Abstract
In adults, coffee, sugar-sweetened beverage (SSB) and high energy drink consumption have been related to increases in risky behaviour, including smoking. However, these associations are not well understood during adolescence. The purpose of this study was to examine the association between beverage consumption and smoking behaviour among Canadian adolescents. Using data from the COMPASS study (2016-2017; n = 46,957), four models were developed to investigate whether beverage consumption explained variability in smoking behaviour in adolescence (age = 15.7 ± 1.2 yrs); 1) smoking status; 2) e-cigarette use status; 3) days smoking cigarettes per month; and 4) days using an e-cigarette per month. Models were adjusted for demographic factors. Logistic (models 1 and 2) and ordinal logistic (models 3 and 4) were used for analysis. An association between the frequency of SSBs, coffee/tea or high energy drinks consumption and smoking behaviour was identified in all models. Greater beverage consumption was associated with being a current smoker (OR = 2.46 (2.02, 2.99)), former smoker, (OR = 2.50 (1.53, 4.08)), and currently using an e-cigarette (OR = 4.66 (3.40, 6.40)). Higher beverage consumption was also associated with more days smoking/using an e-cigarette per month (OR = 2.67 (1.92, 3.70) and 3.45 (2.32, 5.12), respectively). High energy drink consumption on 4 or 5 days of the school week was the best predictor of smoking behaviour in all models. Given the health consequences of smoking and e-cigarette use and their association with SSB, high energy drinks and coffee consumption, policy initiatives to prevent smoking initiation and limit access to these beverages needs ongoing attention and implementation.
Highlights
Tobacco use remains a leading risk factor contributing to the burden of disease in Canada (Alam et al, 2019)
Our study demonstrated a consistent and significant association between beverage consumption and smoking and e-cigarette behaviours within the COMPASS cohort
We found that e-cigarette use and cigarette smoking demonstrate similar associations across different types of caffeinated beverage consumption and the most robust association existed between high energy drink consumption and smoking behaviours
Summary
Tobacco use remains a leading risk factor contributing to the burden of disease in Canada (Alam et al, 2019). 15% of the Canadian population are considered cigarette smokers, including 10.6% of Canadian youth (aged 15–19) (Reid et al, 2019). 15% of Canadians have used an e-cigarette, with adolescents and young adults reporting the highest rate of e-cigarette use of any age category, with 23% of students in grades 7–12 having ever tried an e-cigarette (Reid et al, 2019). Since the introduction of e-cigarettes, the prevalence of their use has continued to rise in the youth population. This is concerning as e-cigarette use is a risk factor for subsequent cigarette smoking (Greenhill et al, 2016; Soneji et al, 2017). Continued attention to preventing smoking initiation during adolescence should be a public health priority
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