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Cigarette Smoking and Multiple Health Risk Behaviors: A Latent Class Regression Model to Identify a Profile of Young Adolescents


  • Lorena Charrier
  • Paola Berchialla
  • Paola Dalmasso
  • Alberto Borraccino
  • Patrizia Lemma
  • Franco Cavallo


Cigarette smoking is often established during adolescence when other health‐related risk behaviors tend to occur. The aim of the study was to further investigate the hypothesis that risky health behaviors tend to cluster together and to identify distinctive profiles of young adolescents based on their smoking habits. To explore the idea that smoking behavior can predict membership in a specific risk profile of adolescents, with heavy smokers being more likely to exhibit other risk behaviors, we reanalyzed the data from the 2014 Health Behaviour in School‐Aged Children Italian survey of about 60,000 first‐ and third‐grade junior high school (JHS) and second‐grade high school (HS) students. A Bayesian approach was adopted for selecting the manifest variables associated with smoking; a latent class regression model was employed to identify smoking behaviors among adolescents. Finally, a health‐related risk pattern associated with different types of smoking behaviors was found. Heavy smokers engaged in higher alcohol use and abuse and experienced school failure more often than their peers. Frequent smokers reported below‐average academic achievement and self‐rated their health as fair/poor more frequently than nonsmokers. Lifetime cannabis use and early sexual intercourse were more frequent among heavy smokers. Our findings provide elements for constructing a profile of frequent adolescent smokers and for identifying behavioral risk patterns during the transition from JHS to HS. This may provide an additional opportunity to devise interventions that could be more effective to improve smoking cessation among occasional smokers and to adequately address other risk behaviors among frequent smokers.

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  • Lorena Charrier & Paola Berchialla & Paola Dalmasso & Alberto Borraccino & Patrizia Lemma & Franco Cavallo, 2019. "Cigarette Smoking and Multiple Health Risk Behaviors: A Latent Class Regression Model to Identify a Profile of Young Adolescents," Risk Analysis, John Wiley & Sons, vol. 39(8), pages 1771-1782, August.
  • Handle: RePEc:wly:riskan:v:39:y:2019:i:8:p:1771-1782
    DOI: 10.1111/risa.13297

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    References listed on IDEAS

    1. Linzer, Drew A. & Lewis, Jeffrey B., 2011. "poLCA: An R Package for Polytomous Variable Latent Class Analysis," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 42(i10).
    2. Stueve, A. & O'Donnell, L.N., 2005. "Early alcohol initiation and subsequent sexual and alcohol risk behaviors among urban youths," American Journal of Public Health, American Public Health Association, vol. 95(5), pages 887-893.
    3. Chris Roberts & J. Freeman & O. Samdal & C. Schnohr & M. Looze & S. Nic Gabhainn & R. Iannotti & M. Rasmussen, 2009. "The Health Behaviour in School-aged Children (HBSC) study: methodological developments and current tensions," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 54(2), pages 140-150, September.
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    1. Biljana Kilibarda & Jelena Gudelj Rakic & Sonja Mitov Scekic & Srmena Krstev, 2020. "Smoking as a weight control strategy of Serbian adolescents," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(8), pages 1319-1329, November.

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