Predictors of Cigar, Cigarillo, and Little Cigar Initiation Among Hip Hop-Identifying Youth

BACKGROUND

We explored predictors of cigar product initiation among Hip Hop-identifying U.S. youth using data from the U.S. Food and Drug Administration's Fresh Empire evaluation. Participants were Hip Hop-identifying youth living in evaluation markets who had not initiated cigar product use at their first survey.

OBJECTIVES

We modeled cigar product initiation odds using discrete time survival analysis logistic regression models as a function of factors related to one's large social, physical, social/normative, and intrapersonal environment, and other tobacco use.

RESULTS

In the unique sample, 26.2% initiated cigar product use. Factors associated with higher cigar product initiation odds included: current/former (vs. non-susceptible never) cigarette smoking (odds ratio [OR]=5.35; p=.008); cigarette experimentation (vs. non-susceptible never smoking) (OR=3.26; p<.001); current (vs. never) e-cigarette use (OR=2.06; p<.001) and hookah use (OR=1.83; p=.011); having at least one friend who uses marijuana (OR=1.43; p=.008); high music use (OR=1.32; p=.035); household tobacco use (OR=1.26; p =.042); increased age (OR=1.18; p< .001); and higher sensation seeking (OR=1.16; p=.018). Youth reporting higher perceived smoking risks had lower cigar product initiation odds (OR=0.86; p=.029) as did Hispanic (OR=0.53; p<.001) and non-Hispanic Other youth (OR= 0.68; p=.023) (vs. non-Hispanic Black youth).

CONCLUSIONS

The finding that high music use predicted cigar product initiation should be considered in light of cigar brand sponsorship of musical artists and events and indicates a potential opportunity for counter messaging. Peer crowd segmentation in this study identified unique and differing factors that influence tobacco use risk among Hip Hop-identifying youth that are not found in the general population.

Influencing adolescents’ attitudes towards nicotine products: A systematic review

Background and aim: Use of nicotine can harm adolescents’ brains and increase risk for future addiction to other drugs. Several international studies show that an acceptable attitude towards nicotine products increases the initiation or use of the products. Adolescents have limited or distorted knowledge about nicotine products. Many of them have a positive image of the properties and effects of nicotine products, which increases the chances of smoking or using snus. Yet, we know little about the relationship between youth nicotine use, youth attitudes towards nicotine products and the interventions to influence these attitudes. This systematic review synthesised adolescents’ attitudes towards nicotine products and the ways to influence them. Methods: Systematic searches were carried out from PubMed, MEDLINE, CINAHL, and MEDIC databases and were targeted to randomised controlled trial (RCT) studies published in 2010–2021. Results: A total of seven RCT studies were reviewed with a total population (age range 9–17 years, adolescents 11–17 years) of 15,974. Findings were classified into four categories: school-based interventions, tobacco prevention campaigns, advertisements’ influence on adolescents’ opinions towards nicotine products, and their responses to cigarette pack warnings. Conclusion: Based on this systematic literature review, particularly school-based interventions have an effect on adolescents’ attitudes towards smoking and preventing them from starting to smoke, when they are targeted before the age of puberty. School-based interventions should be further implemented and strengthened, as the school has been shown to have significant potential to support youth’s health. There is a need for further information about the most effective interventions in the different age groups and the qualitative studies on the topic.

Perceived Parental Knowledge Reduces Risk for Initiation of Nicotine and Cannabis Vaping: A Longitudinal Study of Adolescents

PURPOSE

This study examines the role of perceived parental knowledge on initiation of nicotine and cannabis vaping among youth.

DESIGN

Longitudinal study from a self-administered online survey. Three waves of data collected in 6-month intervals.

SETTING

79 public and private schools in Texas.

PARTICIPANTS

Adolescents who self-reported never using e-cigarette to vape nicotine (n=1907; weighted sample [N] = 304371) or vape cannabis (n=2212; N=351955) at baseline. Participants were in 8^th, 10^th, and 12^th grade at baseline.

MEASURES

Self-reported measures of nicotine and cannabis vaping.

ANALYSES

Weighted multivariate logistic regression models examined role of perceived parental knowledge at baseline (Spring 2016) as a predictor of nicotine and cannabis vaping initiation at 6-month (Fall 2016) and 12 month (Spring 2017) follow-up. Covariates were age, sex, race/ethnicity, and other tobacco use.

RESULTS

Initiation rates were 5.9% for nicotine vaping and 8.6% for cannabis vaping, at 12-month follow-up overall. Higher perceived parental knowledge was associated with lower odds of nicotine vaping initiation at 6 months (adj OR: .69; 95% CI: .50-.93) and 12 months (adj OR: .68; 95% CI: .50-.92). Similarly, higher perceived parental knowledge was associated with lower odds of cannabis vaping initiation at 6 months (adj OR: .58; 95% CI: .38-.87) and 12 months (adj OR: .53; 95% CI: .38-.74).

CONCLUSION

E-cigarette prevention efforts directed at adolescents should incorporate parent engagement strategies as a method of increasing actual and perceived parental knowledge of their child's location, activities and peer groups.

Awareness, use and perceptions of cigarillos, heated tobacco products and nicotine pouches: A survey among Dutch adolescents and adults

OBJECTIVES

Many tobacco and related products (TRPs) are less strictly regulated and marketed as less harmful than cigarettes. Little is known about their awareness, use, user profile, use behavior, reasons for use and risk perception, especially for the newest products. In an exploratory survey study among Dutch adolescents and adults, we have investigated three examples of non-cigarette TRPs available on the worldwide market.

METHODS

In a two-step web-based design, data on cigarillos, heated tobacco products (HTPs) and nicotine pouches were collected. In the first step (N = 5805), a representative sample (≥13 years) was studied to quantify their awareness, ever and current use in the Dutch population. In the second step (N = 526), in-depth data regarding use behavior, reasons for use and risk perception were collected among users and non-users.

RESULTS

Awareness (<50%) and use (<15% ever use and <2% current use) is relatively low for all three products, but overall higher among men, (e-)cigarette users and respondents with higher education and social economic status. Most participants became aware of the products through people they knew. Reasons for use were mainly curiosity, pleasant taste, flavour variety, and lower harmfulness. All products were perceived as (slightly) less harmful and addictive than cigarettes.

CONCLUSIONS

This study is one of the first to investigate awareness and use of cigarillos, HTPs and nicotine pouches. To prevent increased use, we recommend regulators to extend flavour and smoking bans to these products. In addition, public information may discourage use by increasing awareness of health risks.

Association between school-based tobacco retailer exposures and young adolescent cigarette, cigar and e-cigarette use

BACKGROUND

Associations between retail tobacco availability and tobacco use have been mixed. This study examined associations between school-based retail environment exposures and current use of cigarettes, cigar products and e-cigarettes among middle school youth in Cleveland, OH.

METHODS

Retailers selling tobacco products were identified using the 2015 Cleveland Food Retail Database (n=639 stores). Youth survey data were drawn from the 2016 Cleveland Youth Risk Behavior Survey, administered to all 7th/8th graders across the Cleveland Metropolitan School District (n=3778, response rate=83.0%). Past 30-day cigarette, cigar product and e-cigarette use were assessed. Student demographics, number of days walking to/from school each week and number of times youth stopped at a retailer to/from school each week were included. For each school (n=63), tobacco retail density (TRD) and proximity (TRP) to nearest retailer were calculated for each product. Multiple regression analysis assessed associations between retail exposures and youth tobacco use.

RESULTS

Across all schools, 3.9%, 10.2% and 8.6% of students currently use cigarettes, cigar products and e-cigarettes, respectively, and 15.2% currently use at least one tobacco product. TRD and TRP were not associated with current use; frequency of walking to school and stopping at retailers were strongly associated with current use.

CONCLUSIONS

Although TRD and TRP were not significantly associated with tobacco product use, youth who reported regularly walking to/from school or who reported stopping at a retail store before/after school were significantly more likely to be a current tobacco product user. This may be due to increased exposure to exterior and point-of-sale marketing.

Impact of Little Cigars and Cigarillos Packaging Features on Product Preference

Background: We conducted a discrete choice experiment (DCE) among young adult cigarette smokers in the period July–August 2018 to examine their preference for cigarillos in response to various packaging-related attributes, including flavor, flavor description, quality descriptors, pack size, and prices. Methods: A convenience sample of 566 US young adult cigarette smokers aged 18–34, among whom 296 were current little cigar and cigarillo (LCC) smokers, were recruited using Facebook ads and invited to participate in an online (Qualtrics) tobacco survey containing DCE and tobacco use questions. In the experiment, participants chose among two cigarillo products or “neither” (opt-out). Results: We analyzed preferences for LCCs using multinomial, nested, random parameter logit models. Results showed that young adult cigarette smokers preferred grape over menthol, tobacco/regular, and wine flavors; “color only” and “color and text” flavor depictions over text only; “smooth” and “sweet” quality descriptors over “satisfying”; and larger pack sizes and lower prices. Conclusions: Regulating packaging-related features will impact LCC choices among US young adult smokers. FDA regulation over these packaging-related features may impact LCC use among young adult smokers.

Age of initiation of cigarillos, filtered cigars and/or traditional cigars among youth: Findings from the Population Assessment of Tobacco and Health (PATH) study, 2013-2017

SIGNIFICANCE

Early age of initiation of tobacco use is associated with sustained tobacco use and lower rates of smoking cessation. Although much is known about age of initiation of cigarette use, much less is known about the age of initiation of cigar product use among youth.

METHODS

Survival analyses of the Population Assessment of Tobacco and Health youth annual datasets (ages 12-17) from 2013 to 2017 were conducted for any cigar product use, cigarillos or filtered cigars, and traditional cigars across four cigar use outcomes, age of initiation of: susceptibility to use, ever use, past 30-day use and "fairly regular" use. An interval censoring survival method was implemented to estimate the probability of each outcome for age of initiation of each cigar product overall. Differences in age of initiation by sex and race/ethnicity were assessed using weighted Cox proportional hazards models for interval-censored data.

RESULTS

For each outcome across the three cigar products, striking increases in the probability of initiation begin before 17 years old. For cigarillo or filtered cigars, males had a higher risk of onset of susceptibility to use, initiating ever use, and initiating past 30-day use at earlier ages than females. Compared to Non-Hispanic Whites, Hispanic and Non-Hispanic Other had lower risk of initiating ever use and past 30-day use at earlier ages. Non-Hispanic Black youth had higher risk of initiating past 30-day use and "fairly regular" use than Non-Hispanic White youth at earlier ages. Similar findings are reported for any cigar use and traditional cigar use.

CONCLUSION

Developmentally and culturally appropriate cigar use interventions and communication campaigns should be provided to youth before 17 years of age to prevent the onset and progression of cigar products. Regulatory policies that reduce appeal of all cigar products should be implemented to curb cigar initiation among youth.

Correlates of tobacco product reuptake and relapse among youth and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016)

OBJECTIVE

This study examines sociodemographic and tobacco use correlates of reuptake and relapse to tobacco use across a variety of tobacco products (cigarettes, electronic nicotine delivery systems, cigars, hookah and smokeless tobacco) among the US population.

DESIGN

Data were drawn from the first three waves (2013-2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth (ages 12-17) and adults (ages 18+). Reuptake (past 30-day use among previous tobacco users) and relapse (current use among former established users; adults only) were examined among previous users of at least one type of tobacco product at Wave 1 (W1) or Wave 2 (W2) (n=19 120 adults, n=3039 youth). Generalised estimating equations were used to evaluate the association between demographic and tobacco use characteristics at baseline, with reuptake/relapse at follow-up, over two 1-year periods (W1-W2 and W2-Wave 3).

RESULTS

Any tobacco product reuptake occurred in 7.8% of adult previous users and 30.3% of youth previous users. Correlates of any tobacco reuptake included being male, non-Hispanic black and bisexual in adults, but race and sexual orientation were not consistent findings in youth. Among recent former users, relapse rates were greater (32.9%). Shorter time since last use and greater levels of tobacco dependence showed the strongest association with any tobacco relapse.

DISCUSSION

Continued clinical and public health efforts to provide adults with tools to cope with tobacco dependence symptoms, especially within the first year or two after quitting, could help prevent relapse.

Correlates of tobacco product initiation among youth and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016)

OBJECTIVE

To report on demographic and tobacco product use correlates of tobacco product initiation (cigarettes, electronic nicotine delivery systems (ENDS), cigars, hookah and smokeless tobacco) among the US population.

DESIGN

Data were from the first three waves (2013-2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth (aged 12-17 years) and adults (aged 18+ years). Never users of at least one type of tobacco product at Wave 1 (W1, 2013/14) or Wave 2 (W2, 2014/15) were included (n=12 987 youth; n=25 116 adults). Generalised estimating equations were used to evaluate the association between demographic and tobacco product use characteristics at baseline, and tobacco product initiation at follow-up (ever, past 30 day (P30D), frequent (use on 20 or more of thepast 30 days)) over two 1-year periods (W1-W2 and W2-Wave 3).

RESULTS

Youth aged 15-17 years were more likely than youth aged 12-14 years and adults aged 18-24 years were more likely than older adults to initiate P30D tobacco use across products; non-heterosexuals were more likely than heterosexuals to initiate P30D cigarette and ENDS use. Older adults were more likely than young adults, and males were more likely than females, to be frequent users of ENDS on initiation. Ever use of another tobacco product predicted P30D initiation of each tobacco product.

DISCUSSION

Other tobacco product use and age predict P30D tobacco initiation across products whereas associations with other demographic characteristics vary by product. Continued contemporary evaluation of initiation rates within the changing tobacco product marketplace is important.

Retail Tobacco Marketing in Rural Versus Nonrural Counties: Product Availability, Discounts, and Prices

Objectives. To assess tobacco product availability, advertised discounts, and prices in rural and nonrural stores, comparing results for two definitions of rural. Method. This geospatial study linked data from marketing surveillance in a representative sample of licensed tobacco retailers in California (n = 1,276) and categorized rural/nonrural stores at the county and tract levels. Data were collected from January to March, 2017, and mixed-models analyses tested for differences by location (rural vs. nonrural). Results. Compared to nonrural stores, rural-county stores were 2.1 (95% confidence interval [CI; 1.2, 3.6]) times more likely to sell chewing tobacco and 2.5 (95% CI [1.4, 4.2]) times more likely to sell roll-your-own. Rural-county stores sold larger packs of cigarillos for less than $1 (coefficient = 0.22, 95% CI [0.05, 0.39]) and charged less for the cheapest cigarette pack regardless of brand (estimated mean difference = $-0.21, 95% CI [-0.39, -0.03]). Contrary to expectation, a popular brand of chewing tobacco cost more in rural-county stores. A tract-level definition of rural reclassified only 1 in 10 stores, and did not substantially alter the results. Overall, 32.9% of stores advertised discounts on chewing tobacco, but this was more common in rural than nonrural census tracts (adjusted odds ratio = 1.81, 95% CI [1.14, 2.88]). Discussion. Evidence that $1 buys more cigarillos in rural-county stores than elsewhere adds to health equity concerns that the prevalence of cheap, flavored tobacco is not limited to neighborhoods characterized by socioeconomic disadvantage, higher proportions of African Americans, and higher proportions of school-age youth. Policies that focus on the retail environment for tobacco are needed to make tobacco less attractive and more costly everywhere, including rural areas.

Factors affecting cigarette smoking among adolescents in South Korea, Vietnam, and Thailand

PURPOSE

The current study was designed to describe risk and preventive factors related to cigarette smoking among adolescents in South Korea, Vietnam, and Thailand.

DESIGN AND METHODS

A cross-sectional descriptive design was used. Student data were extracted from three national data sets, specifically the Global Youth Tobacco Survey from each country. Complex sampling multinomial logistic regression was performed to find factors related to current smoking.

RESULTS

The prevalence of cigarette smoking was 4.7% in South Korean students, 2.8% in Vietnamese students, and 10.9% in Thai students. Students shared three risk factors related to current smoking: male sex, use of other tobacco products, and susceptibility to smoking. Additionally, only one preventive factor of cigarette smoking was found among South Korean adolescents: exposure to antitobacco advertisements. The findings suggest that personal, familial, social, and public area characteristics are associated with smoking among adolescents from these nations.

PRACTICE IMPLICATIONS

These results could be useful for screening students vulnerable to cigarette smoking and the collaborative planning of interventions to prevent adolescents from smoking in these three Asian countries.

Systematic review of cigars, cigarillos, and little cigars among adolescents: Setting research agenda to inform tobacco control policy

INTRODUCTION

We conducted a systematic review of the literature on cigar research on youth to identify potential future research agenda to generate evidence to inform cigar regulations to prevent cigar use among youth.

METHODS

We searched articles on Medline, EMBASE, and PsycINFO in April 2017 to identify articles relevant to cigars and adolescents. Two independent coders examined 48 articles to determine eligibility: (1) published between 2000-April 2017; (2) published in English; (3) conducted in the United States; (4) published in a peer-review journal; (5) examined cigars, cigarillos, or little cigars; (6) included youth (12-18 years old); and (7) included empirical data. Three independent coders reviewed the included articles (n = 48) to identify whether the studies addressed FDA's Research Priorities.

RESULTS

The studies addressed FDA's Research Priorities of "behavior" (n = 48), "communications" (n = 4), "marketing influences" (n = 1), and "impact analysis" (n = 1). Studies on "behavior" underscored the need for improvements in measurement, such as using brand names and distinguishing cigar products. The review revealed the need for restrictions on cigar flavors, development of media campaigns and interventions, increasing the cost (via taxation), and evaluating the impact of cigar policies.

CONCLUSIONS

The studies mostly focused on surveillance of behaviors and use patterns, which revealed cigar specific issues to address in policies to decrease cigar use among youth. The lack of studies addressing other FDA's research priorities highlighted the critical need for future studies that inform prevention of youth cigar use.

Plain tobacco packaging, increased graphic health warnings and adolescents' perceptions and initiation of smoking: DePICT, a French nationwide study

BACKGROUND

Plain packaging (PP) of tobacco products and increased graphic warnings may contribute to lower attractiveness of smoking, particularly among youths. In France, this policy was introduced on 1 January 2017. We examined changes in smoking-related perceptions and behaviours among a nationwide sample of French adolescents before (2016) and 1 year post (2017) implementation.

METHODS

DePICT is a two-wave cross-sectional national telephone survey of adolescents aged 12-17 years per study wave (2016: n=2046 2017: n=1999). All participants reported smoking-related perceptions, as well as ever and current tobacco use. Smokers were also asked about their perceptions of tobacco brands. Data were weighted to be representative of youths in the French population: adjusted prevalence ratios (PRs, 95% CI) estimating changes between the two study waves were calculated using multivariate log-binomial regression models.

RESULTS

In 2017, as compared with 2016, French adolescents were more likely to report fear of the consequences of smoking (PR=1.06, 95% CI 1.02 to 1.09) and that smoking is dangerous (PR=1.08, 95% CI 1.05 to 1.11). They were also less likely to report that their friends (PR=0.61, 95% CI 0.54 to 0.70) and family (PR=0.51, 95% CI 0.44 to 0.60) accept smoking. Additionally, smoking initiation significantly decreased (PR=0.96, 95% CI 0.93 to 0.98) and a non-statistically significant drop in current tobacco use was observed (PR=0.93, 95% CI 0.78 to 1.11). Smokers' attachment to their tobacco brand also decreased (PR=0.47, 95% CI 0.30 to 0.73).

CONCLUSION

Our findings suggest that PP and increased graphic warnings could contribute to changes in smoking norms and rates among adolescents.

Attitudes and Risk Perceptions Toward Smoking Among Adolescents Who Modify Cigar Products

Objective

To examine high school youths' perceptions of health risks, and personal and parental attitudes toward cigarette, cigar, and marijuana use among youth who use or modify cigars.

Participants

The 2013 Cuyahoga County Youth Risk Behavior Survey used a two-stage cluster sample design to randomly sample public high schools and classrooms. Students in selected classrooms were eligible; 16,855 students completed the survey.

Main Outcome Measures

This study examines the association between risk perceptions of and youths' personal and parental attitudes toward smoking cigarettes, cigars, and marijuana with current use of cigars, cigarillos or little cigars (CCLCs) or modified CCLCs (ie, freaking or blunting).

Results

23.5% of youth reported current use of CCLCs in some way; 11.0% reported current freaking and 18.5% reported current blunt use. CCLC users tended to be male and Black. Perceiving all smoking behaviors as risky, wrong, or wrong by parents reduced odds of using CCLCs. After multivariate analysis, Blacks had increased odds of using CCLCs if they perceived smoking cigarettes as harmful, which was not found among other race/ethnicity categories. Having parents who believed that smoking CCLCs is wrong increased the odds of youth freaking or blunting among all CCLC users. Odds of blunting was greater for those who believed CCLCs were more risky among all CCLC users.

Conclusions

Findings suggest that CCLC users may think cigars are safer than cigarettes, and that modifiers may think their use is safer and more in line with their parents' views than non-modified CCLCs.

Neighborhood Variation in the Price of Cheap Tobacco Products in California: Results From Healthy Stores for a Healthy Community

BACKGROUND

Retail marketing surveillance research highlights concerns about lower priced cigarettes in neighborhoods with a higher proportion of racial/ethnic minorities but focuses almost exclusively on premium brands. To remedy this gap in the literature, the current study examines neighborhood variation in prices for the cheapest cigarettes and a popular brand of cigarillos in a large statewide sample of licensed tobacco retailers in a low-tax state.

METHODS

All 61 local health departments in California trained data collectors to conduct observations in a census of eligible licensed tobacco retailers in randomly selected zip codes (n = 7393 stores, completion rate=91%). Data were collected in 2013, when California had a low and stagnant tobacco tax. Two prices were requested: the cheapest cigarette pack regardless of brand and a single, flavored Swisher Sweets cigarillo. Multilevel models (stores clustered in tracts) examined prices (before sales tax) as a function of neighborhood race/ethnicity and proportion of school-age youth (aged 5-17). Models adjusted for store type and median household income.

RESULTS

Approximately 84% of stores sold cigarettes for less than $5 and a Swisher Sweets cigarillo was available for less than $1 in 74% of stores that sold the brand. The cheapest cigarettes cost even less in neighborhoods with a higher proportion of school-age residents and Asian/Pacific Islanders.

CONCLUSIONS

Neighborhood disparities in the price of the cheapest combustible tobacco products are a public health threat. Policy changes that make all tobacco products, especially combustible products, less available and more costly may reduce disparities in their use and protect public health.

IMPLICATIONS

Much of what is known about neighborhood variation in the price of combustible tobacco products focuses on premium brand cigarettes. The current study extends this literature in two ways, by studying prices for the cheapest cigarette pack regardless of brand and a popular brand of flavored cigarillos and by reporting data from the largest statewide sample of licensed tobacco retailers. Significantly lower prices in neighborhoods with a higher proportion of youth and of racial/ethnic groups with higher smoking prevalence are a cause of concern. The study results underscore the need for policies that reduce availability and increase price of combustible tobacco products, particularly in states with low, stagnant tobacco taxes.

Marijuana as a 'concept' flavour for cigar products: availability and price near California schools

OBJECTIVES

To assess the retail availability of cigar products that refer to marijuana and the largest package size of cigarillos available for ≤$1.

METHODS

Trained data collectors conducted marketing surveillance in a random sample of licensed tobacco retailers that sold little cigars/cigarillos (LCCs) (n=530) near a statewide sample of middle and high schools (n=132) in California. Multilevel models examined the presence of marijuana co-marketing and cigarillo pack size as a function of school/neighbourhood characteristics and adjusted for store type.

RESULTS

Of stores that sold LCCs, approximately 62% contained at least one form of marijuana co-marketing: 53.2% sold cigar wraps marketed as blunt wraps, 27.2% sold cigarillos marketed as blunts and 26.0% sold at least one LCC with a marijuana-related 'concept' flavour. Controlling for store type, marijuana co-marketing was more prevalent in school neighbourhoods with a higher proportion of young residents (ages 5-17 years) and with lower median household income. Nearly all stores that sold LCCs (87.9%) offered the products for ≤$1. However, significantly larger packs at similarly low prices were available near schools in lower-income neighbourhoods and with a lower percentage of Hispanic students.

CONCLUSIONS

Understanding how the tobacco industry manipulates cigar products and marketing to capitalise on the appeal of marijuana to youth and other priority populations is important to inform regulation, particularly for flavoured tobacco products. In addition, the retail availability of five and six packs of LCCs for ≤$1 near California schools underscores policy recommendations to establish minimum prices for multipacks.

Epidemiological profile of smoking and nicotine addiction among asthmatic adolescents

OBJECTIVE

Despite the harmful effects of cigarette smoking, this habit in asthmatic adolescents continues to be a health problem worldwide. Our objectives were to determine the epidemiological profile of smoking and the degree of nicotine dependence among asthmatic adolescents.

STUDY DESIGN

Through a cross-sectional investigation, 3383 adolescents (13-19 years of age) were studied.

METHODS

Information was collected using a previously validated questionnaire. Two study groups of adolescent smokers were formed: one composed of asthmatic adolescents and the other of healthy youths.

RESULTS

Asthmatic adolescents were found to be more likely to smoke (21.6% vs 11.8%) and to have some degree of nicotine dependence compared with healthy adolescents (51.6% vs 48.8%). The most important characteristic of smoking in asthmatic adolescents was found to be an onset before 11 years of age due to curiosity about cigarettes. Asthmatic youths continue smoking because this habit decreases their anxiety and stress. Adolescents know that smoking is addictive and often smoke on waking up in the morning or when they are sick. Yet, these adolescents do not consider smoking to be a problem.

CONCLUSION

In this study, curiosity about cigarettes was the primary reason why asthmatic adolescents smoked for the first time and developed a greater dependence to nicotine compared with healthy adolescents. Moreover, the findings show that many of the factors that favour the development of smoking are preventable, given that they are present in the family and social environment.