Tobacco use and co-varying behaviors among adolescents and young adults

The purpose of this dissertation was to explore the relationship between cigarettes and other health compromising behaviors, in adolescence and young adults. The first paper of this dissertation sought to determine trends in the use of individual and multiple tobacco products, among adolescent tobacco users, using repeated cross-sectional data from the Youth Risk Behavior Surveillance System (YRBSS), from 1997-2011; and to examine differences in these trends by key socio-demographic factors. Trends indicate that there are significant changes in the prevalence and types of products used by high school students, as well key socio-demographic differences. Many of the significant trends may be attributed to an increase in smokeless tobacco use, among tobacco users. The second paper of this dissertation aimed to elucidate the temporal relationship of weight control behaviors and smoking from adolescence to young adulthood, from 1994-2002, using nationally representative longitudinal data from the Add Health Study. Regression analyses testing the bi-directional relationships between smoking and weight control behaviors showed that there is likely an association between these two behaviors. Ever smoking in young adulthood is predicted by weight control variables in late adolescence. Most models predicting weight control behaviors in young adulthood were statistically insignificant and less than one. These models did not provide evidence that early smoking led to weight control behaviors. Results of these analyses did not find consistent or overwhelming support for either behavior preceding the other. The third paper was a series of systematic literature reviews on the Fairness Doctrine on tobacco, food marketing to children, and counter-marketing campaigns and strategies to guide the development of a Fairness Doctrine-like campaign on sugar-sweetened beverages (SSBs). These reviews gave insight into a potential counter-marketing campaign on SSBs aimed a youth. Potential effects of the proposed campaign include increased self-regulation by the SSB industry, decreased consumption of SSB, and changes in the attitudes, beliefs, and knowledge of SSBs. A counter-marketing campaign focused on SSBs may be step in curbing the childhood obesity epidemic, and appears feasible and justifiable as one potential strategy aimed at this epidemic