title: Weight status, quality of life, and cigarette smoking among adolescents in Washington State.
abstract: OBJECTIVE
  We examine age- and sex-specific associations between weight status and intensity of cigarette smoking in a large sample of adolescents. Additionally, we test whether quality of life (QOL) and weight control behaviors (i.e., trying to lose, gain, or stay the same weight) mediate the association.
  
  
  METHODS
  We used cross-sectional data from the 2010 Washington State Healthy Youth Survey collected in grades 8, 10, and 12 (n = 11,222). Multinomial logistic regression was used to model cigarette smoking (none, light, frequent) as a function of weight status, weight control behaviors, and QOL by sex and age. Indirect effects of presumed mediators were assessed using the product of coefficients approach.
  
  
  RESULTS
  Weight status was not associated with smoking. Trying to stay the same weight was associated with lower odds of light smoking for younger girls (OR = 0.25; 95% CI = 0.08, 0.84), whereas trying to lose weight was associated with higher odds of light smoking for older girls (OR = 1.73; 95% CI = 1.11, 2.70). Low QOL was associated with higher odds of light and frequent smoking for both girls and boys (P < 0.001). The mediation effects of weight control behavior and QOL combined were significant in the associations between body mass index percentile and smoking among older girls.
  
  
  CONCLUSIONS
  Targeted interventions designed to promote QOL and healthy weight control behaviors among youth may help to decrease the prevalence of smoking.
authors.affiliation: Institute of Social Medicine and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhang Tang Rd., Hangzhou, 310058, People's Republic of China. rosa@zju.edu.cn
authors.forename: Hong-Mei
authors.initials: HM
authors.lastname: Wang
authors.forename: Janice F
authors.initials: JF
authors.lastname: Bell
authors.forename: Todd C
authors.initials: TC
authors.lastname: Edwards
authors.forename: Donald L
authors.initials: DL
authors.lastname: Patrick
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D050177:Overweight / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D011788:Quality of Life; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D014861:Washington / Q000453:epidemiology