Adolescence and later life disease burden: Quantifying the contribution of adolescent tobacco initiation from longitudinal cohorts

Citation

Viner, Russell M.; Hargreaves, Dougal S.; Motta, Janaina Vieira dos Santos; Horta, Bernardo; Mokdad, Ali H.; & Patton, George (2017). Adolescence and later life disease burden: Quantifying the contribution of adolescent tobacco initiation from longitudinal cohorts. Journal of Adolescent Health. vol. 61 (2) pp. 171-178

Abstract

Purpose Adolescence is a time of initiation of behaviors leading to noncommunicable diseases (NCDs). We use tobacco to illustrate a novel method for assessing the contribution of adolescence to later burden. Methods Data on initiation of regular smoking during adolescence (10–19 years) and current adult smoking were obtained from the 1958 British Birth Cohort, the U.S. National Longitudinal Study of Adolescent Health (Add Health), the Pelotas 1982 Birth Cohort, and the Victorian Adolescent Health Cohort Study. We estimated an “adolescent attributable fraction” (AAF) by calculating the proportion of persisting adult daily smoking initiated < age 20 years. We used findings to estimate AAFs for >155 countries using contemporary surveillance data. Results In the 1958 British Birth Cohort, 81.6% of daily smokers at age 50 years initiated < age 20 years, with a risk ratio of 6.1 for adult smoking related to adolescent initiation. The adjusted AAF was 69.1. Proportions of smokers initiating <20 years, risk ratio, and AAFs were 83.3%, 7.0%, and 70.4% for Add Health; 75.5%, 3.7%, and 50.2% in Victorian Adolescent Health Cohort Study; and 70.9%, 5.8%, and 56.9% in Pelotas males and 89.9%, 6.4%, and 75.9% in females. Initiation <16 years resulted in the highest AAFs. Estimated AAFs globally ranged from 35% in China to 76% in Argentina. Conclusions The contribution of adolescent smoking initiation to adult smoking burden is high, suggesting a need to formulate and implement effective actions to reduce smoking initiation in adolescents. Similar trends in other NCD risks suggest that adolescents will be central to future efforts to control NCDs.

URL

https://doi.org/10.1016/j.jadohealth.2017.02.011

Keyword(s)

Adolescent Attributable fraction Etiologic fraction Tobacco Noncommunicable disease

Reference Type

Journal Article

Journal Title

Journal of Adolescent Health

Author(s)

Viner, Russell M.
Hargreaves, Dougal S.
Motta, Janaina Vieira dos Santos
Horta, Bernardo
Mokdad, Ali H.
Patton, George

Year Published

2017

Volume Number

61

Issue Number

2

Pages

171-178

Edition

July 19, 2017

ISSN/ISBN

1054-139X

DOI

10.1016/j.jadohealth.2017.02.011

Reference ID

8222