Youth Cigarette Research Articles

How Does Youth Cigarette Use Respond to Weak Economic Periods? Implications for the Current Economic Crisis

This paper examines whether youth cigarette use increases during weak economic periods (as do youth alcohol and drug use). The data come from the 1997 National Longitudinal Survey of Youth. With repeated measures over the 1997–2006 period, for almost 9,000 individuals, the samples include 30,000+ teenagers (15–19 years) and 30,000+ young adults (20–24 years). Logit models with state and year controls are estimated. The results indicate that teenagers and young adults increase cigarette use when the economy is weaker, implying that the current financial crisis has likely increased youth cigarette use relative to what it would have otherwise been.

Examining correlates of different cigarette access behaviours among Canadian youth: Data from the Canadian Youth Smoking Survey (2006)

Understanding factors associated with youth cigarette access behaviours can provide insight into the development of more effective means of preventing youth from accessing cigarettes. This cross-sectional study used self-reported data collected from 41,886 students in grades 9 to 12 who participated in the 2006–07 Youth Smoking Survey to examine the student- and school-level characteristics that differentiate youth smokers who usually access cigarettes from a social source versus buying their own from retailers. Multi-level regression analyses revealed significant between-school variability in the odds of a smoking student reporting that they usually buy their own cigarettes. Important student-level characteristics associated with how youth usually access their cigarettes included binge drinking and being asked for age or photo identification when purchasing cigarettes from a retailer. Future studies should further explore the school- and student-level characteristics associated with youth cigarette access behaviour.

Is youth smoking responsive to cigarette prices? Evidence from low- and middle-income countries

ObjectiveTo estimate the price elasticity of cigarette demand among youth in low- and middle-income countries (LMIC).DataThe Global Youth Tobacco Survey was used to obtain data on the smoking behaviour of...

Sources of Cigarettes Among Adolescent Smokers

Background: Few studies have described youth cigarette sources in terms of whether the cigarettes were free or purchased. Understanding the different ways youth obtain tobacco can guide development of interventions to more effectively reduce youth smoking. Purpose: To determine the propensity for youth to purchase cigarettes versus obtain cigarettes for free, and the factors associated with each obtainment method. Methods: Our sample included 812 youth ages 12-17 who reported ever smoking a whole cigarette. Our outcome was the source of the last cigarette smoked (purchased vs. free) and independent variables included demographics, smoking behaviors, and smoking status of parents/siblings/friends. We conducted logistic regression to assess relationships between outcome and independent variables. Results: Eighty-four percent of youth obtained their last cigarette for free and 16% purchased their last cigarette. Youth who smoked less and had less weekly spending money were more likely to have obtained their last cigarette for free. Discussion: Youth smokers appear to have a high propensity to obtain their cigarette for free, particularly those who smoke relatively infrequently. Translation to Health Education Practice: Interventions that target sources of free cigarettes have the potential to reduce the progression of youth smoking at a critical stage in its development.

A social contextual analysis of youth cigarette smoking development

We apply a social contextual perspective based on Bronfenbrenner's ecology of human development theory to understanding development of youth cigarette smoking. We examine the contributions of family, peer, school, and neighborhood contexts. Context attributes examined were derived from social learning and social control theories. Data are from 6,544 youth who participated in at least one of five waves of data collection between Spring 2002 and Spring 2004, 1,663 randomly selected parents who participated in one or more of three waves of data collection in the same time period; and the U.S. Census. Three-level hierarchical growth models were used to examine the contributions of time-varying measures of the four social contexts to development of smoking from age 11-17 years. Interactions between variables were examined within and between social contexts. Attributes of each social context made independent contributions to adolescent smoking development; there also were significant interactions between variables from different contexts indicating joint contextual effects. Attributes of the social bond moderated exposure to models of smoking within and between the family and peer contexts. Results suggest the value of a social contextual perspective in research on the etiology of youth smoking development as well as the utility of guidance by social learning and social control theories. While all contexts were implicated in adolescent smoking, the family and peer contexts were primarily implicated, with findings suggesting the need for consideration of interactive effects between social learning and social control variables within and between these contexts.

Mass Media Interventions to Reduce Youth Smoking Prevalence

Mass media interventions for reduction of youth cigarette smoking have been recommended based on a broad array of evidence, although few randomized community trials have been reported. Four matched pairs of independent media markets were identified; one member of each pair was randomized to receive the intervention. School surveys were conducted in all markets, in 2001 before (n=19,966) and in 2005 after (n=23,246) the interventions were completed. Grade 7-12 students from public schools in these eight medium-sized metropolitan areas participated in the summative evaluations; Grades 4-12 students were targeted to receive mass media interventions in four of these markets. Four simultaneous campaigns consisting of specially developed messages based on behavioral theory and targeted to defined age groups of racially and ethnically diverse young people were placed in popular TV, cable, and radio programming using purchased time for 4 years. Prevalence of youth smoking and psychosocial mediators of smoking. No significant impacts of these interventions on smoking behaviors or mediators were found for the overall samples. A positive effect was found for one mediator in subgroups. Among Hispanic participants a marginally favorable effect on smoking prevalence and significant effects on mediators were found. General awareness of smoking prevention TV messages was slightly higher over time in the intervention areas. Mass media interventions alone were unable to induce an incremental difference in youth smoking prevalence, probably because of a relatively strong tobacco control environment that included a substantial national smoking prevention media campaign.

A social contextual analysis of youth cigarette smoking development

A social contextual analysis of youth cigarette smoking development

Prevalence of youth cigarette smoking and selected social factors in 25 European countries: findings from the Global Youth Tobacco Survey

To present Global Youth Tobacco Survey (GYTS) data on the prevalence of cigarette smoking and selected social factors among students aged 13-15 years in 25 European countries. The GYTS is a school-based survey of students aged 13-15 years. The GYTS was conducted in 25 European countries (2002-2005) and produced representative data for each country. In 25 European countries studied, 22% of boys and 18% of girls smoked cigarettes. In 17 of 25 countries, current cigarette smoking did not differ between boys and girls. Exposure to secondhand smoke is very high throughout the 25 countries. Exposure to pro-tobacco indirect advertising (having tobacco company logos on promotional items and being given free cigarettes) is frequent throughout the countries. Intensified efforts to lessen harm caused by tobacco use among youth in 25 European countries included in this study are urgently needed. These countries need to develop and implement comprehensive tobacco control programs including public education campaigns, cessation programs, enforcement of existing measures, and related policy efforts. The WHO FCTC provides a useful framework for implementing such a comprehensive approach.

Tobacco control policy and adolescent cigarette smoking status in the United States.

Tobacco policies that limit the sale of cigarettes to minors and restrict smoking in public places are important strategies to deter youth from accessing and consuming cigarettes. We examined the relationship of youth cigarette smoking status to state-level youth access and clean indoor air laws, controlling for sociodemographic characteristics and cigarette price. Data were analyzed from the 2001 to 2002 U.S. Health Behavior in School-Aged Children survey, a cross-sectional survey conducted with a nationally representative sample of 13,339 students in the United States. Compared with students living in states with strict regulations, those living in states with no or minimal restrictions, particularly high school students, were more likely to be daily smokers. These effects were somewhat reduced when logistic regressions were adjusted for sociodemographic characteristics and cigarette price, suggesting that higher cigarette prices may discourage youth to access and consume cigarettes independent of other tobacco control measures. Strict tobacco control legislation could decrease the potential of youth experimenting with cigarettes or becoming daily smokers. The findings are consistent with the hypothesis that smoking policies, particularly clean indoor air provisions, reduce smoking prevalence among high school students.

Comparison of Research Designs for Two Controlled Trials of Mass Media Interventions

This paper compares two controlled trials of mass media interventions, factors influencing their designs, and design lessons learned from these experiences. Mass media evaluations based on a scientific research model are motivated by gaps in knowledge. The results of such research are intended to serve the needs of consensus development processes through which confident recommendations can be made for intervention strategies that should be more widely applied. For these purposes, the scientific research context emphasizes internal validity of evaluation design, such as controlled experiments. This paper describes two such trials, implemented at different times with differing social contexts for youth cigarette smoking, smoking prevention research evidence bases, and tobacco control environments. Common and unique features of the two trials are reviewed, and observations are noted about the conditions under which controlled trials of mass media interventions might be warranted.

Youth crowds and cigarette smoking: A prospective study

This study examined the prospective relationship between crowd affiliation and smoking behavior among a national sample of 16–22 year old Danes (N = 952). Self-reported data were collected by means of a postal questionnaire at baseline and at 18 months follow-up. The sample included participants, who at baseline reported to identify with a crowd with either a low-smoking norm (n = 705) or a high-smoking norm (n = 247). The results showed that participants, who at baseline identified with a crowd with a high-smoking norm were compared to those, who identified with a low-smoking norm crowd, more likely to have started smoking at time of the follow-up (OR = 2.15). Further, discordance between one's behavior and the norm of the crowd resulted more often in a change in smoking behavior (OR = 2.00) and crowd identification (OR = 2.15) than the absence of such discordance. The results confirm the importance of crowds in smoking initiation and call for more attention to this issue in smoking prevention.

Youth Audience Segmentation Strategies for Smoking-Prevention Mass Media Campaigns Based on Message Appeal

Mass media interventions are among the strategies recommended for youth cigarette smoking prevention, but little is known about optimal methods for reaching diverse youth audiences. Grades 4 through 12 samples of youth from four states (n = 1,230) rated smoking-prevention messages in classroom settings. Similar proportions of African American, Hispanic, and White youth participated. Impact of audience characteristics on message appeal ratings was assessed to provide guidance for audience segmentation strategies. Age had a strong effect on individual message appeal. The effect of gender also was significant. Message ratings were similar among the younger racial/ethnic groups, but differences were found for older African American youth. Lower academic achievement was associated with lower appeal scores for some messages. Age should be a primary consideration in developing and delivering smoking-prevention messages to youth audiences. The unique needs of boys and girls and older African American adolescents should also be considered.

Changing patterns of cigarette use among white and black youth, US 1976–2003

To help understand the decline, rise, and then decline again in rates of youth cigarette use over the past several decades, this study examines the changing influence of family background and social activities on individual propensities to smoke. Such changes may define different trends among youth at high or low risk of smoking and provide insights into the source of the fluctuations in the trends. After pooling cross-sectional surveys of samples of high school seniors from 1976 to 2003, we test for changes in the association of smoking with family background and social activities using logistic regression models that allow time of survey to interact with individual-level characteristics. The findings show little change in the influence of individual determinants among black youth, but white youth with highly educated parents and who go out frequently contribute most to the trends in smoking prevalence.

Internet cigarette purchasing among 9th grade students in western New York: 2000–2001 vs. 2004–2005

Objective. To assess trends and correlates of youth cigarette purchasing behavior on the Internet. Methods. In 2000–2001, Roswell Park Cancer Institute conducted a survey asking 7019 ninth grade students in Erie and Niagara Counties in New York State about their tobacco use and purchasing habits, including use of the Internet to buy cigarettes. The 2004–2005 survey is a replication of the 2000–2001 survey. Both surveys used an anonymous, self-administered questionnaire survey. These data were combined in order to examine trends in youth smoking behavior. Results. Students surveyed in 2004–2005 were 2.6 times more likely (95% CI: 1.5, 4.6) to have purchased cigarettes over the Internet in the 30 days prior to the survey than those surveyed in 2001 (5.2% to 1.6%); however, the intention to use the Internet as a cigarette source in the future did not change between survey periods. Conclusion. Youth online cigarette purchasing has increased but intention to use the Internet to purchase cigarettes in the future has remained the same, suggesting that this trend may be reaching a plateau. Recent public efforts to reduce online cigarette sales will need to be evaluated in order to determine which policy or combination of policies are most effective.

Retail Tobacco Outlet Density and Youth Cigarette Smoking: A Propensity-Modeling Approach

We examined whether retail tobacco outlet density was related to youth cigarette smoking after control for a diverse range of neighborhood characteristics. Data were gathered from 2116 respondents (aged 11 to 23 years) residing in 178 census tracts in Chicago, Ill. Propensity score stratification methods for continuous exposures were used to adjust for potentially confounding neighborhood characteristics, thus strengthening causal inferences. Retail tobacco outlets were disproportionately located in neighborhoods characterized by social and economic disadvantage. In a model that excluded neighborhood confounders, a marginally significant effect was found. Youths in areas at the highest 75th percentile in retail tobacco outlet density were 13% more likely (odds ratio [OR]=1.13; 95% confidence interval [CI]=0.99, 1.28) to have smoked in the past month compared with those living at the lowest 25th percentile. However, the relation became stronger and significant (OR=0.21; 95% CI=1.04, 1.41) after introduction of tract-level confounders and was statistically significant in the propensity score-adjusted model (OR = 1.20; 95% CI = 1.001, 1.44). Results did not differ significantly between minors and those legally permitted to smoke. Reductions in retail tobacco outlet density may reduce rates of youth smoking.

Youth Attitudes and Beliefs Toward Alternative Tobacco Products: Cigars, Bidis, and Kreteks

Youth use of cigars, bidis, and kreteks has spread as youth cigarette use has declined. This study investigates young people's attitudes toward and beliefs about these alternative tobacco products. The study used data from a convenience sample survey of 5,016 7th-through 12th-grade students in Massachusetts. The cigar attitudes receiving the highest endorsement levels were that cigars smell good and are something different to try, whereas the item receiving the lowest endorsement was that cigars give you a goodbuzz. The most endorsed bidi attitudes were that bid is look like joints and are something different to try. For kreteks, the most endorsed items were that kreteks smell good and are something different to try. Multivariate analyses found that reporting that these products tasted, smelled good, or were something different to try predicted use. Because the study was conducted with a convenience sample in one state, results do not necessarily generalize.

Is there a relation between school smoking policies and youth cigarette smoking knowledge and behaviors?

To comply with workplace legislation, New Zealand schools are required to have policies regarding tobacco smoking. Many schools also have policies to prevent tobacco use by students, including education programmes, cessation support and punishment for students found smoking. This paper investigated the associations between school policies and the prevalence of students' cigarette smoking. Furthermore, we investigated the association between school policy and students' tobacco purchasing behavior, knowledge of health effects from tobacco use and likelihood of influencing others not to smoke. Data were obtained from a self-report survey administered to 2,658 New Zealand secondary school students and staff from 63 schools selected using a multi-stage sampling procedure. Components of school policy were not significantly associated with smoking outcomes, health knowledge or health behavior, and weakly related to a punishment emphasis and students advising others to not smoke. Similarly, weak associations were found between not advising others to not smoke and policies with a punishment emphasis as well as smoke-free environments. The results suggest that having a school tobacco policy was unrelated to the prevalence of tobacco use among students, tobacco purchasing behavior and knowledge of the negative health effects of tobacco.

The importance of peer effects, cigarette prices and tobacco control policies for youth smoking behavior

This paper expands the youth cigarette demand literature by undertaking an examination of the determinants of smoking among high school students incorporating the importance of peer effects and allowing cigarette prices (taxes) and tobacco control policies to have a direct effect and an indirect effect (via the peer effect) on smoking behavior. To control for the potential endogeneity of our school-based peer measure we implement a two-stage generalized least squares estimator for a dichotomous dependent variable and implement a series of diagnostic tests. The key finding is that peer effects play a significant role in youth smoking decisions: moving a high-school student from a school where no children smoke to a school where one quarter of the youths smoke is found to increase the probability that the youth smokes by about 14.5 percentage points. The results suggest that there is a potential for social multiplier effects with respect to any exogenous change in cigarette taxes or tobacco control policies.

State Tobacco Control Spending and Youth Smoking

We examined the relationship between state-level tobacco control expenditures and youth smoking prevalence and cigarette consumption. We estimated a 2-part model of cigarette demand using data from the 1991 through 2000 nationally representative surveys of 8th-, 10th-, and 12th-grade students as part of the Monitoring the Future project. We found that real per capita expenditures on tobacco control had a negative and significant impact on youth smoking prevalence and on the average number of cigarettes smoked by smokers. Had states represented by the Monitoring the Future sample and the District of Columbia spent the minimum amount of money recommended by the Centers for Disease Control and Prevention, the prevalence of smoking among youths would have been between 3.3% and 13.5% lower than the rate we observed over this period.

Methods, locations, and ease of cigarette access for American youth, 1997–2002

The purpose of this paper is to examine trends in middle and high school students' perceived ease, methods, and locations of access to cigarettes, and to assess differences related to their sociodemographic characteristics and smoking status. Annual data from nationally representative samples of 8th-, 10th-, and 12th-grade students were analyzed for the 1997-2002 period. Analyses were conducted in 2003. Perceived ease of access decreased significantly among never and past smokers. Decreased individual purchasing in retail outlets, as well as decreased purchasing from vending machines, were reported by 8th- and 10th-grade students. All grades reported decreased purchasing from self-service placements of cigarettes. Decreases in access were not reported across all retailer types, and no significant increases were seen in the percent of underage purchasers who reported being asked to show identification. Both gender and ethnicity were significantly related to where and how underage youth reported obtaining cigarettes. Cigarette access for minors has been declining, but remains high. Findings show that (1) perceived access to cigarettes clearly increases with level of smoking, and (2) policies to reduce such access may be having an impact as evidenced by decreased retail and vending machine purchases and self-service purchases. However, states should continue to strengthen efforts to reduce youth cigarette access, especially in the areas of confirming buyer age via identification checks, and should make efforts to decrease access across all retailer types. Federal regulations like those previously implemented by the Food and Drug Administration might strongly assist in reducing youth access to cigarettes.