The Cigarette Smoking Initiation and Continuation in Adolescents Undergoing a Long-term Behavioral I
Thursday, April 15, 2021
Posted by: Natalia Gromov
Hasti
Masihay-Akbar, Parisa Amiri, Leila Cheraghi, Amir Abbas Momenan, Fereidoun
Azizi.
The Cigarette Smoking
Initiation and Continuation in Adolescents Undergoing a Long-term Behavioral
Intervention.
Nicotine & Tobacco Research, Volume 23, Issue 4, April 2021, Pages 702–710,
https://doi.org/10.1093/ntr/ntaa208
Introduction. Targeting
adolescents’ smoking reduces its burden on health systems. We investigated the
effects of the first multidisciplinary community-based lifestyle intervention
in the Eastern Mediterranean region, on smoking initiation, continuation, and
risk of current smoking in Iranian adolescents.
Methods. The
current analyses were conducted on 945 nonsmoker adolescents (12–18 years) who
participated in Phase II of Tehran Lipid and Glucose Study (TLGS) and were
examined four times in 12 years. The lifestyle intervention including
school-based and public programs was implemented, focusing on all components of
healthy lifestyle. Using a two-step cluster analysis, families were classified
as high and low risk, based on parental risk factors of adolescents’ smoking.
Participants who failed to complete all the follow-ups (n = 99) and those with
missing smoking data were excluded. Subsequently, 872 adolescents (538 control,
334 intervention) were included in the Cox model on smoking initiation, and 674
adolescents (414 control, 260 intervention) were included in the logistic
regression on smoking status.
Results. Mean
age of adolescents was 15.08 ± 1.94 years at baseline. The hazard of the
smoking initiation was significantly lower in the intervention (hazard ratio =
0.71, 95% confidence interval: 0.51–0.99; p = .044) compared with control
group. At the end of the fourth follow-up, intervention reduced the odds of
current cigarette smoking by 29%. Within the intervention group, the high-risk
cluster was at a 35% lower risk of initiating smoking and had 37% lower odds of
becoming a current smoker. However, the intervention could not make a
difference in preventing those who initiated smoking from maintaining it during
the follow-ups.
Conclusions. Our
results demonstrate that lifestyle modification programs targeting at-risk
populations could reduce risk of smoking initiation and current smoking in
adolescents in long term.
Implications. Experiencing
cigarette smoking at the critical period of adolescence could result in
adulthood habitual smoking. Therefore, identifying adolescents who are more at
risk of smoking initiation and implementing targeted interventions are of great
importance in public health. Our findings highlight the long-term effectiveness
of a multidisciplinary community-based behavioral intervention on forming
smoking behaviors in adolescents. The current intervention was successful in
reducing smoking uptake in adolescents living in high-risk families.
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