Measurement and description of cigarette smoking and weight reducing behaviors in female adolescents.

Ethnographic interviews with female adolescents were used to develop summated-rating scales to measure cigarette smoking and weight-reducing behaviors. The Cigarette Smoking Scale is based on the frequency that one smokes cigarettes rather than the number of cigarettes smoked, and includes items related to the subjective and addictive effects of nicotine, social cues for cigarette smoking, and situational opportunities to smoke. The Dieting Patterns Scales measure the frequency of employing three different types of weight-reducing strategies; exercise and a "healthy" diet, skipping meals and fasting, and the use of diet pills and diet drinks. The scales were found to be: (a) sensitive to group differences, indicating construct validity, (b) stable, and (c) internally consistent. The Cigarette Smoking Scale and Dieting Patterns Scales were used to examine the relationships among cigarette smoking, weight-reducing behaviors, dietary intake, maturation, and body composition of 129 eighth-, tenth-, and twelfth-grade girls. Two-thirds of girls included in this study reported dieting to lose weight within the past year. This behavior was associated with a lower energy intake, a higher body mass index, and lower socio-economic status. Both dieting and frequency of employing different types of weight-reducing strategies were consistent across school grades. The importance of measuring both the frequency and type of weight-reducing strategy was indicated by the distinct relationships noted among the Dieting Patterns Scales, dietary intake, and body mass index. The use of diet pills and diet drinks was associated with significantly lower energy, macronutrient, calcium, iron and riboflavin intake. Skipping meals and fasting was unrelated to energy intake but positively related to vitamin C and folacin intake. Lastly, exercise and "healthy" diet behaviors were related to a higher intake of dietary fat. Cigarette smoking was unrelated to weight-reducing behaviors and dieters were not more likely to smoke than non-dieters. However, smokers were thinner. Teens' knowledge and/or beliefs regarding the effects of smoking on body weight may help define the relationship between smoking and dieting