with trying to lose weight (Model 1) and the 5 weight control behaviors, controlling for trying to lose weight (Model 2).

RESULTS

In Model 1, compared with students who were not trying to lose weight, students who were trying to lose weight had higher odds of current cigarette use (AOR = 1.30, 95% CI: 1.15-1.49). In Model 2, the association of current cigarette use with the 2 healthy weight control behaviors was not statistically significant. Each of the 3 unhealthy weight control practices was significantly associated with current cigarette use, with AORs for each behavior approximately 2 times as high among those who engaged in the behavior, compared with those who did not.

CONCLUSION

Some students may smoke cigarettes as a method of weight control. Inclusion of smoking prevention messages into existing weight management interventions may be beneficial.

Associations between smoking and extreme dieting among adolescents

This study examined the association between cigarette smoking and dieting behaviors and trends in that association among US adolescents in grades 9-12 between 1999 and 2007. Youth Risk Behavior Survey datasets were analyzed using the multivariable logistic regression method. The sample size of each survey year ranged from 13,554 to 15,273 with girls representing 49-51% of the sample (N = 71,854). About 62% of the entire study participants were whites and 14% were blacks. Prevalence estimates of current smoking and corresponding 95% confidence intervals were computed across four comparison groups formed by gender and body weight. Extreme dieting was an independent predictor of smoking. Extreme dieters showed a higher variability of smoking behavior than their peers. The magnitude of the association between smoking and extreme dieting became smaller in recent years among adolescents but remained unchanged among non-overweight girls over that same time period. When adolescent smoking behavior is examined, the intensity of dieting behavior should be considered within its association with other co-occurring unhealthy behaviors.

The association of smoking and acne in men in Hong Kong and in India: a retrospective case-control study in primary care settings

Previous studies on the association of smoking with acne vulgaris have reported conflicting results. The objective of this study was to investigate such an association. Our setting was three primary care practices in Hong Kong and one primary care practice in India. Patient characteristics in all four practices are similar. All medical records in these practices incorporate a section in which the smoking habits of each patient is routinely documented. We searched our database and retrieved 632 records of patients with acne seen in the previous 5 years. We also retrieved 632 records of age- and sex-matched controls. Fifty-three out of 379 male patients with acne and 25 out of 379 male controls were smokers (P = 0.001; OR, 2.3; 95% CI, 1.4-3.8). Six out of 253 female patients with acne and three out of 253 female controls were smokers (OR, 2.0; 95% CI, 0.5-9.4). We conclude that smoking is likely to bear a positive correlation with acne for men. Our numbers are too small for a definite conclusion to be drawn for females.