Risky behavior in youth: an analysis of the factors influencing youth smoking decisions in Canada

This article considers smoking behavior among young people in Canada, looking in particular for evidence on why young people take up smoking. Using data from the National Population Health Survey, we find that reported knowledge about the health effects of own smoking is less useful than might have been expected in explaining why some young people smoke but that responses to a question about whether people worry too much about the health effects of second-hand smoke is informative. We also find that for subjects too young to have begun their own household formation, the number of people in their household who regularly smoke in the house is an informative variable. In particular, among young people aged 12-14 years, having a household member who regularly smokes inside the house (as opposed to having none) increases the probability that the young person will smoke by 2%, whereas for the those aged 15-19, having a household member who regularly smokes inside the house increases the probability that the young person will smoke by 18%.     

Household smoking behavior and ETS exposure among children with asthma in low-income,minority households

Environmental tobacco smoke (ETS) exposure was measured among 242 children with asthma who live in homes where at least one person smokes. Subjects were identified through clinics, schools, community agencies, and hospitals serving low-income, medically underserved communities in Los Angeles. Parents were surveyed about smoking behaviors in the household, children's ETS exposure, and attitudes towards smoking and smoking behavior change. Validation measures included urine cotinine for the child with asthma and passive air nicotine monitors placed in the subjects' homes. Overall reported levels of household smoking and ETS exposure were low, with a significant amount of household smoking taking place outside rather than inside the home. Over 47% of the respondents reported absolute restrictions against smoking in the home, and these restrictions were associated with lower reported levels of smoking, ETS exposure, and air nicotine and urine cotinine concentrations.     

Nine-year prediction of adolescent smoking by number of smoking parents

For scientific and public health reasons, it is important to identify the role of family influences on child smoking acquisition. Using a well-followed (>90%) cohort of 3,012 children and their parents, this study prospectively investigated the influence of smoking by 0 vs. 1 vs. 2 parents when the children were young (3rd grade), on whether the children subsequently became daily smokers. It is the only study to investigate the prediction of child/adolescent smoking at the end of the smoking acquisition period (12th grade) by parental smoking at the start of the period (3rd grade). Logistic regression analyses revealed that having one parent who smokes substantially increases the risk that children will become daily smokers, relative to families where neither parent smokes (OR=1.90, p<.01). There is no evidence that the increased risk depends on parent or child gender. These results suggest the need for public health interventions that inform parents of young children that their own smoking behavior increases their children's risk for future smoking.     

Youth perspectives on concurrent smoking and vaping: Implications for tobacco control

Most people who smoke cigarettes begin young. Consequently, public health efforts directed at youth are a priority. The increasing popularity of electronic nicotine delivery systems (ENDS) among youth in the United States has raised concerns in the public health community about the potential of ENDS to renormalize cigarette smoking and perpetuate nicotine addiction, creating dual users who both vape and smoke. Despite limited and inconclusive evidence about dual use for young people, restrictive approaches towards ENDS have shaped tobacco control agendas in the United States. Based on analysis of 26 interviews with young dual users in California, we explored the meanings young people ascribe to their dual using practices and how those meanings relate to the broader tobacco control environment which structures their lives. Results suggest that dual users of ENDS and cigarettes overwhelmingly perceive a utilitarian meaning of dual use and view vaping as a tool for reducing smoking-related harm in the near term and facilitating quitting smoking in the long term. Also, participants’ narratives related to Tobacco 21 laws, which prohibit sales of both ENDS and cigarettes to individuals under 21 years of age, revealed concerns about restrictive policies that limit access to less harmful tobacco products. Results of this study raise important questions about whether we are working towards further reductions in the prevalence of smoking and tobacco-related diseases.     

Factors associated with continued smoking during pregnancy: analysis of socio-demographic,pregnancy and smoking-related factors

This study investigated the characteristics associated with smoking during pregnancy. A total of 7836 pregnant women were surveyed between 1992 and 1999 in England. Of these 27% were smoking during pregnancy. Pregnant women were more likely to smoke if they were less educated, living in rented accommodation, in unskilled manual or unemployed groups, and single or had a partner who smokes. Analysed by logistic regression, whether or not a pregnant women has a partner and, if so, his smoking status, was by far the biggest predictor of the pregnant woman's current smoking status. Thus, compared with women with partners who never smoke, the odds ratio (OR) of smoking during pregnancy for women with a partner who smokes was 2.3 (1.9-2.7) while those with no partner had an OR of 4.8 (3.8-6.0). For women exposed to passive smoke at home or at work the OR was 2.5 (2.1-3.0). Housing tenure was the most important socio-demographic predictor.Thus pregnant women living in rented council housing were nearly twice as likely (OR 1.93;1.63-2.29) as those buying their own home to be current smokers.The number of women who continued to smoke during pregnancy increased 10-fold from the least to the most deprived group.These findings highlight the importance of tobacco control strategies that address pregnant women's life circumstances and broader inequalities as well as those that focus on individual smoking behaviour.     

Gender differences in cigarette smoking, social correlates and cessation among adolescents

Background

Despite well-established gender differences in adult smoking behaviors, relatively little is known about gender discrepancies in smoking behaviors among adolescents, and even less is known about the role of gender in smoking cessation among teen populations.

Method

The present study examined gender differences in a population of 755 adolescents seeking to quit smoking through the American Lung Association's Not-On-Tobacco (N-O-T) program. All participants enrolled in the N-O-T program between 1998 and 2009. All participants completed a series of questionnaires prior to and immediately following the cessation intervention. Analyses examined gender differences in a range of smoking variables, cessation success and direct and indirect effects on changes in smoking behaviors.

Results

Females were more likely to have parents, siblings and romantic partners who smokes, perceive that those around them will support a cessation effort, smoke more prior to intervention if they have friends who smoke, and to have lower cessation motivation and confidence if they have a parent who smokes. Conversely, males were more likely to have lower cessation motivation and confidence and be less likely to quit if they have a friend who smokes.

Conclusions

Gender plays an important role in adolescent smoking behavior and smoking cessation. Further research is needed to understand how these differences may be incorporated into intervention design to increase cessation success rates among this vulnerable population of smokers.     

Epidemiology of passive smoke: a prospective study in 589 children

BACKGROUND: Several studies have found that in children of smoking parents there is an increased incidence of respiratory illnesses and diminished pulmonary function. In infants of smoking atopic parents IgE levels are higher, atopic symptoms start earlier, and children are more likely to wheeze if the mother smokes than if she does not. Maternal smoking of 0.5 packs or more/day was identified as a risk for asthma developing in the 1st year of life. Among the environmental measures of our prevention program there is an absolute prohibition of smoking in the house of a "at risk" baby. MATERIALS AND METHODS: We have studied 289 atopic children, 169 males and 120 females, aged 3.5 to 7.5 years, attending our Division because affected by respiratory allergy. We have asked their parents if they smoked and if there were smoking relatives in their homes, independently of the number or the packs of cigarette smoked. The parents of 300 children comparable for age and sex visiting our outpatient clinic for non respiratory disease served as controls. RESULTS: Smokers were 175 fathers and 109 mothers of the asthmatic children and 153 fathers and 89 mothers of the controls. DISCUSSION: Analysis of data shows that passive smoking is significantly associated with the development of asthma in atopic children, and that males are more at risk than females. We stress that a high number of asthmatic children have atopic, and asthmatic parents. Cigarette smoke is not only a triggering factor of respiratory allergy in babies at risk of atopy, but especially an additional genetic factor, since asthma can be more easily provoked if an atopic parent smokes (more if both parents smoke), and even in children of not atopic, smoking parents.     

An examination of different smoking patterns among Canadian youth: New insight for tobacco control programming

Patterns of smoking can vary among youth smokers. The purpose of this study was to examine three different patterns of smoking among youth (daily smoking, smoking sporadically on weekdays and weekends, and smoking during weekdays only), and to examine the sociodemographic characteristics that are associated with each smoking pattern in a representative sample of Canadian youth smokers. Data were collected as part of the 2010/2011 Youth Smoking Survey (YSS) from 31,396 students in grades 9 to 12 from secondary schools in 9 Canadian provinces. Data from the YSS were used to assess smoking behaviors and sociodemographic factors that are associated with smoking patterns among youth. We used logistic regression models to examine factors associated with week day only and some day smoking patterns relative to daily smoking patterns. Results indicate that among current youth smokers, the majority are daily smokers (62.0%), followed by some day (23.5%) and week day only (13.5%) smokers. Students who smoke some days were more likely than daily smokers to share cigarettes with others; however, they were less likely than daily smokers to have a parent, step-parent or guardian who smokes cigarettes and less likely to have close friends who smoke cigarettes. Conversely, students who smoke week days only were less likely than daily smokers to have a sibling who smokes cigarettes. These data suggest that the school environment continues to play an important role in reducing youth smoking rates in Canada, especially among youth who only smoke week days. The high percentage of week day only smokers suggests that current school-level tobacco control initiatives may be insufficient for preventing youth smoking onset.     

Cigarette smoking in New Zealand: Results from the 1976 population census.

The 1976 New Zealand Census included information about 2 201 178 persons over 15 years. Thirty-eight percent of men and 31 percent of women smoked cigarettes regularly. The peak age for male smoking is from 45-49 years and in men aged 35 to 39 years more than half (55 percent) smoke more than 20 cigarettes a day. In the youngest age group (15 to 19 years) more girls than boys are cigarette smokers. Sixteen percent of the population (353 627) stated that they have given up regular cigarette smoking. Smoking is least prevalent in Nelson, Marlborough and Canterbury, while the greatest percentage of smokers are found in the East Coast of the North Island and Southland. Except for Southland, there are significantly more smokers in the younger age groups (16 to 24 years) in the North Island than in the South Island. Cigarette smoking in New Zealand is probably less prevalent than in the past and the figures compare favourably with those of other countries. However, the high levels of smoking among young people, particularly women, is a major health problem.     

Affect-management and habit mechanisms in the modification of smoking behavior.

The present study contrasted two major models of why people smoke. Tomkins' affect management model implies that positive and negative affect smokers may need to find alternate affect-management strategies to substitute for cigarettes in order to quit smoking. Hunt and Matarazzo's overlearning model suggests that treatment approaches directed toward the extinction of the overlearned smoking habit should be most effective. In order to decide between these models relationships between measures of habit in smoking, affect-management reasons for smoking and subjects' reliance on various self-control techniques were considered. A factor analysis of the 33 subjects in two smoking modification programs who were abstinent at follow-up revealed that their use of two of the self-control techniques—muscle relaxation and thought stopping—was positively related to indices of their smoking habit, but not to affect-management reasons for smoking. As predicted, no relationships were found between use of self-control techniques and either affect-management or habit for the 65 subjects who were not abstinent at follow-up.     

Young people's awareness of illicit drug use in the family

A sample of Scottish schoolchildren aged 14–15 (N = 1240) were asked a series of questions regarding their knowledge and experience of illicit drugs. They were asked to report on personal lifetime drug use and whether they knew of any family member who had ever used drugs. More than four in ten respondents admitted to having used an illegal drug, with a similar number admitting to awareness of drug use by another family member. There was a strong statistical relationship between respondents’ own use and drug use by all types of family members. However, although respondents who reported using drugs themselves were more likely to nominate other drug users in their family, only a small minority of respondents stated that a family member initiated them into drug use and few stated that they were aware of any problematic use. Although prior drug use by family members may not directly lead to use by young people, these data indicate that illegal drug use tends to cluster within families.     

Why do young women smoke? III. Attention and impulsivity as neurocognitive predisposing factors

Since nicotine has been shown to facilitate sustained attention and control of impulsivity, impairment in these domains may influence individuals who initiate smoking for various reasons to continue to smoke cigarettes. The purpose of this study was to determine whether young women who smoke regularly but are not abstinent at the time of testing, differ in their cognitive functioning from non-smokers and whether they resemble women who smoked in the past but quit. Female undergraduate students aged 20-30 years were recruited by advertisement from institutes of higher education in the Jerusalem area. The study sample consisted of 91 current smokers (CS), 40 past smokers (PS) and 151 non-smokers (NS). 46 occasional smokers (OS) were also tested. Confounding by withdrawal state was neutralized by including only CS and OS who smoked their last cigarette less than 90 min before testing. Subjects performed a computerized neurocognitive battery, which tests the domains of attention, memory, impulsivity, planning, information processing and motor performance. Analyses were controlled for age. The results showed that CS made significantly more errors than NS on the Continuous Performance Task (CPT), Matching Familiar Figures Test (MFFT) and Tower of London (TOL) test. PS were significantly worse than NS on the MFFT and TOL test. PS did not differ significantly from CS on any test. No association was found between duration of smoking and performance. These findings suggest that a neurocognitive profile characterized by impairments in sustained attention and control of impulsivity may be one of the factors that predispose young women who initiate cigarette smoking to maintain the habit.     

Reviewing the needs of unemployed youth in smoking intervention programmes

In Australia, the impact of unemployment on adolescent smoking behaviour continues to present a major public health problem. Traditional prevention programmes in both primary and secondary schools appear to be achieving a delay in the onset of smoking. However, smoking rates of young people who are unemployed are unacceptably higher than those of in-school youth. This paper provides a review of the published literature, showing that there has been little effort to address smoking patterns or experiences of quitting for this target group. While the provision of employment opportunities or skill training for this group is important, these strategies will not eliminate the problem of smoking. Steps must be taken to encourage research into the development of tailored programmes for unemployed youth who smoke. These programmes must be carefully considered and evaluated and meet the needs of this diverse group of young people.     

Optimistic bias in adolescent and adult smokers and nonsmokers

Optimistic biases regarding the risks of smoking were examined among 200 adolescents (aged 12-17) and 203 adults (aged 30-50). Strong majorities of adolescent and adult smokers and nonsmokers agreed that smoking is addictive and causes death for "most people" who smoke. However, for themselves personally, adolescent and adult smokers were more likely than nonsmokers to doubt that they would die from smoking even if they smoked for 30 or 40 years. Furthermore, 60% of adolescent and 48% of adult smokers believed that they "could smoke for a few years and then quit" if they wished, figures far higher than for nonsmokers. Thus an optimistic bias regarding smoking risks appears to be held by both adolescent and adult smokers, especially by adolescents and especially regarding addiction. Implications for smoking prevention programs are discussed.     

Reliability of children's self-reported cigarette smoking.

Youth who first smoke cigarettes during childhood are a high risk for habitual smoking. Evaluating the reliability of children's smoking initiation is essential to research efforts to explain or prevent smoking onset. The present study is the first to establish reliability of self-reported smoking behavior with questionnaire data from elementary school children (N = 1,184). Data from a longitudinal investigation are used to examine the consistency of children's self-reported smoking across items and over time. Both cross-sectional and longitudinal analyses demonstrate that children report having tried smoking and lifetime use remarkably consistently. However, only about half the children reliably estimated their grade at first use. The study results suggest that some but not all standard questionnaire items yield reliable self-report data about initial smoking behavior from respondents as young as 8 to 11 years.     

Monoamine oxidase polymorphisms and smoking behaviour in Japanese

Although nicotine dependence is one of the primary reasons why smokers cannot quit smoking, nicotine cannot explain all of the psychopharmacological effects of tobacco smoke. Accumulating evidence points to potent inhibition of monoamine oxidase (MAO) which metabolizes neurotransmitters relating to additive behaviour. We have therefore investigated the association between smoking behaviour and MAO ( variable number of tandem repeat in the promoter region and A644G) polymorphisms. The genotypes were examined in 504 Japanese outpatients (217 men and 287 women) who visited Aichi Cancer Centre Hospital. The age-adjusted odds ratios (aORs) were estimated by a logistic model. Among males, we did not find a significant association of the smoking habit with either of the polymorphisms. The median Fargastrom test for nicotine dependence (FTND) score among male current smokers was significantly higher with than without the 4-repeat allele (5.8 and 4.7, respectively). The aOR of FTND 6 versus FTND 6 was 2.72 (95% confidence interval 1.13-6.50) for males with the 4-repeat allele. Among females, the aOR of being current smokers compared to never smokers was 0.49 (0.26-0.93) for individuals with the 4-repeat allele. Our results indicate that the polymorphisms of influence the smoking habit for female, as well as the nicotine dependence and smoking initiation for male smokers. These findings among male smokers support the view that MAO affects a smokers' requirement for nicotine and may explain why some people are predisposed to tobacco addiction and why some individuals find it difficult to stop smoking.     

Smoking among High School Students in 10 Italian Towns: Patterns and Covariates

The associations between tobacco smoking and demographic, socioeconomic, environmental, and behavioral factors among adolescents were investigated by administering an anonymous questionnaire to 5,221 ninth (aged 14–15 years) and 4,154 thirteenth grade (aged 18–19 years) students in 10 Italian towns. Using logistic regression analysis, both current smoking and experimental smoking were statistically associated with sibling, best friend, and partner smoking, alcohol drinking, and frequency of drunkenness in both grades and sexes. Attitude of parents toward children's smoking was also found to be associated with the probability of being a current smoker, especially among ninth graders. Parental smoking was associated with current smoking among females only. Socioeconomic factors and level of knowledge of the health consequences of smoking were not associated with either experimental or regular smoking. In conclusion, this survey suggests that social environment plays a fundamental role in both first experimentation with smoking and the process of becoming a regular smoker among adolescents. Students with one or more siblings who smoke, and especially those with best friends and a partner who smoke, were much more likely to have tried smoking and to be current smokers than students without smokers in their environment.     

E-cigarette use is associated with susceptibility to tobacco use among Australian young adults

BackgroundCalls have been made to relax current Australian regulations related to e-cigarettes to increase the accessibility of the devices for smoking cessation purposes. However, e-cigarettes have been found to increase risk of initiation of conventional cigarette smoking, especially among young adults. To assist in guiding the development of policy in Australia, the present study examined whether e-cigarette use among Australian young adults who have never smoked a tobacco cigarette is associated with susceptibility to future tobacco cigarette use.MethodAn online web panel provider recruited 519 never smokers aged 18–25 years (55% female; average age = 21.21 years, SD = 2.32). Respondents completed an online survey that assessed their curiosity about tobacco smoking, willingness and intentions to smoke, and a number of individual and social factors. Cross-sectional regression analyses were conducted to assess the association between e-cigarette use and susceptibility to tobacco cigarette use while controlling for multiple covariates.ResultsCuriosity about tobacco smoking, willingness to smoke, and intentions to smoke were significantly higher among users of e-cigarettes than never users. The relationship between e-cigarette use and susceptibility to future tobacco cigarette use remained significant after controlling for numerous covariates.ConclusionE-cigarette use, even just one or two puffs, has the potential to increase susceptibility to tobacco cigarette use among Australian young adults. Findings suggest that increasing the availability of e-cigarettes by relaxing current strict regulations surrounding their sale may have unintended consequences.     

Smoking Behavior and Ethnicity in Jujuy,Argentina: Evidence from a Low-Income Youth Sample

Latin America is the world region with the highest rates of youth tobacco use and widest socioeconomic gaps, yet no data are available on smoking among Indigenous people, the largest disadvantaged group in the region. A self-administered survey of 3,131 8th grade youth enrolled in a random sample of 27 urban and rural schools was administered in 2004 in Jujuy, Argentina. Standard questions adapted from global surveys were used. Compared with youth of European background (11.4%; 95% CI 6.7–15.1), Indigenous (23.0%; 95% CI 21.0–25.0), and Mixed ethnicity (23%; 95% CI 18.9–27.1) youth had higher prevalence of current smoking. The odds of current smoking remained significantly elevated for Indigenous (OR 1.9; 95% CI = 1.1–3.3) and Mixed youth (OR 2.0; 95% CI 1.2–3.4) after controlling for confounders. Other risk factors that were associated with current smoking included: having any friends who smoke, repeating a grade in school, depressive symptoms in previous year, drinking any alcohol in the previous week and thrill seeking orientation. These results underscore the importance of social and cultural diversity aspects of the global tobacco epidemic.     

Young People's Feelings About Drugs

This paper presents the findings of a study which involved the collection of qualitative data through a series of focus groups with young people aged 24-16. The aim of the study, as presented, was to explore the feelings that young people themselves express, about the use of illegal drugs, along with reasons that they give as to why young people might take such drugs. The findings suggest that there is a general acceptance of 'soft' drug use by young people, alongside a degree of fatalism in accepting this by those who believe drug use to be wrong. Familiarization with drugs would appear to be an important factor in shaping young people's views of drugs, along with a belief, to some extent, that individuals have the right to choose for themselves about using drugs.