Brief Report: Social Risk Factors Predict Cigarette Smoking Progression Among Adolescents with Asthma

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Abstract
Objective To compare smoking progression in adolescents with and without asthma and to compare their psychosocial risk factors. Methods Participants were 1,507 adolescents with asthma and 1,507 healthy matched controls from Waves I and II of the Add Health Project assessed at baseline and again 1 to 2 years later at follow-up. Three levels of smoking progression (defined as smoking more frequently and/or intensely over time) were identified: (a) Late Experimenters (never smokers at baseline, ever smokers at follow-up), (b) Early Experimenters (ever smokers at baseline, current/current frequent smokers at follow-up), and (c) Early Smokers (current smokers at baseline, current frequent smokers at follow-up). Results Twenty percent of adolescents experienced progression in their smoking behavior; those with and without asthma were equally likely to progress. Among adolescents who progressed, 37% were Late Experimenters, 42% were Early Experimenters, and 21% were Early Smokers. Exposure to friends who smoked was a consistent and powerful social risk factor for smoking progression among adolescents with asthma—more so than among adolescents without asthma. This effect was intensified among Late Experimenters by the presence of a positive history of parent smoking. Conclusions Findings underscore the importance of addressing cigarette smoking behavior and its social risk factors among adolescents with asthma in both clinical and public health contexts, during early adolescence, and through research on this topic.

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