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. 2021 May 12:19:37.
doi: 10.18332/tid/133932. eCollection 2021.

Underweight, overweight, and tobacco use among adolescents aged 12-15 years: Evidence from 23 low-income and middle-income countries

Qian Wang  1
Affiliations

Underweight, overweight, and tobacco use among adolescents aged 12-15 years: Evidence from 23 low-income and middle-income countries

Qian Wang. Tob Induc Dis. .

Abstract

Introduction: Compared with the number of studies in adults, body weight in relation to tobacco use has been understudied in the adolescent population. This study aimed to examine the association between underweight, overweight and tobacco use in low- and middle-income countries.

Methods: Data were derived from the Global School-Based Student Health Survey (GSHS). Data from 71176 adolescents aged 12-15 years residing in 23 countries were analyzed. The Centers for Disease Control and Prevention (CDC) 2000 growth charts were used to identify underweight, normal weight, and overweight/ obesity. Weighted age- and gender-adjusted prevalence of weight categories and tobacco use was calculated. Multivariate logistic regression analysis was performed to estimate the association between weight categories and tobacco use for each country, controlling for covariates. Pooled odds ratios and confidence intervals were computed using random- or fixed-effects meta-analyses.

Results: A significant association between weight categories and tobacco use was evident in only a few countries. Adolescents reporting tobacco use in French Polynesia, Suriname, and Indonesia, had 72% (95% CI: 0.15-0.56), 55% (95% CI: 0.24-0.84), and 24% (95% CI: 0.61-0.94) lower odds of being underweight, respectively. Adolescents reporting tobacco use in Uganda, Algeria, and Namibia, had 2.30 (95% CI: 1.04-5.09), 1.71 (95% CI: 1.25-2.34), and 1.45 (95% CI: 1.00-2.12) times greater odds of being overweight/obese, but those in Indonesia and Malaysia had 33% (95% CI: 0.50-0.91) and 16% (95% CI: 0.73-0.98) lower odds of being overweight/obese.

Conclusions: The association between tobacco use and BMI categories is likely to be different among adolescents versus adults. Associating tobacco use with being thin may be more myth than fact and should be emphasized in tobacco prevention programs targeting adolescents.

Keywords: adolescents; low- and middle-income countries; overweight; tobacco use; underweight.

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Conflict of interest statement

The author has completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The author declares that she has no competing interests, financial or otherwise, related to the current work. Q. Wang reports that she received from Shanghai Jiao Tong University School of Medicine, a grant (No. 19X100040041).

Figures

Figure 1
Figure 1
Country-wise association between past 30-day any tobacco use and being underweight estimated by multivariate logistic regression
Figure 2
Figure 2
Country-wise association between past 30-day any tobacco use and being overweight/obese estimated by multivariate logistic regression
See this image and copyright information in PMC

References

    1. World Health Organization Noncommunicable diseases. 2018. Jun 1, Accessed November 7, 2020. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
    1. World Health Organization . 2018 Global Progress Report on Implementation of the WHO Framework Convention on Tobacco Control. World Health Organization; 2018. https://www.who.int/fctc/reporting/WHO-FCTC-2018_global_progress_report.....
    1. Anderson C, Becher H, Winkler V. Tobacco Control Progress in Low and Middle Income Countries in Comparison to High Income Countries. Int J Environ Res Public Health. 2016;13:1039. doi: 10.3390/ijerph13101039. - DOI - PMC - PubMed
    1. Gilmore AB, Fooks G, Drope J, Bialous SA, Jackson RR. Exposing and addressing tobacco industry conduct in low-income and middle-income countries. Lancet. 2015;385:1029–1043. doi: 10.1016/S0140-6736(15)60312-9. - DOI - PMC - PubMed
    1. Filozof C, Fernández Pinilla MC, Fernández-Cruz A. Smoking cessation and weight gain. Obes Rev. 2004;5(2):95–103. doi: 10.1111/j.1467-789X.2004.00131.x. - DOI - PubMed

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