Weaker Self-Esteem in Adolescence Predicts Smoking

The association of self-esteem and psychosocial outcomes in young adults: a 10-year prospective study

BACKGROUND

This study investigates the association between self-esteem assessed either in adolescence or in adulthood with adult academic and psychosocial outcomes.

METHOD

One hundred and thirty-one junior high school students were selected based on their experience of academic difficulty or success, and both groups were selected equally from regular or low-performing schools. Ten years later, 100 of these individuals participated in a follow-up assessment of academic, socioprofessional, and health-related outcomes. Logistic and linear regression models were performed to estimate the association of self-esteem (measured by the Rosenberg Self-Esteem Scale) at baseline and at follow-up, as well as change in self-esteem categories (high vs. low) on all outcomes.

RESULTS

Fifty-four percent of adolescents were consistently high in self-esteem over the 10-year period, 17% experienced an improvement, 21% a decrease, and 8% stayed at a low level. Outcomes at follow-up were more consistently associated with young adult self-esteem than adolescent self-esteem. Self-esteem was associated with several outcomes (i.e., personal goals, life satisfaction, alcohol, and health outcomes) and its effects were different depending on the period considered and categories of self-esteem change.

CONCLUSIONS

The self-esteem difficulties which are common in adolescence raise concerns about their potential impact on important outcomes later in life. However, self-esteem difficulties in young adulthood were more associated with negative outcomes at this phase of life (whether low self-esteem persisted into adulthood, or emerged only during adulthood). Relative to outcomes in young adulthood, the period of greatest interest for improving well-being may be concentrated in the years immediately surrounding the studied outcomes.

KEY PRACTITIONER MESSAGE

Self-esteem change from adolescent to adulthood is associated with a large diversity of outcomes. Less is known concerning the extent to which adolescent self-esteem may independently determine outcomes in young adulthood as compared to more temporally proximal self-esteem levels. Only self-esteem difficulties in young adulthood were associated with negative outcomes at this phase of life (whether they persisted from adolescence into adulthood, or emerged for the first time during adulthood). Targeting self-esteem difficulties that are temporally proximal to the period of interest may improve mental health and well-being.

Chubby, Hairy and Fearless. Subcultural Identities and Predictors of Self-Esteem in a Sample of Polish Members of Bear Community

Bear subculture exists within a larger gay community, which has been recognized by public health experts as disproportionately burdened with stigma and related health adversities. Bears are distinguished by a particular body look—body hirsuteness and heavy-set physique. Previous research documented the various health risks, and the exposure to both sexual minority and weight stigma, of this population. In this study we focused on the determinants of self-esteem in Bears. We explored the significance of such predictors as: perceived sexual minority and weight stigma, age, resilience, and physique as reflected by the BMI. Our sample consisted of 60 men from the Polish Bear community (i.e., Bears, Cubs, Otters, Wolves). Linear regression models were performed for the entire sample (N = 60) and for Bear-identified men (N = 31). Perceived sexual minority stigma negatively, and resilience positively, predicted self-esteem. In the case of Bear-identified men, age, perceived exposure to weight discrimination, and BMI were also significant predictors of self-esteem. Higher BMI in the case of Bear-identified men predicted higher self-esteem. Our results suggest that although Bear-identified men are characterized by their similarities to other gay men, subcultural identities create unique social contexts that are important for health and health interventions in this population.

The effects of hardcore smokers' depression and self-esteem on daily smoking amount

BACKGROUND

This is a secondary data analysis designed as a longitudinal study aimed at investigating the effects of depression and self-esteem on daily smoking amounts among hardcore smokers over time.

METHODS

The subjects of this study were 264 hardcore smokers aged 19 years or older who participated in all waves of the 9th-13th Korea Welfare Panel Studies. Self-report questionnaires were used to collect data. Data analyses were performed using SPSS WIN 24.0 and AMOS 18.0, and data were analyzed using a latent growth model.

RESULTS

The intercept of depression and self-esteem among the subjects had statistically significant effects on the intercept of the daily smoking amount. The slope of depression and self-esteem among the subjects also had statistically significant effects on the slope of the daily smoking amount. The slope of depression indirect affected the slope of daily smoking amount via the level of self-esteem.

CONCLUSION

It is important to determine the initial levels and the rates of change of depression, self-esteem, and daily smoking amount among hardcore smokers. In order to reduce the daily smoking amount among hardcore smokers, interventions for depression and methods to improve self-esteem among hardcore smokers should be considered.

Associations between self-esteem and smoking and excessive alcohol consumption in the UK: A cross-sectional study using the BBC UK Lab database

Introduction

There is mixed evidence regarding the associations between self-esteem and smoking and excessive alcohol consumption. This study aimed to investigate whether self-esteem is associated with smoking status and alcohol consumption in a large sample of adults in the United Kingdom after adjusting for age, sex, socio-economic status and depressed mood.

Methods

Design: Cross-sectional correlational study conducted under the aegis of the British Broadcasting Corporation (BBC) between 2009 and 2013.Participants: 187,398 respondents (67.9% female) with a mean age of 32.82 years (SD = 12.41) providing complete data.Setting: UK.

Measures

Online self-report questionnaire. The outcomes were smoking status (current smoker, ever smoker) and alcohol consumption (current drinker, excessive drinker); the input variable was self-esteem measured using a Single Item Self-Esteem Scale; covariates were age, sex, SES, and depressed mood measured using a single item question.

Results

The odds of being an ever smoker and a current smoker were greater in people with lower self-esteem (AdjOR 0.97; 95% CI 0.95-0.99, Cohen's d = -0.02; and AdjOR 0.96; 95% CI 0.94-0.99, Cohen's d = -0.02 respectively). The odds of being a current drinker were lower in people with lower self-esteem (AdjOR 1.20, 95% CI 1.17-1.24, Cohen's d = 0.10) while being an excessive drinker was associated with lower self-esteem (β = -0.13, p < 0.001, F(5, 187392) = 997.14, p < 0.001, Cohen's d = 0.3).

Conclusions

Lower self-esteem appears to be positively associated with ever- and current smoking and excessive alcohol consumption and negatively associated with current alcohol consumption.

Protective Effect of Biculturalism for Health Amongst Minority Youth: The Case of Pacific Islander Migrant Youths in Hawai'i

This study investigates the mechanisms by which biculturalism impacts various health outcomes amongst youth migrants to Hawai'i who are from the US-Affiliated Pacific Islands jurisdictions. Using purposive sampling, 284 males and females (twelve to nineteen years old) of Pacific Islander ethnicities in Hawai'i completed a survey. Results from path analysis showed that biculturalism significantly and positively affected self-esteem that, in turn, improved eating attitude, body satisfaction and perceived well-being. Further, eating attitude increased healthy eating behaviour and body satisfaction that, in turn, positively affected general health perception and body satisfaction. Positive smoking attitudes increased smoking activities, which negatively affect general health perception. The study demonstrated that self-esteem impacted overall health through its influence on enhancing positive perceptions about the importance of healthy eating, body satisfaction and well-being. Biculturalism indirectly led to increased self-esteem, which in turn directly influenced attitudes about healthy eating, body satisfaction and perceived well-being. Our study provides strong evidence that addressing the problem of health disparities for minority populations in the USA has to start with reaffirming the value of diversity and multiculturalism and embracing an individual's historic cultural identity. Specific implications for funding agencies and researchers of minority health programs are discussed.

Association Of Cigarette Smoking With Anxiety, Depression, And Suicidal Ideation Among Brazilian Adolescents

BACKGROUND

Several studies worldwide have pointed to depression and anxiety symptoms as being related to adolescent smoking. The aim of this study was to investigate, the potential link of cigarette smoking with depression, anxiety, and suicidal ideation and the influence of gender on these relationships in Brazilian adolescents.

METHODS

Associations of smoking with Children Depressive Inventory version 2 (CDI2) scores, Hamilton Anxiety Scale (HAM-A) scores, and poor school performance (i.e., grade retention) were examined in 988 Brazilian students (age range, 11-17 years) enrolled in 82 public and private schools. Logistic regression modeling was employed and the resultant odds ratios (ORs) are reported with 95% CIs.

RESULTS

Of 988 participants, 240 (24.3%) were smokers. Mean (±standard error) HAM-A scores were higher for smokers (21.1 ± 9.7) than nonsmokers (15.4 ± 8.6; p < 0.0001). Relative to nonsmokers, smokers had higher total CDI2 scores (p = 0.033), and higher scores for the CDI2 domains of Emotional Problems (p = 0.023), Negative Self-esteem (p < 0.001), and Functional Problems (p = 0.046). Suicidal ideation was common among smokers with depressive symptoms (54.2%). Smoking was associated with being held back three grades (p < 0.001). Female smokers were more likely to report suicidal ideation than male smokers (p = 0.020). Logistic regression modeling revealed significant associations of suicidal ideation with being female (OR, 1.81; 95% CI, 1.38-2.37), being a female smoker (OR, 2.05; 95% CI, 1.51-2.80), and having a HAM-A score > 16 (OR, 2.18; 95% CI, 1.66-2.86).

CONCLUSION

Smoking was found to be associated with anxiety symptoms, depressive symptoms, and poor school performance in Brazilian adolescents; and female smokers reported more suicidal ideation than male smokers.

Cigarette and hookah smoking and their relationship with self-esteem and communication skills among high school students

Background: Tobacco smoking is one of the most important public health problems that may be prevented. There is limited information about its relationship with communication skills. Findings on the relationships between self-esteem and cigarette/hookah smoking are inconsistent. The aim of this study was to investigate the relationships between cigarette and hookah smoking,self-esteem and communication skills among a representative sample of high school students.

Methods: In this cross-sectional study, a sample of 1321 tenth-grade students (14-17 years) was selected through multi-stage proportionally cluster sampling in Tabriz, 2017. The participants completed a self–administered multiple choice questionnaire including questions about cigarette smoking, hookah smoking, self-esteem, and communication skills.

Results: After controlling for potential confounders, the results demonstrated that higher score of self-esteem protects students against being in advanced stages of cigarette smoking (odds ratio [OR] = 0.95, 95% CI: 0.92-0.99, P=0.012). However, there was no significant association between self-esteem score and the hookah smoking. Also, there was no significant association between communication skills score and cigarette and hookah smoking.

Conclusion: According to our findings, self-esteem was associated with cigarette smoking, but not with hookah smoking. Furthermore, there was no statistically significant association between communication skills score and cigarette and hookah smoking.

Smoking among school-going adolescents in selected secondary schools in Peninsular Malaysia- findings from the Malaysian Adolescent Health Risk Behaviour (MyaHRB) study

BACKGROUND

A multitude of studies have revealed that smoking is a learned behaviour during adolescence and efforts to reduce the incidence of smoking has been identified as long-term measures to curb the smoking menace. The objective of this study was to determine the prevalence as well as the intra and inter-personal factors associated with smoking among upper secondary school students in selected schools in Peninsular Malaysia.

METHODS

A study was carried out in 2013, which involved a total of 40 secondary schools. They were randomly selected using a two-stage clustering sampling method. Subsequently, all upper secondary school students (aged 16 to 17 years) from each selected school were recruited into the study. Data was collected using a validated standardised questionnaire.

RESULTS

This study revealed that the prevalence of smoking was 14.6% (95% CI:13.3-15.9), and it was significantly higher among males compared to females (27.9% vs 2.4%, p < 0.001). Majority of smokers initiated smoking during their early adolescent years (60%) and almost half of the respondents bought cigarettes themselves from the store. Multivariable analysis revealed that the following factors increased the likelihood of being a current smoker: being male (aOR 21. 51, 95% CI:13.1-35), perceived poor academic achievement (aOR 3.42, 95% CI:1.50-7.37) had one or both parents who smoked (aOR 1.80, 95% CI:1.32-2.45; aOR 6.50, 95 CI%:1.65-25.65), and always feeling lonely (aOR 2.23, 95% CI:1.21-4.43). In contrast, respondents with a higher religiosity score and protection score were less likely to smoke (aOR 0.51, 95% CI:0.15-0.92; aOR 0.71, 95% CI 0.55-0.92).

CONCLUSION

This study demonstrated that the prevalence of smoking among Malaysian adolescents of school-going age was high, despite implementation of several anti-smoking measures in Malaysia. More robust measures integrating the factors identified in this study are strongly recommended to curb the smoking epidemic among adolescents in Malaysia.

Causal Effect of Self-esteem on Cigarette Smoking Stages in Adolescents: Coarsened Exact Matching in a Longitudinal Study

Objectives

Identification of the causal impact of self-esteem on smoking stages faces seemingly insurmountable problems in observational data, where self-esteem is not manipulable by the researcher and cannot be assigned randomly. The aim of this study was to find out if weaker self-esteem in adolescence is a risk factor of cigarette smoking in a longitudinal study in Iran.

Methods

In this longitudinal study, 4,853 students (14–18 years) completed a self-administered multiple-choice anonym questionnaire. The students were evaluated twice, 12 months apart. Students were matched based on coarsened exact matching on pretreatment variables, including age, gender, smoking stages at the first wave of study, socioeconomic status, general risk-taking behavior, having a smoker in the family, having a smoker friend, attitude toward smoking, and self-injury, to ensure statistically equivalent comparison groups. Self-esteem was measured using the Rosenberg 10-item questionnaire and were classified using a latent class analysis. After matching, the effect of self-esteem was evaluated using a multinomial logistic model.

Results

In the causal fitted model, for adolescents with weaker self-esteem relative to those with stronger self-esteem, the relative risk for experimenters and regular smokers relative to nonsmokers would be expected to increase by a factor of 2.2 (1.9–2.6) and 2.0 (1.5–2.6), respectively.

Conclusion

Using a causal approach, our study indicates that low self-esteem is consistently associated with progression in cigarette smoking stages.