Cent Eur J Public Health 2012, 20(1):11-17 | DOI: 10.21101/cejph.a3726

Factors Associated with Tobacco Smoking and the Belief about Weight Control Effect of Smoking among Hungarian Adolescents

Melinda Pénzes1, Edit Czeglédi2, Péter Balázs1, Kristie L. Foley3
1 Institute of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
2 Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
3 Medical Humanities Program, Davidson College, Davidson, NC, USA

Introduction: The relationship between body weight and smoking has been well-documented among adult populations, but the data among youth are inconsistent. This study explores the relationship among social, behavioural, body weight-related factors and adolescent smoking while identifying factors associated with the belief that smoking controls weight.

Materials and methods: Baseline data from a three-year, prospective cohort study started in 2009 in Hungary's six metropolitan cities. Randomly selected 6th and 9th grade students completed a self-administered questionnaire during the 2009-2010 school year (n=1445; 45% boys, mean age of 6th graders: 12.06 years, SD=0.63; mean age of 9th graders: 15.06 years, SD=0.63). Calculations of Body Mass Index (BMI) were based on objectively measured weight and height data of participants. Appetite-Weight Control Scale of the Short Form of Smoking Consequences Questionnaire was used to measure the belief that smoking supports weight control. Bivariate and multivariate logistic regression analyses were performed to examine the association between the perception of weight control and smoking, while controlling for potential confounding variables (e.g., gender).

Results: 24.8% of participants smoked cigarettes within the past 30 days. The odds of smoking were increased among students who were older, had smoking friends, were exposed to parental smoking, and had poorer academic performance. BMI showed positive association with smoking (increases in BMI were associated with higher odds of smoking), and the belief that smoking controls weight mediated this association. There was no difference in smoking prevalence among those motivated either to lose or gain weight (∼30%), but was considerably lower among adolescents satisfied with their body weight (19%). The belief that smoking supports weight control was more common for girls, older students, and those who perceived themselves as overweight.

Conclusions: Dissatisfaction with body weight and the belief that smoking has weight controlling effects are associated with an increased likelihood of adolescent smoking, therefore they must be considered in smoking prevention programmes among youth.

Keywords: smoking, adolescence, weight control belief, BMI, perceived body shape

Received: September 29, 2011; Revised: January 20, 2012; Accepted: January 20, 2012; Published: March 1, 2012  Show citation

ACS AIP APA ASA Harvard Chicago IEEE ISO690 MLA NLM Turabian Vancouver
Pénzes M, Czeglédi E, Balázs P, Foley KL. Factors Associated with Tobacco Smoking and the Belief about Weight Control Effect of Smoking among Hungarian Adolescents. Cent Eur J Public Health. 2012;20(1):11-17. doi: 10.21101/cejph.a3726. PubMed PMID: 22571010.
Download citation

References

  1. World Health Organization. Highlights on health in Hungary 2005 [Internet]. Geneva: WHO; 2006 [cited 2011 Sep 21].Available from: http://www.euro.who.int/__data/assets/pdf_file/0016/103219/E88736.pdf.
  2. Tombor I, Paksi B, Urbán R, Kun B, Arnold P, Rózsa S, et al. Epidemiology of smoking in the Hungarian population, based on national representative data. Clin Exp Med J. 2011 Mar;5(1):27-37. Go to original source...
  3. Halmai R, Németh Á. Tobacco Smoking. In: Németh Á, KöltőA, editors. Young people's health and lifestyle 2010. Health Behaviour in Schoolaged Children (HBSC) study: a WHO-collaborative cross-national study national report 2010 [Internet]. Budapest: National Institute of Child Health; 2011. p. 35-9 [cited 2011 Sep 24]. Available from: http://www.ogyei.hu/anyagok/HBSC_2010.pdf. (In Hungarian.)
  4. Hibell B, Guttormsson U, Ahlström S, Balakireva O, Bjarnason T, KokkeviA, et al. The 2007 ESPAD report: substance use among students in 35 European countries [Internet]. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs; 2009 [cited 2010 Mar 22]. Available from: http://www.espad.org/documents/Espad/ESPAD_reports/2007/The_2007_ESPAD_Report-FULL_091006.pdf.
  5. Demjén T, Kiss J, Bőti E, Lőrik E, Papp N, Kovács D. Global youth tobacco survey 2008, Hungary [Internet]. Budapest: National Institute for Health Development; 2009 [cited 2010 Jan 25].Available from: http://mek.oszk.hu/07900/07959/07959.pdf. (In Hungarian.)
  6. Urbán R. Smoking outcome expectancies mediate the association between sensation seeking, peer smoking, and smoking among young adolescents. Nicotine Tob Res. 2010 Jan;12(1):59-68. Go to original source... Go to PubMed...
  7. Tyas SL, Pederson LL. Psychosocial factors related to adolescent smoking: a critical review of the literature. Tob Control. 1998;7(4):409-20. Go to original source... Go to PubMed...
  8. Potter BK, Pederson LL, Chan SS, Aubut JA, Koval JJ. 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 Tob Res. 2004 Jun;6(3):397-425. Go to original source... Go to PubMed...
  9. Currie C, Roberts C, Morgan A, Smith R, Settertobulte W, Samdal O, et al. Young people's health in context. Health Behaviour in School-aged Children (HBSC) study: international report from the 2001/2002 survey [Internet]. Copenhagen: WHO Regional Office for Europe [cited 2011 Sep 19]. Available from: http://www.hbsc.org/downloads/IntReport04/Part1.pdf.
  10. Németh Á. Body image, body weight and weight control. In: Németh Á, Költő A, editors. Young people's health and lifestyle 2010. Health Behaviour in School-aged Children (HBSC) study: a WHO-collaborative cross-national study national report 2010 [Internet]. Budapest: National Institute of Child Health; 2011. p. 77-82 [cited 2011 Sep 24]. Available from: http://www.ogyei.hu/anyagok/HBSC_2010.pdf. (In Hungarian.)
  11. Klesges RC, Robinson LA, Zbikowski SM. Is smoking associated with lower body mass in adolescents? A large-scale biracial investigation. Addict Behav. 1998 Jan-Feb;23(1):109-13. Go to original source... Go to PubMed...
  12. Bean MK, Mitchell KS, Speizer IS, Wilson DB, Smith BN, Fries EA. Rural adolescent attitudes toward smoking and weight loss: relationship to smoking status. Nicotine Tob Res. 2008 Feb;10(2):279-86. Go to original source... Go to PubMed...
  13. Boles SM, Johnson PB. Gender, weight concerns, and adolescent smoking. J Addict Dis. 2001;20(2):5-14. Go to original source... Go to PubMed...
  14. Camp DE, Klesges RC, Relyea G. The relationship between body weight concerns and adolescent smoking. Health Psychol. 1993 Jan;12(1):24-32. Go to original source... Go to PubMed...
  15. Cavallo DA, DuhigAM, McKee S, Krishnan-Sarin S. Gender and weight concerns in adolescent smokers.Addict Behav. 2006 Nov;31(11):2140-6. Go to original source... Go to PubMed...
  16. Caria MP, Bellocco R, Zambon A, Horton NJ, Galanti MR. Overweight and perception of overweight as predictors of smokeless tobacco use and of cigarette smoking in a cohort of Swedish adolescents.Addiction. 2009 Apr;104(4):661-8. Go to original source... Go to PubMed...
  17. Cawley J, Markowitz S, Tauras J. Lighting up and slimming down: the effects of body weight and cigarette prices on adolescent smoking initiation. J Health Econ. 2004 Mar;23(2):293-311. Go to original source... Go to PubMed...
  18. Seo DC, Jiang N, Kolbe LJ. Association of smoking with body weight in US high school students, 1999-2005. Am J Health Behav. 2009 MarApr;33(2):202-12. Go to original source...
  19. Weiss JW, Merrill V, Gritz ER. Ethnic variation in the association between weight concern and adolescent smoking. Addict Behav. 2007 Oct;32(10):2311-6. Go to original source... Go to PubMed...
  20. Kaufman AR, Augustson EM. Predictors of regular cigarette smoking among adolescent females: does body image matter? Nicotine Tob Res. 2008 Aug;10(8):1301-9. Go to original source... Go to PubMed...
  21. Leatherdale ST, Wong SL, Manske SR, Colditz GA. Susceptibility to smoking and its association with physical activity, BMI, and weight concerns among youth. Nicotine Tob Res. 2008 Mar;10(3):499-505. Go to original source... Go to PubMed...
  22. O'Loughlin J, Karp I, Henderson M, Gray-Donald K. Does cigarette use influence adiposity or height in adolescence? Ann Epidemiol. 2008 May;18(5):395-402. Go to original source... Go to PubMed...
  23. Strauss RS, Mir HM. Smoking and weight loss attempts in overweight and normal-weight adolescents. Int J Obes Relat Metab Disord. 2001 Sep;25(9):1381-5. Go to original source... Go to PubMed...
  24. WinterAL, de Guia NA, Ferrence R, Cohen JE. The relationship between body weight perceptions, weight control behaviours and smoking status among adolescents. Can J Public Health. 2002 Sep-Oct;93(5):362-5. Go to original source...
  25. Kendzor DE, CopelandAL, Stewart TM, Businelle MS, Williamson DA. Weight-related concerns associated with smoking in young children. Addict Behav. 2007 Mar;32(3):598-607. Go to original source... Go to PubMed...
  26. Koval JJ, Pederson LL, Zhang X, Mowery P, McKenna M. 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 Tob Res. 2008 Sep;10(9):1449-55. Go to original source... Go to PubMed...
  27. Tomeo CA, Field AE, Berkey CS, Colditz GA, Frazier AL. Weight concerns, weight control behaviors, and smoking initiation. Pediatrics. 1999 Oct;104(4 Pt 1):918-24. Go to original source... Go to PubMed...
  28. Xie B, Chou CP, Spruijt-Metz D, Reynolds K, Clark F, Palmer PH, et al. Weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents. Prev Med. 2006 Mar;42(3):229-34. Go to original source... Go to PubMed...
  29. French SA, Perry CL, Leon GR, Fulkerson JA. Weight concerns, dieting behavior, and smoking initiation among adolescents: a prospective study. Am J Public Health. 1994 Nov;84(11):1818-20. Go to original source...
  30. Lowry R, Galuska DA, Fulton JE, Wechsler H, Kann L. Weight management goals and practices among U.S. high school students: associations with physical activity, diet, and smoking. J Adolesc Health. 2002 Aug;31(2):133-44. Go to original source... Go to PubMed...
  31. Fulkerson JA, French SA. Cigarette smoking for weight loss or control among adolescents: gender and racial/ethnic differences. J Adolesc Health. 2003 Apr;32(4):306-13. Go to original source... Go to PubMed...
  32. Marcelino G, Oliveira JM, Ravasco P, Marques-Vidal P. Weight concerns and weight reduction practices of Portuguese adolescents. Nutr Hosp. 2009 Nov-Dec;24(6):758. Go to PubMed...
  33. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000 May 6;320(7244):1240-3. Go to original source... Go to PubMed...
  34. Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007 Jul 28;335(7612):194. Go to original source... Go to PubMed...
  35. Centers for Disease Control and Prevention. Youth risk behavior survey: questionnaires and item rationales [Internet]. Atlanta, GA: CDC; 2011 [cited 2008 Oct 31]. Available from: http://www.cdc.gov/healthyyouth/yrbs/questionnaire_rationale.htm.
  36. Lloyd-Richardson EE, Papandonatos G, KazuraA, Stanton C, Niaura R. Differentiating stages of smoking intensity among adolescents: stagespecific psychological and social influences. J Consult Clin Psychol. 2002 Aug;70(4):998-1009. Go to original source...
  37. Myers MG, McCarthy DM, MacPherson L, Brown SA. Constructing a short form of the Smoking Consequences Questionnaire with adolescents and young adults. Psychol Assess. 2003 Jun;15(2):163-72. Go to original source... Go to PubMed...
  38. Urbán R, Demetrovics Z. Smoking outcome expectancies: A multiple indicator and multiple cause (MIMIC) model. Addict Behav. 2010 Jun;35(6):632-5. Go to original source... Go to PubMed...
  39. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986 Dec;51(6):1173-82. Go to original source...
  40. Piko B. Smoking in adolescence: do attitudes matter?Addict Behav. 2001 Mar-Apr;26(2):201-17. Go to original source... Go to PubMed...
  41. Piko BF.Adolescent smoking and drinking: the role of communal mastery and other social influences. Addict Behav. 2006 Jan;31(1):102-14. Go to original source... Go to PubMed...
  42. Pikó B. Health awareness in adolescence. Budapest: Akadémiai Kiadó; 2002. (In Hungarian.)
  43. Murray DM, Perry CL. The measurement of substance use among adolescents: when is the 'bogus pipeline' method needed? Addict Behav. 1987;12(3):225-33. Go to original source... Go to PubMed...
  44. Luepker RV, Pallonen UE, Murray DM, Pirie PL. Validity of telephone surveys in assessing cigarette smoking in young adults. Am J Public Health. 1989 Feb;79(2):202-4. Go to original source...
  45. Charlton A. Smoking and weight control in teenagers. Public Health. 1984 Sep;98(5):277-81. Go to original source...
  46. Klesges RC, Elliott VE, Robinson LA. Chronic dieting and the belief that smoking controls body weight in a biracial, population-based adolescent sample. Tob Control. 1997;6(2):89-94. Go to original source... Go to PubMed...
  47. Halek C, Kerry S, Humphrey H, Crisp AH, Hughes JM. Relationship between smoking, weight and attitudes to weight in adolescent schoolgirls. Postgrad Med J. 1993 Feb;69(808):100-6. Erratum in: Postgrad Med J. 1993 Aug;69(814):667. Go to original source... Go to PubMed...
  48. Rees DI, Sabia JJ. Body weight and smoking initiation: evidence from Add Health. J Health Econ. 2010 Sep;29(5):774-7.
  49. European Commission. UCP. Hungary. National law. Act no. 48 of 2008 on the basic requirements and certain restrictions applying to commercial advertising activities [Internet]. Brussels: European Commission; 2011 [updated 2011 Jun 10; cited 2012 Feb 5]. Available from: https://webgate.ec.europa.eu/ucp/public/index.cfm?event=public.country.showCountry&countryID=HU.
  50. Kaleta D, Usidame B, Polańska K. Tobacco advertisements targeted on women: creating an awareness among women. Cent Eur J Public Health. 2011 Jun;19(2):73-8. Go to original source...
  51. Cooper Z, Fairburn CG, Hawker DM. Cognitive-behavioral treatment of obesity: a clinician's guide. New York: Guilford Press; 2003.
  52. Höglund D, Samuelson G, Mark A. Food habits in Swedish adolescents in relation to socioeconomic conditions. Eur J Clin Nutr. 1998 Nov;52(11):784-9. Go to original source...