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Today's teen smokers are more likely to engage in risky behaviors than teens who smoked in the early nineties

The risk profile of the American adolescent smoker has changed, according to a new study. Today's adolescent smokers are more likely to engage in risky sexual behavior, risky alcohol-related behaviors, and to not use a seatbelt or bicycle helmet than adolescent smokers in the early 1990s.

Some may argue that this greater link between smoking and certain risky behaviors among today's adolescents suggests that smoking may be becoming a more socially deviant behavior among adolescents, notes Jonathan D. Klein, M.D., M.P.H. Dr. Klein and colleagues at the University of Rochester School of Medicine suggest that doctors screen adolescents who smoke for other risky behaviors, and that adolescents may benefit from multifaceted prevention programs that target both smoking and other risky behaviors.

The researchers analyzed data from national Youth Risk Behavior Surveys from 1991 to 2003. They controlled for gender, race/ethnicity, and school grade to examine the associations between smoking and other risky behaviors. The strength of the relationship between smoking and lifetime number of sexual partners increased slightly from 1991 to 2003. Smokers in 2001 were almost twice as likely to have had sexual partners in the past 3 months as they were in 1991. Smokers were five times more likely in 1997 than they were in 1991 to never wear a bicycle helmet. Increased links between smoking and binge drinking and physical fighting were also seen.

In contrast, risky sexual behaviors and binge drinking declined among adolescents who didn't smoke during this period. The relationship between smoking and other drug use remained stable or slightly decreased over time. Nevertheless, between 5 and 12 percent of adolescent nonsmokers used marijuana at least once in the past month, whereas 39 to 59 percent of smokers did. Similarly, 34 to 45 percent of nonsmokers reported having at least one sex partner in their life compared with more than 67 percent of smokers. The study was supported in part by the Agency for Healthcare Research and Quality (HS14418).

See "The changing risk profile of the American adolescent smoker: Implications for prevention programs and tobacco interventions," by Deepa R. Camenga, M.D., Dr. Klein, and Jason Roy, Ph.D., in the July 2006 Journal of Adolescent Health 39, pp. 120.e1-120.e10.

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