"I did it my way"--an explorative study of the smoking cessation process among Danish youth.

OBJECTIVE: To explore the smoking cessation process of adolescents and their attitudes and beliefs towards smoking cessation and cessation interventions. METHOD: Focus group discussions and individual interviews during April-May 2004 with 26 persons aged 15-21 years who all initiated a quit attempt on 1 January 2004. RESULTS: The approach towards all stages of the youth smoking cessation process varied greatly among both successful and unsuccessful quitters. Apart from 'commitment' or the amount of energy put into a cessation attempt, there were no differences in the way successful and unsuccessful quitters approached the quit attempt. 'Smoking friends' and 'social support' were important for maintaining cessation. Further, participants had negative attitudes towards formalized smoking cessation interventions. CONCLUSION: There are many approaches to the smoking cessation process. Whether an attempt is successful depends more on individual conditions and the amount of commitment invested in the attempt than on the specific cessation strategy used. PRACTICE IMPLICATIONS: Future adolescent smoking cessation interventions should be flexible regarding both structure and content and should focus on the individual learning process, rather than adhering to rigid cessation strategies.

The Association between leisure time physical activity and smoking in adolescence: an examination of potential mediating and moderating factors.

BACKGROUND: Although physical activity has been associated negatively with smoking in adolescence, the association is not well understood. PURPOSE: This study examines the relationship between adolescents' leisure time physical activity and smoking behavior, while considering BMI, weight concern, sense of coherence, and physically active self-concept as potential mediating and moderating variables. METHOD: Data were obtained through a postal survey among 3,940 Danes aged 16 to 20. Bivariate and multivariate logistic regressions were performed to identify significant associations as well as mediating and moderating effects. RESULTS: In the bivariate model, leisure time physical activity was negatively associated with smoking; adolescents who were active at least one hour per week were up to half as likely to smoke as inactive adolescents. In the adjusted model, however, the association disappeared. Further analyses revealed that physically active self-concept acted both as a mediator and as a moderator of the studied relationship. CONCLUSION: The data suggest that participation in leisure time physical activity is indeed inversely associated with adolescent smoking, but only when physical activity is perceived as an important part of the self. Hence, interventions designed to promote physical activity among youth may also aim to boost physically active self-concepts.

Youth crowds and substance use: the impact of perceived group norm and multiple group identification.

The impact of group identity on adolescent tobacco, alcohol, and marijuana use was examined through a postal survey. The study included adolescents who identified with 1 subgroup (n = 1425) as well as adolescents who identified with 2 (n = 895) or 3 (n = 339) subgroups. The results showed that identification with the pop, skate/hip-hop, techno, and hippie subgroups was associated with higher risks of substance use, whereas identification with the sporty, quiet, computer nerd, and religious subgroups was associated with lower risks. Perceived group norm mediated the group identity-substance use relationship. Furthermore, identification with multiple groups with corresponding norm increased norm-consistent substance use, whereas identification with multiple groups with opposing norms reduced normative behavior. Implications for health promotion are discussed.

Smoking cross-culturally: risk perceptions among young adults in Denmark and the United States.

Research examining smokers' understanding of their smoking risk reveals that smokers acknowledge some risk but often deny or minimize personal risk. We examined risk perceptions of lung cancer among smokers and non-smokers in a smoking-lenient (Denmark) and a smoking-prohibitive (the United States) culture. Participants were 275 Danish students attending trade schools (mean age 22.6 years) and 297 US students attending community colleges in Florida (mean age 23.6 years). Results revealed cross-cultural differences suggesting that Danish smokers showed greater risk minimization than US smokers. In addition, in both countries the risk of a typical smoker was rated as lower by smokers than non-smokers, and smokers rated their personal risk as lower than they rated the risk of the typical smoker. Cross-cultural differences in moralization of smoking might be one explanation for these findings.

The association between high blood pressure, physical fitness, and body mass index in adolescents.

BACKGROUND: The aim of this study was to analyze the association of fitness and fatness with blood pressure (BP) and hypertension. This was a cross-sectional study of 13,557 boys and girls 15-20 years of age. Fitness was estimated from a shuttle run test, fatness from body mass index (BMI), and BP was measured sitting after 5 min of rest. Other lifestyle variables were self-reported. RESULTS: Boys had a higher systolic BP (SBP) than girls. A low physical fitness level and high BMI were independently associated with a high BP and risk of having hypertension in both girls and boys. Interaction was found between BMI and fitness. In a stratified analysis an odds ratio (OR) of 3.99 was found for hypertension in girls with a BMI > 25 kg m(-2) compared to lean girls if all had a low fitness level, and an OR of 2.14 for a high BMI in girls with a high fitness level. In boys, OR for high versus low BMI were 3.23 in the low fit and 2.34 and 2.50 in the middle and upper tertile of fitness, respectively. CONCLUSIONS: Fitness and BMI were independently associated to BP. BMI was a stronger predictor of hypertension in those with a low fitness level, especially in girls.