PA) Exposure to family and friends who smoke and elevated
levels of depression significantly affect the likelihood
of alternate tobacco product use among adolescents,
a study by researchers from the University of Pennsylvania
School of Medicine and Georgetown University indicates.
The study, titled "Psychosocial Correlates of Alternate
Tobacco Product Use during Early Adolescence,"
appears in the August issue of Preventive Medicine.
Recent research shows that alternate tobacco products,
including smokeless tobacco (chewing tobacco and moist
snuff), cigars, cigarillos, pipes, bidis (sweet flavored
cigarettes from Southeast Asia), and kreteks (clove-flavored
cigarettes), are gaining in popularity among youth.
"This trend is dangerous because alternate tobacco
products can lead to cancers of the oral cavity and
a host of other negative health consequences,"
said senior author Janet Audrain, PhD, member
of the Abramson Cancer Center of the University of
Pennsylvania, and assistant professor in the Department
of Psychiatry at Penn's School of Medicine.
While previous research has shown that both exposure
to other smokers and depression increase the likelihood
of cigarette use among adolescents, this is one of the
first studies to examine the influence that these social
and psychological factors have on alternate tobacco
Audrain led a research team that interviewed 1,107 ninth
grade students as part of a four-year investigation
of the social, psychological and genetic predictors
of adolescent smoking adoption. These students completed
a survey that assessed current smoking practices, exposure
to other smokers, levels of depression, and alternate
tobacco product use. Demographic data including age,
gender, and race were also collected.
Over eight percent of the teens reported using an alternate
tobacco product (smokeless tobacco, cigars, pipes, bidis
and/or kreteks) in the last thirty days. Among the eleven
percent of freshman who reported being current cigarette
smokers (smoked in the last month), 45 percent were
also current users of an alternate tobacco product.
The researchers found that current alternate tobacco
product users were significantly more likely to be male,
white and current cigarette smokers. In addition, teens
with higher levels of exposure to other smokers and
those with greater depressive symptoms were found to
be two to three times more likely to be current users
of alternate tobacco products, regardless of demographic
factors and current cigarette smoking.
"It is important that future studies determine
adolescents' beliefs and motivations surrounding the
benefits of using alternate tobacco products,"
said study co-investigator and author Kenneth P. Tercyak,
PhD, assistant professor of oncology at Georgetown University
Medical Center. "Since it is possible that adolescents
might have misconceptions about the safety of these
products, anti-tobacco messages targeted to youth should
include warnings about the risks of using these products."
This research was funded by the National Cancer Institute
and the National Institute on Drug Abuse and was conducted
by the University of Pennsylvania/Georgetown University
Transdisciplinary Tobacco Use Research Center.
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