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Study Identifies Predictors of Smoking Discontinuation in Novice Adolescent Smokers

June 3, 2014
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PHILADELPHIA — Among new adolescent smokers, boys were more likely to discontinue smoking than girls, and both boys and girls who found package warning labels to be intimidating were also more likely to stop, according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

“Currently, few longitudinal studies identify factors that help or hinder young smokers to stop smoking,” said Jennifer O’Loughlin, Ph.D., professor in the Department of Social and Preventive Medicine at the University of Montreal in Quebec, Canada. “In our study, we learned that male sex, older age, cigarette package warnings, and participation in team sports helped with smoking discontinuation, while family stress, worry about weight, being overweight, illicit drug use, and cravings for cigarettes hindered.”

Of the students who participated in the Nicotine Dependence in Teens (NDIT) study and who smoked at least occasionally, boys were 80 percent more likely to discontinue smoking than girls, and older adolescents were 30 percent more likely to discontinue than younger adolescents. Participants who said cigarette package warnings made them afraid to smoke and those who participated in team sports were 44 percent and 40 percent more likely to quit, respectively.

“Overall, these results support that healthy family habits, which include nonsmoking as the norm as well as positive exchange and functioning, will help novice smokers discontinue smoking,” said O’Loughlin. “Parents who smoke should understand the effects of their smoking on their children, and families should work together or with professionals to identify and reduce sources of family stress. Parents should engage their children in sports and other healthy activities.

“It is imperative that we better understand the factors that promote smoking discontinuation in girls compared with boys, so that we can design gender-specific interventions,” she added.

O’Loughlin and colleagues next plan to develop a nomogram, a short screening tool, to help health practitioners distinguish between youths who likely need intervention to help them stop smoking from those who do not.

From 1999 to 2000, students ages 12 or 13 from 10 secondary schools in Montreal were enrolled in the NDIT study. Of the 1,293 participants, 706—262 boys and 444 girls—who reported smoking at enrollment or who initiated smoking during follow-up were included in this study. After collecting baseline data including self-report questionnaires and anthropometric measurements, the researchers collected follow-up data every three months for the next five years, until the participants completed secondary school. The analysis included data for 620 participants.

Forty-three percent of the participants’ parents smoked, 87 percent had friends who smoked, and 78 percent reported often seeing their teachers or other school staff smoking.

The researchers found that 40 percent of the study participants discontinued smoking during follow-up. Discontinuation was defined as a student reporting no cigarette smoking in at least four consecutive follow-up cycles over a one-year period.

Students who reported family stress, who worried about weight, who were overweight, who used illicit drugs, who had higher tolerance to cigarette smoke, or who had other nicotine dependence symptoms were 10 to 30 percent less likely to discontinue smoking.

“The predictors we identified make good sense and several are amenable to intervention, which is good news,” said O’Loughlin.

This study was funded by the Canadian Cancer Society. O’Loughlin declares no conflicts of interest.

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