Prospective Analysis of the Influence of Sport and Educational Factors on the Prevalence and Initiation of Smoking in Older Adolescents from Croatia

Abstract

The prevalence of smoking among Croatian adolescents is alarmingly high, but no previous study has prospectively examined the sport- and academic-factors associated with smoking and smoking initiation. This study aimed to prospectively examine the associations between scholastic (educational) achievement and sport factors and smoking in 16- to 18-year-old adolescents. This two-year prospective cohort study included 644 adolescents who were 16 years of age at baseline (46% females). Baseline testing was implemented at the beginning of the 3rd year of high school (September 2014) when participants were 16 years old. Follow-up testing was completed at the end of the fourth year of high school, which occurred 20 months later. The evaluated predictor variables were educational-achievement- and sport-related-factors. The outcome variables were (i) smoking at baseline; (ii) smoking at follow-up; and (iii) smoking initiation over the course of the study. We assessed the associations between predictors and outcomes using logistic regression models adjusted for age, gender, socioeconomic status, and conflict with parents. The educational variables were consistently associated with smoking, with lower grade-point-average (Baseline: odd ratio (OR): 2.01, 95% confidence interval (CI): 1.61–2.55; Follow-up: 1.59, 1.31–1.94), more frequent absence from school (Baseline: OR: 1.40, 95% CI: 1.19–1.69; Follow-up: 1.30, 1.08–1.58), and lower behavioral grades (Baseline: OR: 1.80, 95% CI: 1.10–2.89; Follow-up: 1.57, 1.03–2.41) in children who smoke. Adolescents who reported quitting sports were at greater odds of being smokers (Baseline: 2.07, 1.31–3.32; Follow-up: 1.66, 1.09–2.56). Sport competitive achievement at baseline was protective against smoking initiation during following two-year period (0.45, 0.21–0.91). While the influence of the educational variables on smoking initiation has been found to be established earlier; sport achievement was identified as a significant protective factor against initiating smoking in older adolescents. Results should be used in development of an anti-smoking preventive campaign in older adolescents.

Does Participation in Sports Influence the Prevalence of and Initiation into Multiple Substance Misuse in Adolescence? A Two-Year Prospective Analysis

“…Briefly, Zenic et al reported a two-fold increase in harmful drinking in both adolescent boys and girls over a two-year period [9]. On the other hand, another study reported a much lower increase in smoking prevalence over two years in adolescent boys than in girls (girls: 37% to 49%; boys 44% to 48%) [31]. Our results, however, emphasized another interesting conclusion.…”

“…Although we could not find any study performed in southeastern Europe where trends in changes in CSHD were reported, we may say that the increase in the prevalence of CSHD prevalence that we found for those between 16 and 18 years of age in this period was expected. Namely, recent studies in the former Yugoslavia reported a significant increase in the smoking prevalence in Bosnian-Herzegovinian and Croatian adolescents over a two-year period (from 40% to 47% ever smokers) and from 28% to 36% (daily smokers) for Croatian and Bosnian-Herzegovinian adolescents, respectively) [10,31]. In addition, a significant increase in drinking prevalence was recorded by the AUDIT score in adolescents from Bosnia and Herzegovina for the same age [9].…”

“…According to recent findings, it seems that sports participation may not be simplified when observed as a factor of influence on drinking, so various facets of sports participation should be evaluated independently in order to more precisely identify the complex relationships that may exist between sports and the consumption of various psychoactive substances in adolescence [9,10]. This is particularly evident with regard to participation in individual (i.e., athletics, swimming) and team sports (i.e., football/soccer, basketball, handball), and studies repeatedly found differential effects of participation in these two type of sports on substance misuse in adolescence [9,31]. In brief, participation in team sports was repeatedly associated with higher likelihood of alcohol drinking (because of the post-sport social gatherings) [32].…”

“…On the other hand, athletes involved in some individual sports were often at risk of smoking (i.e., in some aesthetic sports athletes are concerned on body weight, because smoking increases basal metabolism) [24,25]. Other facets of sports participation that are found as being specifically related to substance misuse in puberty include experience, level of sport competition (i.e., sport achievement), and intensity of training (i.e., commitment to sport), altogether highlighting the necessity for more profound studying of the problem [7,27,31].…”

“…In addition, there is a lack of research that prospectively evaluates the relationship between sports participation and CSHD in adolescence. Finally, to the best of our knowledge, no study has so far examined this problem in southeastern Europe, which would be particularly important knowing the alarmingly high rates of substance misuse among adolescents from this region [6,9,31]. Therefore, the aim of this prospective study was to evaluate the causal effects that exist between various factors explaining sports participation and CSHD in adolescence.…”