Teens Who Work Are More Likely to Smoke

In recent years, public health interventions to reduce teen smoking have begun to show positive results. However, none of these interventions specifically target working teens, despite research showing that the amount of time teens work is associated with higher rates of substance use. Furthermore, compared with other social domains of teen activity (such as family, neighborhoods, school, and peer groups), work has not been thoroughly investigated as a risk factor for teen smoking, especially among urban youth.

A study led by RAND Health researcher Rajeev Ramchand^[1] examined the links between working and smoking among a group of urban teenagers. The researchers used data from a longitudinal dataset that tracked a cohort of 798 teens, predominantly African-Americans, in Baltimore, Maryland, schools all the way from 1st grade through the end of high school. The researchers focused on whether working in and around the 10th grade was associated with increased smoking among teens. They assessed three research questions: (1) whether, among smokers, 10th graders who worked started smoking at younger ages than nonworkers; (2) whether 10th graders who worked were more likely to smoke at the present time relative to nonworkers; and (3) whether teens who started to work between 10th and 11th grades were more likely to start smoking than those who did not start working.

The study found a strong link between working and smoking among these 10th-grade teens. Even after adjusting for other factors that influence teen smoking behavior, the analysis found a clear association between the amount of time worked and current tobacco use.

The study also found that

• among teen smokers, those who worked for more than 10 hours a week tended to start smoking at younger ages than those who did not work or worked less than 10 hours a week.
• among teens who had not yet used tobacco, those who started to work between grades 10 and 11 and those who worked over both years were at least three times more likely to begin smoking than teens who did not begin to work in this period.

The study showed that working very likely contributes to the smoking behaviors of teens. It also confirmed that the relationship between teen work and smoking previously demonstrated in affluent suburban areas also holds true in a less affluent urban area. The researchers theorize that young workers may resort to smoking for several reasons:

• Teens may use cigarettes as a way to take a break from job duties, particularly if they are exposed to older workers who are accustomed to cigarette breaks.
• Teens' earnings enable them to buy cigarettes more readily.
• Teens may be seeking relief from the stress of balancing work and school responsibilities.

If further research confirms the link between teen smoking and work, policymakers should focus on the workplace as a promising venue for smoking prevention programs and antismoking policies.

Notes

• [1] The research was conducted when Ramchand and his coauthors were with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.