Television viewing and smoking volume in adolescent smokers: a cross-sectional study

Background. Previous research has shown a relationship between television viewing and smoking initiation. The relationship between television viewing and the amount of cigarettes consumed by adolescent smokers per time unit (day, week, month…) has not yet been studied. Methods. A cross-sectional sample of children by means of self-reports administered by research assistants in schools was obtained. Participants were 421 smokers in a random sample of 4th year students in 15 secondary schools in Flanders, Belgium. Main outcome measures were quantifiable, closed survey questions about smoking volume, whether or not parents and friends smoked, frequency of going out and average weekly TV viewing volume. Results. Television viewing was a significant predictor of smoking volume. Smokers who watch more TV smoke more. The relationship was curvilinear (quadratic). The relationship becomes stronger (curves upward) for higher levels of viewing. Those who watch 5 or more hours a day smoke between 60 and 147 cigarettes more per week than those who watch 1 h or less. Conclusions. Television viewing is significantly related to smoking volume. The content of television may glamorize smoking. Children may learn to associate smoking with viewing regardless of content. It is also possible that heavier smoking leads to more viewing or that a third variable influences both smoking volume and viewing. Regardless of the causal direction of the relationship television viewing appears to be an indicator or predictor of smoking volume. The curvilinear nature of the relationship deserves further attention.