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Azagba S, Manzione L, Shan L, King J. Trends in Smoking Behaviors Among US Adolescent Cigarette Smokers. Pediatrics 2020; 145:peds.2019-3047. [PMID: 32015140 DOI: 10.1542/peds.2019-3047] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Identifying trends in smoking behaviors among youth cigarette smokers could inform youth policy and interventions. METHODS Using 2011-2018 National Youth Tobacco Survey data, logistic/linear regressions were used to analyze trends in smoking frequency, intensity, age of first cigarette use, and electronic cigarette (e-cigarette) use frequency among current smokers. Stratified analyses were conducted among male, female, middle school, and high school students and race and ethnicity subgroups separately. RESULTS From 2011 to 2018, there was a decrease in smoking ≥10 days (50.0% to 38.3%), ≥20 days (37.2% to 26.3%), and 30 days (26.6% to 18.2%) among current smokers. Smoking prevalence decreased among male, female, high school, non-Hispanic white, and non-Hispanic other students. Overall, light smoking (≤5 cigarettes per day [CPDs]) increased (76.6% to 82.7%), and moderate smoking (6-10 CPDs) decreased (10.7% to 8.3%). Trends in light, moderate, and heavy smoking varied by demographic groups. Age at first cigarette use increased among female (12.28 to 13.29), high school (12.91 to 13.18), and non-Hispanic other students (11.64 to 12.83) and decreased among male students (12.90 to 12.57). From 2014 to 2018, there was an increase in e-cigarette use frequency for ≥10 days (20.8% to 40.9%), ≥20 days (13.5% to 31.7%), and all 30 days (9.3% to 22%). CONCLUSIONS From 2011 to 2018, current youth cigarette smokers smoked fewer days and fewer CPDs, and age of first cigarette use increased. However, over time, male youth smoked more heavily and started smoking earlier. E-cigarette use increased from 2014 to 2018. Differences by demographic characteristics can inform future research and interventions.
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Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, School of Medicine and
| | - Lauren Manzione
- Department of Family and Preventive Medicine, School of Medicine and
| | - Lingpeng Shan
- Department of Family and Preventive Medicine, School of Medicine and
| | - Jessica King
- Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, Utah
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Jacobs M. Adolescent smoking: The relationship between cigarette consumption and BMI. Addict Behav Rep 2018; 9:100153. [PMID: 31193813 PMCID: PMC6542372 DOI: 10.1016/j.abrep.2018.100153] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/17/2018] [Accepted: 12/07/2018] [Indexed: 12/20/2022] Open
Abstract
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. The weight impact of tobacco use by adolescents, unlike adults, has not been conclusively determined. This study examines the relationship between cigarette use and the body weight (BMI) of high school aged youth. Since smoking can be considered endogeneous in weight studies, smoking is instrumented in a two-stage process. Cigarette use is associated with higher BMI, but magnitudes vary by age. Models run on early, middle and older adolescents show that the relationship diminishes over time. The relationship between BMI and smoking decreases as females age but increases for males. Overweight and obese adolescents were more frequent tobacco users. Results suggest that electronic and conventional tobacco has similar BMI associations when used independently.
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Kong G, Kuguru KE, Krishnan-Sarin S. Gender Differences in U.S. Adolescent E-Cigarette Use. CURRENT ADDICTION REPORTS 2017; 4:422-430. [PMID: 29545987 DOI: 10.1007/s40429-017-0176-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose of Review This study aims to review the recent (2012-2017) available gender difference data on e-cigarette use among adolescents. Recent Findings E-cigarettes are the most commonly used tobacco product among adolescents, and recent study findings showed that e-cigarette use can lead to cigarette smoking. However, gender differences in e-cigarette use among adolescents are relatively unknown. Summary We used the search terms "adolescents" and "e-cigarettes" on PubMed and identified 652 articles. Of these, 16 articles (2.5%) examined gender differences in adolescent e-cigarette use. Boys appear to have greater use of e-cigarettes, but girls may be at increased risk if e-cigarettes are targeted to them, as it has been for cigarettes. Data on gender differences are limited, and future research should continue to examine gender differences in e-cigarette use. Trends in use rates could evolve with new regulations and innovations in e-cigarette marketing and product features.
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Affiliation(s)
- Grace Kong
- Yale School of Medicine, 34 Park Street, Room S-211, New Haven, CT 06519, USA
| | - Karissa E Kuguru
- Yale School of Medicine, 34 Park Street, Room S-211, New Haven, CT 06519, USA
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Hale WJ, Perrotte JK, Baumann MR, Garza RT. Low self-esteem and positive beliefs about smoking: a destructive combination for male college students. Addict Behav 2015; 46:94-9. [PMID: 25838000 DOI: 10.1016/j.addbeh.2015.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 02/24/2015] [Accepted: 03/07/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Men exhibit higher rates of smoking relative to women (CDC, 2014). Given the associated health and socio-economic consequences, it would be valuable to explore the psychological factors underlying this variance. We contend that positive beliefs about smoking influence this difference, and that self-esteem moderates these beliefs. METHOD As part of a multi-institutional collaborative study funded by the American Legacy Foundation, 445 participants who reported being either steady or occasional smokers completed a series of questionnaires assessing their beliefs and behaviors involving smoking as well as several dispositional variables. Moderated mediation was used to test for conditional indirect effects. RESULTS The total, indirect, and direct effects of gender were significant for individuals with lower, but not higher self-esteem. Males with lower self-esteem exhibited more positive beliefs and smoking behavior than females with lower self-esteem. No differences between males and females with higher self-esteem were observed. CONCLUSION The gender gap in smoking behavior appears to occur primarily among individuals with lower self-esteem. It is a particularly detrimental risk factor for males, as it is related to higher positive views about smoking and increased tobacco consumption. These results highlight the importance of developing multifaceted gender specific belief-based preventative interventions to address smoking related behaviors.
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Chung SS, Joung KH. Risk factors for current smoking among American and South Korean adolescents, 2005-2011. J Nurs Scholarsh 2014; 46:408-15. [PMID: 25224519 DOI: 10.1111/jnu.12099] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2014] [Indexed: 01/14/2023]
Abstract
PURPOSE Population data concerning smoking rates of adolescents and adults in the United States and Korea (South Korea) has highlighted the need for attention to this age group. This study compared the risk factors related to smoking and examined the gender differences with other risk factors in smoking among American and Korean adolescents between 2005 and 2011. ORGANIZING CONSTRUCT AND METHODS Participants were students in grades 9-11 selected from nationally representative surveys conducted in 2005 and 2011. FINDINGS In 2011, similar risk factors for current smoking were identified in American and Korean adolescents. These included male gender, school grade, depression, experience of alcohol drinking, current use of alcohol, use of glue or other inhalants, and experience of sexual intercourse. Among Korean adolescents, weight perception and weight control were unique risk factors for current smoking. Interactions with gender and other risk factors in each nation were revealed. CONCLUSIONS These risk factors, their change from earlier years, and gender differences should be recognized in the screening of vulnerable individuals for smoking and formulating effective intervention programs. CLINICAL RELEVANCE These results will provide information for the design and implementation of cessation programs for adolescents in these countries.
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Affiliation(s)
- Sung Suk Chung
- Professor, Department of Statistics and Institute of Applied Statistics, Chonbuk National University, Jeonju, Korea
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The gender-specific association between asthma and the need to smoke tobacco. Heart Lung 2013; 43:77-83. [PMID: 24238774 DOI: 10.1016/j.hrtlng.2013.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 09/24/2013] [Accepted: 09/25/2013] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To examine the associations between multidimensional tobacco dependence and youths' asthma status with gender as an effect modifier. BACKGROUND Despite the adverse respiratory effects, some adolescents with asthma smoke tobacco. Girls and boys have been shown to have different motivations for tobacco use. METHODS Secondary analyses were conducted of data obtained from 1248 adolescents who completed the British Columbia Youth Survey of Smoking and Health II. The sample was limited to youth who reported current or experimental tobacco use and who provided asthma status information. Tobacco dependence was assessed with the modified-Fagerström Tolerance Questionnaire and four-dimension Adolescents' Need for Smoking Scale (ANSS), which assesses social dependence, physical dependence, emotional dependence, and sensory dependence on tobacco. All analyses were stratified by gender. RESULTS The sample was 535 boys and 713 girls who were 15.9 years of age (SD = 1.5), on average. Gender was associated with both self-reported asthma status and the physical dependence dimension of the ANSS. Multiple linear regression analyses revealed that girls with asthma, compared with girls without asthma, had higher physical tobacco dependence scores, after adjusting for demographic and other factors. None of the tobacco dependence dimensions was associated with the asthma status of boys. CONCLUSIONS Asthmatic girls who report smoking may be doing so because they develop physical dependence relatively quickly and lose their autonomy with respect to tobacco use. They may require significant support for smoking cessation, including cognitive behavioral therapy and nicotine replacement therapy.
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Dawson DB, Sotelo FL, Roesch SC, Klonoff EA. Testing the invariance of adolescent survey-based smoking-related behaviors across ethnic groups and gender. J Health Psychol 2013; 19:1576-85. [PMID: 23988682 DOI: 10.1177/1359105313495907] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present study examined the factor structure of 3 smoking-related items administered as part of the California Health Interview Survey. Factorial invariance was examined across Asian Americans (N = 377), Caucasians (N = 1739), African Americans (N = 115), and Latin Americans (N = 814), and across young men (N = 1612) and women (N = 1767). Factorial invariance analyses revealed all minority ethnic groups to be significantly different (p < .05) from Caucasians, and men to differ significantly from women. These findings suggest that the types of smoking behaviors assessed in the California Health Interview Survey do not predict behaviors uniformly across groups.
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Abstract
Adolescent smoking behavior is assumed to be associated with smoking outcome expectancies. Results in this paper are based on data from the control group of two data collections among Norwegian secondary school students taken approximately 30 months apart (T1 and T2). The dimensionality of smoking outcome expectancies was the same at both time points, revealing three components ("Addicted", "Not harmful" and "Social"). After correction for attenuation, the Pearson's correlation between T1 and T2 was 0.41 for the total sumscore, indicating low to moderate relative stability. When examining smoking expectancy sumscore means by smoking habits at T1 and T2, never smokers were different from smokers on both occasions. Never smokers scored low on "Social" and "Not harmful", and high on "Addictive". All associations were statistically significant (p < 0.001). The "Social" dimension was the strongest predictor of smoking behavior at T1 and T2. One of the outcome expectancy sumscores ("Addictive") at T1 predicted smoking habits at T2 after controlling for smoking habits at T1 (p < 0.01). This predictor was significant also after entering outcome expectancy sumscores at T2 into the model (p < 0.05). These results indicate that outcome expectations other than the health-related ones should be paid attention to when planning new prevention programs.
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Affiliation(s)
- Ola Jøsendal
- Department of Health Promotion and Development, University of Bergen, Norway.
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Okoli CTC, Torchalla I, Ratner PA, Johnson JL. Differences in the smoking identities of adolescent boys and girls. Addict Behav 2011; 36:110-5. [PMID: 20965665 DOI: 10.1016/j.addbeh.2010.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 09/28/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess sex-disaggregated differences in youths' characterizations of their own smoking behavior. METHOD Cross-sectional data including demographics (sex, age, and grade level), perceived addiction to tobacco, Dimensions of Tobacco Dependence Scale (DTDS) scores, the Modified Fagerström Tolerance Questionnaire (M-FTQ) scores, smoking history, and self-reported smoking identity were collected from questionnaires administered to 7246 students in British Columbia, Canada. Differences in tobacco dependence by sex and by smoking identity were examined. RESULTS Girls were more likely to report being ex-, social, irregular, or regular smokers than were boys; and were more likely to select more than one smoking identity to describe their smoking behavior. Among the current smokers, the boys smoked more cigarettes each day, on average, and had significantly higher scores on the social and sensation dependence dimensions of the DTDS, and the M-FTQ, compared with the girls. Girls in each smoking identity group had lower scores on every tobacco dependence measure, except the emotional dependence dimension of the DTDS. CONCLUSION Adolescent boys and girls appear to understand and subscribe to 'smoking identity' groups in similar patterns. However, there may be differences in the ways boys and girls conceptualize, describe, and endorse smoking identities. Researchers should examine the consistency between adolescents' smoking identities and researcher-derived categorizations of their smoking in planning and selecting appropriate interventions. Future research should explore qualitative gender differences in the smoking identities of adolescents.
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Affiliation(s)
- Chizimuzo T C Okoli
- British Columbia Centre of Excellence for Women's Health, E311 - 4500 Oak Street, Box 48, Vancouver, BC V6H 3N1, Canada.
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Urbán R, Demetrovics Z. Smoking outcome expectancies: A multiple indicator and multiple cause (MIMIC) model. Addict Behav 2010; 35:632-5. [PMID: 20167433 DOI: 10.1016/j.addbeh.2010.01.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 01/02/2010] [Accepted: 01/27/2010] [Indexed: 11/15/2022]
Abstract
The present study was carried out to assess the construct validity of the short form of the Smoking Consequences Questionnaire, a brief measure of smoking outcome expectancies on a large sample of adolescents (N = 953). The results of this study support a four-factor structure of smoking outcome expectancies, including expectancies of negative consequences, positive reinforcement, negative reinforcement and appetite-weight control, as well as the assertion that gender, smoking status and sensation-seeking have a distinct pattern of associations with the four outcome expectancy factors.
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Affiliation(s)
- Róbert Urbán
- Eötvös Loránd University, Department of Personality and Health Psychology Budapest, H-1064, Hungary.
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Wills TA, Sargent JD, Stoolmiller M, Gibbons FX, Gerrard M. Movie smoking exposure and smoking onset: a longitudinal study of mediation processes in a representative sample of U.S. adolescents. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2008; 22:269-77. [PMID: 18540724 DOI: 10.1037/0893-164x.22.2.269] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The authors tested 2 mechanisms for the relation of movie smoking exposure with onset of cigarette smoking in adolescence. Longitudinal data with 8-month follow-up were obtained from a representative sample of 6,522 U.S. adolescents, ages 10-14 years. Structural modeling analysis based on initial nonsmokers, which controlled for 10 covariates associated with movie exposure, showed that viewing more smoking in movies was related to increases in positive expectancies about smoking and increases in affiliation with smoking peers, and these variables were both related to smoking onset. A direct effect of movie exposure on smoking onset was also noted. Mediation findings were replicated across cross-sectional and longitudinal analyses. Tests for gender differences indicated that girls showed larger effects of movie exposure for some variables. Implications for policy and prevention research are discussed.
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Affiliation(s)
- Thomas A Wills
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, USA.
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Kaufman AR, Augustson EM. Predictors of regular cigarette smoking among adolescent females: does body image matter? Nicotine Tob Res 2008; 10:1301-9. [PMID: 18686177 PMCID: PMC3746513 DOI: 10.1080/14622200802238985] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examined how factors associated with body image predict regular smoking in adolescent females. Data were from the National Longitudinal Study of Adolescent Health (Add Health), a study of health-related behaviors in a nationally representative sample of adolescents in grades 7 through 12. Females in Waves I and II (n = 6,956) were used for this study. Using SUDAAN to adjust for the sampling frame, univariate and multivariate analyses were performed to investigate if baseline body image factors, including perceived weight, perceived physical development, trying to lose weight, and self-esteem, were predictive of regular smoking status 1 year later. In univariate analyses, perceived weight (p<.01), perceived physical development (p<.0001), trying to lose weight (p<.05), and self-esteem (p<.0001) significantly predicted regular smoking 1 year later. In the logistic regression model, perceived physical development (p<.05), and self-esteem (p<.001) significantly predicted regular smoking. The more developed a female reported being in comparison to other females her age, the more likely she was to be a regular smoker. Lower self-esteem was predictive of regular smoking. Perceived weight and trying to lose weight failed to reach statistical significance in the multivariate model. This current study highlights the importance of perceived physical development and self-esteem when predicting regular smoking in adolescent females. Efforts to promote positive self-esteem in young females may be an important strategy when creating interventions to reduce regular cigarette smoking.
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Affiliation(s)
- Annette R Kaufman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Boulevard, Bethesda, MD 20892, USA.
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Chelland Campbell S, Moffatt RJ, Stamford BA. Smoking and smoking cessation -- the relationship between cardiovascular disease and lipoprotein metabolism: a review. Atherosclerosis 2008; 201:225-35. [PMID: 18565528 DOI: 10.1016/j.atherosclerosis.2008.04.046] [Citation(s) in RCA: 220] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Revised: 04/22/2008] [Accepted: 04/30/2008] [Indexed: 12/17/2022]
Abstract
Cigarette smoking is generally accepted as the most preventable cause of death in the United States today. Individuals who smoke experience a wide range of physiologic side effects that increase the risk of cardiovascular disease (CVD), including insulin resistance, elevated catecholamine levels which contribute to an elevated heart rate and blood pressure, and hypercholesterolemia. The link between hypercholesterolemia and cardiovascular disease has been extensively researched and is undeniable. What is more, this link is strengthened in smokers as cigarette smoking is known to increase total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL), while acting to decrease the cardio-protective high-density lipoprotein (HDL). Alterations in the enzymes that control lipid transport may be a key underlying mechanism contributing to these health destroying effects. This review examines the current literature related to: (1) smoking, lipoproteins, and lipid-related enzymes; (2) the impact of nicotine, carbon monoxide and free radicals on physiologic parameters related to health; and (3) metabolic issues involving smoking cessation and nicotine replacement therapy.
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Affiliation(s)
- Sara Chelland Campbell
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306-1493, USA.
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