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Journal of Pediatric Psychology Advance Access originally published online on June 21, 2008
Journal of Pediatric Psychology 2009 34(2):118-128; doi:10.1093/jpepsy/jsn063
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Asthma-specific Predictors of Smoking Onset in Adolescents with Asthma: A Longitudinal Study

Monique O. M. Van De Ven, PhD1, Rutger C. M. E. Engels, PhD1 and Susan M. Sawyer, MD2,3,4

1Behavioural Science Institute, Radboud University Nijmegen, 2Centre for Adolescent Health, Royal Children's Hospital, 3Department of Paediatrics, the University of Melbourne, and 4Murdoch Childrens Research Institute

All correspondence concerning this article should be addressed to Monique Van De Ven, Behavioural Science Institute, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, the Netherlands. E-mail: M.vandeven{at}pwo.ru.nl


  Abstract

Objective Despite even occasional smoking being more risky for adolescents with asthma, the smoking rate in this vulnerable population remains high. This is the first longitudinal study investigating asthma-specific predictors of smoking initiation. Methods A three-wave longitudinal survey study (22 months) among 257 adolescents with asthma was conducted. The effects of asthma-specific factors [symptom severity, medication adherence, coping, attitude towards asthma, and quality of life (QOL)] on smoking onset were tested with logistic regression models. Results Poorer self-reported adherence and the maladaptive coping strategy of hiding asthma predicted smoking onset. Poorer QOL predicted smoking in boys only. Conclusions Our findings underscore the importance of recognizing and addressing adherence problems during adolescence as low adherence is a risk factor for smoking initiation. Moreover, psychosocial factors, such as coping and QOL for boys, were associated with smoking initiation. This highlights the importance of attending to the psychosocial needs of youth with asthma.

Key words: asthma; adolescent; psychological adaptation; risk factors; tobacco use.

Received July 18, 2007; revision received May 27, 2008; accepted May 28, 2008


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