Overweight, obese adolescents highly likely to experiment with cigarettes
Adolescents with increased body mass index (BMI) tend to feel negatively about their appearance and bodies, and this negative perception may lead them to experiment with cigarettes, a study reports.
Researchers analysed longitudinal panel data from 1,023 middle school youth (mean age at enrolment, 12.5 years; 52 percent female; 24 percent of nonwhite ethnicity). They examined whether smoking initiation was concurrently and prospectively associated with self-reported BMI, and whether self-esteem for physical appearance (SEPA) mediated the effect of BMI on risk of early cigarette smoking.
Unadjusted Pearson correlations showed that BMI predicted smoking initiation concurrently and prospectively. In adjusted models, SEPA showed a mediating effect on the association between BMI and smoking initiation.
Specifically, lower SEPA significantly mediated the positive association between BMI and subsequent smoking (B, 0.10; 95 percent CI, 0.01–0.22).
The present data bring to the foreground an increased risk of experimentation with cigarettes in adolescents who are overweight or obese, who are more likely to have low self-esteem due to their appearance and bodies, researchers said.
Overall, the findings are of clinical importance, given that overweight or obese adolescents who begin smoking have disproportionate risk of negative health consequences because of the individual and interactive risks associated with both excess weight and smoking, they added.
Researchers recommended that healthcare providers discuss weight status with patients and parents, as well as suggest interventions to reduce associated health consequences of increased BMI in a way that is not stigmatizing or judgmental (eg, using neutral words in conversation and documentation) with the aim of avoiding any negative effects on SEPA.