Academic journal article Childhood Obesity

Youth Whose Weight Exceeds Healthy Guidelines Are High-Risk Targets for Tobacco Prevention Messaging and Close Monitoring of Cigarette Use

Academic journal article Childhood Obesity

Youth Whose Weight Exceeds Healthy Guidelines Are High-Risk Targets for Tobacco Prevention Messaging and Close Monitoring of Cigarette Use

Article excerpt

[Author Affiliation]

Meg H. Zeller. 1 Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati OH.

Jennifer Reiter-Purtill. 1 Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati OH.

James L. Peugh. 1 Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati OH.

Yelena Wu. 2 University of Utah, Department of Family & Preventive Medicine, Division of Public Health, Salt Lake City, UT.

Jennifer N. Becnel. 1 Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati OH.

Address correspondence to: Meg H. Zeller, PhD, Professor of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC3015, Cincinnati, OH 45229, E-mail: meg.zeller@cchmc.org

Introduction

Obesity and tobacco use are 2 of 10 "Winnable Battles" targeted by the CDC, given their profound morbidity and mortality risks, as well as the known prevention and intervention solutions for each. Concern is intensified when these two biobehavioral risks co-occur, with the all-cause mortality risk compounded 2.7- to 3.8-fold for the smoker who is also obese.1 Tobacco use typically onsets during adolescence, with prevalence rates increasing across the high school years.2 In fact, 9 of 10 adult smokers had their first cigarette before the age of 18.3 When smoking trajectories are tracked prospectively from adolescence into young adulthood (ages 12-28), clear patterns (e.g., abstainers, low users, and stable users) start to diverge as early as age 15.4,5 Links between adolescent-onset tobacco use and nicotine dependence6,7 further heightens the concern. As such, youth ages 12-17 are long-standing tobacco prevention targets that, in most recent years, have also emerged as a critical focus in obesity prevention efforts.

Encouragingly, tobacco prevention efforts having successfully reduced teen current (past 30 days) smoking rates since their peak in 1997 (i.e., reduction of 70% in 10th-grade students).2 However, during this same time period, rates of excess weight status in youth have reached epidemic levels, with rates of severe pediatric obesity continuing to rise.8 Further, as these "mirror image" trends have emerged, a small yet under-recognized body of literature suggests that youth of excess weight status may be a subgroup at greater risk for smoking behaviors (e.g., having ever smoked, smoking before the age of 13).9,10 Arguably, this makes sense given that adolescent health risk behaviors are known to cluster together. For example, contemporary data from Project EAT11 demonstrated that adolescents who smoked were also less likely to engage in other healthy lifestyle behaviors, such as participating in team sports, eating regular meals, and were more likely to consume fast food or soft drinks. Further, adolescents who want to lose weight may initiate smoking as a method of weight control.12 Examination of whether there are links between these two biobehavioral risks in adolescence is thus timely, of keen public health relevance, with potential clinical implications for clinical monitoring of pediatric patients whose weight exceeds healthy guidelines.

Considerable gaps in this developing literature exist, with several "next steps" needed to inform the testing of more explanatory models of these potential inter-relationships. For example, no studies to date have aimed to replicate previous findings while characterizing smoking across all pediatric excess weight status groups (overweight, obese, and severely obese) within one contemporary and nationally representative sample. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.