Sekulic Damir, Sisic Nedim, Terzic Admir, Jasarevic Indira, Ostojic Ljerka, Pojskic Haris, Zenic Natasa
Faculty of Kinesiology, University of Split, Split, Croatia.
University Department of Health Care Studies, Split, Croatia.
BMJ Open. 2017 Mar 22;7(3):e014066. doi: 10.1136/bmjopen-2016-014066.
Sport and scholastic factors are known to be associated with cigarette smoking in adolescence, but little is known about the causality of this association. The aim of this study was to prospectively explore the relationships of different sport and scholastic factors with smoking prevalence initiation in older adolescents from Bosnia and Herzegovina.
In this 2-year prospective cohort study, there were 872 adolescent participants (16 years at baseline; 46% females). The study consisted of baseline tests at the beginning of the third year (September 2013) and follow-up at the end of the fourth year of high school (late May to early June 2015). The independent variables were scholastic and sport-related factors. The dependent variables were (1) smoking at baseline, (2) smoking at follow-up and (3) smoking initiation over the course of the study. Logistic regressions controlling for age, gender and socioeconomic status were applied to define the relationships between independent and dependent variables.
School absence at the baseline study was a significant predictor of smoking initiation during the course of the study (OR 1.4, 95% CI 1.1 to 1.8). Those who reported quitting sports at baseline showed an increased risk of smoking at the end of the study (OR 1.4, 95% CI 1.1 to 2.0) and of smoking initiation (OR 1.8, 95% CI 1.3 to 2.0). Adolescents who reported lower competitive achievements in sport were at a higher risk of (1) smoking at baseline (OR 1.5, 95% CI 1.1 to 2.1), (2) smoking at follow-up (OR 1.5, 95% CI 1.1 to 2.1) and (3) smoking initiation (OR 1.6, 95% CI 1.1 to 2.6).
In developing accurate antismoking public health policies for older adolescents, the most vulnerable groups should be targeted. The results showed that most participants initiated smoking before 16 years of age. Therefore, further investigations should evaluate the predictors of smoking in younger ages.
运动和学业因素与青少年吸烟有关，但其因果关系尚不明确。本研究旨在前瞻性地探讨波斯尼亚和黑塞哥维那年龄较大青少年中不同运动和学业因素与吸烟率起始之间的关系。
在这项为期2年的前瞻性队列研究中，有872名青少年参与者（基线时16岁；46%为女性）。该研究包括在第三年开始时（2013年9月）进行基线测试，以及在高中第四年末（2015年5月下旬至6月初）进行随访。自变量为学业和运动相关因素。因变量为：（1）基线时吸烟，（2）随访时吸烟，以及（3）研究过程中的吸烟起始情况。应用控制年龄、性别和社会经济地位的逻辑回归来确定自变量和因变量之间的关系。
基线研究时缺课是研究过程中吸烟起始的显著预测因素（比值比1.4，95%置信区间1.1至1.8）。那些在基线时报告停止运动的人在研究结束时吸烟风险增加（比值比1.4，95%置信区间1.1至2.0），吸烟起始风险也增加（比值比1.8，95%置信区间1.3至2.0）。报告运动中竞争成绩较低的青少年有更高的风险：（1）基线时吸烟（比值比1.5，95%置信区间1.1至2.1），（2）随访时吸烟（比值比1.5，95%置信区间1.1至2.1），以及（3）吸烟起始（比值比1.6，95%置信区间1.1至2.6）。
在为年龄较大的青少年制定准确的反吸烟公共卫生政策时，应针对最脆弱群体。结果显示，大多数参与者在16岁之前开始吸烟。因此，进一步的调查应评估较年轻年龄段吸烟的预测因素。
