Obese teenage girls are more than twice as likely as other girls to develop high-level nicotine addiction as young adults, according to a new study. Nearly 20 percent of American adolescents currently are obese, the authors note.

Smoking is just one of the problematic behaviors that appeal to some teens, along with delinquency, drug use, alcohol use and early or unprotected sexual activity. Some of the risk factors that could lead teens to engage in these behaviors include low self-esteem, depression and poor academic performance. Obese teenage girls in the study were more likely to report each of these risk factors.

‘As we address the issue of obesity, it is important to prevent poor medical outcomes, but we must also recognize the risk for these psychosocial outcomes and support and counsel teens appropriately,