title: Tobacco use and other risk behaviors: cross-sectional and predictive relationships for adolescent orthodontic patients.
abstract: BACKGROUND
  The purpose of these analyses was to examine the prevalence of selected substance abuse, general and dental health risk, and scholastic risk behaviors and their cross-sectional and predictive relationships with tobacco use among 15, 179 adolescent orthodontic patients in Southern California.
  
  
  METHODS
  Subjects were recruited through 154 orthodontists' offices and interviewed by telephone at baseline and two-year posttest.
  
  
  RESULTS
  Results show a pattern of increasing prevalence of risk behaviors with age. In most cases, gender differences were small. There were statistically significant positive relationships between each risk behavior and tobacco use status for both boys and girls. Prevalence rates of risk behaviors other than tobacco use were highest for current smokers, intermediate for experimenters, and lowest for respondents reporting that they had never used tobacco. Baseline tobacco use predicted each posttest risk behavior in logistic regression analyses. Principle components analysis (with varimax rotation) of posttest risk practices other than tobacco use yielded three theoretically meaningful factors, all which were predicted by baseline tobacco use in multiple regressions.
  
  
  CONCLUSIONS
  These findings show that tobacco use among adolescents can predict subsequent risk practices other than tobacco use as long as two years, and that unhealthy behaviors among teens are interrelated. Orthodontists, who have a high frequency of adolescent patient contact, may be in a unique position to deliver health promotion interventions to their patients; possibly targeting multiple risk behaviors.
authors.affiliation: Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, CA 92182, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Zakarian
authors.forename: M F
authors.initials: MF
authors.lastname: Hovell
authors.forename: T L
authors.initials: TL
authors.lastname: Conway
authors.forename: C R
authors.initials: CR
authors.lastname: Hofstetter
authors.forename: D J
authors.initials: DJ
authors.lastname: Slymen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009970:Orthodontics / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D014029:Tobacco Use Disorder / Q000150:complications* / Q000453:epidemiology*; D014076:Tooth Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy