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Weight status, quality of life, and cigarette smoking among adolescents in Washington State

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Abstract

Purpose

We examine age- and sex-specific associations between weight status and intensity of cigarette smoking in a large sample of adolescents. Additionally, we test whether quality of life (QOL) and weight control behaviors (i.e., trying to lose, gain, or stay the same weight) mediate the association.

Methods

We used cross-sectional data from the 2010 Washington State Healthy Youth Survey collected in grades 8, 10, and 12 (n = 11,222). Multinomial logistic regression was used to model cigarette smoking (none, light, frequent) as a function of weight status, weight control behaviors, and QOL by sex and age. Indirect effects of presumed mediators were assessed using the product of coefficients approach.

Results

Weight status was not associated with smoking. Trying to stay the same weight was associated with lower odds of light smoking for younger girls (OR = 0.25; 95 % CI = 0.08, 0.84), whereas trying to lose weight was associated with higher odds of light smoking for older girls (OR = 1.73; 95 % CI = 1.11, 2.70). Low QOL was associated with higher odds of light and frequent smoking for both girls and boys (P < 0.001). The mediation effects of weight control behavior and QOL combined were significant in the associations between body mass index percentile and smoking among older girls.

Conclusion

Targeted interventions designed to promote QOL and healthy weight control behaviors among youth may help to decrease the prevalence of smoking.

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Abbreviations

QOL:

Quality of life

BMI:

Body mass index

HYS:

Healthy Youth Survey

References

  1. Ogden, C. L., Carroll, M. D., Curtin, L. R., Lamb, M. M., & Flegal, K. M. (2010). Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA, 303(3), 242–249.

    Article  PubMed  CAS  Google Scholar 

  2. Ahmad, N., Biswas, S., Bae, S., Meador, K. E., Huang, R., & Singh, K. P. (2009). Association between obesity and asthma in US children and adolescents. Journal of Asthma, 46(7), 642–646.

    Article  PubMed  Google Scholar 

  3. Freedman, D. S., Mei, Z., Srinivasan, S. R., Berenson, G. S., & Dietz, W. H. (2007). Cardiovascular risk factors and excess adiposity among overweight children and adolescents: The Bogalusa Heart Study. Journal of Pediatrics, 150(1), 12–17.

    Article  PubMed  Google Scholar 

  4. Wardle, J., & Cooke, L. (2005). The impact of obesity on psychological well-being. Best Practice & Research Clinical Endocrinology & Metabolism, 19(3), 421–440.

    Article  Google Scholar 

  5. Whitlock, E. P., Williams, S. B., Gold, R., Smith, P. R., & Shipman, S. A. (2005). Screening and interventions for childhood overweight: A summary of evidence for the US Preventive Services Task Force. Pediatrics, 116(1), e125–e144.

    Article  PubMed  Google Scholar 

  6. Baker, J. L., Olsen, L. W., & Sørensen, T. I. (2007). Childhood body-mass index and the risk of coronary heart disease in adulthood. New England Journal of Medicine, 357(23), 2329–2337.

    Article  PubMed  CAS  Google Scholar 

  7. Nguyen, Q. M., Srinivasan, S. R., Xu, J. H., Chen, W., & Berenson, G. S. (2008). Changes in risk variables of metabolic syndrome since childhood in pre-diabetic and type 2 diabetic subjects: The Bogalusa Heart Study. Diabetes Care, 31(10), 2044–2049.

    Article  PubMed  CAS  Google Scholar 

  8. Bell, J. F., Zimmerman, F. J., Arterburn, D. E., & Maciejewski, M. L. (2011). Health-care expenditures of overweight and obese males and females in the medical expenditures panel survey by age cohort. Obesity (Silver Spring), 19(1), 228–232.

    Article  Google Scholar 

  9. Wang, Y. C., McPherson, K., Marsh, T., Gortmaker, S. L., & Brown, M. (2011). Health and economic burden of the projected obesity trends in the USA and the UK. Lancet, 378(9793), 815–825.

    Article  PubMed  Google Scholar 

  10. Bamia, C., Trichopoulou, A., Lenas, D., & Trichopoulos, D. (2004). Tobacco smoking in relation to body fat mass and distribution in a general population sample. International Journal of Obesity and Related Metabolic Disorders, 28(8), 1091–1096.

    Article  PubMed  CAS  Google Scholar 

  11. Chiolero, A., Jacot-Sadowski, I., Faeh, D., Paccaud, F., & Cornuz, J. (2007). Association of cigarettes smoked daily with obesity in a general adult population. Obesity (Silver Spring), 15(5), 1311–1318.

    Article  Google Scholar 

  12. John, U., Hanke, M., Rumpf, H. J., & Thyrian, J. R. (2005). Smoking status, cigarettes per day, and their relationship to overweight and obesity among former and current smokers in a national adult general population sample. International Journal of Obesity (London), 29(10), 1289–1294.

    Article  CAS  Google Scholar 

  13. Grogan, S., Fry, G., Gough, B., & Conner, M. (2009). Smoking to stay thin or giving up to save face? Young men and women talk about appearance concerns and smoking. British Journal of Health Psychology, 14(Pt1), 175–186.

    Article  PubMed  Google Scholar 

  14. Potter, B. K., Pederson, L. L., Chan, S. S., Aubut, J. A., & Koval, J. J. (2004). Does a relationship exist between body weight, concerns about weight, and smoking among adolescents? An integration of the literature with an emphasis on gender. Nicotine & Tobacco Research, 6(3), 397–425.

    Article  Google Scholar 

  15. Farhat, T., Iannotti, R. J., & Simons-Morton, B. G. (2010). Overweight, obesity, youth, and health-risk behaviors. American Journal of Preventive Medicine, 38(3), 258–267.

    Article  PubMed  Google Scholar 

  16. Cawley, J., Markowitz, S., & Tauras, J. (2004). Lighting up and slimming down: The effects of body weight and cigarette prices on adolescent smoking initiation. Journal of Health Economics, 23(2), 293–311.

    Article  PubMed  Google Scholar 

  17. Rees, D. I., & Sabia, J. J. (2010). Body weight and smoking initiation: Evidence from Add Health. Journal of Health Economics, 29(5), 774–777.

    Article  PubMed  Google Scholar 

  18. Koval, J. J., Pederson, L. L., Zhang, X., Mowery, P., & McKenna, M. (2008). Can young adult smoking status be predicted from concern about body weight and self-reported BMI among adolescents? Results from a ten-year cohort study. Nicotine & Tobacco Research, 10(9), 1449–1455.

    Article  Google Scholar 

  19. Crone, M. R., & Reijneveld, S. A. (2007). The association of behavioural and emotional problems with tobacco use in adolescence. Addictive Behaviors, 32(8), 1692–1698.

    Article  PubMed  Google Scholar 

  20. Bonomi, A. E., Patrick, D. L., Bushnell, D. M., & Martin, M. (2000). Validation of the United States’ version of the World Health Organization Quality of Life (WHOQOL) instrument. Journal of Clinical Epidemiology, 53(1), 1–12.

    Article  PubMed  CAS  Google Scholar 

  21. Topolski, T. D., Patrick, D. L., Edwards, T. C., Huebner, C. E., Connell, F. A., & Mount, K. K. (2001). Quality of life and health-risk behaviors among adolescents. Journal of Adolescent Health, 29(6), 426–435.

    Article  PubMed  CAS  Google Scholar 

  22. Zullig, K. J., Valois, R. F., Huebner, E. S., Oeltmann, J. E., & Drane, J. W. (2001). Relationship between perceived life satisfaction and adolescents’ substance abuse. Journal of Adolescent Health, 29(4), 279–288.

    Article  PubMed  CAS  Google Scholar 

  23. Farhat, T., Iannotti, R. J., & Simons-Morton, B. G. (2011). Obesity, smoking, and health-related quality of life among adolescent girls. Childhood Obesity, 7(2), 101–109.

    Google Scholar 

  24. Washington State Department of Health. The Healthy Youth Survey provides important information about adolescents. http://www.doh.wa.gov/DataandStatisticalReports/HealthBehaviors/HealthyYouthSurvey.aspx.Accessed 25th June 2012.

  25. Kuczmarski, R. J., Ogden, C. L., Guo, S. S., Grummer-Strawn, L. M., Flegal, K. M., Mei, Z., et al. (2002). 2000 CDC Growth Charts for the United States: Methods and development. Vital and Health Statistics, 11(246), 1–190.

    Google Scholar 

  26. Centers for Disease Control and Prevention. 2009 Youth Risk Behavior Survey. United States High School Survey Data Users Manual. http://www.cdc.gov/HealthyYouth/YRBS/pdf/national_usersmanual_yrbs.pdf. Accessed 25th June 2012.

  27. Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W. (2003). Health-related quality of life of severely obese children and adolescents. JAMA, 289(14), 1813–1819.

    Article  PubMed  Google Scholar 

  28. Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989.

    Article  PubMed  Google Scholar 

  29. Park, E. (2009). Gender as a moderator in the association of body weight to smoking and mental health. American Journal of Public Health, 99(1), 146–151.

    Article  PubMed  Google Scholar 

  30. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.

    Article  PubMed  CAS  Google Scholar 

  31. MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593–614.

    Article  PubMed  Google Scholar 

  32. Washington State Department of Health. Healthy Youth Survey data analysis and technical assistance manual. http://www.doh.wa.gov/DataandStatisticalReports/HealthBehaviors/HealthyYouthSurvey/AnalysisManual. Accessed 8th October 2012.

  33. Tsiros, M. D., Olds, T., Buckley, J. D., Grimshaw, P., Brennan, L., Walkley, J., et al. (2009). Health-related quality of life in obese children and adolescents. International Journal of Obesity (London), 33(4), 387–400.

    Article  CAS  Google Scholar 

  34. French, S. A., & Jeffery, R. W. (1995). Weight concerns and smoking: A literature review. Annals of Behavioral Medicine, 17(3), 234–244.

    Article  Google Scholar 

  35. French, S. A., Perry, C. L., Leon, G. R., & Fulkerson, J. A. (1994). Weight concerns, dieting behavior, and smoking initiation among adolescents: A prospective study. American Journal of Public Health, 84(11), 1818–1820.

    Article  PubMed  CAS  Google Scholar 

  36. Jessor, R. (1991). Risk behavior in adolescence: A psychosocial framework for understanding and action. Journal of Adolescent Health, 12(8), 597–605.

    Article  PubMed  CAS  Google Scholar 

  37. Cavallo, D. A., Smith, A. E., Schepis, T. S., Desai, R., Potenza, M. N., & Krishnan-Sarin, S. (2010). Smoking expectancies, weight concerns, and dietary behaviors in adolescence. Pediatrics, 126(1), e66–e72.

    Article  PubMed  Google Scholar 

  38. Leatherdale, S. T., Wong, S. L., Manske, S. R., & Colditz, G. A. (2008). Susceptibility to smoking and its association with physical activity, BMI, and weight concerns among youth. Nicotine & Tobacco Research, 10(3), 499–505.

    Article  Google Scholar 

  39. Brener, N. D., Mcmanus, T., Galuska, D. A., Lowry, R., & Wechsler, H. (2003). Reliability and validity of self-reported height and weight among high school students. Journal of Adolescent Health, 32(4), 281–287.

    Article  PubMed  Google Scholar 

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Acknowledgments

We gratefully acknowledge Lillian Bensley from the Washington State Department of Health for her assistance in providing the data set for the study.

Conflict of interest

The authors declare no conflict of interests.

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Authors and Affiliations

  1. Institute of Social Medicine and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhang Tang Rd., Hangzhou, 310058, People’s Republic of China

    Hong-Mei Wang

  2. Department of Health Services, University of Washington, 1208 NE 43rd Street, Box 359455, Seattle, WA, 98195, USA

    Janice F. Bell, Todd C. Edwards & Donald L. Patrick

Authors
  1. Hong-Mei Wang
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  2. Janice F. Bell
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  3. Todd C. Edwards
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  4. Donald L. Patrick
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Correspondence to Hong-Mei Wang.

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Wang, HM., Bell, J.F., Edwards, T.C. et al. Weight status, quality of life, and cigarette smoking among adolescents in Washington State. Qual Life Res 22, 1577–1587 (2013). https://doi.org/10.1007/s11136-012-0306-4

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