Intended for healthcare professionals


Mobile phone use has not replaced smoking in adolescence

BMJ 2003; 326 doi: (Published 18 January 2003) Cite this as: BMJ 2003;326:161
  1. Leena Koivusilta, researcher (leena.koivusilta{at},
  2. Tomi Lintonen, senior assistant professor,
  3. Arja Rimpelä, professor of community health
  1. Department of Social Policy, FIN-20014 University of Turku, Turku, Finland
  2. School of Public Health, FIN-33014 University of Tampere, Tampere, Finland

    EDITOR—Charlton and Bates hypothesised that the fall in smoking and the rise in ownership of mobile phones among adolescents in the late 1990s were related.1 Mobile phones were argued to be competition to cigarettes by competing for the spending money that is scarce in adolescence. We tested this hypothesis in Finnish adolescents.

    We collected cross sectional data in February 2001 from nationally representative samples of 14, 16, and 18 year old Finns by using a self administered structured mailed questionnaire (adolescent health and lifestyle survey). The samples comprised 9309 adolescents, and the response rate was 70% (6516). We used cumulative logistic regression models to study the associations between the dependent variable, smoking status (never tried or smoked once, smoked at least twice but not smoking daily, smoking daily), and the explanatory variables, mobile phone use (not at all, occasionally or daily for less than 1 hour, daily for at least 1 hour), the amount of weekly spending money (cut-off points: first and third distribution quarters by age and sex), and sex.

    Among the respondents, 57% (3518) had smoked at least twice, 24% (1507) smoked daily, and 91% (5582) used mobile phones. The proportion of smokers was positively associated with the amount mobile phones were used (figure).


    Smoking prevalence by mobile phone use among 14 to 18 year olds

    In the logistic regression analysis the univariate association between smoking and mobile phone use was positive, so that the amount of smoking increased in proportion to the use of mobile phones (P<0.001). Taking account of the amount of spending money did not change the association. In the multivariate model the cumulative odds ratio for increased smoking was 7.7 (95% confidence interval 6.1 to 9.9) in participants using a mobile phone at least 1 hour daily compared with those not using a mobile phone at all.

    Often adolescents both smoke and use mobile phones, and this association remains when the amount of weekly spending money is taken into account. A high proportion of Finnish adolescents use mobile phones, but their use is associated with health endangering lifestyles indicated by smoking. This association may not, however, apply to countries at different stages on the innovation diffusion curve2 or where parents do not help pay for their children's mobile phone costs as much as they do in Finland (T A Wilska, Nordic sociological conference, Reykjavik, August 2002). The symbolic role of mobile phones and smoking in modern adolescent cultures needs to be studied.3


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