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September 11, 2002

Depression and Exposure to Other Smokers Linked to Alternate Tobacco Product Use Among Teens

(Philadelphia, PA) Exposure to family and friends who smoke and elevated levels of depression significantly affect the likelihood of alternate tobacco product use among adolescents, a study by researchers from the University of Pennsylvania School of Medicine and Georgetown University indicates. The study, titled "Psychosocial Correlates of Alternate Tobacco Product Use during Early Adolescence," appears in the August issue of Preventive Medicine.

Recent research shows that alternate tobacco products, including smokeless tobacco (chewing tobacco and moist snuff), cigars, cigarillos, pipes, bidis (sweet flavored cigarettes from Southeast Asia), and kreteks (clove-flavored cigarettes), are gaining in popularity among youth.

"This trend is dangerous because alternate tobacco products can lead to cancers of the oral cavity and a host of other negative health consequences," said senior author Janet Audrain, PhD, member of the Abramson Cancer Center of the University of Pennsylvania, and assistant professor in the Department of Psychiatry at Penn's School of Medicine.

While previous research has shown that both exposure to other smokers and depression increase the likelihood of cigarette use among adolescents, this is one of the first studies to examine the influence that these social and psychological factors have on alternate tobacco product use.

Audrain led a research team that interviewed 1,107 ninth grade students as part of a four-year investigation of the social, psychological and genetic predictors of adolescent smoking adoption. These students completed a survey that assessed current smoking practices, exposure to other smokers, levels of depression, and alternate tobacco product use. Demographic data including age, gender, and race were also collected.

Over eight percent of the teens reported using an alternate tobacco product (smokeless tobacco, cigars, pipes, bidis and/or kreteks) in the last thirty days. Among the eleven percent of freshman who reported being current cigarette smokers (smoked in the last month), 45 percent were also current users of an alternate tobacco product.

The researchers found that current alternate tobacco product users were significantly more likely to be male, white and current cigarette smokers. In addition, teens with higher levels of exposure to other smokers and those with greater depressive symptoms were found to be two to three times more likely to be current users of alternate tobacco products, regardless of demographic factors and current cigarette smoking.

"It is important that future studies determine adolescents' beliefs and motivations surrounding the benefits of using alternate tobacco products," said study co-investigator and author Kenneth P. Tercyak, PhD, assistant professor of oncology at Georgetown University Medical Center. "Since it is possible that adolescents might have misconceptions about the safety of these products, anti-tobacco messages targeted to youth should include warnings about the risks of using these products."

This research was funded by the National Cancer Institute and the National Institute on Drug Abuse and was conducted by the University of Pennsylvania/Georgetown University Transdisciplinary Tobacco Use Research Center.

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