title: Youth Whose Weight Exceeds Healthy Guidelines Are High-Risk Targets for Tobacco Prevention Messaging and Close Monitoring of Cigarette Use.
abstract: BACKGROUND
  Adolescents are long-standing tobacco prevention targets, given that smoking patterns typically originate before adulthood. Pediatric overweight/obesity remains at epidemic levels. Links between these two biobehavioral risks are not well understood, yet of keen public health and pediatric care relevance. The aims of the present study were to examine smoking behaviors and attitudes of overweight (OV), obese (OB), and severely obese (SO) adolescents, compared to healthy weight (HW), utilizing the nationally representative sample, Monitoring the Future.
  
  
  METHODS
  Smoking behavior prevalence (ever, current, or age of initiation), perceived risk of harm, disapproval of others smoking, and peer smoking were determined for a pooled 2008-2009 sample of 19,678 10th graders (Mage=16.09±0.47 years) by CDC-defined BMI percentile-based categories within race/ethnic group (69.5% white, 14.5% African American, and 16.0% Hispanic). Logistic regression examined the impact of excess weight status on smoking behaviors and attitudes relative to HW.
  
  
  RESULTS
  Relative to HW of same race/ethnicity, white or African American OV, OB, and SO had higher odds of recent smoking, with the highest prevalence among SO. For white youth, excess weight increased odds of ever smoking, early daily smoking (before grade 9), perceiving low risk of harm, and not disapproving of others smoking. Findings varied for African American or Hispanic youth.
  
  
  CONCLUSIONS
  As we move toward fostering a tobacco-free generation, youth whose weight exceeds healthy guidelines are high-risk targets for tobacco prevention messaging and close monitoring of cigarette use, particularly those who are severely obese as well as white youth of excess weight, starting before adolescence.
authors.affiliation: 1 Cincinnati Children's Hospital Medical Center , Division of Behavioral Medicine and Clinical Psychology, Cincinnati OH.
authors.forename: Meg H
authors.initials: MH
authors.lastname: Zeller
authors.affiliation: 1 Cincinnati Children's Hospital Medical Center , Division of Behavioral Medicine and Clinical Psychology, Cincinnati OH.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Reiter-Purtill
authors.affiliation: 1 Cincinnati Children's Hospital Medical Center , Division of Behavioral Medicine and Clinical Psychology, Cincinnati OH.
authors.forename: James L
authors.initials: JL
authors.lastname: Peugh
authors.affiliation: 2 University of Utah , Department of Family & Preventive Medicine, Division of Public Health, Salt Lake City, UT.
authors.forename: Yelena
authors.initials: Y
authors.lastname: Wu
authors.affiliation: 1 Cincinnati Children's Hospital Medical Center , Division of Behavioral Medicine and Clinical Psychology, Cincinnati OH.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Becnel
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001741:Black or African American; D040343:Behavioral Risk Factor Surveillance System; D004198:Disease Susceptibility; D005006:Ethnicity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008297:Male; D063766:Pediatric Obesity / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D015995:Prevalence; D011627:Puberty / Q000523:psychology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D000074606:Smoking Prevention; D012931:Social Environment; D012959:Socioeconomic Factors; D044465:White People