Predictors Of Tobacco Use Research Articles

Access to pocket money and low educational performance predict tobacco use among adolescent boys in Kerala, India

Background Tobacco use is increasing among adolescents. We conducted this study to find prevalence and correlates of tobacco use among adolescent boys in Trivandrum city, Kerala. Methods Using a two-stage cluster sampling technique, 1323 boys (12–19 years) were selected from 14 schools. Information on tobacco use, academic performance, pocket money, and other variables was collected using a questionnaire. Multivariate analyses were done to find associations between current use of tobacco and other variables. Results Prevalence of current tobacco use was 11.3% (95% CI 9.6–13.0). Current tobacco use was 2.9 times higher among older boys compared to younger boys (OR 2.9, CI 1.6–5.3), 2 times higher among boys whose fathers used tobacco (OR 2.0, CI 1.3–3.1), 2.9 times higher among boys whose friends used tobacco (OR 2.9, CI 1.6–5.1) compared to their counterparts, 3 times higher among boys securing poor (<40% marks) grade compared to those securing excellent (>80% marks) grade (OR 3.0, CI 1.4–6.6), and 4 times higher among those who received pocket money compared to those who did not (OR 4.0, CI 2.2–7.4). Conclusions Health programs to quit tobacco are suggested in schools with special emphasis on poor performers, those receiving pocket money, and those whose fathers and friends use tobacco.

Associations between visual and auditory hallucinations in children and adolescents, and tobacco use in adulthood.

The cross-sectional association between tobacco use and psychotic features has been well established. If psychotic features precede tobacco use, then tobacco may be used to self-medicate psychotic symptoms. The aim was to assess if psychotic features in adolescents constitute a risk factor for later tobacco use. A random target sample of 2,600 children aged 4-16 years from the Dutch general population was followed up across a 14-year interval. At different ages (childhood, adolescence, young adulthood), information about visual and auditory hallucinations was obtained using standardized questionnaires for parents and subjects themselves. At outcome (ages 18-30), tobacco use was assessed. Auditory hallucinations, but not visual hallucinations, in early and late adolescence, assessed via parents and adolescents themselves, predicted tobacco use in adulthood. The present study confirmed that auditory psychotic features in adolescence are associated with tobacco use in adulthood. Tobacco may be used to self-medicate auditory, but not visual, hallucinations.

Longitudinal predictors of continued tobacco use among patients diagnosed with cancer.

Even though continued smoking by cancer patients adversely affects survival and quality of life, about one third of patients who smoked prior to their diagnosis continue to smoke after their diagnosis. The implementation of smoking cessation treatments for cancer patients has been slowed by the lack of data on correlates of tobacco use in this population. Thus, this longitudinal study assessed demographic, medical, addiction, and psychological predictors of tobacco use among 74 head, neck, and lung cancer patients. Multivariable binary logistic regression analyses, with outcome categorized as smoker or nonsmoker, indicated that the likelihood that patients would be a smoker was associated with lower levels of perceived risk and a higher level of quitting cons. Multivariable nominal logistic regression, with outcome classified as continuous smoker, continuous quitter, relapser, or follow-up quitter, indicated that: (a). patients categorized as continuous smokers reported significantly lower quitting self-efficacy than follow-up quitters and continuous quitters, (b). relapsers reported a significantly lower level of quitting self-efficacy than either follow-up quitters or continuous quitters, and (c). continuous smokers exhibited a significantly lower level of risk perceptions than continuous abstainers. These findings can be useful for the development and evaluation of treatments to promote smoking cessation among cancer patients.

Tobacco use patterns and attitudes among teens being seen for routine primary care.

To describe the tobacco-related attitudes, behaviors, and needs of smoking and nonsmoking teens being seen for routine pediatric care and to identify predictors of tobacco use. Cross-sectional survey of adolescent primary care patients who completed self-administered questionnaires in medical office waiting rooms while waiting for routine care visits. A group-practice HMO in the Pacific Northwest. A sample of 2526 teenagers, ages 14 to 17, who consented to receive health promotion interventions as a part of a randomized trial in seven pediatric and family practice offices. A 38-item questionnaire assessed tobacco use history, attitudes, quit attempts, and stage of acquisition or cessation along with gender, age, race/ethnicity, body mass index, educational plans, frequency of exercise, attempts to lose weight, and depressed mood. Sixty-seven percent of teens approached (2526 of 3747) consented to complete a questionnaire and receive tobacco- or diet-related interventions as a part of their medical visit. About 23% of teen patients reported smoking at least one cigarette in the last month, although only 14% described themselves as current "smokers." Most current smokers (84%) smoked at least 20 days in the last month. Logistic regression predictors of smoking included older age, Native American ethnicity, lower educational aspirations, lower body mass index, smoking among half or more friends, smokers at home, and a positive depression screen. Among ever-regular smokers, most were in the action (28%), preparation (21%), or contemplation (22%) readiness to quit smoking stages, and 77% of current smokers had made one or more serious quit attempts in the last year. Most teens in these medical facilities consented to receive tobacco and diet interventions, and most self-described current smokers were contemplating or preparing to quit. Medical visits provide attractive opportunities for tobacco intervention, but messages should be tailored based on the patient's tobacco status and stage of acquisition or cessation.

Prevalence and predictors of tobacco use among Asian Americans in the Delaware Valley region.

This study examined tobacco use rates and potential predictors of use among Asian Americans residing in the Delaware Valley region. A cross-sectional survey design was used. The sample consisted of 1174 Chinese, Koreans, Vietnamese, and Cambodians. Findings indicated that the mean age at initiation of tobacco use was 18.3 years. Among the respondents, 40.2% had a history of tobacco use, and 29.6% were current users. Men were more likely than women to smoke. There were significant differences between never smokers, current smokers, and ex-smokers in sex, ethnicity, educational attainment, and marital and employment status. The findings suggest that tobacco use is still a serious public health problem among Asian Americans, especially men.

Adolescent alcohol and tobacco use: onset, persistence and trajectories of use across two samples.

We examined the alcohol-tobacco relationship using two prospective, ethnically diverse samples. Trajectories of alcohol and tobacco use are portrayed overall and by sex and ethnicity. Using prospective analyses, we examine directional influences between alcohol and tobacco use, and we characterize initiation versus persistence of drinking and smoking as a function of use of the other substance. Data were from the National Longitudinal Study of Adolescent Health (AddHealth) and the Adolescent Health Risk Study (AHRS). Follow-up intervals for AddHealth and AHRS were 1 and 5 years, respectively. AddHealth respondents (n = 4831) were on average 14.8 years old (48% male, 23% black, 61% white) and AHRS respondents (n = 1814) were on average 16.7 years old (47% male, 44% black, 49% white). Two alcohol consumption variables and two smoking variables were used: drinking frequency and heavy drinking frequency, and regular (current) smoking and daily number of cigarettes. Alcohol and tobacco use exhibited monotonic increases over adolescence and young adulthood. Men and white respondents reported more use than women and black respondents. Alcohol and tobacco were moderately associated at both times. Analyses revealed that prior alcohol use predicted tobacco use more strongly than the converse. Initiation of smoking was a function of prior drinking; to a lesser extent, initiation of drinking was a function of prior smoking. Persistence of smoking was a function of prior drinking and persistence of drinking was a function of prior smoking. Provisional support exists for the claim that alcohol use predicts tobacco use more strongly than the converse. For both drinking and smoking, onset and persistence are predicted by prior use of the other substance, and these associations were robust across sex and ethnicity.

Determinants of Youth Tobacco Use in West Virginia: A Comparison of Smoking and Smokeless Tobacco Use

Purpose: To identify and compare the determinants of different types of tobacco use among rural youths and discuss the implication of these differences for youth tobacco use cessation. Methods: Ninth grade participants (n = 883) were 95% white, between 13 and 19 years old with a mean age of 14.6 years. Students were classified into four exclusive groups: non–tobacco use, smoking only, smokeless tobacco (ST) use only, and conjoint smoking and ST use. The influences of 14 specific risk factors on tobacco use were investigated for each group using separate multiple logistic regression analyses. Results: Among participants, 20% were smokers only, 6% were ST users only, and 10% were conjoint users. Students who had more friends (odds ratio [OR] =] 2.75) and siblings (OR = 1.96) who smoke, family problems (OR = 1.70), and favorable attitudes toward tobacco use (OR = 1.12) were more likely to smoke than were other students. Among students who used only ST, gender was a primary determinant (95% were male). Excluding gender, sibling ST use (OR = 4.28), friends' ST use (OR = 1.71), and favorable attitudes (OR = 1.11) were the most significant risk factors. Male students were also more likely to use both cigarettes and ST (OR = 8.62). In addition, among students who used both tobacco products, siblings' and friends' ST use were significant (OR = 3.09 and 2.13, respectively), as well as family problems (OR = 2.41) and attitude (OR = 1.15). Unlike smokers only or ST users only, lack of knowledge about tobacco was a significant determinant among conjoint users (OR = 1.39). Conclusions: Findings revealed that 7 of 14 factors were significant predictors of tobacco use. Some factors predicted smoking only, ST only, and conjoint use; however, the pattern of predictors varied for these three categories. Implications for these findings as they relate to tobacco use interventions are discussed.

Predicting tobacco use to age 18: a synthesis of longitudinal research.

To synthesize the available evidence on predictors of adolescent tobacco use. Meta-analysis was conducted on the empirical findings of published and unpublished studies of the natural development of tobacco use that used prospective multi-wave panel designs. The research literature that was analyzed included 106 reports on 64 studies representing data from a total of 145,750 study subjects; 1261 prospective and cross-sectional effect sizes were computed from these studies and used in the meta-analysis. Product-moment correlations were analyzed examining the strength of the relationships between predictor variables and current and later tobacco use. In addition, findings reported as 2 x 2 contingency tables were analyzed to examine conditional relations and estimate the positive predicted values (PPV) and sensitivity indices for the predictive relationships. The mean correlations for 17 different categories of predictors and current or later tobacco use ranged from -0.08 for race to 0.52 for prior tobacco use and were significant and positive except for race. Analysis of the conditional relationships showed that PPV for tobacco use ranged from a mean of 0.18 for predictors related to personal skills and knowledge (i.e. 82% of those 'at risk' on this construct did not use tobacco) to 0.70 for use of tobacco or other substances by parents. Current use of tobacco and other substances by youths, and use among their peers, showed stronger relationships with later tobacco use than other examined predictors. Combined with other predictive risk factors, these relationships are sufficiently strong to be useful in identifying for intervention those children most likely to become habitual tobacco users.

Psychosocial correlates of adolescent drug-taking behaviour

This research was designed to test the extent to which personality, environmental factors, and conventional behaviours predict drug-taking among a sample of Australian high school students. Respondents (n=199; 101 females and 98 males) indicated the extent of their alcohol, tobacco and marijuana use. Correlational analyses showed broad support for the view that personality and environmental factors as well as conventional behaviours are related to drug use. Regression analyses showed that the significant predictors of drug use vary according to the drug in question. In particular, the predictors of mood-enhancing drugs (alcohol and marijuana) appear distinctive from the predictors of tobacco use. The results are discussed in the context of previous research in this area.

Prevalence and predictors of tobacco use among Lumbee Indian women in Robeson County, North Carolina.

Tobacco use among some Native American tribes is high compared to the overall US population. Little is known, however, about tobacco use among Native Americans in North Carolina, a state with strong economic ties to tobacco. To assess the epidemiology of tobacco use in this population, data from the North Carolina Native American Cervical Cancer Project was reviewed. Nine hundred eighty-two Lumbee Indian women in Robeson County provided general demographic information as well as information on cancer risk knowledge, attitudes and behaviors during the 5-year study. Women were selected from the community using a random sample of 5200 persons from the tribal roll of approximately 40,000 persons. 20.6% of women were current smokeless tobacco users, while 23.7% were current smokers. Demographic and social support predictors were unique for the different types of tobacco use. Cigarette smoking was associated with younger age, higher education, excellent or good self-reported health, having a recent physical exam, separated or divorced marital status, low church participation, and alcohol consumption. Conversely, use of smokeless tobacco was associated with older age, lower education level, fair or poor self-reported health, widowed marital status, and having a high number of friends. These data show a high prevalence of smokeless tobacco use among women in this population, and a contrast in the predictors of tobacco use by source. Intervention programs for tobacco use cessation should be sensitive to these differences.

Peer and parental influences on adolescent tobacco use.

Longitudinal models of the development of adolescent smoking and smokeless tobacco (ST) use were tested for a sample of 643 adolescents, age 14 to 17. The sample was assessed at three time points. Smoking, smokeless tobacco, and other problem behaviors formed a single problem behavior factor. Structural equation modeling indicated that inadequate parental monitoring and association with deviant peers at Time 2 predicted tobacco use at Time 3. When parental and peer smoking at Time 2 were added to the model, each accounted for significant variance in predicting Time 3 smoking, but inadequate parental monitoring and association with deviant peers still accounted for some of the variance in Time 3 smoking. In predicting boys' smokeless tobacco use, monitoring at Time 2 predicted smokeless tobacco use, but only when parental approval of ST use was not included. Fathers approval of ST use at Time 2 predicted ST use at Time 3, while maternal disapproval predicted its use.