 |
|
Health-Compromising Behaviors: Why Do Adolescents Smoke or Drink?
Identifying Underlying Risk and Protective Factors
Elisabeth Simantov, PhD;
Cathy Schoen, MS;
Jonathan D. Klein, MD, MPH
Arch Pediatr Adolesc Med. 2000;154:1025-1033.
Objectives To better understand the motivation for adolescent smoking and drinking and to identify the underlying risk and protective factors associated with these behaviors among adolescents.
Design Cross-sectional, school-based survey of students in grades 5 through 12.
Participants A nationally representative sample of 2574 boys and 2939 girls in grades 7 through 12 from 297 public, private, and parochial schools across the United States who participated in The Commonwealth Fund Survey of the Health of Adolescent Girls and Boys in 1997.
Main Outcome Measures Sex-specific adjusted relative risks (RRs) and 95% confidence intervals (CIs) comparing self-reported regular smokers and regular drinkers by risk and protective factors with adolescents reporting none of these behaviors.
Results Adolescent boys and girls were equally likely to be regular smokers (11.2%). The prevalence rate of regular drinking was only slightly higher for boys (22.4%) than it was for girls (19.3%). The rates of both health-risk behaviors were significantly higher for those reporting risk factors, and the strengths of associations varied by sex. Sex differences also emerged in motivation for engaging in these behaviors. When we adjusted for demographic characteristics, exposure to childhood abuse (RR, 4.1; 95% CI, 2.4-7.0) and stressful life events (RR, 2.4; 95% CI, 1.1-5.4) were strongly associated with increased risk for boys' regular smoking. Similar associations were found for regular drinking. For girls, a history of abuse (RR, 1.8; 95% CI, 1.1-2.8), violence within the family (RR, 2.2; 95% CI, 1.6-3.2), depressive symptoms (RR, 1.6; 95% CI, 1.0-2.4), and stressful life events (RR, 3.1; 95% CI, 1.8-5.6) were significantly associated with increased risk for regular smoking. Similar associations were again found for regular drinking. Parental support was protective against both health-risk behaviors for both sexes. Participation in extracurricular activities was associated with lower risk for regular smoking for boys (RR, 0.4; 95% CI, 0.2-0.7) and for girls (RR, 0.3; 95% CI, 0.2-0.5); however, there was no significant association between drinking behavior and participation in activities.
Conclusions The increased risk for regular smoking and regular drinking among adolescents with a history of abuse, family violence, depressive symptoms, and stressful life events suggests that routine screening for abuse, violence, and other family experiences should be an essential component of adolescent health care visits. Effective prevention programs to reduce smoking and drinking among adolescents should recognize that health-risk behaviors may be associated with other negative life experiences and that the strength of these associations differs by sex.
From The Commonwealth Fund, New York, NY (Dr Simantov and Ms Schoen); and University of Rochester School of Medicine, Rochester, NY (Dr Klein).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Association of Multiple Behavioral Risk Factors with Adolescents' Willingness to Engage in eHealth Promotion
Tercyak et al.
J Pediatr Psychol 2008;0:jsn085v1-jsn085.
ABSTRACT
| FULL TEXT
Needs in adolescents
Jones et al.
BMJ 2008;336:573-573.
FULL TEXT
Child Maltreatment in the United States: Prevalence, Risk Factors, and Adolescent Health Consequences
Hussey et al.
Pediatrics 2006;118:933-942.
ABSTRACT
| FULL TEXT
Pharmacologic Response to Depressive Disorders Among Adolescents
Sewitch et al.
Psychiatr. Serv. 2005;56:1089-1097.
ABSTRACT
| FULL TEXT
Will I Be Alive in 2005? Adolescent Level of Involvement in Risk Behaviors and Belief in Near-Future Death
Valadez-Meltzer et al.
Pediatrics 2005;116:24-31.
ABSTRACT
| FULL TEXT
Developmental Heterogeneity in Adolescent Depressive Symptoms: Associations With Smoking Behavior
Rodriguez et al.
Psychosom. Med. 2005;67:200-210.
ABSTRACT
| FULL TEXT
Tobacco, Alcohol, and Other Drugs: The Role of the Pediatrician in Prevention, Identification, and Management of Substance Abuse
Kulig and and the Committee on Substance Abuse
Pediatrics 2005;115:816-821.
ABSTRACT
| FULL TEXT
Social support and sexually transmitted disease related healthcare utilisation in sexually experienced African-American adolescents
Lowery et al.
Sex. Transm. Infect. 2005;81:63-66.
ABSTRACT
| FULL TEXT
Childhood abuse and risk of smoking onset
Nichols and Harlow
J. Epidemiol. Community Health 2004;58:402-406.
ABSTRACT
| FULL TEXT
Predictors of smoking behaviour among indigenous Sami adolescents and non-indigenous peers in North Norway
Spein et al.
Scand J Public Health 2004;32:118-129.
ABSTRACT
Intersections of Gender and Age in Health Care: Adapting Autonomy and Confidentiality for the Adolescent Girl
Pinto
Qual Health Res 2004;14:78-99.
ABSTRACT
A Critical Role for the Cannabinoid CB1 Receptors in Alcohol Dependence and Stress-Stimulated Ethanol Drinking
Racz et al.
J. Neurosci. 2003;23:2453-2458.
ABSTRACT
| FULL TEXT
Consequences and Correlates of Adolescent Depression
Glied and Pine
Arch Pediatr Adolesc Med 2002;156:1009-1014.
ABSTRACT
| FULL TEXT
Effect of Abuse on Health: Results of a National Survey
Diaz et al.
Arch Pediatr Adolesc Med 2002;156:811-817.
ABSTRACT
| FULL TEXT
Outcomes in Young Adulthood for Very-Low-Birth-Weight Infants
Hack et al.
NEJM 2002;346:149-157.
ABSTRACT
| FULL TEXT
|
