Wang Qian
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Tob Induc Dis. 2021 May 12;19:37. doi: 10.18332/tid/133932. eCollection 2021.
Compared with the number of studies in adults, body weight in relation to tobacco use has been understudied in the adolescent population. This study aimed to examine the association between underweight, overweight and tobacco use in low- and middle-income countries.
Data were derived from the Global School-Based Student Health Survey (GSHS). Data from 71176 adolescents aged 12-15 years residing in 23 countries were analyzed. The Centers for Disease Control and Prevention (CDC) 2000 growth charts were used to identify underweight, normal weight, and overweight/ obesity. Weighted age- and gender-adjusted prevalence of weight categories and tobacco use was calculated. Multivariate logistic regression analysis was performed to estimate the association between weight categories and tobacco use for each country, controlling for covariates. Pooled odds ratios and confidence intervals were computed using random- or fixed-effects meta-analyses.
A significant association between weight categories and tobacco use was evident in only a few countries. Adolescents reporting tobacco use in French Polynesia, Suriname, and Indonesia, had 72% (95% CI: 0.15-0.56), 55% (95% CI: 0.24-0.84), and 24% (95% CI: 0.61-0.94) lower odds of being underweight, respectively. Adolescents reporting tobacco use in Uganda, Algeria, and Namibia, had 2.30 (95% CI: 1.04-5.09), 1.71 (95% CI: 1.25-2.34), and 1.45 (95% CI: 1.00-2.12) times greater odds of being overweight/obese, but those in Indonesia and Malaysia had 33% (95% CI: 0.50-0.91) and 16% (95% CI: 0.73-0.98) lower odds of being overweight/obese.
The association between tobacco use and BMI categories is likely to be different among adolescents versus adults. Associating tobacco use with being thin may be more myth than fact and should be emphasized in tobacco prevention programs targeting adolescents.
与针对成年人的研究数量相比，青少年人群中与烟草使用相关的体重问题研究较少。本研究旨在探讨低收入和中等收入国家中体重过轻、超重与烟草使用之间的关联。
数据来源于全球学校学生健康调查（GSHS）。对来自23个国家的71176名12至15岁青少年的数据进行了分析。使用美国疾病控制与预防中心（CDC）2000年生长图表来确定体重过轻、正常体重以及超重/肥胖情况。计算了按年龄和性别加权的体重类别及烟草使用患病率。进行多变量逻辑回归分析以估计每个国家体重类别与烟草使用之间的关联，并对协变量进行控制。使用随机效应或固定效应荟萃分析计算合并比值比和置信区间。
仅在少数几个国家中，体重类别与烟草使用之间存在显著关联。在法属波利尼西亚、苏里南和印度尼西亚，报告使用烟草的青少年体重过轻的几率分别低72%（95%置信区间：0.15 - 0.56）、55%（95%置信区间：0.24 - 0.84）和24%（95%置信区间：0.61 - 0.94）。在乌干达、阿尔及利亚和纳米比亚，报告使用烟草的青少年超重/肥胖的几率分别高出2.30倍（95%置信区间：1.04 - 5.09）、1.71倍（95%置信区间：1.25 - 2.34）和1.45倍（95%置信区间：1.00 - 2.12），但在印度尼西亚和马来西亚，报告使用烟草的青少年超重/肥胖的几率分别低33%（95%置信区间：0.50 - 0.91）和16%（95%置信区间：0.73 - 0.98）。
青少年与成年人相比，烟草使用与体重指数类别之间的关联可能有所不同。将烟草使用与消瘦联系起来可能更多是一种误解而非事实，在针对青少年的烟草预防项目中应予以强调。
