Academic journal article Central European Journal of Public Health

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

Academic journal article Central European Journal of Public Health

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

Article excerpt


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.

Key words: smoking, adolescence, weight control belief, BMI, perceived body shape


Tobacco smoking is the leading preventable risk factor of Disability Adjusted Life Years for Hungarian people (1). According to the latest representative data, the prevalence of current daily smoking is 29.9% among Hungarian adults between 1 8 and 64 years of age with an additional 6.2% of occasional smokers (2). Recent data among youth aged 10-18 suggest that current daily smoking ranges from 21% to 33% depending on the age of the target population. Smoking trends have declined in both genders in the recent years, although current smoking among high school girls exceeds the prevalence rates of boys (3-6).

Numerous factors are associated with adolescent smoking including age, parental smoking, parental socioeconomic status, peer smoking, attitudes of family and friends, school factors, risk behaviours, lifestyle, stress, self-esteem, attitudes and health concerns (7). A comprehensive review suggests that concerns about weight can also be an important factor for smoking, especially among females (8). In modern societies the thin body ideal, and sociocultural pressures to be thin had a deep impact on the adolescent population; girls, in particular, are often dissatisfied with their body image and perceive themselves as overweight. Dieting and other weight control methods are well-known features of adolescent behaviour to achieve an idealized perfect body shape (9, 10). The youth's assumption that tobacco smoking can be used as a weight control method is based on the widespread belief that smoking is an effective weight control strategy although its anorectic effect is slow and may benefit only older individuals (11). …

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