CIGARETTE-SMOKING AND SELF-REPORTED HEALTH-PROBLEMS AMONG US HIGH-SCHOOL SENIORS, 1982-1989

Purpose. To estimate the independent effect of cigarette smoking on re spiratory tract symptoms and health status indicators among high schoo l seniors. Design. Consolidated data sets from one-time cross-sectiona l survey designs. Setting. High schools in the United States, 1982-198 9. Sample. A total of 26,504 high school seniors, with an 83% response rate. Measures. Odds ratios for respiratory tract symptoms and health status indicators for cigarette smokers compared with nonsmokers, whi le controlling for sex, socioeconomic status, and use of other drugs. Results. High school seniors who were regular cigarette smokers and wh o began smoking by grade nine were significantly more likely than neve r smokers to report shortness of breath when not exercising (adjusted odds ratio [OR] = 2.7), coughing spells (OR = 2.1), productive cough ( OR = 2.4), and wheezing or gasping (OR = 2.6). These smokers were also more likely to have seen a doctor or other health professional for an emotional or psychologic complaint (OR = 3.0) and to rate their overa ll health as poorer than average (OR = 2.4). We found strong dose-resp onse relationships for most outcome measures. Conclusions. Cigarette s moking among high school seniors is associated with respiratory tract symptoms and poorer overall physical health and may be a marker for un derlying mental health problems. Smoking prevention activities directe d at adolescents should include information on the early adverse healt h consequences of cigarette smoking.