Teenage girls who think they are overweight are twice as likely to smoke than those who are comfortable with their bodies, a new study shows.

Also, girls who had used weight control measures — those who had exercised, skipped meals, taken diet pills, vomited after eating — were more likely to smoke than girls who had not, according to the study published in the Canadian Journal of Public Health. "Body image can drive smoking behaviour," said lead author Anne-Luise Winter, a research co-ordinator at the Institute for Clinical Evaluative Studies in Toronto. "There's a perception among teenage girls that smoking is a good method of weight control." Toronto psychiatrist Dr. Devanshu Desai said he was amazed that adolescent girls who felt they were fat were 50 per cent more likely to smoke than girls who felt their weight was healthy or who believed they were too thin. Researchers at the Ontario Tobacco Research Unit, Canadian Institute for Health Information and the Centre for Addiction and Mental Health also participated in the study. It is based on the responses of about 2,000 girls and boys to the 1997 version of the Ontario Student Drug Use Survey. The survey questions Ontario students in Grades 7, 9, 11 and 13 about their use of illicit drugs, tobacco products and alcohol. The study found that teenage boys who felt they were overweight — and there were about half as many of them as there were girls — were not more likely to smoke than boys who were satisfied with their weight. However, boys who admitted to having skipped meals to control their weight were more likely to smoke than boys who didn't skip meals. Merryl Bear, director of the National Eating Disorder Information Centre, said teens were more concerned about the here and now — fitting in with the right crowd, looking good in a prom dress — than about long-term ramificiations of smoking such as the risk of developing lung cancer or emphysema. Winter added that smoking cessation programs need to examine healthy body images instead of focusing on long-term health. Health officials need to start targeting anti-smoking campaigns at girls before they reach puberty, she said. Girls often gain weight as their bodies adapt to puberty, which coinicides with the age when they are likely experimenting with smoking. "So we really have to catch them early and we can't really afford to wait till they're in high school ... (when) they're veterans of smoking and (a) variety of weight control behaviours." Cheryl Moyer, director of cancer control programs for the Canadian Cancer Society, said the study underscores the need to take a multi-faceted approach to smoking cessation messages directed at young girls. "The message can't just be that smoking can kill you. It has to address why girls are drawn to start smoking in the first place."

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