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Cigarette Use and Adolescent Metabolic and Bariatric Surgery
Author(s) -
Zeller Meg H.,
Kidwell Katherine M.,
ReiterPurtill Jennifer,
Jenkins Todd M.,
Michalsky Marc P.,
Mitchell James E.,
Courcoulas Anita P.,
Inge Thomas H.
Publication year - 2021
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.23084
Subject(s) - medicine , obesity , logistic regression , weight loss , odds ratio , prospective cohort study , cigarette smoking , surgery
Objective This study aimed to track conventional cigarette smoking behaviors and associated correlates in adolescents with severe obesity who did or did not undergo metabolic and bariatric surgery to 4 years after surgery/baseline. Methods Utilizing a prospective controlled design, surgical ( n = 153; mean BMI = 52) and nonsurgical ( n = 70; mean BMI = 47) groups that completed assessments before surgery/at baseline and at Years 2 and 4 post surgery (Year 4: n = 117 surgical [mean BMI = 38]; n = 56 nonsurgical [mean BMI = 48]) were compared. Separate logistic regression models tested correlates of Year 4 current smoking. Results More than half of participants (surgical: 55%; nonsurgical: 60%) had ever smoked a cigarette, with current smoking increasing with time. Groups did not differ in Year 4 current smoking (surgical: 23%; nonsurgical: 33%), with ≈ 50% meeting criteria for “heavy” smoking (≥ half pack/day) and ≈ 40% smoking their first cigarette before ninth grade. Factors associated with higher odds of Year 4 current smoking included dysregulation ( P < 0.001), internalizing symptoms ( P = 0.01), alcohol use ( P = 0.04), caregiver smoking ( P < 0.001), friend smoking ( P = 0.001), and perceiving low harm ( P = 0.02), plus greater percent weight loss ( P = 0.03) in the surgical group. Conclusions Smoking is a clinical health challenge for adolescents and young adults with severe obesity, including those who have undergone metabolic and bariatric surgery. Upstream identification, monitoring, and intervention to prevent smoking uptake and escalation in youth with obesity across settings should be prioritized.