Ussery, Emily Neusel (2015). Investigating the relation between physical activity and cigarette smoking: A longitudinal analysis from the United States and a pilot test of a structured afterschool program in Uruguay.
The overarching goals of this project were to 1) extend the existing evidence on the longitudinal relation between physical activity and cigarette smoking, and 2) test an intervention model that uses physical activity promotion as a strategy to reduce smoking risk among adolescents. To achieve the first goal, nationally representative data from Add Health were analyzed using autoregressive cross-lagged models to assess the bi-directional, longitudinal relations between overall physical activity, sports participation and cigarette smoking from adolescence (12-19 years old) to early adulthood (25-32 years old). I found that adolescent smokers engaged in significantly less physical activity and were less likely to play sports one year later compared to non-smokers. Adolescent smokers were also significantly less likely to play sports in young adulthood compared to non-smokers. Total physical activity was not a significant predictor of future cigarette use at any time point. However, adolescents who participated in sports were significantly more likely to smoke one year later compared to non-sports participants.^ To achieve the second goal, a structured afterschool program was pilot tested and evaluated in two Uruguayan secondary schools using a quasi-experimental, pre-post design with a waitlist control group. The primary behavioral objectives of the program were to increase physical activity engagement and reduce smoking risk. The results of the effectiveness study were inconclusive, with no significant intervention effects observed. The study’s small sample size (n=77) limited its ability to detect significant between-group differences. The process evaluation revealed that the program was feasible to implement in the target schools and demonstrated high fidelity of implementation and satisfaction among participants. Average student attendance was relatively low (61%), indicating that incentives should be considered to maintain participation over time. Recommendations for improving the content and delivery of the program were generated from these data.^ Interventions that successfully prevent cigarette use among adolescents may also have the potential to prevent future declines in physical activity. Afterschool programs hold great potential for improving adolescent health outcomes in the context of Uruguayan public schools. Their ability to impact physical activity levels and smoking behavior in this setting should be evaluated on a larger scale.
Ussery, Emily Neusel
University of Texas