1. Changes in smoking habits among 11-17 years old adolescents 1 Semmelweis University, Faculty of Medicine, Institute of Public Health 2 Eötvös Lóránd University, Faculty of Education and Psychology, Department of Personality and Health Psychology Pénzes Melinda 1 melindapenzes@gmail.com Mónok Kata 2 Balázs Péter 1

2. Estimated smoking prevalence among adolescents in Hungary 23.2% - 13-15 years (GYTS 2008) 39% - 15-24 years: (Eurobarometer 2009) 17.9% and 17.6% - Grade 5th, 7th, 9th, 11th boys and girls (HBSC 2006) 33% - 15-16 years (ESPAD 2007) Background and Objectives SMOKING Changes in one-year period Sociodemographics age grade settlement type of school school achievement Parental smoking Smoker friends Anti-smoking school program Body perception Weight concerns Belief that smoking can control weight

3. Methods Self-administered questionnaires – overlapping questions for Survey I and Survey II Budapest and Debrecen, Győr, Miskolc, Pécs, Szeged SPSS 17.0 Cross-sectional and longitudinal analyses, binary logistic regression 2009/2010 winter2010/2011 winter2011/ 2012 winter Grade 6th & 9th Grade 8th & 11th Grade 7th & 10th actual position Longitudinal study of body weight control and tobacco smoking among adolescents This publication was made possible by Grant Number 1 R01 TW007927-01 from the Fogarty International Center, the National Cancer Institute, and the National Institutes on Drug Abuse, within the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the NIH.

4. Sample characteristics ResearchSurvey ISurvey II Grade6th9thTotal7th10thTotal Students (n)8071401220874013412081 Participate in follow up (n)---5258491374 Participating schools (n)364278334073 Participating classes (n)63471104258100 Gender (n) Boy407586993372562934 Girl40081512153687781146 Age (years) Mean (SD)12,1 (0,6)15,1 (0,7)14,0 (1,6)13,1 (0,7)16,1 (0,7)15,0 (1,6) Range11-1514-1911-1912-1714-1912-19 Type of school (%) Elementary school--36,5--32,1 High school--27,0--25,3 Vocational school--36,4--42,7 School achievement (%) ≤3,5021,54335,427,453,544,5 ≥3,5178,55764,672,646,555,5

5. Changes in smoking prevalence I. Grade 6th7thChange9th10thChange Experimenters (%) Survey I and II 24.827.12.361.767.45.7 Follow up 21.533.311.857.469.512.1 Current smokers (%) Survey I and II 6.37.81.534.540.05.5 Follow up 4.47.32.926.938.011.1 Experimenters: tried smoking even one puff. Current smokers: were smoking during the past 30 days. TotalFollow up Survey ISurvey IIChangeSurvey ISurvey IIChange Experimenters (%) 48.253.25.043.755,712.0 Current smokers (%) 24.228.54.318.326.48.1

6. Changes in smoking prevalence II. Survey I – Categories of smokers by gender and school class % %

7. Students in follow up Tried cigarette smoking between Survey I and Survey II (%) 11,9 Boy12,9 Girl11,1 7th class11,7 10th class12,0 Quitted smoking between Survey I and Survey II (%) 3,4 Boy3,5 Girl3,4 7th class1,9 10th class4,4 Became current smoker between Survey I and Survey II (%) 11,4 Boy11,2 Girl11,5 7th class4,8 10th class15,4 Changes in smoking prevalence % p<0,05

8. Survey I Survey II Survey I-II OR95% CIOR95% CIOR95% CI GenderBoys1.00 Girls1.210.97-1.511.42**1.10-1.841.311.00-1.71 SettlementCities1.00 Capital (Budapest)1.010.81-1.271.020.79-1.321.45**1.11-1.91 Type of schoolElementary1.00 High school2.08*1.55-2.803.00*2.14-4.202.82*1.99-4.01 Secondary specialized school2.16*1.60-2.932.64*1.89-3.712.36*1.64-3.40 Vocational school2.48*1.56-4.0712.06*5.19-28.024.85*2.16-10.91 School achievement≤3,501.00 ≥3,510.47*0.37-0.600.48*0.36-0.640.51*0.37-0.70 Parental smokingNone1.00 One parent1.75*1.37-2.241.57**1.18-2.081.210.90-1.64 Both parents1.44**1.06-1.951.350.93-1.951.100.75-1.60 Smoker friendsNone1.00 1-32.69*2.04-3.542.88*2.09-3.952.31*1.68-3.20 4-58.35*6.13-11.389.28*6.56-13.145.81*3.95-8.55 Anti-smoking school program No1.00 Yes1.090.82-1.441.140.77-1.681.090.77-1.53 Predictors of smoking experimentation *p<0.001; **p<0.05

9. Survey I Survey II Survey I-II GirlsBoysGirlsBoysGirlsBoys OR [95% CI] Higher subjective BMI 1.05*1.10**1.07*1.04*1.021.14** [1.01-1.10][1.05-1.15][1.03-1.12][1.01-1.08][0.97-1.08][1.07-1.22] Desire to lose weight 1.0020.650.890.811.190.54* [0.70-1.43][0.41-1.03][0.65-1.21][0.54-1.21][0.77-1.84][0.30-0.95] Smoking can help weight reduction 1.68*1.421.48*1.93*1.321.24 [1.19-2.39][0.93-2.17][1.06-2.06][1.31-2.83][0.86-2.03][0.72-2.13] Smoking has appetite-weight control effect 1.02* 1.011.02*0.99 [1.01-1.04] [1.01-1.03][0.99-1.02][1.01-1.04][0.98-1.02] *p<0.05; **p<0.001 Interrelations between weight concerns and current smoking

10. Conclusion Experimenters and current smokers prevalence  –girls –grade 9th  10th Experimentation: 13 years old Follow up sample –11.4% became current smoker –3.4 % quitted smoking Main predictors of smoking experimentation –type of school, poorer school achievement, one parent smoking, more smoker friends Current smokers –higher subjective BMI –no desire to lose weight –belief that smoking can decrease weight and appetite

11. Thank you for your attention!