title: Risk factors for smoking among adolescent survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.
abstract: BACKGROUND
  Few studies have examined risk factors for smoking among adolescent survivors of childhood cancer. The present study reports on the rate of smoking and identifies factors associated with smoking in a sample of adolescent survivors from the Childhood Cancer Survivor Study (CCSS).
  
  
  METHODS
  Participants included 307 adolescent survivors and 97 healthy siblings (ages 14-20) who completed a self-report survey of health, quality of life, and health behaviors.
  
  
  RESULTS
  Smoking rates did not differ significantly between survivor and sibling groups (ever smokers: 28% vs. 33%, recent smokers: 10% vs. 9%, respectively). Ever smoking was significantly associated with peer smoking, smokers in the household, binging, suicidal behavior, and no history of CRT. There were significant interactions of peer smoking with gender and CRT for ever smoking and with binging for recent smoking. Recent smoking was more likely for survivors with other household smokers (RR=2.24, CI=1.21-4.16), past suicidality (RR=1.89, CI=1.00-3.56), and no CRT (RR=2.40, CI=1.12-5.17). Among survivors with few smoking friends, ever smoking was more likely for survivors with no CRT (RR=4.47, CI=1.43-13.9), and recent smoking was more likely among survivors who binged (RR=3.37, CI=1.17-9.71).
  
  
  CONCLUSIONS
  Despite the health risks associated with survivorship, nearly one in three adolescent survivors of childhood cancer has smoked. Exposure to other smokers, in particular, appears to increase the likelihood of smoking for some survivors. Providing smoking cessation programs targeted to family members, helping survivors choose non-smoking friends, and teaching ways to resist smoking influences from peers may be important pathways for smoking prevention with adolescent survivors.
authors: Department of Pediatrics, Section of Psychology, Baylor College of Medicine, Houston, TX 77030, USA. lskahall@texaschildrens.org
authors: Lisa S
authors: LS
authors: Kahalley
authors: Leslie A
authors: LA
authors: Robinson
authors: Vida L
authors: VL
authors: Tyc
authors: Melissa M
authors: MM
authors: Hudson
authors: Wendy
authors: W
authors: Leisenring
authors: Kayla
authors: K
authors: Stratton
authors: Ann C
authors: AC
authors: Mertens
authors: Lonnie
authors: L
authors: Zeltzer
authors: Leslie L
authors: LL
authors: Robison
authors: Pamela S
authors: PS
authors: Hinds
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