Asthma-specific predictors of smoking onset in adolescents with asthma: a longitudinal study.

OBJECTIVE Despite even occasional smoking being more risky for adolescents with asthma, the smoking rate in this vulnerable population remains high. This is the first longitudinal study investigating asthma-specific predictors of smoking initiation. METHODS A three-wave longitudinal survey study (22 months) among 257 adolescents with asthma was conducted. The effects of asthma-specific factors [symptom severity, medication adherence, coping, attitude towards asthma, and quality of life (QOL)] on smoking onset were tested with logistic regression models. RESULTS Poorer self-reported adherence and the maladaptive coping strategy of hiding asthma predicted smoking onset. Poorer QOL predicted smoking in boys only. CONCLUSIONS Our findings underscore the importance of recognizing and addressing adherence problems during adolescence as low adherence is a risk factor for smoking initiation. Moreover, psychosocial factors, such as coping and QOL for boys, were associated with smoking initiation. This highlights the importance of attending to the psychosocial needs of youth with asthma.