The gender-specific association between asthma and the need to smoke tobacco.
OBJECTIVE
To examine the associations between multidimensional tobacco dependence and youths' asthma status with gender as an effect modifier.


BACKGROUND
Despite the adverse respiratory effects, some adolescents with asthma smoke tobacco. Girls and boys have been shown to have different motivations for tobacco use.


METHODS
Secondary analyses were conducted of data obtained from 1248 adolescents who completed the British Columbia Youth Survey of Smoking and Health II. The sample was limited to youth who reported current or experimental tobacco use and who provided asthma status information. Tobacco dependence was assessed with the modified-Fagerström Tolerance Questionnaire and four-dimension Adolescents' Need for Smoking Scale (ANSS), which assesses social dependence, physical dependence, emotional dependence, and sensory dependence on tobacco. All analyses were stratified by gender.


RESULTS
The sample was 535 boys and 713 girls who were 15.9 years of age (SD = 1.5), on average. Gender was associated with both self-reported asthma status and the physical dependence dimension of the ANSS. Multiple linear regression analyses revealed that girls with asthma, compared with girls without asthma, had higher physical tobacco dependence scores, after adjusting for demographic and other factors. None of the tobacco dependence dimensions was associated with the asthma status of boys.


CONCLUSIONS
Asthmatic girls who report smoking may be doing so because they develop physical dependence relatively quickly and lose their autonomy with respect to tobacco use. They may require significant support for smoking cessation, including cognitive behavioral therapy and nicotine replacement therapy.
Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology College of Nursing, 2 Chia-pu Road, West Sec. Pu-tz, Chiayi 613, Taiwan. Electronic address: sxg90huang@gmail.com.
Su-Er
SE
Guo
School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC, V6T 1Z3, Canada.
Pamela A
PA
Ratner
Tobacco Treatment and Prevention Division, Tobacco Policy Research Program, University of Kentucky College of Nursing, 315 College of Nursing Building, Lexington, KY 40536-0232, USA.
Chizimuzo T C
CT
Okoli
School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC, V6T 1Z3, Canada.
Joy L
JL
Johnson
D000293:Adolescent; D001249:Asthma / Q000150:complications* / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D012044:Regression Analysis; D057566:Self Report; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D014029:Tobacco Use Disorder / Q000150:complications*
ANSS; Adolescents' Need for Smoking Scale; CES-D; COPD; ETS; Gender differences; Lung disease; M-FTQ; Nicotine dependence; The Center for Epidemiological Studies – Depression; Tobacco use; Youth; chronic obstructive pulmonary disease; environmental tobacco smoke; modified-Fagerström Tolerance Questionnaire for adolescents