RISKY BEHAVIOR IN TEENS WITH CYSTIC-FIBROSIS OR SICKLE-CELL DISEASE -A MULTICENTER STUDY

Objective. To determine the prevalence and age of onset of common risk y behaviors such as smoking and sexual activity in teens with cystic f ibrosis and those with sickle cell disease and to compare their behavi ors with those of adolescents in the general population. Design. Surve y. Setting. All five major pediatric tertiary care centers in North Ca rolina (study participants with sickle cell disease or cystic fibrosis ) and North Carolina public schools (comparison population). Participa nts. Three hundred twenty-one adolescents with cystic fibrosis or sick le cell disease aged 12 to 19 years (mean age, 15.6 years; 49% female) . Demographically matched comparison teens for each group were selecte d from 2760 in-school adolescents (mean age, 16.0 years; 51% female). Main Outcomes Measures. Prevalence of tobacco and marijuana use, alcoh ol use, sexual intercourse, sexually transmitted diseases, seat belt u se, weapon carrying, and age of onset of these behaviors. Results. Chr onically ill teens reported significantly less lifetime and current us e of tobacco, marijuana, and alcohol; less sexual intercourse; less we apon carrying, less drunk driving, and more seat belt use than their p eers. Nonetheless, 21% of the teens with cystic fibrosis and 30% of th ose with sickle cell disease had smoked; sexual intercourse was report ed by 28% and 51%, respectively. Age of onset of these behaviors was f requently older for the chronically ill teens. Conclusion. Teens with cystic fibrosis or sickle cell disease took more potentially damaging health risks than might be expected, although the prevalence was lower than reported by their peers. Future longitudinal studies should exam ine the relationships between chronic illness, physical and psychosoci al maturation, and risky behavior. Screening for psychosocial issues, including risky behaviors, should be incorporated into the routine hea lth care of chronically ill teens.