Ethnic variation in the association between weight concern and adolescent smoking

Abstract

This study examined differences in associations between weight concern and smoking initiation among culturally diverse adolescents. Statistical analyses were conducted on responses from 3515 students in the 8th and 9th grades from three school districts in Los Angeles County. The restrained eating scale, adapted from the Dutch Eating Behavior Questionnaire, was used to measure students' weight concerns. Our results indicated that weight concern was significantly associated with increased risk for smoking. Those who scored higher on weight concern were approximately 40% more likely to report having tried smoking and smoked in the past 30 days. Compared to White students who reported weight concerns, Asian–American and African–American students were significantly less likely to report having tried smoking whereas Hispanic students were more likely to report having tried smoking. Health educators may wish to design smoking prevention programs which advocate for alternative methods of weight reduction rather than using smoking as a means of weight control.

Introduction

Weight concern has been identified as a motive for cigarette smoking among adolescents (Crocker et al., 2001). One of the reasons adolescents may start smoking, return to smoking after quitting, or never attempt to quit may be the perceived benefit of smoking for weight control (Gritz et al., 1989, Potter et al., 2004).

Ethnicity may also affect weight concern, and thereby indirectly affect smoking. Ethnic differences in weight concern have been explored; for example, African–American girls generally are more satisfied at heavier weights than White girls and are less likely to engage in weight reduction (Neumark-Sztainer, Story, Falkner, Beuhring, & Resnick, 1999). Racial/ethnic differences in smoking prevalence are also well-documented (Cachelin et al., 2003, Chen and Unger, 1999). For example, about twice as many White as Black adolescents smoke cigarettes, with Hispanic prevalence rates in between (Wiecha, 1996). Asian–American youth have the lowest smoking prevalence rate (Epstein et al., 1998, United States Department of Health and Human Services. (USDHHS), 1998). Is the lower weight concern among African–Americans and the lower smoking prevalence among African–Americans a coincidence? The goal of this study is to examine differences in associations between weight concern and smoking initiation among culturally diverse adolescents. Including two ethnic groups that have been understudied in this context, Asian–Americans and Hispanics, affords an extensive test of the hypothesized connection between weight concern and smoking.