Factors associated with the onset of smoking and alcohol consumption: A cross-sectional study among Lebanese adolescents in schools

Objectives: This study aimed to evaluate factors and profiles associated with the earlier onset of cigarette/ waterpipe smoking and alcohol consumption among Lebanese adolescents in schools. Methods: A total of 4000 adolescents (mean age = 15.31 +/- 2.01 years) participated in this cross-sectional study. The standardized questionnaire was taken from the Health Behavior in School Children (HBSC) study in different countries (France, Belgium, and the USA) and adjusted to the Lebanese population. K-means clus-tering analysis was conducted to classify participants into three clusters according to their patterns (sur-rounded by smokers, surrounded by drinkers, and ease of talking to family members and friends) and Cox regression analyzes were conducted.Results: Participants were divided into three clusters. Cluster 1 (16.75% of participants) included adolescents with the lowest ease of talking to a family member or friend, with the latter smoking and drinking a lot (worst cluster). Cluster 2 (54.95%) included adolescents with moderate ease of talking to a family member and more to friends, surrounded by low-to-moderate smoking and alcohol consumption, particularly for a best friend (positive influence cluster). Finally, cluster 3 (28.30%) included adolescents with low ease of talk -ing to friends, moderate ease of talking to a family member, and low-to-moderate smoking and alcohol con-sumption (low influence cluster). The results of the Cox regressions (taking the age at onset of smoking cigarettes and waterpipes as the dependent variables) showed that older age at onset of cigarette and water -pipe smoking was significantly associated with female participants and those belonging to clusters 2 and 3 compared to cluster 1. Moreover, a younger age at first alcohol use and getting drunk was significantly asso-ciated with living outside Beirut, whereas female gender and belonging to clusters 2 or 3 compared to cluster 1 were significantly associated with older age at first alcohol use and getting drunk.Conclusion: This study identified risk factors (ease of talking as well as smoking and alcohol-drinking status of parents, siblings, and friends) and profiles related to early alcohol and cigarette/waterpipe use. These risk fac-tors and profiles could help implement prevention campaigns to reduce substance use and improve adoles-cent health.(c) 2022 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.

Automated summary

This study aimed to evaluate factors and profiles associated with the earlier onset of cigarette/waterpipe smoking and alcohol consumption among Lebanese adolescents in schools. The results revealed that the ease of talking, smoking and alcohol-drinking status of parents, siblings, and friends were all related to early alcohol and cigarette/waterpipe use among adolescents.