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Weight Concerns, Weight Control Behaviors, and Smoking Initiation

Objective. To examine the cross-sectional relationships between weight concerns, weight control behaviors, and initiation of tobacco use among youths. Study Design. Smoking status, weight concerns, and weight control behaviors were assessed in a cross-sectional sample of 16 862 children, 9 to 14 years of age, in 1996. Logistic regression was used to examine the relationship between weight concerns, weight control behaviors, and early stages of smoking initiation (precontemplation, contemplation, and experimentation). All analyses were adjusted for age, body mass index, and known predictors of initiation. Results. Approximately 9% of participants had experimented with cigarettes, and 6% were contemplating cigarette smoking. Contemplation of tobacco use was associated with misperception of being overweight (boys: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.10–2.48), unhappiness with appearance (girls: OR, 2.05; 95% CI, 1.48–2.84; boys: OR, 1.60; 95% CI, 1.05–2.42), and a tendency to change eating patterns around peers (girls: OR, 2.87; 95% CI, 2.28–3.62; boys: OR, 1.83; 95% CI, 1.25–2.66). Experimentation with cigarettes was associated with daily exercise to control weight among boys (OR, 1.92; 95% CI, 1.07–3.43) and with monthly purging (OR, 2.54; 95% CI, 1.27–5.07) and daily dieting among girls (OR, 1.79; 95% CI, 1.09–2.96). Conclusions. Our findings suggest that, among both girls and boys, contemplation of smoking is positively related to weight concerns. Experimentation seems to be positively related to weight control behaviors. It is important for both pediatricians and comprehensive school health programs to address healthy methods of weight maintenance and to dispel the notion of tobacco use as a method of weight control.