Associations between adolescent smoking and beliefs about the weight-controlling aspects of cigarettes

Belief that smoking cigarettes is a means of weight control has been shown to be associated with smoking initiation. In this study, we examined the relationship between frequent smoking (smoking 20 or more of the past 30 days), weight control beliefs, and perception that one needs to lose weight using data from the 2008 Florida Youth Tobacco Survey (FYTS). The FYTS was administered to 38,510 middle school students and 40,283 high school students in 744 Florida public schools with response rates of 79% and 73%, respectively. The data were weighted and SUDAAN was used to fit logistic regression models. We examined if belief that cigarettes help control weight was associated with frequent smoking, controlling for gender, race/ethnicity, grade level, and body image. Students who thought that smoking definitely helps control weight were 13.4 times more likely to be frequent smokers than students who thought that smoking definitely does not help control weight. Non-Hispanic black females were significantly less likely than those in all other race-sex categories to be frequent smokers. The likelihood of being a frequent smoker (compared to 6th graders) increased with increasing grade level from 1.8 times more likely in 7th grade to 14.0 times more likely in 12th grade. Perception that one needs to lose weight was not significantly associated with frequent smoking. This analysis indicates that student education about the realities of the weight control aspects of smoking versus the adverse health effects could help reduce the prevalence of frequent smoking among youth.