The Changing Risk Profile of the American Adolescent Smoker: Implications for Prevention Programs and Tobacco Interventions
Received 14 June 2005; accepted 26 October 2005.
Abstract
Purpose
To determine how the association between cigarette smoking and other risky behaviors, such as substance use, violence, and risky sexual practices, has changed between 1991 and 2003.
Methods
Youth Risk Behavior Surveys (YRBS) from 1991 to 2003 were analyzed. For each cohort, logistic regression models controlling for gender, race/ethnicity, and school grade were used to describe the associations between smoking and other risky behaviors. Changes in the odds ratios over time were confirmed with a trend analysis.
Results
The strength of the relationship between smoking and other risky behaviors increased for lifetime number of sexual partners (1991 odds ratio [OR] 1.49; 2003 OR 1.61 (p < .001)), sexual partners in the past 3 months (1991 OR 1.77; 2001 OR 2.05 (p < .001)), and never wearing a bicycle helmet 1991 OR 1.40; 1997 OR 5.94 (p < .001). Increases were also seen for binge drinking, and physical fighting. The association between cigarette smoking and marijuana use decreased slightly.
Conclusions
Future prevention efforts and tobacco intervention programs should recognize that current adolescent smokers are even more likely to engage in risky sexual behavior, risky alcohol-related behaviors, and to not use a seatbelt or bicycle helmet than were adolescents in the early nineties.
aStrong Children’s Research Center, Department of Pediatrics, Division of Adolescent Medicine, University of Rochester School of Medicine, Rochester, New York
bDepartment of Biostatistics and Computational Biology, University of Rochester School of Medicine, Rochester, New York
Address correspondence to: Dr. Jonathan D. Klein, Division of Adolescent Medicine, University of Rochester School of Medicine, 601 Elmwood Avenue Box 690, Rochester NY 14642.
ABSTRACT