Agbaje Andrew O
Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland; Children's Health and Exercise Research Centre, Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
Behav Res Ther. 2025 Feb;185:104674. doi: 10.1016/j.brat.2024.104674. Epub 2024 Dec 17.
Long-term accelerometer-based studies examining whether engaging in physical activity (PA) reduces the risk of smoking in children are lacking, and whether directly measured adiposity increases smoking risk is uncertain.
From the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, 2503 children aged 11 years with complete smoking and at least one valid time-point movement behaviour data were followed up until age 24 years. ActiGraph assessed sedentary time (ST), light PA (LPA), and moderate-to-vigorous PA (MVPA) at ages 11, 15, and 24-year clinic visits and smoking-based questionnaires were administered, whilst fat mass was measured with dual-energy x-ray absorptiometry scanner. Data were analysed with generalized linear-mixed effect models with logit-links and structural equation models.
Mean [SD] age at baseline was 11.71 [0.20] years and the prevalence of smoking at ages 13, 15, and 24 years were 1.5%, 13.5%, and 26.6%, respectively. Higher MVPA at age 11 years was significantly associated with lower odds of smoking at age 13 years (odds ratio, 0.991; [95% CI, 0.983-0.999], P = 0.035). Cumulative MVPA during ages 11-24 years was significantly associated with lower odds of progressive smoking during growth from ages 13-24 years (0.992; [95% CI, 0.989-0.996], P < 0.001). Cumulative ST and LPA had no significant associations with smoking. Higher fat mass suppressed (10% suppression) the inverse relationship between MVPA and smoking. In path analysis, higher MVPA at age 15 years temporally preceded reduced smoking at age 24 years.
In the present study, engaging in MVPA from age 11 years may prevent 9 in 1000 children from starting smoking at the age of 13 years when smoking prevalence was 15 in 1000 children, i.e potentially preventing 60% of children from initiating smoking. However, the MVPA preventive approach diminished as children grew into young adults.
基于加速度计的长期研究缺乏对儿童进行体育活动（PA）是否会降低吸烟风险的考察，且直接测量的肥胖是否会增加吸烟风险尚不确定。
从英国出生队列雅芳亲子纵向研究（ALSPAC）中选取2503名11岁的儿童，这些儿童有完整的吸烟情况及至少一个有效的时间点运动行为数据，并随访至24岁。在11岁、15岁和24岁的门诊就诊时，用ActiGraph评估久坐时间（ST）、轻度PA（LPA）和中度至剧烈PA（MVPA），并发放基于吸烟情况的问卷，同时用双能X线吸收仪扫描测量脂肪量。数据用带logit链接的广义线性混合效应模型和结构方程模型进行分析。
基线时的平均[标准差]年龄为11.71[0.20]岁，13岁、15岁和24岁时的吸烟率分别为1.5%、13.5%和26.6%。11岁时较高的MVPA与13岁时较低的吸烟几率显著相关（比值比，0.991；[95%置信区间，0.983 - 0.999]，P = 0.035）。11 - 24岁期间的累积MVPA与13 - 24岁生长过程中渐进性吸烟的较低几率显著相关（0.992；[95%置信区间，0.989 - 0.996]，P < 0.001）。累积ST和LPA与吸烟无显著关联。较高的脂肪量抑制了（10%的抑制作用）MVPA与吸烟之间的负相关关系。在路径分析中，15岁时较高的MVPA在时间上先于24岁时吸烟减少。
在本研究中，从11岁开始进行MVPA可能会使每1000名儿童中有9名在13岁时不开始吸烟，当时吸烟率为每1000名儿童中有15名吸烟，即有可能防止60%的儿童开始吸烟。然而，随着儿童成长为年轻人，MVPA的预防作用减弱。
