RELATIONSHIP BETWEEN CIGARETTE-SMOKING AND HEALTH RISK AND PROBLEM BEHAVIORS AMONG US ADOLESCENTS

Objective: To examine whether sociodemographic factors and health risk and problem behaviors explain the prevalence of cigarette smoking amo ng US adolescents. Design: Probability survey. Participants: A nationa lly representative sample of US adolescents. Main Outcome Measures: We ighted prevalence, adjusted odds ratio (OR), and 95% confidence interv als (CIs) for current smoking status by health risk and problem behavi ors. Results: The prevalence of smoking was highest among adolescents who were white, older, and who had a high school education or lived in the Northeast. When we adjusted for sociodemographic factors and heal th risk and problem behaviors, smoking was associated with marijuana u se (OR, 3.7; 95%CI, 2.7-5.1), binge drinking (OR, 2.1; 95% CI, 1.6-2.8 ), and fighting (OR, 1.4; 95% CI, 1.1-1.7) among white adolescent male s. Similar associations between each of these 3 behaviors and cigarett e smoking were found among white adolescent females and African Americ an and Hispanic adolescent males and females. Cigarette smoking was al so associated with using smokeless tobacco, having multiple sexual par tners, and not using bicycle helmets among white adolescent males and females, having multiple sexual partners among Hispanic adolescent fem ales, and carrying weapons among Hispanic adolescent males. Conclusion s: Marijuana use, binge drinking, and fighting are correlates of cigar ette smelting among US adolescents. These associations, which vary by sex and race or ethnicity, suggest clustering to form a risk behavior syndrome.