Smoking Friends Research Articles

Prevalence and Determinants of Cigarette Smoking among the College Students of Kathmandu Valley

Objective: To estimate the prevalence of smoking among the college students and to identify the factors associated with smoking. Material & Methods: This is a cross sectional study carried out on 304 college students in Kathmandu valley using purposive sampling during the months of December 2009 to January 2010. The self administrated questionnaire was adopted from Global Youth Tobacco Survey 2007 (GYTS) and data were collected after the verbal consent taken. The statistical analysis was done using descriptive statistics, univariate and binary logistic regression to measure prevalence of smoking and to identify the association between dependent and independent variables. Results: We found 7 in 10 students were currently smokers. Among currently smokers, 78% were established smokers. The mean age of smoking onset was 14.15 years (SD=2.62). The mean number of cigarettes smoked per day was 5.03(SD=3.72) and average daily expenditure was Rs. 15.18 (SD=7.87). About 90% students tried to quit smoking and 17% non smokers were susceptibility smokers. The following factors: sex (adjusted odds ratio(aor)=3.88,95% CI= 2.12;7.11), living with or without family members (aor=1.79,95% CI=1.01;3.17), father occupation (aor=1.85,95% CI=1.04;3.30), and friend's smoking habits (aor=4.60,95% CI =1.92;11.0) were associated with cigarette smoking. Conclusion: There is the need of effective intervention programs to control cigarette smoking among college students. Key Words: Cigarette smoking; College students; Prevalence of smoking; Risk factors DOI: 10.3126/ajms.v1i2.3279Asian Journal of Medical Sciences 1 (2010) 53-58

Adolescent psychological and social predictors of young adult smoking acquisition and cessation: A 10-year longitudinal study.

A 10-year follow-up study to test the extent to which theory-based adolescent psychological and social factors directly predict and moderate the prediction of young adult smoking acquisition and cessation. A prospective community-based sample. A total of 2,970 adolescents participated in the large Washington State Hutchinson Smoking Prevention Project (HSPP) longitudinal cohort. As predictors, psychological factors (i.e., parentnoncompliance, friendcompliance, rebelliousness, achievement motivation, and thrill seeking) and social environmental factors (i.e., parent's and friend's smoking) were measured when adolescents were 17-18 years old. As main outcome measures, smoking acquisition and cessation were assessed both at ages 18 and 28. Psychological and social factors predicted 3% to 7% probability (p < .05) of smoking acquisition and a nonsignificant to 24% probability (p < .05) of smoking continuation (not quitting) in young adulthood. Both friendcompliance and rebelliousness were more powerful predictors of young adult-smoking continuation than of smoking acquisition. First evidence that parent noncompliance, friend compliance, and a lack of achievement motivation predict smoking acquisition and (with the exception of parent noncompliance) smoking continuation in young adulthood. Including these psychological factors in future interventions designed to promote young adult smoking cessation may be useful.

The Changing Role of Self-Efficacy in Adolescent Smoking Initiation

Refusal self-efficacy is assumed to be linked to adolescent smoking. The aim of the present study was to examine the changing role of self-efficacy in adolescent smoking over time while controlling for parental, sibling, and friends' smoking. This study used data from five annual waves of the "Family and Health" project. A total of 428 adolescents (mean age = 13.3 years; standard deviation = .48) and their parents participated at baseline. Only never smokers at baseline (n = 272) were included to measure smoking initiation. First, the effects of baseline self-efficacy, parental, sibling, and friends' smoking on adolescent smoking initiation at measurement five were examined. Second, with latent growth curves analyses, individual growth curve parameters of adolescent smoking, self-efficacy, parental, sibling, and friends' smoking were calculated. Subsequently, these growth parameters were used to predict growth of adolescent smoking. Findings showed that baseline self-efficacy, parental and friends' smoking did not predict adolescent smoking at wave five, but baseline sibling smoking did. However, growth curve parameters showed that a decrease in self-efficacy, an increase in proportion of smoking friends, and an increase in sibling smoking over time were related to an increase in adolescent smoking. Initial levels of sibling and friends' smoking moderated the link between self-efficacy and adolescent smoking over time. A decrease in self-efficacy over time, rather than baseline self-efficacy, is associated with smoking initiation in adolescence. Findings emphasize the need for more fine-grained analyses when looking at self-efficacy or other individual characteristics that might fluctuate over time.

Transitions between the stages of smoking in Iranian adolescents

ObjectiveThis study examined the prevalence of smoking, the rates of transitions, and predictors of transition through the three stages of smoking. MethodsA total of 1785 high school students in Tabriz (northwest of Iran) were assessed at 2 time points with a 12-month interval in 2005 and 2006, regarding changes in smoking stages. The predictor variables were measured when the students were in the 10th grade. Logistic regression was employed to predict the different smoking stages at grade 11. ResultsThe results showed that 14.3% (95% confidence interval, 12.3%–16.4%) and 2.8% (2.0%–4.0%) of the never smokers became experimenters and regular smokers, respectively, whereas 16.5% (12.4%–21.7%) of the experimenters became regular smokers. Among never smokers, participation in groups with at least one smoker (odds ratio, 1.24 (95% confidence interval, 1.05–1.47)), having smoker friends (1.85 (1.21–2.83)), and a positive attitude toward smoking (1.22 (1.02–1.46)) predicted smoking experience. Among the experimenters, those who had general risk behaviors (2.56 (1.12–5.87)) and participated in groups with at least one smoker (2.58 (1.26–5.31)) significantly progressed to becoming a regular smoker at the follow-up. ConclusionPrevention of smoking in adolescence should begin by focusing on the predictors of transition through smoking stages, especially participating in smoker groups.

Adolescent romantic relationships and change in smoking status

Although smoking rates have decreased, smoking among adolescents continues to be a problem. Previous research has shown the importance of peer influences on adolescent smoking behavior but has mostly neglected the impact of adolescent romantic relationships. This study examines the influence of romantic relationships with smokers and non-smokers on smoking initiation and cessation over a one-year period using data from the National Longitudinal Study of Adolescent Health (Add Health). For initial non-smokers, we examined whether the total length of time in romantic relationships with smokers and non-smokers at Wave I, as well as amount of exposure to smoking through romantic partners, predicted smoking initiation at Wave II. Among initial regular smokers, we examined whether these same relationship characteristics predicted smoking cessation at Wave II. These analyses were conducted separately for respondents in any type of romantic relationship, as well as just those respondents in close romantic relationships. Results indicated that, for close romantic relationships, cessation was more likely among smokers with more time in relationships with non-smoking partners. Greater exposure to smoking through romantic partners at Wave I significantly decreased the likelihood of cessation among initial smokers and increased the likelihood of initiation among initial non-smokers. For all relationships, greater exposure to smoking through romantic partners at Wave I significantly reduced the likelihood of cessation. These associations held when controlling for best friend smoking, as well as demographic factors and school-level smoking, suggesting that peer-based smoking programs aimed at adolescents should incorporate a focus on romantic relationships.

Predicting adolescent perceptions of the risks and benefits of cigarette smoking: A longitudinal investigation.

To evaluate developmental changes, personal smoking experiences, and vicarious smoking experiences as predictors of adolescents' perceptions of the risks and benefits of cigarette smoking over time, and to identify new and effective targets for youth smoking prevention programs. There were 395 adolescents surveyed every 6 months for two school years, from the beginning of 9th grade to the end of 10th grade. Time, participant smoking, friend smoking, parental smoking, and sex were evaluated as predictors of smoking-related short-term risk perceptions, long-term risk perceptions, and benefits perceptions using multilevel modeling techniques. Perceptions of benefits did not change over time. Perceptions of risk decreased with time, but not after sex and parental smoking were included in the model. Adolescents with personal smoking experience reported decreasing perceptions of risk and increasing perceptions of benefits over time. Adolescents with more than 6 friends who smoked also reported increasing perceptions of benefits over time. Changes in risk perceptions may not purely be the result of developmental processes, but may also be influenced by personal and vicarious experience with smoking. Findings highlight the importance of identifying and targeting modifiable factors that may influence perceptions.

Disentangling two underlying processes in the initial phase of substance use: Onset and frequency of use in adolescent smoking

PurposeMost studies on adolescent smoking focus either on the probability of smoking onset or frequency of smoking. We assume the existence of two different qualitatively distinct processes in smoking acquisition. Therefore our objective was to test a two-part latent growth model, which assumes that psychosocial variables associated with the probability of smoking onset are different from, or differently related to variables associated with frequency of smoking given smoking onset. MethodsThe predictive associations of blocks of variables of (1) intrapersonal factors, (2) cognitions, (3) role models, and (4) family variables, on both smoking onset, and frequency of smoking given smoking onset, were tested in a nationwide sample of Dutch adolescents by using a two-part model. SummarySmoking onset was instigated by a variety of factors, while similar and other factors predicted frequency of smoking given smoking onset itself. Self-esteem, attitudes, and proportion of friends smoking, were identified as factors that affected both absolute smoking and frequency of smoking. Overall conclusionsThis study illustrates that it makes sense to differentiate between smoking onset and frequency of smoking and that few factors are active in both processes.

Evaluating depressive symptom interactions on adolescent smoking prevention program mediators: a mediated moderation analysis.

Smoking prevention interventions have been shown to be effective in reducing smoking prevalence in the United States. Further work is needed to address smoking in China, where over one third of the world's current smokers reside. China, with more than 60% of the male population being smokers, also presents a unique opportunity to test cognitive processes involved in depression, social influences, and smoking. Adolescents at-risk for developing depression may process social information differently from low-risk counterparts. The Wuhan Smoking Prevention Trial was a school-based longitudinal randomized controlled trial aimed at preventing initiation and escalation of adolescent smoking behaviors. Thousand three hundred and ninety-one male seventh-grade students were assessed with a 200-item paper-and-pencil baseline survey, and it was readministered 1 year later following program implementation. Friend prevalence estimates were significantly higher among 30-day smokers and among those at highest risk for depression symptoms. The program appeared to be successful in changing the perception of friend smoking prevalence only among adolescents with a comorbidity of high scores of depression symptoms and who have experimented previously with smoking. This Program x Comorbidity interaction on perceived friend smoking prevalence was significant in predicting 30-day smoking 1 year after program implementation. This study provides evidence that those adolescents with high levels of depressive symptoms may be more sensitive to social influences associated with smoking prevalence. Individual Disposition x Social Environmental Influences may be important when developing future effective prevention programming.

Higher prevalence rates of smoking in rural than urban areas among school-going adolescents in the Lusaka Province, Zambia

Objectives: The objective of the study was to compare prevalence rates of smoking in schoolgoing adolescents among urban, peri-urban, and rural districts. Design: Secondary analysis of the Zambia Global Youth Tobacco Survey (GTYS) data of 2007. Main outcome measure: Tobacco smoking status. Results: Totals of 2378 adolescents in Lusaka urban, 1756 in Kafue per-urban, and 1386 in Chongwe/Luangwa rural districts were enrolled into the study. Smoking rates were 10.5% in urban, 11.1% in peri-urban, and 13.5% in rural districts. After adjusting for age, sex, grade, parental and best friend smoking status, and knowing that smoking is harmful to health, compared to adolescents in Lusaka urban district, adolescents in Chongwe/Luangwa rural districts were 17% (AOR=1.17, 95%CI [1.10, 1.23]) more likely to smoke cigarettes. No significant difference in smoking rates was observed between adolescents in urban and peri-urban districts. Conclusions: The prevalence rate of smoking among adolescents was higher in rural than urban district. Antismoking interventions should be more targeted to adolescents in rural than urban areas.

Willingness of cancer patients to help family members to quit smoking

The impact of social support on successful smoking cessation has been well documented. However, little is known about whether personal experience with cancer may motivate cancer survivors to support smoking cessation among their family members and friends. As a first step in this line of research, we sought to explore interest in playing a supportive role for smoking cessation as well as correlates of such interest among cancer survivors. Cancer survivors undergoing radiation therapy (N=211) completed a 77-item pencil-paper questionnaire. A section of the survey assessed interest in helping a smoker quit and characteristics of the smoking social network member. Respondents provided information on their smoking status, medical status, and psychosocial and behavioral factors related to cigarette smoking. Over half of the respondents 114 (54%) reported having someone close to them (family member or friend) smoking cigarettes who they thought should quit. Of these respondents (44 females, 70 males) 78% (89/114) reported they were definitely or probably interested in helping a smoker quit. Nearly all respondents wanted to help a family member (typically an adult child). Results suggest the potential feasibility of engaging cancer survivors to help family members quit smoking. Research is needed to determine the optimal methods and timing for engaging the cancer patient to maximize positive effects and minimize potential harms.

Evaluation of California's in-school tobacco use prevention education (TUPE) activities using a nested school-longitudinal design, 2003–2004 and 2005–2006

BackgroundCurrent legislative language requires the California Department of Public Health, California Tobacco Control Program, to evaluate the effectiveness of the school-based Tobacco Use Prevention Education (TUPE) programme in California every...

Friendship networks and trajectories of adolescent tobacco use

This article examines how friendship networks in adolescence are linked to tobacco use trajectories through a combination of analytic techniques that traditionally are located in separate literatures: social network analysis and developmental trajectory analysis. Using six years of longitudinal data from the National Longitudinal Study of Adolescent Health, we identify a set of six unique developmental trajectories of smoking (never smokers, steady lows, delayed increasers, early increasers, decreasers, and steady highs). Individuals' locations in their friendship networks were then linked to their trajectory group membership. Adolescents with a greater number of smoking friends were more likely to belong to the higher use trajectories. Beyond this exposure to smoking peers, individuals who at baseline were either members of a smoking group or liaisons to a smoking group were more likely than members of a nonsmoking group to belong to the higher use trajectories. Liaisons to a smoking group were particularly likely to belong to the delayed increaser trajectory group. Trajectory group membership for adolescents who belonged to a nonsmoking group did not significantly differ from those who were isolates or liaisons to a nonsmoking group. The study suggests features of an individual's social network have long-lasting associations with smoking behaviors.

Concordance of Adolescent Reports of Friend Alcohol Use, Smoking, and Deviant Behavior as Predicted by Quality of Relationship and Demographic Variables

The strongest predictor of adolescent alcohol use is affiliation with friends who drink, use other drugs, or engage in deviant behavior. Most studies measure this variable using adolescent perceptions of friend problem behavior, but some research suggests these perceptions may be inaccurate. The current study's objective was to determine the concordance between adolescent perceptions of their friend's drinking, smoking, and deviant behavior and the friend's self-report. Relationship characteristics and demographic variables were explored as predictors of report concordance. Participants (targets) were 232 adolescents ages 13 or 15 (53% girls) from Wave 9 of the Tween to Teen Project. At least one reciprocally endorsed friend participated for 59% of target adolescents (n = 232/390). Targets completed computer-assisted interviews. Friends completed telephone interviews. The relations between target perceptions of friend and friend self-reports of drinking and smoking were statistically significant (p < .001), but concordance was driven largely by agreement regarding the absence of behavior. Although 22% of friends drank and 8.6% smoked, fewer than 60% of targets perceived these behaviors. Deviant behavior reports correlated moderately (r = .45), with 51% of adolescents underreporting friend deviance. There were few predictors of report concordance. Adolescents and their friends generally provided concordant reports of one another's drinking and smoking behaviors, but most agreement concerned the absence of behavior; most targets provided underreports of their friend's engagement in deviant behaviors. These findings suggest that adolescent perceptions of friends' problem behavior do not exaggerate the involvement of their friends in these behaviors.

Similarities and Differences between Smoking and Non-smoking Ten-year-old Children in Primary Schools

For the majority of smokers, smoking is related to other forms of risk behaviour, especially poorer eating habits. The primary preventive educational programme "No smoking is a norm" focuses on children of younger school age (under 10 yrs), enables comparison and statistical evaluation of whether there are any differences (and which) between ten-year-olds with various smoking experiences, with special attention paid to their exposure to the influence of smokers, and their eating habits. Analysis of data gained from a questionnaire compared groups of boys and girls, smokers and non-smokers, and children from families with no smokers, occasional smokers, and frequent smokers. Statistical significance of the differences was tested in the EPI INFO programme by means of the chi2 test. From 1,082 children, almost one quarter (22.9%) have already tried smoking, boys more frequently (25%) than girls (19%) (p < 0.05); and almost 7% smoked repeatedly. The household is the most frequently stated environment for accessing cigarettes in children: 51% of children are given cigarettes by their parents, siblings, grandparents or other relatives, another almost 17% take cigarettes themselves from unprotected stock. From 246 children who have smoked, more than one third were offered cigarettes by their friends, and some (4%) even bought them. Children with smoking experience more often come from smokers' families and more often have smoking siblings and friends who offer them cigarettes. Children claimed to have consumed alcoholic drinks over the past month, repeatedly smoking more often than those with one attempt (aprox. 81% vs 58%) and never smokers (32%). Smokers also more frequently ate salty snacks such as crisps, sausages, and fast foods. The circumstance of whether there are smokers in the child's household or not significantly influenced children's opinions on the smoking of men/boys and women/girls (fewer critics and more admirers in smokers' families), selection of friends, availability of cigarettes, and smoking behaviour of the children. The examination of a cohort of ten-year-olds in a semi-longitudinal study confirmed the growing trend of experimenting with smoking. Strong relations to smoking behaviour in families were identified--such that influence a more tolerant approach to parents' smoking, selection of smoking or non-smoking friends, more frequent consumption of alcohol and salty snacks.

Determinants of smoking initiation among women in five European countries: a cross-sectional survey

BackgroundThe rate of smoking and lung cancer among women is rising in Europe. The primary aim of this study was to determine why women begin smoking in five different European countries at different stages of the tobacco epidemic and to determine if smoking is associated with certain characteristics and/or beliefs about smoking.MethodsA cross-sectional telephone survey on knowledge and beliefs about tobacco was conducted as part of the Women in Europe Against Lung Cancer and Smoking (WELAS) Project. A total of 5 000 adult women from France, Ireland, Italy, Czech Republic, and Sweden were interviewed, with 1 000 from each participating country. All participants were asked questions about demographics, knowledge and beliefs about smoking, and their tobacco use background. Current and former smokers also were asked questions about smoking initiation. Basic statistics on the cross-sectional data was reported with chi-squared and ANOVA p-values. Logistic regression was used to analyze ever versus never smokers. Linear regression analyses were used to analyze age of smoking initiation.ResultsBeing older, being divorced, having friends/family who smoke, and having parents who smoke were all significantly associated with ever smoking, though the strength of the associations varied by country. The most frequently reported reason for initiation smoking was friend smoking, with 62.3% of ever smokers reporting friends as one of the reasons why they began smoking. Mean age of smoking initiation was 18.2 years and over 80% of participants started smoking by the age of 20. The highest levels of young initiators were in Sweden with 29.3% of women initiating smoking at age 14-15 and 12.0% initiating smoking younger than age 14. The lowest level of young initiators was in the Czech Republic with 13.7% of women initiating smoking at age 14-15 and 1.4% of women initiating smoking younger than age 14. Women who started smoking because their friends smoked or to look 'cool' were more likely to start smoking at a younger age. Women who started smoking to manage stress or to feel less depressed were more likely to start smoking at an older age.ConclusionsIn all five participating countries, friends were the primary factor influencing ever smoking, especially among younger women. The majority of participants began smoking in adolescence and the average reported age of smoking initiation was youngest in Sweden and oldest in the Czech Republic.

Eating habits, physical activity, smoking and alcohol consumption in adolescents attending school in the province of Buenos Aires

Knowledge on dietary habits, tobacco and alcohol consumption in adolescents is crucial to plan early preventive programs. The objective was to assess the eating habits, physical activity and tobacco and alcohol consumption in adolescents of Buenos Aires, in order to get information on cardiovascular risk factors. Cross-sectional observational study in adolescents aged 11-16 years of 12 urban and rural, public and private schools of the province of Buenos Aires. An anonymous survey was carried out including demographical data, eating habits, physical activity, smoking and alcohol consumption. 1230 adolescents were surveyed, 46% of rural zones. Of them, 42.5% restrained food intake to control weight; 92% performed physical activity at least 1 h a week; 29.3% were smokers and 38.4% drank alcoholic beverages. Females restrained more food intake (46.3% vs. 37.7%; p=0.003) and were heavier smokers (32.6% vs. 25.2%; p=0.005). Alcohol consumption and smoking were associated (OR 8.27; p<0.001). Having a smoker friend increased almost 4 times the chance of smoking. Alcohol consumption by the best friend (OR 10.0; p<0.001), father o brother also increased chance in the adolescent. Adolescents of rural zones performed less physical activity (89.6% vs. 94.2%; p=0.003) and smoked more cigarettes (32.1% vs. 26.8%; p=0.04). 42% restrained food intake to control weight, and almost all performed physical activity. Rates of smoking and alcohol consumption were 29.3% and 38.4%, and were strongly associated. Smoking was more common in females and in rural zones, and more associated to alcohol and a smoker friend.

Association between Family Structure, Parental Smoking, Friends Who Smoke, and Smoking Behavior in Adolescents with Asthma

Recent investigations show that the smoking prevalence among asthmatic adolescents is higher than among healthy adolescents, and the causes that lead these asthmatic adolescents to smoke are unclear. We investigated the association between family structure, parental smoking, smoking friends, and smoking in asthmatic adolescents (n = 6,487). After adjusting for sex and age, logistic regression analyses showed that nonintact family structure, parental smoking, and smoking friends are associated with smoking in adolescents with and without asthma. Asthmatic adolescents who reside in the household of a nonintact family have a 1.90 times greater risk of smoking compared with those who live with both biological parents. It is important that parents who have children with asthma be made aware that the presence of smokers in the home and adolescent fraternization with smoking friends not only favor the worsening of asthma, but also induce the habit of smoking.

Predictors of transition in different stages of smoking: a longitudinal study.

We investigated longitudinally the prevalence of smoking according to three stages of smoking (never smoking, experimenting the smoking, and regular smoking), the rates of transition from one stage to another one, and determinant predictors of transition through these stages of smoking. Of all 10(th) grade students in Tabriz, 1785 students were randomly selected and assessed twice, with a 12-month interval, with respect to the changes of stage. The predictor variables were measured when the students were in the 10(th) grade. Logistic regression and principal component analysis were used to analysis data at grade 11. Of 1785 students, 14.3% (CI 95%: 12.3-16.4) and 2.8% (CI 95%: 2.0-4.0) of the never smokers became experimenters and regular smokers, respectively and 16.5% (CI 95%: 12.4-21.7) of the experimenters became regular smokers. Among never smokers, participating in smoker groups (OR=1.24), having smoker friends (OR=1.85) and a positive attitude towards smoking (OR=1.22) predicted experimentation; and participating in smokers groups (OR=1.35) and a lower socioeconomic class (OR=0.36) predicted regular smoking. Among experimenters, students having general high risk behaviors (OR=2.56) and participating in smoker groups (OR=2.58) were distinguished as those who progressed to regular smoking in follow-up. Programs aimed at smoking prevention and intervention should incorporate plans which focus on predictors of transition through smoking stages, and targeting participation in smoker groups.

Prevalence and Predictors of Environmental Tobacco Smoke Exposure among Adolescents in Cambodia.

Objective:To estimate the prevalence and predictors of environmental tobacco smoke (ETS) exposure among nonsmoking adolescents in Cambodia.Materials and Methods:Analysis of data from the Global Youth Tobacco Survey (GYTS) conducted in 2003 in Cambodia. Data were analysed to obtain the prevalence of ETS exposure at home and elsewhere by age and gender. Logistic regression analysis was conducted to assess the association between ETS and gender, age, smoking status of parents and friends.Results:67.1% (64.0, 70.0) males and 67.4% (64.2, 70.5) females reported being exposed to ETS either at home or elsewhere. Adolescents who had one or both smoking parents had a more than three times the odds of ETS exposure at home (OR = 3.71; 95% CI (3.02, 4.57)). Those who had smoking friends were more likely to be exposed to ETS both at home and outside home (OR = 1.74; 95% CI (1.36, 2.24)). The overall proportion of adolescents exposed to ETS outside home was higher than those exposed at home (P < 0.001), suggesting that exposure in public areas was the main form of ETS among adolescents in Cambodia.Conclusions:Exposure to ETS is high among adolescent in Cambodia, which indicates an urgent need for specific measures, policies and regulations to protect nonsmoker Cambodian adolescents both within and outside home.

Determinants of Exposure to Environmental Tobacco Smoke (ETS) among Non Smoking Adolescents (Aged 11-17 Years Old) in Greece: Results from the 2004-2005 GYTS Study

The aim of the study is to investigate the determinants of exposure to ETS among Greek adolescents aged 11–17 years old. The GYTS questionnaire was completed by 5,179 adolescents. About 3 in 4 responders (76.8%) were exposed to ETS at home, and 38.5% were exposed to ETS outside of the home. Gender, age group, parental and close friends smoking status were significant determinants of adolescent’s exposure to ETS. The results of the study could be valuable for the implementation of public health initiatives in Greece aiming to reduce the burden of adolescent’s exposure to passive smoking.