On the Rise: Use of Tobacco and Purging by Teens for Weight Control

From 1997 through 1999, researchers at Brigham and Women's Hospital expanded the Growing Up Today Study (GUTS), which they established in 1996 to study the relationship between diet, physical activity and weight gain as children grow through adolescence.

Originally funded by the National Institute of Diabetes and Digestive and Kidney Diseases, GUTS enrolled 16,600 9- to 14-year-old boys and girls. In 1996, the participants completed the first of four annual mail questionnaires.


  • With the Robert Wood Johnson Foundation (RWJF) funding, the researchers:

    • Added questions to the 1997, 1998 and 1999 questionnaires on the use of tobacco, alcohol and other drugs.
    • Conducted additional analyses.


  • The researchers published articles and/or abstracts in Pediatrics, the Journal of the American Academy of Child & Adolescent Psychiatry and the American Journal of Epidemiology which highlighted the following findings:

    • Some 9 percent of the boys and girls experimented with cigarettes. Experimentation was associated with daily exercise to lose weight among boys and monthly purging and daily dieting among girls.
    • Cigar use increased with age among boys and girls. Cigar users were much more likely than nonusers to have experimented with cigarettes, smokeless tobacco and alcohol. Cigar users reported more hours per week of physical activity than nonusers.
    • During one year, 4.3 percent of girls and 3.6 percent of boys started smoking, 5.3 percent of girls and 4.8 percent of boys started getting drunk and 2.4 percent of girls and 0.6 percent of boys started engaging in bulimic behaviors.
    • 12.5 percent of boys and 10.8 percent of girls reported smoking.