Smoking and health in substance-abusing adolescents: a two-year follow-up

To examine the prevalence and persistence of cigarette smoking along with health outcomes in a clinical sample of substance-abusing adolescents.

This is a 2-year prospective case series study.

Subjects were recruited from two private, hospital-based inpatient adolescent substance abuse treatment facilities.

A consecutive sample of 166 adolescents, ages 12 to 18, meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed, revised) criteria for substance abuse participated in the present investigation. Of the original sample, 154 and 144 were interviewed 12 and 24 months after discharge, respectively.

Information regarding cigarette smoking, drug and alcohol use, and respiratory problems was based on self-report by the adolescents and was corroborated by parent interview. The prevalence of smoking in this sample of teens immediately before treatment was 85%. Sixty-one percent of the sample smoked 1/2 pack or more/day and 75% were daily smokers. Although prevalence (74 and 77%) and average daily cigarette consumption (11.1 and 10.7 cigarettes daily) decreased at 12 and 24 months after treatment, rates remained very high. Teens reporting posttreatment respiratory problems smoked more, and heavier smokers at the time of treatment were more likely to report respiratory problems at follow-up than lighter smokers.

Substance-abusing teens smoke at rates far and above those of the general adolescent population. Further, these teens appear at increased risk for negative health consequences regardless of posttreatment drug and alcohol use. These findings highlight the importance of preventing adolescent cigarette smoking by substance abuse treatment programs.