The Recruitment of New Smokers by Adolescents

This study investigated predictors of recruiting others to smoke among 273 seventh graders who had smoked at least once. Almost half (44%) of the 273 students had either offered a cigarette to a friend, made fun of a nonsmoker, or encouraged a friend to smoke during the previous year. Significant predictors of recruitment included self-described smoking status, best friend (same sex) smokes, perceived positive consequences of smoking, number of same-sex friends who smoke, perceived negative consequences of smoking, perceived benefits of quitting smoking, and self-reported alcohol use. Together, the significant variables predicted 34% of the variance in self-reported recruitment. Implications for reducing adolescent smoking are discussed.     

Saturation of tobacco smoking models and risk of alcohol and tobacco use among adolescents.

PURPOSE: To examine how saturation of an adolescent's environment with models of cigarette smoking (e.g., parents, siblings, friends) affects the probability of tobacco and alcohol use among junior high and high school students. METHODS: The Health and Smoking Questionnaire was administered to 806 adolescents (182 smokers and 624 nonsmokers; 57.2% female) average age of 15.1 years (SD = 1.6) in a mid-size Midwestern town. The questionnaire contains standardized items in five domains: demographics, smoking status and history, perceptions of risk and risk reduction, risk factors for tobacco use, and parenting style. RESULTS: Risk for smoking or using alcohol increased dramatically as the number of models who smoke increased in an adolescent's environment. For instance, adolescents with one significant other who smoked were nearly four times (OR = 3.76, p <.001) more likely to smoke than someone with no significant others who smoked. However, if an adolescent had four significant others who smoked, they were over 160 times more likely to smoke (OR = 161.25, p <.001). Similar results were found for alcohol use; adolescents who had one significant other who smoked were more than 2.5 (OR = 2.66, p <.001) times more likely to drink than those without smoking models. Adolescents who had four significant other smoking models were 13 times (OR = 13.08, p <.001) more likely to drink. CONCLUSIONS: As the number of cigarette smokers in an adolescent's environment increases, risk of tobacco and alcohol use increases substantially. These data suggest that multiple models of tobacco use will substantially increase risk for substance use in adolescents.     

Social environmental and individual factors associated with smoking among a panel of adolescent girls

This study assessed changes in the influence of social environmental and individual factors-and the interaction of these factors with time-on smoking prevalence for girls. Longitudinal panel surveys of adolescent girls (N = 921 in both 2000 and 2004) from schools in Louisiana were completed in the ninth grade (2000) and then again in the twelfth grade (2004). A fixed effects hierarchical multiple regression model assessed the relation of changes in social environmental and individual factors to smoking prevalence. Increases in smoking prevalence over time among adolescent girls were associated with their perceptions of themselves as overweight and perceiving low risk associated with smoking. Increases in smoking prevalence over time were also associated with having friends who smoked, perceptions of friends' approval of smoking, having family members who smoked, and having monetary discretionary spending. Having friends who smoked was more strongly associated with smoking in the twelfth grade than in the ninth grade. While more black adolescent girls smoked than did white girls in the ninth grade, by the twelfth grade, more white adolescents girls smoked than did black girls. Interventions that target adolescent girls should consider the temporal variability of individual and social environmental factors.     

Social Environmental and Individual Factors Associated with Smoking Among a Panel of Adolescent Girls

This study assessed changes in the influence of social environmental and individual factors—and the interaction of these factors with time—on smoking prevalence for girls. Longitudinal panel surveys of adolescent girls (N = 921 in both 2000 and 2004) from schools in Louisiana were completed in the ninth grade (2000) and then again in the twelfth grade (2004). A fixed effects hierarchical multiple regression model assessed the relation of changes in social environmental and individual factors to smoking prevalence. Increases in smoking prevalence over time among adolescent girls were associated with their perceptions of themselves as overweight and perceiving low risk associated with smoking. Increases in smoking prevalence over time were also associated with having friends who smoked, perceptions of friends' approval of smoking, having family members who smoked, and having monetary discretionary spending. Having friends who smoked was more strongly associated with smoking in the twelfth grade than in the ninth grade. While more black adolescent girls smoked than did white girls in the ninth grade, by the twelfth grade, more white adolescents girls smoked than did black girls. Interventions that target adolescent girls should consider the temporal variability of individual and social environmental factors.     

青少年学生吸烟饮酒及其他药物使用的现状调查

目的了解青少年学生吸烟饮酒及其他药物使用的现状，为预防吸烟饮酒对青少年身体的危害提供数据。方法以菏泽市6所学校的1699名青少年学生为研究对象，采用修订的青少年危险行为调查问卷。结果51．4％的学生吸过烟，14．2％的学生近期内吸烟，8．0％的学生经常吸烟，12．8％的学生尝试过戒烟，15．5％的学生在13岁前就吸过1整支烟。76．5％的学生喝过酒，36．7％的学生近期内喝酒，27．7％的学生喝醉，37．1％的学生在13岁前饮酒。6．5％的人未经医生许可私自服用镇静安眠类药物，6．2％的人对服用过的药物有依赖。在吸烟、饮酒及其他药物使用的得分上，大学生高于高中生，高中生高于初中生。男生明显高于女生，农村学生普遍高于城市学生（P〈0．01）。结论青少年学生吸烟饮酒及其他药物使用的情况较为普遍，学校应针对青少年学生不同年龄阶段的特点，开展有针对性的健康教育，以减少吸烟饮酒对其的危害。     

Concurrent use of tobacco products by California adolescents

BACKGROUND: To describe patterns and correlates of tobacco product use other than cigarettes in adolescents 12-17 years of age. METHODS: Adolescent respondents (N = 6090) to the 1999 California Tobacco Survey provided estimates of ever and current use (in last 30 days) of smokeless tobacco, cigars, and bidis, which were examined by cigarette smoking experience, demographics, and known predictors of cigarette use. RESULTS: Only 3% of adolescents who never smoked cigarettes experimented with other tobacco products. Among ever smokers who were not current smokers, the rate was 35%. Nearly 60% of current cigarette experimenters had tried another tobacco product, but almost 90% of current established smokers had experimented with one. Over 40% of current established smokers used another tobacco product in the last 30 days. Factors predictive of cigarette smoking were also highly associated with other tobacco use. In ever cigarette smokers, having peers who used other tobacco products was most highly associated with other tobacco use. Problem or risky behaviors, beliefs that cigarettes are safe or beneficial, and receptivity to tobacco promotions were also independently associated with other tobacco product use. CONCLUSIONS: Adolescent smokers who use other tobacco products may be prone to risky behavior and such use may hasten the development of nicotine tolerance.     

Teens in trouble: cigarette use and risky behaviors among private, high school students in La Paz, Bolivia.

OBJECTIVE: To describe the prevalence of cigarette smoking and to identify risky behaviors associated with smoking among adolescents attending high schools in a district of La Paz, Bolivia. METHODS: The Youth Risk Behavior Survey was administered to a sample of 394 males and 182 females, from 13-18 years of age, at six, randomly-selected schools in District II of La Paz. Frequencies, chi-square tests, and logistic regression were employed to identify factors associated with cigarette use during the 30 days prior to the survey. RESULTS: Approximately 40% of the sample (39.4% of males and 33.7% of females) had smoked cigarettes in the 30 days prior to interview. For both males and females, consumption of alcohol was the single greatest risk factor associated with cigarette use. The males and females who reported consuming at least one alcoholic beverage on three or more occasions in the previous 30 days were 22.3 and 58.5 times (95% CIs: 6.7, 74.1 and 6.8, 502.6, respectively) more likely to smoke tobacco than those who reported no alcohol consumption. Additional risk factors included having participated in a physical fight, having carried a weapon, having had sexual intercourse, and having used illicit drugs during the previous 30 days. CONCLUSIONS: Because teenagers who smoke are also likely to engage in a variety of other risky behaviors, parents, school administrators, and health educators may wish to use smoking to identify at-risk individuals. Among Bolivian teenagers, interventions should focus on preventing cigarette use and associated risk behaviors.     

Density of tobacco retail outlets near schools and smoking behaviour among secondary school students

Objective: To investigate whether the density of tobacco retail outlets near schools in Victoria, Australia, is associated with adolescent smoking behaviour. Methods: Cross‐sectional survey data of 2,044 secondary school students aged 12–17 years was combined with tobacco outlet audit data. Associations between students' self‐reported tobacco use and the density of tobacco outlets near schools was examined using multilevel logistic and negative binomial regression models, with cigarette price at local milk bars and key socio‐demographic and school‐related variables included as covariates. Results: Increased tobacco retail outlet density was associated with a significant increase in the number of cigarettes smoked in the previous seven days among students who smoked in the past month (IRR=1.13; 95% CI 1.02–1.26), but not the odds of smoking in the past month in the larger sample (OR=1.06; 95% CI 0.90–1.24), after controlling for local mean price of cigarettes and socio‐demographic and school‐related variables. Conclusions and implications: This study suggests there is a positive association between tobacco retail outlet density and cigarette consumption among adolescent smokers, but not smoking prevalence, in the Australian context. There is value in considering policy measures that restrict the supply of tobacco retail outlets in school neighbourhoods as a means of reducing youth cigarette consumption.     

武汉市私立学校中学生吸烟状况的初步分析

目的　了解私立学校中学生的吸烟状况 ,为加强青少年吸烟行为的干预措施提供依据。方法　以美国南加州大学提供的“青少年控烟项目调查问卷”为基础 ,对武汉市 8所私立学校 1 30 7名中学生进行问卷调查。以尝试吸烟率、吸过一整支烟的吸烟率、过去 30d吸烟率、吸过 1 0 0支烟吸烟率描述学生的吸烟行为。结果　中学生的初始吸烟年龄平均为 1 1 .2岁 ;尝试吸烟率为 54 .0 % ,吸过 1整支烟的比例为 2 2 .0 % ,过去 30d内吸烟率为 1 9.4 % ,吸烟 >1 0 0支的学生占 4 .4 % ;吸烟情况分析中 ,54 .1 %的学生是在好奇的情况下抽烟 ;吸烟来源中 ,46 .0 %的学生报告香烟是从朋友或同学那里得到的。结论　私立学校中学生的吸烟状况严重 ,加强对吸烟行为的早期预防教育和干预控制刻不容缓     

Adolescent smokers' provision of tobacco to other adolescents.

OBJECTIVES: This study examined adolescent smokers provision of tobacco to other adolescents. METHODS: Data from a survey of 8th-, 9th-, and 10th-grade students in Minnesota were analyzed by using mixed-model logistic regression. RESULTS: More than two thirds (68.8%) of adolescent smokers had provided tobacco to another adolescent in the previous 30 days. Mother's smoking, number of friends who smoke, owning tobacco merchandise, number of cigarettes smoked in the past week, source of last cigarette (commercial), and recent attempt to buy cigarettes were associated with providing. CONCLUSIONS: The social availability of tobacco to youth needs further examination.     

Cigarette smoking attitudes and first use among third- through sixth-grade students: the Bogalusa Heart Study.

OBJECTIVES: This study examined cigarette smoking attitudes, peer and parental influence, and first use among children in southeastern Louisiana. METHODS: Data from 933 children in grades 3 through 6 in the Bogalusa Heart Study (1993 through 1994) were analyzed. RESULTS: Fifteen percent of the children had tried smoking. Of these, 40% first smoked with a family member, and 46% obtained their first cigarette from a family member or from home. Correlates of ever having smoked were race, sex, having a best friend or family member who smoked, and attitudes that smoking is disgusting and that nonsmokers get better grades. CONCLUSIONS: Prevention programs should begin early and focus on family and peer influences as well as attitudes.     

高中生吸烟行为特征及与其他危险行为关系分析

目的了解蚌埠市高中生的吸烟特征,为制定有效的干预措施提供科学依据。方法采取分层随机整群抽样,在蚌埠市区12所中学高中班中随机抽取11所中学22个班的全体学生进行问卷调查。结果3 131名高中生中,有800名高中生曾经吸过一整支烟,曾经吸烟率为25.6%,男生高于女生,其中,35.8%的学生吸一整支烟时的年龄<13岁,15~16岁是青少年尝试吸烟的高发年龄。8.9%的高中生曾有过经常性吸烟行为。在调查前30 d,4.6%的学生在学校吸烟,男生高于女生;4.9%的学生平均每天吸烟≥2支,男生高于女生;获得香烟的方式以在商店买烟为主,占50.5%。多因素logistic回归分析表明:最近12个月打架,厌学情绪、最近30 d饮酒、谈恋爱、性行为、最近7 d上网吧、参加校内运动队、性别对高中生吸烟影响最大。结论应及早对青少年进行控制吸烟的健康教育,使他们认识到吸烟的危害,自觉抵制烟草。同时对其他相关危险行为进行干预,以发挥干预措施的综合效应,提高控烟效果。     

Tobacco Use Among Adolescent Students and the Influence of Role Models

Background:

Seventy per cent of premature deaths among adults are due to behavioral patterns that emerge in adolescence, including smoking.

Objective:

The objective was to study the prevalence of tobacco use among adolescent students in South Delhi and its epidemiological correlates.

Materials and Methods:

This was a cross-sectional study.

Setting:

Three schools and two colleges of South Delhi were chosen. There were 550 adolescent students aged 14-19.

Statistical Analysis:

Statistical analysis was done using proportions, the chi-square test, and multivariate logistic regression.

Results:

A total of 88 (16.0%) students reported having ever tried cigarette or bidi smoking. The prevalence of current smoking was 7.1%. Exactly 10% (55) of the students reported having ever used smokeless forms of tobacco. The prevalence of tobacco use overall was found to be 20.9%, and was significantly higher (P=0.016) among the males than the females. Tobacco use was found to be significantly associated with having seen a brother/sister smoke (OR 5.15), best friend smoke (OR 2.92), and belonging to a nuclear family (OR 1.96).

Conclusions:

Tobacco use is still an important risk behavior among adolescent students. This study found a strong association of tobacco use by the adolescents with their having seen various role models ever smoking.     

Viewing tobacco use in movies: does it shape attitudes that mediate adolescent smoking?

BACKGROUND: Social cognitive theory posits that children develop intentions and positive expectations (utilities) about smoking prior to initiation. These attitudes and values result, in part, from observing others modeling the behavior. This study examines, for the first time, the association between viewing tobacco use in movies and attitudes toward smoking among children who have never smoked a cigarette. DESIGN/SETTING: Cross-sectional school-based survey was used among randomly selected Vermont and New Hampshire middle schools. The sample consisted of 3766 middle school students (grades 5-8). The sample was primarily white and equally distributed by gender. The primary exposure was number of movie tobacco-use occurrences viewed. We first counted occurrences of tobacco use in each of 601 recent popular motion pictures. Each student was asked to select movies they had seen from a random subset of 50 movies. Based on movies the adolescent had seen, movie tobacco-use occurrences were summed to determine exposure .The outcome was susceptibility to smoking, positive expectations, and perceptions of smoking as normative behavior for adolescents or adults. RESULTS: The movies in this sample contained a median of five occurrences of tobacco use (interquartile range=1, 12). The typical adolescent never-smoker had viewed 15 of the 50 movies on his/her list. From movies adolescents reported seeing, exposure to movie tobacco-use occurrences varied widely: median=80, and interquartile range 44 to 136. The prevalence of susceptibility to smoking increased with higher categories of exposure: 16% among students who viewed 0 to 50 movie tobacco occurrences; 21% (51 to 100); 28% (101 to 150); and 36% (>150). The association remained statistically significant after controlling for gender, grade in school, school performance, school, friend, sibling and parent smoking, sensation-seeking, rebelliousness, and self-esteem. Compared with adolescents exposed to < or =50 occurrences of tobacco use, the adjusted odds ratio of susceptibility to smoking for each higher category was 1.2 (95% confidence interval 0.9, 1.5), 1.4 (1.1, 1.9), and 1.6 (1.3, 2.1), respectively. Similarly, higher exposure to tobacco use in movies significantly increased the number of positive expectations endorsed by the adolescent and the perception that most adults smoke, but not the perception that most peers smoke. CONCLUSIONS: This study provides empirical evidence that viewing movie depictions of tobacco use is associated with higher receptivity to smoking prior to trying the behavior.     

Relationship between perceived life satisfaction and adolescents' substance abuse.

PURPOSE: To explore the relationship between perceived global life satisfaction and selected substance use behaviors among 5032 public high school students. METHODS: The 1997 South Carolina Youth Risk Behavior Survey substance abuse and life satisfaction variables were used. An adjusted polychotomous logistic regression analysis utilizing SAS/SUDAAN, revealed a significant race/gender interaction. Subsequent multivariate models were constructed individually for four race/gender groups. Adjusted odds ratios and 95% confidence intervals were calculated to assess the magnitude of risk for selected substance abuse behaviors and their association with reduced global life satisfaction. RESULTS: Cigarette smoking, chewing tobacco, marijuana, cocaine, regular alcohol use, binge drinking, injection drug, and steroid use were significantly (p < .05) associated with reduced life satisfaction for specific race/gender groups (white males; black males; white females; and black females). In addition, age (< or = 13 years) of first alcohol drink, first marijuana use, first cocaine use, and first cigarette smoked were also significantly (p < .05) associated with reduced life satisfaction. CONCLUSION: Longitudinal studies are needed to determine whether dissatisfaction with life is a consequence or determinant of substance abuse behavior for adolescents.     

Sex differences in prevalence rates and predictors of cigarette smoking among in-school adolescents in Kilimanjaro, Tanzania

An analysis of the Global Youth Tobacco Survey for Kilimanjaro, Tanzania was carried out to assess sex differences in the prevalence rates and predictors of current cigarette smoking among in-school adolescents. A total of 2323 adolescents participated in the study of whom 53% were females and 47% males. The prevalence of current cigarette smoking was 3.0% and 1.4% among males and females, respectively. The common factors that were significantly positively associated with cigarette smoking between sexes were: having more pocket money, closest friend smoked cigarettes, seeing actors smoke on TV, videos or movies, and seeing advertisements for cigarettes at social gatherings. Seeing anti-smoking messages at social gatherings were negatively associated with smoking among both sexes. While having had something such as a t-shirt or pen with a cigarette brand logo on it was positively associated with cigarette smoking among males, it was negatively associated with cigarette smoking among females. Male adolescents older than 15 years, those in their 9th year of schooling, and those who had seen cigarette brand names on TV were more likely to smoke. Meanwhile, male respondents who were in their 8th year of schooling, had seen anti-smoking media messages, and advertisements for cigarettes in newspapers or magazines were less likely to smoke. Among female adolescents, those who had parents who smoked, and surprisingly those who perceived that cigarette smoking as harmful were more likely to smoke. Interestingly, seeing advertisement for cigarettes on billboards was negatively associated with smoking among female adolescents. Interventions aimed to reduce adolescent smoking need to be designed and implemented with due consideration of sex differences in these associated factors.     

Perceived smoking norms,socioenvironmental factors,personal attitudes and adolescent smoking in China: a mediation analysis with longitudinal data

PurposeTo gather information on inter-relationships among risk factors affecting adolescent smoking for tobacco control in China, the world’s largest tobacco producer and consumer.MethodLongitudinal data were collected six months apart in 2003 from 813 students in grades 7, 8, 10, and 11 from two schools in Beijing, China. Linear regression was used to assess both the direct effect from predictor variables (smoking among influential others, pro-tobacco media, and attitudes toward smoking) on cigarette use and the indirect effect mediated through the perceived smoking norms (percentage of smokers among peers).ResultsAmong the 803 subjects (mean age of 15.5 years, SD = 1.7; 52.1% female), 18.3% of males and 1.7% of females smoked in the past 30 days. Smoking among influential others (best friends, father, mother, male teachers, female teachers, and adults in general) and perceived positive psychological and social rewards from smoking at baseline were associated with number of cigarettes smoked at follow-up, whereas exposure to pro-tobacco media was not significantly associated with smoking. The mediated effect was greater for adult smoking (70% to 90%) than for best friend smoking (11% to 16%).ConclusionSmoking among influential others and attitudes toward smoking influence adolescent smoking both directly and indirectly. The finding of the indirect effect mediated through perceived smoking norms expands our knowledge on smoking etiology. Effective adolescent smoking intervention programs in China need to include a component targeting adult smoking to reduce perceived smoking norms.     

Multiple Correlates of Cigarette Use Among High School Students

A cross-sectional survey research design measured factors related to cigarette use among 2,212 senior high school students. Results showed 14.3% of the sample smoked cigarettes at least occasionally, with 5.3% reporting they were daily smokers. About 12.8% indicated they were ex-smokers. Males and females smoked at almost equal rates, and the percentage of 10th grade student smokers was slightly higher (16.4%) than the percentage of juniors and seniors who smoked. Approximately 22% of Hispanic students, 15% of Caucasian students, and 4.5% of African-American students reported smoking cigarettes at least occasionally. An initial regression analysis used 21 variables to predict cigarette smoking. A more parsimonious regression model (R2 = .28), using variables from the initial regression analysis with significance levels of .01 or less, indicated the most important predictors of cigarette use were ethnic group, attitude toward females who smoke, close friends' use of cigarettes, personal use of marijuana, best friend's use of cigarettes, personal use of alcohol, and school self-esteem. Implications for school health programs are addressed.     

Substance use by indigenous and non-indigenous primary school students

OBJECTIVE: Recent Australian research with adolescents aged 13 to 17 years has found that Indigenous youth are more likely than non-Indigenous adolescents to smoke tobacco and cannabis, although they may be less likely to use alcohol. The objective of this study was to examine whether this pattern exists among younger children. METHOD: A school-based, self-report survey was conducted in primary schools that had high proportions of Aboriginal and Torres Strait Islander children. Four schools were located in metropolitan Brisbane and three in Far North Queensland (sample n = 507 students: 270 girls, 237 boys, aged 9-13 years). RESULTS: Significant numbers of these children had started to experiment with recreational drugs. Twenty-two per cent had attempted to smoke at least one cigarette, 14% smoked in the preceding year, while 3% had smoked more than 10 cigarettes in their lives. Thirty-eight per cent had had at least one drink of alcohol, while 6% had smoked marijuana at least once. There was no significant association between Indigenous/non-Indigenous background and risk of smoking tobacco or marijuana, while Indigenous children were less likely than non-Indigenous children to report experience with alcohol. CONCLUSIONS: Contrary to data from secondary school students, Indigenous youth in primary schools were not more likely than non-Indigenous children to have experimented with tobacco or marijuana, or to be frequent tobacco smokers. It appears therefore that the excessive uptake of drug use among Indigenous youth occurs in the early stages of secondary school. This finding underlines the importance of preventive education in primary schools, especially for Indigenous children who have a high risk of making the transition to drug use in adolescence.     

Effects of individual characteristics and school environment on cigarette smoking among students ages 13-15: A multilevel analysis of the 2007 Global Youth Tobacco Survey (GYTS) data from Vietnam

This paper aims to estimate the prevalence of cigarette smoking among students in Vietnam ages 13-15 and examines its relationship with compositional and contextual factors. The data used in this paper were obtained from the 2007 Global Youth Tobacco Survey conducted in nine provinces in Vietnam. A multilevel logistic regression model was applied to analyse the association between the current incidence of cigarette smoking and factors on both the individual and school level. The prevalence of cigarette smoking among students was 3.3% overall. The prevalence of smoking among male students (5.9%) was higher than that among females (1.2%). Parental smoking was a significant risk factor for smoking among the students. Having a friend who smoked was the strongest predictor of smoking status among the study subjects. We have demonstrated that school-level factors appeared to impact the prevalence of cigarette smoking among students ages 13-15. This paper highlights the importance of utilising an extensive range of actions to prevent students from using tobacco in Vietnam. These actions should include providing specific curricula for students that address both individual characteristics and the school environment. Further, prevention programmes should also target both parental- and peer-smoking issues.