Participating in team sports is associated with a reduced likelihood of youths becoming established smokers, according to a report in the July issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. However, exposure to movie smoking appears to be associated with an increased risk of established smoking in both team sport participants and nonparticipants.

Past studies suggest that there is a direct association between movie smoking exposure and youth smoking initiation, with 30 percent to 50 percent of adolescents' smoking initiation attributed to movie smoking exposure, according to background information in the article. "Movie smoking exposure appears to increase the risk of smoking initiation by enhancing adolescents' perceived benefits of smoking and making them more susceptible to peer influences," the authors write.

Anna M. Adachi-Mejia, Ph.D., of Hood Center for Children and Families, Dartmouth Medical School, Lebanon, N.H., and colleagues analyzed data from school- and telephone-based surveys that assessed movie smoking exposure and team sports participation in 2,048 youths from September 1999 through November 1999 and February 2006 through February 2007. Baseline movie smoking exposure was reported when respondents were ages 9 to 14 and team sport participation was assessed at ages 16 to 21 at follow-up. Movie smoking exposure was classified in quartiles with 0 to 522 smoking occurrences for the first quartile, 523 to 947 for the second, 948 to 1,649 for the third and 1,650 to 5,308 for the fourth.

Respondents had been exposed to an average of 1,191 smoking occurrences from 601 movies at baseline with no significant difference in exposure between sports participants and nonparticipants.

A total of 353 (17.2 percent) of the respondents were established smokers (having smoked 100 cigarettes or more in their lifetime) at follow-up. Those with exposure to the highest quartile of movie smoking compared to those with exposure to the lowest quartile were more likely to become established smokers. "Compared with the other respondents, established smokers were significantly more likely to be male, be older, have parents with lower levels of education, have a higher proportion of close friends who smoke, have parents who smoke, report lower school performance, have higher levels of sensation seeking and rebelliousness and be less likely to be enrolled in school at the time of follow-up," the authors write. Although team sports nonparticipants were twice as likely to become established smokers as sports participants, "in both team sports participants and nonparticipants, the proportion of established smokers increased from lowest to highest levels of movie smoking exposure by the same amount, 19.3 percent."

"In summary, this study supports the benefits of youth participation in team sports, which appears to protect against established smoking even in the face of movie smoking exposure," the authors conclude. "However, movie smoking exposure increases the risk of established smoking among both team sports participants and nonparticipants. Parents, teachers, coaches and clinicians should be aware that encouraging team sports participation in tandem with minimizing early exposure to movie smoking may offer the greatest likelihood of preventing youth smoking."

Arch Pediatr Adolesc Med. 2009;163[7]:638-643.

Archives of Pediatrics & Adolescent Medicine

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