5.30 Harnessing predictors of uptake to prevent smoking

Last updated April 2012 

The National Tobacco Strategy (NTS)1 outlines how programs separate from tobacco control programs that address underlying determinants of smoking also help to create environments that support people not to smoke. It talks of the potential benefits that might be gained through investment in programs designed to strengthen community and cultural resources–programs to reduce the chance of educational failure, family conflict, loss of cultural identity and the development of mental health problems. Positive changes from these programs may well reduce uptake among young people of smoking as well as other health-compromising behaviours.1 Of particular relevance to youth smoking prevention, the NTS endorses broader government policies and programs that address the underlying causes of disadvantage in our community–for instance, efforts to reduce family conflict and to improve school effectiveness. These measures have strong potential to improve the proportion of students feeling a connectedness with school, and to improve academic achievement, both of which are highly protective against smoking uptake2 (see Section 5.9).

5.30.1 Sport and physical activity as protective factors

Research has suggested that physical activity and sport participation are negatively associated with cigarette smoking among young people.3,4 A recent systematic review of articles relevant to sports participation and substance use (alcohol, tobacco and illicit drugs) among secondary school and college students aged 13–24 years identified 34 relevant peer-reviewed quantitative studies published between 1982 and 2008.5 The studies reviewed suggested that sport participation is related to higher levels of alcohol consumption, but lower levels of both cigarette smoking and illegal drug use. The majority (14) of the 15 studies examining the relationship between participation in sport and cigarette smoking found sports involvement to be negatively related to cigarette use, suggesting that participation in sport may serve as a protective factor against tobacco consumption.5

A 2009 study among Cypriot adolescents and young adults investigating the association between level of physical activity (very active, active, moderately active, or inactive) and type of smoking behaviour found a consistent and negative relationship between physical activity and smoking across both sex and age.6 Greater intensity of physical activity was associated with a lower likelihood of smoking; physically active young people smoked fewer cigarettes and were more likely than inactive individuals to be non-smokers or occasional smokers.6

Other research has found that teens who participate in a wide variety of physical activities, particularly with their parents, are at decreased risk for smoking and other risk factors such as drinking, drugs, violence, smoking, sex and delinquency, compared with teens who watch a lot of television.7

Investigators in a study that found that adolescents exhibiting decreasing and erratic team sport participation were more likely to be current smokers than adolescents with low or high sport participation further concluded that adolescents with decreasing team sport participation are at increased risk of later smoking.8 Rodriguez followed this research by examining adolescents' perceptions of their physical selves,9 concluding that physical activity plays a part in influencing physical self-perception and is an important factor to consider in youth smoking interventions. The positive relationship between participation in physical activity such as sport and perception of physical self is supported by other research in this area,10 including a survey among Danish young people aged 16–20 years in which adolescent participation in leisure time physical activity was found to be inversely associated with smoking behaviour.11 This relationship, however, held only among adolescents who perceived physical activity to be an important part of their self-concept, suggesting that participation in leisure time physical activity may have an indirect protective effect on smoking behaviour through its effect on adolescents' self-concept.11

While these research findings do not suggest that scarce tobacco-control resources should be redirected to physical activity and other health programs for young people, there are promising synergies upon which to draw. Sport and recreational 'health promotion sponsorship'12,13 is an example of a synergy that has been harnessed by some Australian states and territories. For example, through Healthway, Smarter than Smoking has sponsored around 60 youth-related sports and arts events or activities annually, with promotional strategies such as signage and merchandise, message endorsement by role models and competitions. Structural strategies have included the implementation of smokefree policies and banning the sale of tobacco products at sponsored events. Other ways in which those in tobacco control can harness sport as a protective factor against smoking include supporting and encouraging programs that target physical activity and other positive health behaviours among youth populations at higher risk of smoking, as well as emphasising the detrimental effects of smoking on fitness in information and messages targeting adolescents.

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1. Ministerial Council on Drug Strategy and Department of Health and Ageing. National Tobacco Strategy 2004-2009. Canberra: Commonwealth of Australia, 2005. Available from: http://www.health.gov.au/internet/wcms/publishing.nsf/Content/phd-pub-tobacco-tobccstrat2-cnt.htm

2. US Department of Health and Human Services. Reducing tobacco use: a report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000. Available from: http://www.cdc.gov/tobacco/sgr/sgr_2000/index.htm

3. Rainey C, McKeown R, Sargent R and Valois R. Patterns of tobacco and alcohol use among sedentary, exercising, nonathletic, and athletic youth. Journal of School Health 1996;66:27-32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8907735

4. Pate R, Trost S, Levin S and Dowda M. Sports participation and health related behaviors among US youth. Archives of Pediatric Adolescent Medicine 2000;154:904-11. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10980794

5. Lisha N and Sussman S. Relationship of high school and college sports participation with alcohol, tobacco, and illicit drug use: a review. Addictive Behaviors 2010;35(5):399-407. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20100638

6. Charilaou M, Karekla M, Constantinou M and Price S. Relationship between physical activity and type of smoking behavior among adolescents and young adults in Cyprus. Nicotine & Tobacco Research 2009;11(8):969–76. Available from: http://ntr.oxfordjournals.org/content/11/8/969.long

7. Nelson M and Gordon-Larsen P. Physical activity and sedentary behavior patterns are associated with selected adolescent health risk behaviors. Pediatrics 2006;117:1281-90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16585325

8. Rodriguez D and Audrain-McGovern J. Team sport participation and smoking: analysis with general growth mixture modeling. Journal of Pediatric Psychology 2004;29:299-308. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15148352

9. Rodriguez D and Audrain-McGovern J. Physical activity, global physical self-concept, and adolescent smoking. Annals of Behavioral medicine 2005;30:251-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16336076

10. Kirkcaldy B, Shephard R and Siefen R. The relationship between physical activity and self-image and problem behaviour among adolescents. Social Psychiatry and Psychiatric Epidemiology 2002;37:544-50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12395145

11. Verkooijen K, Nielsen G and Kremers S. The association between leisure time physical activity and smoking in adolescence: an examination of potential mediating and moderating factors. International Journal of Behavioral Medicine 2008;15(2):157–63. Available from: http://www.informaworld.com/smpp/content~content=a793249177~db=all~jumptype=rss

12. Hafstad A, Aaro L, Engeland A, Anderson A, Langmark F and Stray-Pedersen B. Provocative appeals in anti-smoking mass media campaigns targeting adolescents - the accumulated effect of multiple exposures. Health Education Research 1997;12:227-36. Available from: http://her.oxfordjournals.org/cgi/reprint/12/2/227.pdf

13. Goldman L and Glantz S. Evaluation of antismoking advertising campaigns. Journal of the American Medical Association 1998;279:772-7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9508154