Cognitive factors associated with smoking initiation in adolescents

OBJECTIVE: To study the association between cognitive factors of the behavioral change model "Attitude Self Efficacy" (ASE) at different phases of smoking initiation among adolescents. METHODS: We carried out a cross-sectional survey among students in the second grade of Compulsory Secondary Education (13-14 years old) from Cornellà de Llobregat (Barcelona, Spain) in 2000 to obtain information on cognitive factors and smoking. Logistic regression analysis was used to investigate the variables associated with smoking (odds ratio [OR] of experimenters vs. non-smokers and of smokers vs. experimenters). RESULTS: The prevalence of daily smoking was 22.9% (95% CI, 16.5%-29.3%) among boys and 36.2% (95% CI, 29.7%-42.6%) among girls. Factors associated with experimenting (vs. non-smoking) were: attitudes to smoking (disagreement with smoke-free areas [OR = 3.46; 95% CI, 1.65-7.24], agreement with smoking promotion [OR = 3.42; 95% CI, 1.42-8.28]), and subjective norms (perceiving friends as smokers [OR = 2.50; 95% CI, 1.17-5.35]). The variables associated with regular smoking (vs experimenting) belong to: self-efficacy and attitudes to smoking. CONCLUSIONS: Focussing on subjective norms and smoking attitudes with programs targetted younger ages seems appropriate, since these factors are more closely associated with the experimenting phase. Encouraging skills to refuse cigarettes offered by friends is appropriate at a more advanced age, since this determinant is associated with the change from experimenting to regular smoking.     

上海市部分城区青少年学生吸烟行为及其影响因素分析

目的了解上海市青少年学生的吸烟情况,并探讨其吸烟行为的影响因素. 方法采取分层整群随机抽样的方法,对市内四个区11所学校的2204名12～21岁的在校学生进行不记名问卷调查.结果学生尝试吸烟率为19.3%,其中男生27.8%,女生10.8%;平均开始吸烟年龄是12岁.吸烟学生中,认为应该戒烟的学生占68.5%;尝试过戒烟者占吸烟学生的47.7%.logistic回归分析结果显示:朋友吸烟、经常上网、常去网吧、今后5年有吸烟打算、认为维持不吸烟对自己不重要、认为朋友对吸烟的态度对自己很重要和对吸烟行为的错误认知是影响学生吸烟行为的显著因子. 结论随着青少年成长意识的增强,他们中有一部分人开始尝试吸烟成为烟民,我们应尽早开展预防未成年吸烟行为的教育,同时为青少年戒烟提供更多的帮助.     

青少年及青年HIV感染影响因素

青少年及青年正处于由儿童向完备成年人转变的阶段,性生理趋于成熟,而性心理尚不完善,具有特有的生理与心理特点,易于发生不安全性行为,从而增加了自身感染HIV的风险。青少年及青年中存在较多的易感因素,近年来HIV感染新报告病例数逐年上升,引起了多方面的关注。本文从青少年及青年HIV感染现状、感染与发现途径、易感因素3个方面...     

Prospective association between dieting and smoking initiation among adolescents

PURPOSE: To examine the relation between dieting and smoking initiation among adolescents. DESIGN: Prospective data from a nationally representative study were used. SETTING: Two waves (1994 to 1996) of the National Longitudinal Study of Adolescent Health. SUBJECTS: The sample included 7795 non-Latino Caucasian and non-Latino African-American adolescents. MEASURES: Dieting status was the independent variable and trying smoking and initiation of regular smoking were the dependent variables. Covariates included age, ethnicity, overweight status, false self-perception about being overweight, and availability of cigarettes at home. ANALYSIS: Logistic regression and latent transition analyses were used. RESULTS: Females had a higher prevalence of dieting (55%) when compared with males (25%). Dieting initiation was a significant predictor for initiation of regular smoking among females (OR = 1.94, p = .010), but not among males. Inactive dieting was a significant predictor among males (OR = 1.74, p = .031), but not among females. Compared to nondieters, initiating and consistent female dieters reported a higher probability of transitioning to having tried regular smoking, although results from logistic regression suggested that the association between consistent dieting and initiation of regular smoking was not significant. CONCLUSIONS: There is a positive relation between initiating dieting and initiating regular smoking among females, but among males it is the inactive dieters who show a positive relationship. Results illustrate the importance of examining the association between dieting and the initiation of regular smoking.     

A new measure of smoking initiation and progression among adolescents

OBJECTIVE: To develop a new measure of smoking initiation and progression among adolescents. METHOD: This study used data from 2504 regular and alternative high school students to evaluate the psychometric properties of a new 3-item, 5-stage measure of smoking initiation and progression. RESULTS: The categorization method showed good 4-week test-retest reliability (.83 among boys and .87 among girls). The demographic distribution of adolescents into stages was consistent with previous research. CONCLUSION: This 5-stage classification method could be a useful framework for describing variation along the smoking up-take and progression continuum.     

Primary social factors and smoking in Korean adolescents

Journal of Public Health - The present study aimed to examine the effects of primary social factors on the smoking behaviors according to the smoking stages—initiation and...     

Parental smoking and sociodemographic factors related to smoking among German medical students

Smoking among medical students has been found to vary strongly between European countries. Few studies have addressed factors associated with smoking among medical students within countries. In this study, we assessed the association of parental smoking and sociodemographic factors with smoking habits of medical students at the University of Ulm, Germany, Students who entered the 1st, 3rd and 5th year of medical school in fall 1992 were asked to complete a self-administered questionnaire. Questionnaires were returned by 696 (85.2%) of 817 eligible students. Overall, 23.7% of students were current smokers, and 11.9% were former smokers. Smoking habits were related to maternal smoking: Odds ratios for the association of maternal smoking with ever or current smoking of students were 2.11 (95% CI: 1.48–3.03) and 2.01 (95% CI: 1.35–3.01), respectively, after adjustment for potential confounders in multiple logistic regression. In contrast, no asso-ciation was found between paternal smoking and students' smoking status. Male students were more likely to smoke than female students, and living in a large city during secondary school was also associated with ever smoking. No association was found between students' smoking habits and educational achievement of their mothers and fathers. These results suggest a key role of maternal smoking for smoking among medical students in this society.     

初中生家长对青少年性健康教育态度及其影响因素分析

目的 了解初中生家长对子女进行性健康教育的态度和相关影响因素.方法 本研究为多中心横断面流行病学调查研究,采用多阶段非随机整群抽样的方法,在全国7个地理大区共选取2 895位初中生家长进行调查.结果 被调查对象中,有861名父亲（85.8％）和1 560名的母亲（90.6％）认为父母应该对子女进行性健康教育.458名父亲（54.1％）和789名母亲（51.6％）认为13～15岁是进行相关教育的最佳时期.多因素Logistic回归模型分析结果显示,女孩的家长更愿意对孩子进行性健康教育（OR=1.35,95％CI：1.04～1.75）,孩子的年级越高,家长对其进行性健康教育的态度越消极（x2=13.238,P＜0.01）;女性家长更乐意对子女开展性健康教育（OR=1.47,95％CI：1.12～1.93）,家长对孩子进行性健康教育的意愿随着家长教育程度的升高而升高（x2=31.583,P＜0.01）.职业为工人/农民的家长,对孩子进行性健康教育的态度相对较消极（OR=0.58,95％CI：0.36～0.93）.此外,相对于年收入较低的家长,收入高的家长更愿意对子女开展性健康教育（x2=17.055,p＜0.01）.结论 应通过多渠道有针对性的对初中生家长开展关于青少年性健康教育方面的宣传培训,提高我国青少年学生性健康教育的质量和水平,从而降低相关疾病的发病率.     

Hazard of smoking initiation by age among adolescents in Wuhan, China

BACKGROUND: Knowledge about age of smoking initiation among adolescents in China is helpful for exploring cultural differences in adolescent smoking behavior and informative for global tobacco control. However, little has been documented on this issue. METHOD: Adolescents (6,473) attending grades 7, 8, and 9 completed the baseline survey of a longitudinal, randomized smoking prevention trial. Data were collected in classrooms with a paper-and-pencil questionnaire. A survival model was used in the statistical analysis. RESULTS: The hazard of smoking initiation for boys showed a pattern previously observed in the United States: very low (<2%) before 7 years of age, increasing rapidly after age 10, and peaking at 14-15 years of age. The hazard for girls was below or around 1% until 12 years of age before it increased. The hazard levels were similar for adolescents both in urban and in rural areas, but higher for those in grade 7 than in grades 8 and 9. CONCLUSIONS: Chinese boys in Wuhan, China, experienced a hazard pattern of smoking initiation by age similar to those observed in the United States, while Chinese girls there experienced a rather low risk of smoking initiation. The hazard pattern suggests that the best time for smoking prevention is between 10 and 15 years of age. Adolescents in lower grades are at higher risk of early smoking initiation, suggesting a potential cohort effect in adolescent smoking initiation in Wuhan, China.     

Prevalence and risk factors for smoking among adolescents

OBJECTIVE: Tobacco smoking is one of the main causes of preventable disease and premature disability. The study was aimed at measuring smoking prevalence and related risk factors among adolescents. METHODS: A population-based cross-sectional study was carried out in a representative sample of 1,187 adolescents aged 10 to 19 years living in the urban area of Pelotas, southern Brazil. All adolescents were interviewed separately using a confidential coded questionnaire. Kaplan-Meier test was performed for survival curve analysis. RESULTS: The overall smoking prevalence rate in the sample was 12.1% (95% CI 10.3%-14%). Boys and girls had similar prevalence rates. The following were the risk factors for smoking found in the multivariate logistic regression analysis: older age (OR=28.7; 95% CI 11.5-71.4), older smoking siblings (OR=2.4; 95% CI 1.5-3.8), three or more smoking friends (OR=17.5; 95% CI 8.8-34.8) and low schooling (OR=3.5; 95% CI 1.5-8.0). CONCLUSIONS: The prevalence of smoking among adolescents in the city of Pelotas was high. Campaigns against tobacco use should be aimed at the community and families, targeting adolescents. The government must adopt legal actions in order to prevent adolescents to have access to to smoking.     

Older boyfriends and girlfriends increase risk of sexual initiation in young adolescents

Purpose: To explore the prevalence and impact of older boyfriends or girlfriends on sexual behavior in sixth graders (mean age 11.5 years).

Methods: Students in 19 ethnically diverse middle schools in an urban area were surveyed (n = 2829, response rate 68%). Instrument measured demographics, age of oldest boyfriend or girlfriend, unwanted sexual advances, peer norms, and sexual behavior. Students with older, same-age, or no boyfriend or girlfriend were compared on demographic and psychosocial variables using analysis of variance. Separate multivariate logistic regressions for both boys and girls were used to predict sexual behavior from demographics, psychosocial variables, and age categories of boyfriend or girlfriend.

Results: One-half of the respondents (56%) had never had a serious boyfriend or girlfriend, 35% reported that their oldest boyfriend or girlfriend was <2 years older than they, and 8.5% reported a partner ≥2 years older. Those reporting an older boyfriend or girlfriend were more likely to be Hispanic, were less acculturated, reported more unwanted sexual advances and more friends who were sexually active, and, among girls, were more likely to have experienced menarche. Overall, 4% of students reported ever having had sex. Students with an older boyfriend or girlfriend were over 30 times more likely than those with no boyfriend or girlfriend ever to have had sex (odds RATIO = 33.8 for boys and 44.2 for girls). In the multivariate logistic regressions, peer norms about sexual behavior, having experienced unwanted sexual advances, and having a boyfriend or girlfriend were strongly associated with having had sex.

Conclusions: Having an older boyfriend or girlfriend, although rare, is associated with early sexual onset and unwanted sexual activity in this population of sixth graders.     

常州市青少年伤害发生现况和相关因素

目的了解常州市青少年伤害的发生原因和分布特征,探讨学生伤害的有效干预措施及预防模式。方法采用《中国青少年健康危险行为调查问卷》,多阶段分层整群抽取常州市大、中学校学生3 645名,进行问卷调查分析。结果常州市青少年伤害发生率为9.16%,男性为11.7%,女性为6.7%,男女比1.69∶1,差异有统计学意义(χ2=26.80,P0.01)。性别、学习阶段、家庭类型、学习成绩、家庭经济状况、运动、运动场地安全措施、自身不安全行为、心理因素都是学生伤害发生的影响因素。结论青少年伤害的预防需要政府和卫生部门以及社会的协同,提高青少年及其家长、教师乃至全体公众的自我保护意识和自我保护能力是关键。     

Population attributable risk for adverse pregnancy outcomes related to smoking in adolescents and adults

BACKGROUND: Little is known about how population-attributable risks (PAR) for adverse birth outcomes due to smoking differ in adolescent and adult pregnancies. METHODS: An analysis of community and hospital-based cross-sectional studies in Liverpool was undertaken to estimate the PAR values of low birthweight (LBW), preterm birth, and small for gestational age (SGA) births resulting from pregnancy smoking covering the period between 1983 and 2003. Maternal smoking status and pregnancy outcomes were available for a sample of 12631 women. RESULTS: The prevalence of maternal pregnancy smoking was 40% in the community sample and 33% in adults and 40% among adolescent pregnancies in the hospital sample. The PAR values (95% CI) associated with LBW, preterm birth and SGA outcomes due to maternal pregnancy smoking in the community sample were 27% (25-30), 13% (11-15) and 25% (23-27), respectively. The PAR values in adults in the hospital sample were 29% (27-31) for LBW, 16% (14-19) for preterm birth and 28% (26-31) for SGA. The corresponding PAR values in adolescents were 39% (34-43), 12% (7-18) and 31% (23-40). The LBW risk attributed to pregnancy smoking in adolescents was significantly higher than for adults (P=0.05). CONCLUSION: About one-third of LBW, one-quarter of SGA and one-sixth of preterm births could be attributed to maternal smoking during pregnancy. The magnitude of the problem was greater among adolescent pregnancies, among whom a sub-group of mothers with very high risk for adverse birth outcomes due to pregnancy smoking was identified.     

Model of unplanned smoking initiation of children and adolescents: an integrated stage model of smoking behavior

BACKGROUND: Two lines of psychological research have attempted to spell out the stages of adolescent smoking initiation. The first has focused on behavioral stages of smoking initiation, while the second line emphasized motivational stages. METHODS: A large international sample of European adolescents (N = 10,170, mean age = 13.3 years) was followed longitudinally. Self-reported motivational and behavioral stages of smoking initiation were integrated, leading to the development of the Model of Unplanned Smoking Initiation of Children and Adolescents (MUSICA). The MUSICA postulates that youngsters experiment with smoking while they are in an unmotivated state as regards their plans for smoking regularly in the future. RESULTS: More than 95% of the total population resided in one of the seven stages distinguished by MUSICA. The probability of starting to smoke regularly during the 12 months follow-up period increased with advanced stage assignment at baseline. Unique social cognitive predictors of stage progression from the various stages were identified, but effect sizes of predictors of transitions were small. CONCLUSIONS: The integration of motivational and behavioral dimensions improves our understanding of the process of smoking initiation. In contrast to current theories of smoking initiation, adolescent uptake of smoking behavior was found to be an unplanned action.     

Emotional intelligence and smoking risk factors in adolescents: interactions on smoking intentions.

PURPOSE: To examine interactions between emotional intelligence (EI) and smoking risk factors on smoking intentions in adolescents. METHODS: EI ios defined as the ability to: accurately perceive, appraise, and express emotion; access and/or generate feelings in facilitating thought; understand emotion and emotional knowledge; and regulate emotions. EI of 416 6th graders (53% girls) from middle schools in the Los Angeles area (mean age = 11.3 years; 32% Latino, 29% Asian/Pacific Islander, 13% white, 19% Multiethnic, 6% Other) was assessed with an abbreviated version of the Multifactor Emotional Intelligence Scale, Adolescent Version (MEIS). This was a competence-based measure assessing an individual's ability to perceive, understand, and manage emotion. Logistic regression models were fit to test interactions between EI and ever trying cigarettes, hostility, and perceived ability to refuse a cigarette from someone just met, on intentions to smoke in the next year. RESULTS: High EI adolescents were more likely to intend to smoke in the next year if they had previously experimented with smoking. Those with low EI were more likely to intend to smoke if their perceived ability to refuse a cigarette offer from a person they just met was low or hostility level was high. CONCLUSIONS: These preliminary results indicate that EI interacts with risk factors to reduce smoking intentions, and contributes evidence to a link between EI and smoking in adolescents.