Preventing cigarette smoking with youth

A repeated measures, control group design compared skills-building with attitude modification approaches to prevent cigarette smoking of 234 sixth graders. Subjects in a skills-building condition, more than those in an attitude modification condition or in a control condition, had better posttest scores on cognitive and interpersonal precursors of nonsmoking. Greater pretest to posttest changes in cigarette use were reported for attitude modification condition subjects than for skills-building and control condition subjects. Compared with attitude modification and control condition subjects, skills-building condition subjects had lower reported increases in cigarette use from posttest to 6 months and from 6 to 12 months.The authors thank Cheryl Kelso, Thomas Glynn, Catherine Bell, Lois Holt, Virginia Senechal, Deborah Lodish, Janet Bobo, William Snow, and David Finke. Funding was provided by Division of Cancer Prevention and Control Grant, CA 29640: from the National Cancer Institute, National Institutes of Health, United States Public Health Service, Department of Health and Human Services.Steven Paul Schinke is Chairman, and Lewayne D. Gilchrist is Research Scientist, Social Work Research, Child Development and Mental Retardation Center, University of Washington, Seattle, Washington 98195.     

Psychosocial conditions of cigarette smoking among youth

The study was carried out on 13-17 years old school children from Warsaw elementary and secondary schools (vocational schools, technical schools and general education secondary schools). Statistical analysis of following parameters was estimated: 1. Respondent characteristics (sex, age, type of school, grade); 2. Characteristics of cigarette smoking (nonsmoking, age of first experience of smoking, frequency of smoking, planning the cigarette smoking in future); 3. Psychosocial factors (frequency of cigarette smoking among social environment of respondents, attitude toward smoking, estimating of psychophysical self-confidence, estimating of interpersonal relationships with other significant people and environments and estimating of social role playing in youth. The obtained results showed: 1. Cigarette smoking is one element of the global strategy that smoker uses to cope with interpersonal problems in process of socialization. 2. Smoking is a process conditioned by many factors influencing each other. Among this factors, psychosocial elements are very important. 3. The sources of this process are harmful relations with parents in early childhood, especially with mother. 4. The necessary condition of intaking regular smoking is cigarette smoking by social environments of youth. Frequency of this phenomenon is condited by sociocultural factors.     

The effect of cigarette prices on youth smoking

Prior economic research provides mixed evidence on the impact of cigarette prices on youth smoking. This paper empirically tests the effects of various price measures on youth demand for cigarettes using data collected in a recent nationally representative survey of 17 287 high school students. In addition to commonly used cigarette price measures, the study also examined the effect of price as perceived by the students. This unique information permits the study of the effect of teen-specific price on cigarette demand. The analysis employed a two-part model of cigarette demand based on a model developed by Cragg (1971) in which the propensity to smoke and the intensity of the smoking habit are modeled separately. The results confirm that higher cigarette prices, irrespective of the way they are measured, reduce probability of youth cigarette smoking. There is also some evidence of negative price effect on smoking intensity, but it is sensitive to the price measure used in the model. The largest impact on cigarette demand has the teen-specific, perceived price of cigarettes.     

Factors associated with stages of cigarette smoking among Turkish youth

BACKGROUND: This study examines prevalence and determinants of cigarette smoking among Turkish youth and transition among smoking stages. METHODS: Cross-sectional data from the Global Youth Tobacco Survey (GYTS) obtained from 15 197 youth were used to study factors associated with various stages of cigarette smoking among Turkish youth. RESULTS: Males and high-school students have higher odds of being susceptible to smoking compared with other non-smokers and higher odds of becoming established smokers. Exposure to parent, teacher, and peer smoking, anti-tobacco curricula, cigarette promotions, and perceived ease of access to cigarettes are all significant predictors of being susceptible to smoking and established smoking. Turkish youth who attribute positive traits to smokers are more likely to be susceptible to smoking and to become established smokers. Parental advice and media exposure to anti-tobacco messages were not significantly associated with becoming an established smoker. CONCLUSION: The results reveal the importance of early prevention programmes, which should begin before high school, and targeting efforts towards male students and all students who are not yet smokers but susceptible to smoking. Findings also suggest that prevention policies that challenge the cultural perceptions of smokers among Turkish youth are needed.     

Predictors of different cigarette access behaviours among occasional and regular smoking youth

BACKGROUND: Understanding the different ways underage youth access tobacco is required in order to develop more effective tobacco access restrictions. The purpose of this study was to examine characteristics that predict whether underage smoking youth buy their own cigarettes, buy their cigarettes from friends, or get someone else to buy their cigarettes. METHODS: Logistic regression analyses were used to examine the predictors of three different tobacco access behaviours among 737 occasional smoking and 2,050 regular smoking youth. RESULTS: Most smoking youth were asked their age less than half of the time when trying to buy cigarettes. Occasional smokers usually buy their cigarettes from a friend (59.5%) and the majority of regular smokers usually buy their own cigarettes (59.8%). Occasional smokers were less likely to buy their own cigarettes (OR 0.85) and more likely to ask someone else to buy their cigarettes (OR 1.24) the more frequently they were asked their age on purchase attempts. Regular smokers were also less likely to buy their own cigarettes (OR 0.70) and more likely to buy their cigarettes from someone else (OR 1.51) or a friend (OR 1.18) the more frequently they were asked their age on purchase attempts. INTERPRETATION: Point-of-sale restrictions are insufficient to prevent youth from acquiring cigarettes because youth commonly access cigarettes from social sources. A more comprehensive approach for restricting access is required that targets both underage youth and individuals who purchase tobacco for underage youth.     

Retail tobacco outlet density and youth cigarette smoking: a propensity-modeling approach

OBJECTIVES: We examined whether retail tobacco outlet density was related to youth cigarette smoking after control for a diverse range of neighborhood characteristics. METHODS: 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. RESULTS: 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. CONCLUSIONS: Reductions in retail tobacco outlet density may reduce rates of youth smoking.     

Exposure to brand-specific cigarette advertising in magazines and its impact on youth smoking

BACKGROUND: Despite the potential influence of cigarette advertising on youth smoking, few studies have characterized brand-specific magazine advertising exposure among youths or examined its impact on youth smoking behavior. METHODS: A longitudinal youth survey was conducted to assess baseline exposure to brand-specific cigarette advertising in magazines and to measure subsequent smoking behavior. The sample comprised 1,069 Massachusetts youths, ages 12-15 years at baseline in 1993, and 627 of these youths who were interviewed after 4 years. RESULTS: Five brands accounted for 81.8% of the gross impressions for magazine advertising among Massachusetts youths. These same brands accounted for 88.4% of the brand market share among 12- to 15-year-old smokers nationally in 1993. The levels of brand-specific advertising exposure in the sample were highly correlated with these national brand market shares (r = 0.96, P = 0. 0002). Among the cohort, baseline brand-specific exposure to cigarette advertising in magazines was highly correlated with brand of initiation among new smokers (r = 0.93, P = 0.0001), brand smoked by current smokers (r = 0.86, P = 0.0004), and brand whose advertisements attracted attention the most (r = 0.87, P = 0.0002). CONCLUSION: By documenting a relationship between brand-specific magazine advertising exposure and brand of smoking initiation among new smokers, this study provides strong new evidence that cigarette advertising influences youth smoking.     

Understanding the role of cigarette promotion and youth smoking in a changing marketing environment

In 2001, $11.21 billion was spent on domestic cigarette advertising and promotion, an increase of 16.9% over 2000. This article explains how cigarette industry efforts stimulate demand and encourage smoking within the context of recent changes, including the 1998 Master Settlement Agreement (MSA) and resulting litigation, and variations in tobacco marketing policies. Communication concepts are combined with adolescent development concepts to explain how youth are impacted. Industry documents and current syndicated research data are used to reveal and explain key concepts.     

The early 1990s cigarette price decrease and trends in youth smoking in Ontario

BACKGROUND: Youth are especially vulnerable to fluctuations in cigarette price, and both the smuggling increase during the early 1990s and the 1994 tax decrease made purchasing easier for youth. The purpose of this study is to examine the relation between these price decreases, and trends in smoking prevalence and amount smoked among Ontario youth. METHODS: Data from the Ontario Student Drug Use Survey were analyzed for trend using: 1) polynomial regression, and 2) discontinuity regression with an "event time" of 1993 to capture effects of both pre-tax cut smuggling and the tax cut. RESULTS: Overall, smoking prevalence decreased from 1977 to 1993, jumped upward at this time, and decreased after 1993. Among daily smokers, mean number of cigarettes smoked daily showed an increase followed by a decrease over the 24 years, and a negative quadratic trend. Trends for subgroups are also reported. CONCLUSIONS: These findings suggest that the early 1990s cigarette price decrease may have played a role in increasing youth smoking in Ontario.     

Preventing the onset of cigarette smoking in Norwegian adolescents: The oslo youth study

As part of a 2-year multiple risk factor intervention study, a school-based, multicomponent smoking prevention program for 10- to 15-year-old students in Oslo, Norway, resulted in a significant reduction in the onset of smoking relative to a reference group. Based on reported smoking behavior, the intervention group (N = 278) experienced a smoking onset rate of 16.5% and the reference group (N = 208) a rate of 26.9%. Intervention students had a significantly larger increase in scores on a smoking knowledge index; they also reported a significantly larger increase in frequent exercise and a significantly smaller increase in consumption of alcoholic beverages. A stepwise discriminant analysis showed that the smoking prevention program was an important discriminator of smoking onset. In both reference and intervention groups, students who reported smoking at the follow-up survey had already displayed risk-taking tendencies at the time of the baseline survey 2 years earlier, whether or not they smoked at baseline. Follow-up smokers had more smoking friends and siblings at baseline and evidenced greater acceptability of smoking; they ate sweet, fatty, and salty snack foods more often, exercised less often, and drank more beer and hard liquor than students who were nonsmokers at the follow-up survey.     

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.     

Socio-demographic correlates of cigarette smoking among high school students: results from the British Columbia youth survey on smoking and health

OBJECTIVE: To describe the association between selected socio-demographic factors (age, gender, ethnicity, and region) and the prevalence of smoking among adolescents in two regions of British Columbia, and to report recent findings related to the prevalence of tobacco use in British Columbia. METHODS: A cross-sectional school-based survey was conducted using a random sample of 3,280 students from 13 schools in two regions of British Columbia. Multivariate logistic regression analysis was used to determine the association between age, region, gender and ethnicity and smoking status. RESULTS: Ethnic group membership was strongly associated with smoking status, which changed very little after controlling for the other socio-demographic factors. Controlling for age and ethnicity, the effect of gender on smoking status was moderated by region. CONCLUSION: Reliance on general population tobacco use prevalence rates masks important ethnic and gender differences. To increase the effectiveness of tobacco control policies and programming, greater attention needs to be paid to the socio-demographic correlates associated with adolescents' tobacco use.     

Women's smoking behaviour--caught by a cigarette diary

This study explores women's smoking behaviour in relation to mood, activity and social context. A particular aim was to design a 'cigarette diary', useful for research as well as for practical purposes. Fifty male nurses and secretaries kept a diary for one to three typical work days. Diaries consisted of a set of identical sheets, each of which related to one cigarette. Pre-smoking mood and the context of smoking were carefully noted. It was hypothesized that smoking is positively related to perceived stress. Results partly supported this hypothesis, but they also showed that a majority of the cigarettes were smoked in a state of happiness and relaxation.     

Receptivity to protobacco media and its impact on cigarette smoking among ethnic minority youth in California

Adolescents from different ethnic groups show different cigarette smoking prevalence rates, suggesting potential differences in receptivity to and influences from protobacco media. Understanding these differences will be helpful in tailoring smoking prevention and cessation programs for diverse adolescent populations in the United States. Data from cross-sectional surveys of 20,332 randomly sampled California boys and girls, 12-17 years of age, were analyzed. Results indicate that receptivity to protobacco media was lower among African Americans, Asian Americans, and Hispanics than among White youth. There was a consistent dose-response relationship between receptivity to protobacco media and 30-day cigarette smoking across ethnic groups. Having a cigarette brand preference was associated with the highest risk for cigarette smoking, having a favorite tobacco ad showed the lowest risk, while having received or being willing to use tobacco promotional items was associated with a moderate risk. After controlling for 13 covariates, the odds ratio for receptivity to protobacco media and 30-day cigarette smoking was significant for Whites (RR = 1.38, p < 0.01) and Hispanics (RR = 1.46, p < 0.01), but not for African American (RR = 1.05, p > 0.05) and Asian American (RR = 1.17, p > 0.05) youth. African American, Asian American, and Hispanic adolescents have a lower level of receptivity to protobacco media than do Whites. The association between media receptivity and 30-day cigarette smoking exists for all four ethnic groups without controlling for other smoking predictor variables, but only for Hispanics and Whites when other variables are controlled. Protecting adolescents from protobacco advertising influences is an important element in tobacco control among ethnic minority youth.     

Ovarian function and cigarette smoking

Whitcomb BW, Bodach SD, Mumford SL, Perkins NJ, Trevisan M, Wactawski‐Wende J, Liu A, Schisterman F. Ovarian function and cigarette smoking. Paediatric and Perinatal Epidemiology 2010. Cigarette smoking has been implicated in reproductive outcomes including delayed conception, but mechanisms underlying these associations remain unclear. One potential mechanism is the effect of cigarette smoking on reproductive hormones; however, studies evaluating associations between smoking and hormone levels are complicated by variability of hormones and timing of specimen collection. We evaluated smoking among women participating in the BioCycle Study, a longitudinal study of menstrual cycle function in healthy, premenopausal, regularly menstruating women (n = 259). Fertility monitors were used to help guide timing of specimen collection. Serum levels of oestradiol, progesterone, follicle‐stimulating hormone (FSH), luteinising hormone (LH) and total sex‐hormone binding globulin (SHBG) across phases of the menstrual cycle were compared between smokers and non‐smokers. We observed statistically significant phase‐specific differences in hormone levels between smokers and non‐smokers. Compared with non‐smokers, smokers had higher levels of FSH in the early follicular phase and higher LH at menses after adjusting for potential confounding factors of age, race, body mass index, parity, vigorous exercise, and alcohol and caffeine intake through inverse probability of treatment weights. No statistically significant differences were observed for oestradiol, progesterone or SHBG. These phase‐specific differences in levels of LH and FSH in healthy, regularly menstruating women who are current smokers compared with non‐smokers reflect one mechanism by which smoking may influence fertility and reproductive health.     

Unemployment insurance and cigarette smoking

We provide evidence for the causal relationship between unemployment insurance (UI) and individuals’ smoking behavior using the 1995–2011 Current Population Survey-Tobacco Use Supplement data. Our identification relies on the exploitation of the exogenous variations of the maximum UI weekly benefits across states and over years. Instead of focusing on all unemployed people, we concentrate on those who are eligible for UI benefits. We find that when the maximum UI weekly benefit level increases by $100, smoking cessation increases by approximately 2.9 percentage points among the UI-eligible unemployed. The results are robust to various model specifications. We also explore the mechanism and find suggestive evidence that the increase in the maximum UI weekly benefit leads to a decrease in the probability of over-work of the respective spouse. Moreover, the unemployed who are less educated are more responsive to the increasing UI benefits.     

Longitudinal patterns of cigarette smoking and smokeless tobacco use in youth: the Bogalusa Heart Study.

Tobacco use was studied during 1977-76 (n = 2880) and 1981-82 (n = 2158) in a total biracial community of children, aged 8-17 years, in Bogalusa, Louisiana. White males were the early adopters of tobacco products in both surveys. Cigarette smoking decreased in all race and gender groups while smokeless tobacco use increased in White males. Studies which find a decline in male adolescent smoking should investigate a possible concurrent increase in smokeless tobacco.