Youth with type 2 diabetes (T2D) may be at risk of developing comorbid
complications, including hypertension, hyperlipidemia, and cancer, at
an early age.1,2 The progression of complications could be exacerbated
by the duration of diabetes and the obesity that contributed to the initial diagnosis.
Engaging in health risk behaviors such as smoking cigarettes and drinking
alcohol may further jeopardize the health of these youth. Early initiation of
smoking and drinking in youth, even in some cases of “just trying,” has been
linked to later nicotine/alcohol use disorders and other health conditions.3-8
Published reports of smoking and alcohol use among youth with T2D are
rare.9 Knowledge of the correlates of these health risk behaviors is limited to predominantly
physically healthy youth and youth with type 1 diabetes (T1D). Demographic
variables, for instance, age, sex, race/ethnicity, and socioeconomic
status (SES), have been related to youth health risk behaviors.9-12 Among psychosocial
variables, lower grades, depressive symptomatology, stressful life events,
and environmental factors are associated with youth substance use.10-13 Biological
correlates of substance use risk behaviors are increased body mass index
(BMI) in youth with T1D14 and physically healthy youth15,16 and compromised