Adolescent Smoking Behavior Research Articles

Peer and Parental Influences on Adolescent Smoking

The purpose of this study was to determine the relationship between peer and parental factors and smoking behavior of adolescents in urban cities and to investigate whether there are gender differences. A stratified and random cluster sampling design was used to obtain a cross-sectional sample of high school students in two urban cities. The sample consisted of 512 Korean adolescents (256 boys and 256 girls) aged 15 to 18 (mean age 16.7+/-.58). Self-reported questionnaire consisted of adolescent smoking behavior, peer smoking and alcohol use, parental smoking and alcohol use, father-mother-peer relationships and perceived social support from peers and parents. Multiple logistic regression analysis was used to examine the hypothesized model. The findings showed that peer and parental factors accounted for 30.3% of the variance in adolescent smoking and peer smoking was most strongly associated with adolescent smoking behavior (OR=10.18). In addition, peer smoking (OR=4.71), peer alcohol use (OR=4.21), and peer relationships (OR=1.03) were significantly associated with boys' smoking behavior. In girls, peer smoking (OR=26.50) and parent smoking (OR=5.48) were significantly associated with smoking behavior. Consistent with previous findings, peer smoking is a significant factor on adolescent smoking. Specifically, boys would be more influenced from peers than girls. Therefore, smoking prevention programs for adolescents might be focused on the social context such as, resisting to peer pressure and enhancing the self-efficacy to control.

Parental Smoking and Smoking Behavior in Asthmatic and Nonasthmatic Adolescents

Background. Smoking may have serious consequences for asthmatics. Nevertheless, studies have shown that smoking behavior among asthmatics is similar to or even higher than that of nonasthmatics. Since the relationship between parental smoking and child smoking is well established, this study examined whether the association between parental and child smoking behavior is similar for asthmatic and nonasthmatic adolescents. The impact of parental smoking history was also explored. Methodology. A cross-sectional sample of 10,087 Dutch adolescents was used to assess the prevalence of asthma and smoking behavior. Moreover, respondents had to report whether one of their parents currently smoked, had stopped, or had never smoked. In case a parent was a former smoker, the respondent had to report his or her own age at the moment that the parent stopped smoking. Results. Logistic regression analyses showed that, compared with nonasthmatic adolescents, asthmatic adolescents were more likely to have smoking parents. Furthermore, similar associations were found between parental smoking and adolescent smoking among asthmatic and nonasthmatic adolescents. The time at which maternal smoking ceased was associated with a decreased likelihood for ever smoking for both asthmatic and nonasthmatic adolescents. Conclusions. Asthmatic adolescents need to become more aware of the health risks of smoking. Therefore, tailor-made antismoking campaigns are needed at schools to reduce misconceptions among asthmatic adolescents about the risks of smoking. In addition, a personal intervention approach aimed particularly at smoking parents of an asthmatic child, may make them aware of the consequences for their offspring and help them to stop smoking.

Impact of cigarette advertising on smoking behaviour in Spanish adolescents as measured using recognition of billboard advertising

Cross-sectional studies provide empirical support for associations between advertising and adolescent smoking. The aim of this study was to investigate the relationship between Spanish adolescent smoking behaviour and prior awareness of cigarette advertisements on billboards, using a prospective design. 3,664 Spanish children aged 13 and 14 years filled in self-completion questionnaires at baseline, and 6, 12, and 18 months later (cohort study). Slides of three advertisements were projected at baseline. A multivariate logistic regression analysis was carried out to detect possible association between number of identified tobacco advertisements brands at baseline and smoking status along time, controlling ASE Model smoking determinants, smoking prevention interventions, age, gender and socio-economic status. The more advertisements identified at baseline, the greater was the risk of being a smoker (p<0.0001). Final percentages of smokers were 15.8%, 16.3%, 19.3%, and 32.6%, respectively, for zero, one, two and three advertisements recognized. When confounders were controlled, the probability of being a smoker increased with the number of advertisements identified [OR 1.26 (95% CI: 1.09-1.46) after 6 months, OR 1.18 (95% CI: 1.03-1.35) after 12 months and 1.15 (95% CI: 1.02-1.30)] after 18 months. It is possible the association would have been even greater if there had not been a differential loss of smokers from the sample. Increased awareness of cigarette advertising was associated with a higher smoking incidence and an increased risk of Spanish children becoming smokers. It is, therefore, imperative that cigarette advertising should be banned as a matter of urgency.

State Tobacco Excise Taxes and Adolescent Smoking Behaviors in the United States

The objective of the study described in this article was to examine the association between state cigarette excise taxes and smoking behaviors among youth in the United States. A survey was nationally mailed to adolescents in the Growing Up Today Study, an ongoing cohort of offspring of participants in the Nurses' Health Study II. A volunteer sample of 10,981 adolescent boy and girl participated in the Growing Up Today Study, who were 12 to 18 years old in 1999. Logistic regression was used to examine the relationship between state cigarette excise taxes (in quartiles) and experimentation (ever smoked) and established smoking (smoked at least 100 cigarettes in a lifetime). State tax levels in 1999 ranged from 2.5 to 100 cents. In a model that adjusted for age, gender, peer smoking, parental smoking, state clustering, state poverty level, and possession of tobacco promotional items, higher tax rates were associated with decreased odds of experimentation (test for trend p < 0.01). The highest quartile of tax (60-100 cents) was significantly associated with lower odds of experimentation (OR = 0.79; 95% CI, 0.64-0.98) and appeared protective against established smoking (OR = 0.80; 95% CI, 0.49-1.29). This study provides recent evidence that higher state cigarette excise taxes are associated with decreased experimental smoking among adolescent boys and girls. Higher state cigarette taxes may also be associated with lower odds of established smoking in this age group, although the association appears to be attenuated by peer and parental smoking. These results support the inclusion of tobacco taxes in state tobacco control programs.

Predictors of smoking development in a population-based sample of adolescents: A prospective study

Purpose To study the development of smoking behavior in adolescents using a longitudinal, multivariate design. Methods Adolescents (n = 14,133, age range 12 to 18 years) took part in the longitudinal Add Health study (two waves, separated by 1 year, 56% smokers and 44% nonsmokers at Wave 1). Eight risk factor domains were established at Wave 1 (daily activities, psychological health, personality, school situation, family functioning, rough living, religion, and neighborhood status), which were further separated into subdomains by factor analysis. Subdomains were used to predict risk at Wave 2 of smoking initiation, progression, or failure to discontinue, using logistic regression analysis. Analyses were performed for boys and girls separately and results corrected for age, race, urbanicity, and socioeconomic status. Results Use/abuse of other substances by self and peers influenced most stages of smoking, whereas trouble in school was associated with initiation and progression of smoking. Poor family relations predicted initiation of experimental smoking for girls, whereas low involvement in active pastimes predicted failure to discontinue experimental smoking. For boys, low religiosity predicted progression to regular smoking and failure to quit regular smoking, whereas delinquency also reduced success of regular smoking discontinuation. Conclusions These findings may direct efforts for prevention and intervention of adolescent smoking behavior and may also provide guidance for future studies.

Predictors of smoking development in a population-based sample of adolescents: A prospective study

Purpose To study the development of smoking behavior in adolescents using a longitudinal, multivariate design. Methods Adolescents (n = 14,133, age range 12 to 18 years) took part in the longitudinal Add Health study (two waves, separated by 1 year, 56% smokers and 44% nonsmokers at Wave 1). Eight risk factor domains were established at Wave 1 (daily activities, psychological health, personality, school situation, family functioning, rough living, religion, and neighborhood status), which were further separated into subdomains by factor analysis. Subdomains were used to predict risk at Wave 2 of smoking initiation, progression, or failure to discontinue, using logistic regression analysis. Analyses were performed for boys and girls separately and results corrected for age, race, urbanicity, and socioeconomic status. Results Use/abuse of other substances by self and peers influenced most stages of smoking, whereas trouble in school was associated with initiation and progression of smoking. Poor family relations predicted initiation of experimental smoking for girls, whereas low involvement in active pastimes predicted failure to discontinue experimental smoking. For boys, low religiosity predicted progression to regular smoking and failure to quit regular smoking, whereas delinquency also reduced success of regular smoking discontinuation. Conclusions These findings may direct efforts for prevention and intervention of adolescent smoking behavior and may also provide guidance for future studies.

Adolescent smoking cessation.

Approximately 25% of high school students report current cigarette use, 85% of adolescents think about quitting, and around 80% of current smokers made a quit attempt in the past year. This review analyzes recent additions to the adolescent smoking cessation literature from June 1, 2003 to May 1, 2003. Adolescent attitudes toward smoking cessation are largely affected by their smoking history. Youth cessation interventions largely focus on behavioral interventions, and research concerning these interventions has yielded mixed results. Little data exist about the effectiveness of nicotine replacement therapy in adolescents, but there is growing evidence that youth use this pharmacotherapy. Recent research has explored the use of nicotine replacement therapy as an adjunct for enhanced smoking reduction in adults, and future research may focus on this tactic for youth as well. Internet cessation adjuncts and telephone quit lines also serve as future frontiers for adolescent smoking cessation research. Information concerning adolescent smoking behaviors, effective interventions, and smoking cessation therapy continue to grow and provide data that improve our understanding of adolescent smoking cessation. Although we cannot directly extrapolate the adult findings to this population, adult cessation research continues to inform future adolescent cessation efforts.

Influence and selection processes in friendships and adolescent smoking behaviour: the role of parental smoking

Concerning the role of parental smoking on development of adolescent smoking, most studies have exclusively focused on the direct effects of parents’ smoking on youths’ smoking. However, parental smoking may also play an indirect role by affecting youths’ susceptibility to peer influences and by affecting friendship selection. Data were from a three-wave short-term longitudinal study of 1595 adolescents. Findings showed high similarities in smoking between reciprocal friends. Additionally, friend's smoking and parents’ smoking were moderately related to adolescent smoking onset, but parents’ smoking did not moderate the prospective association between best friend's smoking and adolescent smoking. Finally, parental smoking seemed to affect the selection of new friends: In particular, adolescents with smoking parents were most likely to become affiliated with smoking friends. There was no evidence that parental smoking affected termination of friendships.

Time spent with friends who smoke and quit attempts among teen smokers

Social interactions, as well as pharmacological effects, can reinforce smoking behavior in adolescents and pose challenges to smoking cessation. We hypothesized that time spent with friends who smoke would be inversely related to both the number and duration of previous quit attempts for teens receiving smoking cessation treatment. Demographic- and smoking-related data were collected from 98 adolescent smokers enrolled in an accruing smoking cessation study (68% female, 70% Caucasian, mean age 15.3 years). Among smokers who had at least one quit attempt, time spent with friends who smoke was inversely associated with the number of prior quit attempts ( χ 2=9.55, P=.0085) but not with their duration, suggesting a potential relationship between an adolescent's affiliation with smoking peers, smoking identity, and fewer quit attempts.

Understanding smoking behaviour in children and adolescents.

Knowledge of what leads to long term tobacco use is the basis for interventions to help young people avoid this behaviour, as Patricia MacDonald explains

Understanding smoking behaviour in children and adolescents

Understanding smoking behaviour in children and adolescents

The Smoking Behaviors of Adolescents and Their Friends: Do Parents Matter?

Objective. This study examines relations among adolescent smoking, parental authoritativeness, parental disapproval of smoking, parental smoking, friends' self-reported smoking, and friends' reports of their parents' authoritativeness. Design. 317 adolescents (12-15 years of age) gave saliva samples and completed questionnaires concerning their own smoking behavior, aspects of their parents' parenting behaviors (used to construct a measure of authoritative parenting), their parents' smoking behaviors, and parental disapproval of smoking. Independent reports obtained from friends were used to calculate measures of friends' smoking and levels of friends' parents' authoritativeness. Results. Higher levels of authoritative parenting and parental disapproval of smoking along with lower levels of parental smoking were associated with a lower likelihood of smoking during adolescence. Friends' smoking was positively associated with adolescent smoking, and it mediated the association between parental smoking and target adolescents' smoking. Friends' parents' authoritativeness did not mediate the association between friends' smoking and adolescent smoking. Conclusions. Along with friends' smoking, parental authoritativeness and parental disapproval of smoking are important influences on adolescent smoking. Consideration of the conjoint influence of the family and the peer group, rather than either in isolation, improves understanding of adolescent smoking behavior.

Psychological constructs to predicting smoking behavior among Korean secondary school students

Background. Current research on cigarette smoking has largely been focused on identifying the relationship between psychological attributes and the onset or initiation of smoking behavior. Few data are available on the psychological predictors of smoking behavior among Korean adolescents. This study examined the prevalence of smoking behavior among Korean adolescents, revealed factors affecting their smoking behavior, and identified the relationship between smoking behavior and psychological variables. Methods. Four Korean-version questionnaires were used to assess adolescents' smoking behavior and their psychological attributes: Smoking Habit Scale, Multidimensional Health Locus of Scale, Self-efficacy Scale, and Self-esteem Scale. Frequency, Chi-square, ANOVA, correlation, and regression analyses were performed to analyze the data obtained in the study. Results. The results indicate that smoking problem in the Korean adolescents is a crucial factor that might adversely affect their overall health. Forty-three percent of adolescents responded that they had smoked a cigarette in their lifetime and 26% are current smokers. Male adolescents were more likely to smoke in their lifetime and have currently smoked a cigarette than females. The adolescents aged 17–18 years had smoked more cigarette than those in other age groups. Among the five psychological variables, IHLC and self-efficacy significantly differentiated adolescents at different smoking status. Furthermore, IHLC, self-esteem, and self-efficacy were significantly correlated with smoking behavior and those psychological constructs had a significant linear relation to account for smoking behavior. Conclusions. Psychological variables have a meaningful influence on smoking behavior of adolescents.

Lifetime parental smoking history and cessation and early adolescent smoking behavior

Background. Associations are examined between parental smoking and smoking onset by their children. Smoking parents are more likely to have children who start smoking in their teenage years; however, less is known about whether parental quitting is related to adolescent smoking. Methods. A cross-sectional national sample of 2,206 adolescents, ages 10–14 years, living in two-parent households were interviewed for the DEFACTO annual report on Dutch youth smoking behavior. Adolescent smokers reported that they have tried smoking, even one puff. Respondents indicated whether their parents were never, former, or current smokers, and provided, in the case a parent had quit, their age at that time. Results. Logistic regression analyses revealed that likelihood increased gradually: adolescents with both parents being current smokers were four times more likely to be a smoker compared to adolescents with parents who had never smoked. Additionally, within the group of adolescents whose parents quit smoking, the findings demonstrated that the earlier the parents stopped smoking in the life of their offspring, the less likely their children were to start smoking in adolescence. Conclusions. Parental smoking history is associated with smoking initiation in early adolescence. Parental cessation at an early age of their offspring reduces the likelihood of adolescent smoking initiation. Preventive efforts, therefore, should focus on the benefits of parental cessation as early as possible.

Effects of short‐term cosmetic versus long‐term health fear appeals in anti‐smoking advertisements on the smoking behaviour of adolescents

AbstractA field study exposed 235 high school students to anti‐smoking advertisements over a five‐month period to test the effectiveness of short‐term cosmetic versus long‐term health fear appeals in preventing or reducing smoking. The study was a longitudinal experiment with two experimental groups and a control group. Smoking behaviour was measured prior to message exposure on television, in magazines and on the internet, and at the end of the study period. The primary results were that average smoking declined for subjects exposed to either type of anti‐smoking fear appeal but not for the control group and short‐term cosmetic fear appeals were more effective for males but long‐term health fear appeals were more effective for females. Copyright © 2003 Henry Stewart Publications.

Beyond modeling: Parenting practices, parental smoking history, and adolescent cigarette smoking

This study explored parental beliefs and behaviors designed to convey an antismoking message across levels of self-reported parent and adolescent smoking behavior. Parental self-efficacy, beliefs about smoking, the family relationship, antismoking messages, reactions to smoking, and household smoking rules were explored. Participants were 345 6th, 8th, and 10th graders (50% female; 93% White) and their parents (86% mothers). Beliefs about smoking, parental efficacy, and rules varied across levels of both parental and adolescent smoking. Parents with a history of smoking and parents of adolescents who had tried smoking were less efficacious, held weaker antismoking beliefs, and less often reported household smoking rules. Overall, examining parental behavior across levels of both parent and youth smoking is important. Similarly, parental efficacy, not previously studied in relation to parenting about smoking, may be important to target in future interventions.

Parents' and friends' smoking status as predictors of smoking onset: findings from six European countries

This study assessed the relationship between the smoking behavior of adolescents and the smoking status of their parents and friends among adolescents from six European countries. A longitudinal study collected data from 15 705 adolescents on their own smoking status, and that of their parents, best friend and friends in general. Cross-sectional regression analysis showed that adolescent smoking was most strongly associated with friends' smoking and best friend's smoking, explaining 38% of the variance in the total sample. Longitudinal regression analysis, however, showed that the beta coefficients of the smoking status of the best friend and friends in general were comparable to that of parental smoking. Parental smoking behavior was found to be as predictive of smoking onset after 1 year as friends' smoking status.

Is restricting tobacco sales the answer to adolescent smoking?

Background Enforcement of legislation restricting retail access to tobacco is increasingly relied on to reduce adolescent smoking rates. In 1996, health authorities in the Northern Sydney Health Area began monitoring tobacco retailer compliance (PROOF program) with staged purchase attempts by adolescents below the legal age (18 years). Methods Repeat cross-sectional surveys before (1995) and after (2000) the introduction of PROOF monitored changes in adolescent smoking behaviour. Students aged 12 to 17 years from 11 Northern Sydney metropolitan public secondary schools were surveyed for self-reported smoking and tobacco purchasing behavior in 1995 ( n = 5,206) and 2000 ( n = 4,120). Results Between 1996 and 2000, 545 retailer compliance checks found 34% unlawfully sold cigarettes to minors and 28% of these repeated the offence. Nine prosecutions resulted. Modelling revealed a significant association between the intervention and never having smoked (adjusted OR = 1.16, 95% CI = 1.01–1.33) although there was no significant association with being a current smoker. The odds of being a smoker were greater for students from coeducational schools, with this effect being modified by gender. Conclusions There was no reduction in adolescent smoking with active enforcement of tobacco access laws despite an apparent increase in students who reported never to have smoked.

Smoking behavior among urban and rural Native American adolescents in California

Background Previous studies have documented a high prevalence of tobacco use among Native American adolescents. However, little is known about the smoking behavior of Native American adolescents who live in urban areas. This study used statewide data from California to examine the smoking behavior and related psychosocial risk factors among Native American adolescents living in urban and rural counties. Methods The Independent Evaluation of the California Tobacco Control Program conducted three population-based statewide surveys of 10th-grade California public school students in 1996, 1998, and 2000. Past-month smoking and psychosocial correlates were examined among 22,440 respondents, including 1060 Native Americans. Results Native Americans had a 32% excess risk of past-month smoking compared with other ethnic groups. Smoking prevalence did not differ between urban (27.7%) and rural (29.3%) Native Americans. Native Americans reported higher access to cigarettes and exposure to smoking peers than other groups. Those psychosocial variables explained some, but not all, of the excess risk of smoking among Native Americans. Conclusions Effective smoking prevention and cessation interventions are needed for Native American adolescents in urban and rural areas of California.

SMOKING PATTERNS AND CESSATION MOTIVATION AMONG KOREAN ADOLESCENTS

Objectives Although adolescent smoking is increasing, there is a concomitant lack of research on effective adolescent smoking cessation. The purpose of study is to describe smoking behaviors of adolescents and identify cessation motivations among smoking students. Methods We surveyed 2,695 adolescents at one middle school and two high schools in Yangcheon-Gu, Seoul, Korea during December 2002. We surveyed through the self-administrated questionnaire including the age at onset of smoking, reason for starting smoking, smoking patterns during the past 30 days, and cessation attempts and motivations. Results The students who reported having tried smoking were 861 (32.9%) and current smokers were 278 (10.3%). In regard to smoking experience, there was gender difference (boys 37.2% vs. girls 28.6%, P < 0.05). Many students (70.4%) began smoking at the age from thirteen to sixteen years and smoked fewer than 5 cigarettes per day. We found that many smokers (77.2%) had previously attempted smoking cessation. The important reasons for trying to quit smoking were that smoking makes health bad (62.0%) and persons around me (i.e., parents, brothers(s), sister(s), friends) recommend me to stop smoking (22.9%). The biggest obstacles to quitting cigarette smoking were the withdrawal symptom and significant others smoke. Conclusions There is a need for health education and specific strategies to help adolescents stop smoking.