1
|
Park MH, Song HY. Transtheoretical model to predict the stages of changes in smoking cessation behavior among adolescents. Front Public Health 2024; 12:1399478. [PMID: 39081357 PMCID: PMC11286591 DOI: 10.3389/fpubh.2024.1399478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/24/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Previous studies on adolescent smoking cessation behavior based on the transtheoretical model have primarily focused on the development of cessation programs. Attempting to quit smoking is a prerequisite for executing smoking cessation. Appropriate methods must be selected based on the characteristics and intentions of individuals to increase smokers' satisfaction and success rates in quitting. Therefore, this study aimed to identify changing processes influencing the stages of change associated with successful smoking cessation among adolescents and examined the related factors. This descriptive study explored a transtheoretical model of different stages of changes in smoking cessation behavior among adolescent smokers. Methods The participants included 237 middle and high school students in South Korea. We examined the differences in stages of changes in smoking cessation behaviors based on general characteristics, smoking-related characteristics, smoking cessation change processes (cognitive and behavioral), smoking decisional balance (pros and cons of smoking), and self-efficacy. Results The probability of reaching the preparation stage of smoking cessation was significantly lower among participants who did not know their father's educational level than among those who knew their father's educational level. Conversely, this probability was significantly higher among participants whose mothers had a college or higher education level and those who did not know their mother's educational level than in those whose mothers had a high school or lower education level. Conclusion These findings indicated that parental education is a significant predictor of the preparation stage of smoking cessation, highlighting the importance of the family environment in facilitating smoking cessation among adolescents. Accordingly, communication and support at home could help reinforce adolescents' determination to quit smoking and make relevant plans. Thus, smoking cessation support should stress the need to enhance communication at home.
Collapse
Affiliation(s)
- Min Hee Park
- Department of Nursing, Wonkwang University, Iksan, Republic of Korea
| | - Hye-Young Song
- College of Nursing, Woosuk University, Jeonju, Republic of Korea
| |
Collapse
|
2
|
Mills SD, Zhang Y, Wiesen CA, Hassmiller Lich K. Improving Prediction of Tobacco Use Over Time: Findings from Waves 1-4 of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2024; 26:194-202. [PMID: 37671638 PMCID: PMC10803117 DOI: 10.1093/ntr/ntad171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 08/04/2023] [Accepted: 09/04/2023] [Indexed: 09/07/2023]
Abstract
INTRODUCTION First-order Markov models assume future tobacco use behavior is dependent on current tobacco use and are often used to characterize patterns of tobacco use over time. Higher-order Markov models that assume future behavior is dependent on current and prior tobacco use may better estimate patterns of tobacco use. AIMS AND METHODS This study compared Markov models of different orders to examine whether incorporating information about tobacco use history improves model estimation of tobacco use and estimated tobacco use transition probabilities. We used data from four waves of the Population Assessment of Tobacco and Health Study. In each Wave, a participant was categorized into one of the following tobacco use states: never smoker, former smoker, menthol cigarette smoker, non-menthol cigarette smoker, or e-cigarette/dual user. We compared first-, second-, and third-order Markov models using multinomial logistic regression and estimated transition probabilities between tobacco use states. `RESULTS The third-order model was the best fit for the data. The percentage of former smokers, menthol cigarette smokers, non-menthol cigarette smokers, and e-cigarette/dual users in Wave 3 that remained in the same tobacco use state in Wave 4 ranged from 63.4% to 97.2%, 29.2% to 89.8%, 34.8% to 89.7%, and 20.5% to 80.0%, respectively, dependent on tobacco use history. Individuals who were current tobacco users, but former smokers in the prior two years, were most likely to quit. CONCLUSIONS Transition probabilities between tobacco use states varied widely depending on tobacco use history. Higher-order Markov models improve estimation of tobacco use over time and can inform understanding of trajectories of tobacco use behavior. IMPLICATIONS Findings from this study suggest that transition probabilities between tobacco use states vary widely depending on tobacco use history. Tobacco product users (cigarette or e-cigarette/dual users) who were in the same tobacco use state in the prior two years were least likely to quit. Individuals who were current tobacco users, but former smokers in the prior two years, were most likely to quit. Quitting smoking for at least two years is an important milestone in the process of cessation.
Collapse
Affiliation(s)
- Sarah D Mills
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Yu Zhang
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | - Kristen Hassmiller Lich
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
3
|
Song R, Park M. Meta-analysis of the effects of smoking prevention programs for young adolescents. CHILD HEALTH NURSING RESEARCH 2022; 27:95-110. [PMID: 35004501 PMCID: PMC8650902 DOI: 10.4094/chnr.2021.27.2.95] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose This meta-analysis aimed to analyze the effects of smoking prevention programs for young adolescents at early smoking stages to identify the appropriate characteristics of prevention programs for this population. Methods Searches of health-related databases and Google Scholar were conducted, and 23 randomized studies were included in the analysis. The main outcome variable was smoking behavior. The analysis was conducted using Comprehensive Meta-Analysis software (version 3.0). Results Smoking prevention programs significantly reduced smoking behaviors (OR=0.85, 95% CI=0.77-0.93). School-based programs (OR=0.79, 95% CI=0.75-0.83), programs by trained teachers or educators (OR=0.77, 95% CI=0.71-0.83), high-intensity programs (OR=0.82, 95% CI=0.75-0.91), and programs in an in-school setting (OR=0.82, 95% CI=0.74-0.90) had the most significant effect on reducing smoking behavior. Conclusion For young adolescents, smoking prevention programs are most effective when they are school-based or highintensity programs, and when conducted by teachers or educators with proper training. Further studies are required since there was insufficient research to explore the effect of web-based programs or family-centered programs on adolescent smokers.
Collapse
Affiliation(s)
- Rhayun Song
- Professor, College of Nursing, Chungnam National University, Daejeon, Korea
| | - Moonkyoung Park
- Assistant Professor, College of Nursing, Chungnam National University, Daejeon, Korea
| |
Collapse
|
4
|
Masiero M, Cutica I, Mazzocco K, Zunino A, Cropley M, Pravettoni G. A Comprehensive Model of Tobacco Cigarette Smoking in Adolescence: The Role of Attachment Style and Personality. THE JOURNAL OF PSYCHOLOGY 2021; 155:589-605. [PMID: 34185624 DOI: 10.1080/00223980.2021.1934374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 04/16/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022] Open
Abstract
Several previous studies have investigated the association between smoking, attachment style and personality, but they were either focused on personality or on attachment style and considered these variables separately. Starting from such findings, the study aims to investigate both factors, as they might not be independent, in order to clarify their role in the onset of smoking behavior in adolescence. This study was conducted on a convenience sample of 338 adolescents [male: 55% (186) - female: 45% (152)] (aged 16.63 ± 1.63). All participants completed a set of standardized questionnaires that assessed attachment style, personality and smoking behavior (starting age, daily cigarettes, nicotine dependence). Results showed that the dismissing attachment style, novelty seeking, and older age were associated with a higher likelihood of having a cigarette smoking experience; while self-directedness and gender (being female) were associated with a lower likelihood of having a cigarette smoking experience (p < .001). The secure and avoidant attachment styles were associated with a late smoking onset, whereas dismissing attachment and reward dependence were associated with an earlier smoking onset (p < .009). These findings highlight the possibility of developing a psycho-cognitive profile of adolescent smokers, and help to describe a smoking trajectory that may aid in designing tailored interventions and treatments to discourage smoking.
Collapse
Affiliation(s)
| | | | - Ketti Mazzocco
- University of Milan
- European Institute of Oncology, IRCCS
| | | | | | | |
Collapse
|
5
|
Jafari N, MohammadpourAsl A, Asghari-Jafarabadi M. Differentiating between girls and boys in transition through smoking stages: A sex-specific growth mixture modeling. Health Promot Perspect 2021; 11:202-209. [PMID: 34195044 PMCID: PMC8233669 DOI: 10.34172/hpp.2021.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/22/2021] [Indexed: 11/09/2022] Open
Abstract
Background: Smoking is a complex process, and adolescents pass through a number of different stages on the way to become smokers and it is sex-dependent. Methods: In this cohort study, the illustrative samples of 10th-grade students (2241 girls and 2956 boys) were assessed using a multistage sampling in Tabriz, Iran. The main variables of the study were smoking status, intention to start smoking, and smoking during the past week/ month, which were collected using a valid and reliable instrument. Sex-specific GMMs were fitted to assess the transition through smoking stages. Results: GMMs lead in a 2-class optimal model: "Occasional/Intending smokers" and "Non-smokers". GMMs indicated that girls had lower levels of smoking status, intention to start smoking, smoking during the past week/month in both classes (significant and negative intercepts: -8.5 to -0.6). In addition, transitions toward higher levels of smoking status, intention to start smoking, smoking during the past week/month were observed in both classes for boys, but in the second class for girls (significant and positive slopes: 0.2 to 2.7). Conclusion: This study highlighted the importance of stopping the initiation and avoiding transition through smoking stages with special sex-specific planning in the future.
Collapse
Affiliation(s)
- Nasrin Jafari
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar MohammadpourAsl
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran.,Center of the development of interdisciplinary research in Islamic sciences and health sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
6
|
Transition through smoking stages in adolescents: an innovative perspective using growth mixture models. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01535-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
7
|
Shepherd JM, Bakhshaie J, Nizio P, Garey L, Viana AG, Zvolensky MJ. Anxiety symptoms and smoking outcome expectancies among Spanish-speaking Latinx adult smokers: Exploring the role of anxiety sensitivity. J Ethn Subst Abuse 2020; 21:304-324. [DOI: 10.1080/15332640.2020.1759476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | | | | | | | | | - Michael J. Zvolensky
- University of Houston, Houston, TX, USA
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
8
|
Cartocci G, Modica E, Rossi D, Cherubino P, Maglione AG, Colosimo A, Trettel A, Mancini M, Babiloni F. Neurophysiological Measures of the Perception of Antismoking Public Service Announcements Among Young Population. Front Hum Neurosci 2018; 12:231. [PMID: 30210322 PMCID: PMC6124418 DOI: 10.3389/fnhum.2018.00231] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 07/25/2018] [Indexed: 01/04/2023] Open
Abstract
Tobacco constitutes a global emergency with totally preventable millions of deaths per year and smoking-related illnesses. Public service announcements (PSAs) are the main tool against smoking and by now their efficacy is still assessed through questionnaires and metrics, only months after their circulation. The present study focused on the young population, because at higher risk of developing tobacco addiction, investigating the reaction to the vision of Effective, Ineffective and Awarded antismoking PSAs through: electroencephalography (EEG), autonomic activity variation (Galvanic skin response—GSR- and Heart Rate—HR-) and Eye-Tracking (ET). The employed indices were: the EEG frontal alpha band asymmetry and the frontal theta; the Emotional Index (EI), deriving from the GSR and HR signals matching; the ET Visual Attention (VA) index, based on the ratio between the total time spent fixating an area of interest (AOI) and its area. Smokers expressed higher frontal alpha asymmetry values in comparison to non-smokers. Concerning frontal theta, Awarded PSAs reported the highest values in comparison to both Effective and Ineffective PSAs. EI results highlighted that lowest values were expressed by Heavy Smokers (HS), and Effective PSAs obtained the highest EI values. Finally, concerning the Effective PSAs, regression analysis highlighted a correlation between the number of cigarettes smoked by participants (independent variable) and frontal alpha asymmetry, frontal theta and EI values. ET results suggested that for the Ineffective PSAs the main focus were texts, while for the Effective and Awarded PSAs were the visual elements. Results support the use of methods aimed at assessing the physiological reaction for the evaluation of PSAs images, in particular when considering the smoking habits of target populations.
Collapse
Affiliation(s)
- Giulia Cartocci
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Enrica Modica
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Dario Rossi
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | | | | | - Alfredo Colosimo
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | | | | | - Fabio Babiloni
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.,Department of Computer Science, Hangzhou Dianzi University, Xiasha Higher Education Zone, Hangzhou, China
| |
Collapse
|
9
|
Usera JJ. The Efficacy of an American Indian Culturally-Based Risk Prevention Program for Upper Elementary School Youth Residing on the Northern Plains Reservations. J Prim Prev 2018; 38:175-194. [PMID: 28032306 DOI: 10.1007/s10935-016-0462-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Culturally-based risk behavior prevention programs for American Indian elementary school children are sparse. Thus a group of American Indian educators collaborated in the creation of a program that helps children make healthy decisions based on their cultural and traditional value system. In this paper the effectiveness of Lakota Circles of Hope (LCH), an elementary school culturally-based prevention program was studied and evaluated. Three cohorts of fourth and fifth graders participated in a mixed methods quasi-experimental evaluative research design that included focus groups and surveys prior to and following the intervention. Five research questions regarding the program's impact on students' self-esteem and self-efficacy, Lakota identity, communication, conflict resolution and risk behaviors were addressed in this study. Participants were compared to non-participants in three American Indian reservation school sites. Educators completed a survey to record their observations and feedback regarding the implementation of the program within their respective school sites. The study provides preliminary evidence that, when delivered with fidelity, LCH contributes to statistically significant changes in risk behaviors, Lakota identity, respect for others, and adult and parent communication. A two-way multivariate analysis of variance with post hoc analysis of data collected from the LCH participants (N = 1392) were used to substantiate a significant increase in respect for others and a decrease in risk behaviors which included alcohol, tobacco, and substance use at the 0.10 alpha level. Significant positive improvements in parent and adult communication and an increased Lakota identity at the 0.01 alpha level were obtained. There were no significant differences in self-esteem and conflict resolution from pre to post intervention and in comparison with non LCH participating students.
Collapse
Affiliation(s)
- John J Usera
- Research and Evaluation, Catholic Social Services, 529 Kansas City Street, Rapid City, SD, 57701, USA. .,Delta Evaluation Consulting, LLC, 1010 Ball Park Road, Suite 9, Sturgis, SD, 57785, USA.
| |
Collapse
|
10
|
Yi Z, Mayorga ME, Hassmiller Lich K, Pearson JL. Changes in cigarette smoking initiation, cessation, and relapse among U.S. adults: a comparison of two longitudinal samples. Tob Induc Dis 2017; 15:17. [PMID: 28316562 PMCID: PMC5351179 DOI: 10.1186/s12971-017-0121-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 02/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The tobacco epidemic in the U.S. has matured in the past decade. However, due to rapidly changing social policy and commercial environments, tailored prevention and interventions are needed to support further reduction in smoking. METHODS Using Tobacco Use Supplement to the Current Population Survey (TUS-CPS) 2002-2003 and 2010-2011 longitudinal cohorts, five smoking states are defined including daily-heavy, daily-light, non-daily, former and non-smoker. We quantified the changes between smoking states for the two longitudinal cohorts, and used a series of multivariable logistic regression models to examine the association of socio-demographic attributes and initial smoking states on smoking initiation, cessation, and relapse between waves within each cohort. RESULTS The prevalence of adult heavy smoking decreased from 9.9% (95% CI: 9.6%, 10.2%) in 2002 to 7.1% (95% CI: 6.9%, 7.4%) in 2010. Non-daily smokers were less likely to quit in the 2010-2011 cohort than the 2002-2003 cohort (37.0% vs. 44.9%). Gender, age group, smoker type, race and marital status exhibit similar patterns in terms of their association to the odds of initiation, cessation and relapse between the two cohorts, while education groups showed some inconsistent results between the two cohorts regarding the odds of cessation. CONCLUSIONS Transitions between smoking states are complex and increasingly unstable, requiring a holistic, population-based perspective to understand the stocks and flows that ultimately dictate the public health impact of cigarette smoking behavior. This knowledge helps to identify groups in need of increased tobacco control prevention and intervention efforts.
Collapse
Affiliation(s)
- Zinan Yi
- Operations Research Graduate Program, North Carolina State University, Raleigh, NC USA
| | - Maria E Mayorga
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC USA
| | - Kristen Hassmiller Lich
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105E McGavran-Greenberg HallCB #7411, Chapel Hill, NC 27599-7411 USA
| | - Jennifer L Pearson
- Schroeder Institute for Tobacco Research & Policy Studies, Truth Initiative, Washington, DC USA.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| |
Collapse
|
11
|
Mathur C, Stigler MH, Erickson DJ, Perry CL, Forster JL. Transitions in smoking behavior during emerging adulthood: a longitudinal analysis of the effect of home smoking bans. Am J Public Health 2014; 104:715-20. [PMID: 24524528 DOI: 10.2105/ajph.2013.301642] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We studied the effect of home smoking bans on transitions in smoking behavior during emerging adulthood. METHODS We used latent transition analysis to examine movement between stages of smoking from late adolescence (ages 16-18 years) to young adulthood (ages 18-20 years) and the effect of a home smoking ban on these transitions. We used data from the Minnesota Adolescent Community Cohort study collected in 2004 to 2006. RESULTS Overall, we identified 4 stages of smoking: (1) never smokers, (2) experimental smokers, (3) light smokers, and (4) daily smokers. Transition probabilities varied by stage. Young adults with a home ban during late adolescence were less likely to be smokers and less likely to progress to higher use later. Furthermore, the protective effect of a home smoking ban on the prevalence of smoking behavior was evident even in the presence of parental smoking. However, this effect was less clear on transitions over time. CONCLUSIONS In addition to protecting family members from exposure to secondhand smoke, home smoking bans appear to have the additional benefit of reducing initiation and escalation of smoking behavior among young adults.
Collapse
Affiliation(s)
- Charu Mathur
- Charu Mathur, Darin J. Erickson, and Jean L. Forster are with the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis. Melissa H. Stigler and Cheryl L. Perry are with the Division of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas, Austin
| | | | | | | | | |
Collapse
|
12
|
Ditchburn KM, Sellman JD. Tobacco Smoking in Adolescent Psychiatric Outpatients. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2013. [DOI: 10.1080/1067828x.2012.733598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
13
|
Schane RE, Prochaska JJ, Glantz SA. Counseling nondaily smokers about secondhand smoke as a cessation message: a pilot randomized trial. Nicotine Tob Res 2013; 15:334-42. [PMID: 22592447 PMCID: PMC3545714 DOI: 10.1093/ntr/nts126] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 04/04/2012] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Nondaily smoking represents a substantial and growing fraction of smokers, many of whom do not consider themselves smokers or at risk of tobacco-related diseases and, so, may be less responsive to counseling content contained in traditional cessation interventions. This study compares the effects brief counseling interventions (<20 min) focused on the harm smoking does to themselves (harm to self, HTS) versus the harm their secondhand smoke (SHS) does to others (harm to others, HTO) among nondaily smokers. METHODS Randomized trial of 52 nondaily smokers (smoked in the past week, but not daily) recruited between September 2009 and June 2010; 40 completed the study. We measured changes in motivation and smoking status at 3 months postintervention. RESULTS There was a difference in quitting between the two groups, with 9.5% (2 out of 21) for HTS and 36.8% (7 out of 19) for HTO subjects reporting not smoking any cigarettes in the prior week (p = .06 by Fisher exact test and .035 by likelihood-ratio chi-square). Motivation and self-efficacy increased from baseline to 3-month follow-up, but not differentially by intervention group. CONCLUSIONS Consistent with findings from research conducted by the tobacco industry as early as the 1970s that concluded that social smokers feel immune from the personal health effects of tobacco but are concerned about the consequences of their SHS on others, educating nondaily smokers about the dangers of SHS to others appears to be a more powerful cessation message than traditional smoking cessation counseling that emphasizes the harmful consequences to the smoker.
Collapse
Affiliation(s)
- Rebecca E. Schane
- Center for Tobacco Control Research and Education, University of California San Francisco, CA
- Department of Medicine, University of California San Francisco, CA
- San Francisco Free Clinic, San Francisco, CA
| | - Judith J. Prochaska
- Center for Tobacco Control Research and Education, University of California San Francisco, CA
- Department of Psychiatry, University of California San Francisco, CA
| | - Stanton A. Glantz
- Center for Tobacco Control Research and Education, University of California San Francisco, CA
- Department of Medicine, University of California San Francisco, CA
| |
Collapse
|
14
|
Hong NS, Kim KY, Park SW, Kim JY, Bae J, Lee WK, Kim KS. Trends in cigarette use behaviors among adolescents by region in Korea. J Prev Med Public Health 2012; 44:176-84. [PMID: 21894066 PMCID: PMC3249254 DOI: 10.3961/jpmph.2011.44.4.176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives Understanding recent trends in cigarette smoking among adolescents is important in order to develop strategies to prevent cigarette smoking. The aim of this study was to compare recent trends in cigarette smoking for adolescents living in rural areas, small towns and metropolitan cities in Korea. Methods The raw data from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2005 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Logistic regression models were used to evaluate significant linear time trends in cigarette smoking. The indicators of cigarette use behaviors were 'current smoking rate', 'frequent smoking rate', 'heavy smoking rate' and 'smoking experience rate before 13 years of age'. All analyses were conducted according to gender. Results Statistically significant increasing trends in current smoking rate and frequent smoking rate were observed and borderline significant increasing trends in heavy smoking rate were shown among rural boys. Among metropolitan city boys, statistically significant increasing trends were also seen for frequent smoking. Statistically significant decreasing trends in current smoking rate were observed among small town and metropolitan city girls. Smoking experience rate before 13 years of age for rural girls decreased significantly. Conclusions Cigarette smoking prevalence among adolescents in the rural areas has increased in the last five years especially among boys. Our findings suggest that anti-tobacco program for adolescents should be conducted primarily for those in rural areas.
Collapse
Affiliation(s)
- Nam Soo Hong
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
PURPOSE OF REVIEW This review will summarize contemporary data regarding the cardiovascular effects of tobacco exposure. In particular, this review will highlight recent data that focuses on the magnitude of continued exposure both in the United States and abroad, the cardiovascular risks of tobacco exposure despite improvements in medical therapy, and the important effects of low levels of exposure including secondhand smoke (SHS). RECENT FINDINGS Recent data demonstrates that the current burden of tobacco exposure both in the United States and worldwide remains large. Despite improvements in medical therapy for cardiovascular disease the cardiovascular effects of tobacco exposure are substantial. Recent data also demonstrates that even intermittent smoking and exposure to SHS have important cardiovascular effects. SUMMARY The cardiovascular effects of tobacco exposure, including even low levels from SHS, remain important. Continued efforts to reduce exposure to our patients are critical for improved cardiovascular health.
Collapse
|
16
|
Petits fumeurs et fumeurs intermittents. Rev Mal Respir 2010; 27:1150-63. [DOI: 10.1016/j.rmr.2010.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Accepted: 05/31/2010] [Indexed: 11/20/2022]
|
17
|
Affiliation(s)
- Rebecca E Schane
- Center for Tobacco Control Research and Education, University of California, San Francisco 94143-1390, USA
| | | | | |
Collapse
|
18
|
Is the relationship between smoking and mental health influenced by other unhealthy lifestyle factors? Results from a 3-year follow-up study among adolescents in Oslo, Norway. J Adolesc Health 2009; 45:609-17. [PMID: 19931834 DOI: 10.1016/j.jadohealth.2009.04.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2008] [Revised: 04/06/2009] [Accepted: 04/15/2009] [Indexed: 11/20/2022]
Abstract
PURPOSE Several studies have confirmed that smoking is a risk factor for depression in adolescence. These studies have not controlled for other lifestyle factors. The aim of this longitudinal study was to assess the relationship between smoking and depressive symptoms, controlling for other lifestyle factors. METHODS This school-based longitudinal self-report survey was conducted among 15- and 18-year-old students in Oslo, Norway. From a baseline cohort of 3811 students, 2489 (65%) participants were followed up after 3 years and completed questionnaires at baseline and follow-up. Mental distress was assessed with Hopkins Symptom Checklist, version 10. RESULTS There was a statistically significant association between daily smoking at age 15 and mental distress at age 18 for girls, but not for boys (odds ratio [OR]=2.0 [1.5-2.8] and 1.3 [0.7-2.4], respectively). In girls, the association remained statistically significant even after adjustment for sociodemographic variables and several lifestyle factors. In an analysis of 15-years-old "never smokers," a statistically significant association was found between smoking and mental distress for both genders at age 18. Mentally distressed adolescents at age 15 did not show a higher proportion of smoking at age 18 compared with those not distressed. CONCLUSIONS In addition to supporting earlier findings that smoking seems to be causally related to depressive symptoms among adolescent girls, the contribution of this study is that this association only to some extent is confounded by other unhealthy lifestyle habits.
Collapse
|
19
|
Starkey F, Audrey S, Holliday J, Moore L, Campbell R. Identifying influential young people to undertake effective peer-led health promotion: the example of A Stop Smoking In Schools Trial (ASSIST). HEALTH EDUCATION RESEARCH 2009; 24:977-988. [PMID: 19684123 DOI: 10.1093/her/cyp045] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The objective of the study was to develop and evaluate an effective whole-community approach to identifying a diverse group of influential young people to effectively diffuse health promotion messages among their peers. A peer nomination questionnaire, developed through extensive piloting work, was completed by 10 730 Year 8 students (aged 12-13 years) in 59 schools (30 intervention, 29 control) as part of a cluster randomized controlled trial. Influential students identified in 30 intervention schools were trained to disseminate smoke-free health promotion messages through informal contacts with peers. This approach successfully identified, recruited and retained a diverse group of students, broadly representative of their year group, to undertake the role of 'peer supporter'. Although students and staff expressed doubts about the suitability of some young people recruited as peer supporters, the intervention achieved a 22% reduction in the odds of being a regular smoker in intervention compared with control schools [odds ratio 0.78 (95% CI 0.64-0.96)]. Carefully designed and developed peer-led interventions have potential for delivering effective smoking prevention among adolescents. Paying close attention to the way in which peer educators are identified, and involving young people themselves in this process, may be the key to increasing the effectiveness of peer education.
Collapse
Affiliation(s)
- Fenella Starkey
- Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS2 8PS, UK
| | | | | | | | | |
Collapse
|
20
|
Schane RE, Glantz SA, Ling PM. Nondaily and social smoking: an increasingly prevalent pattern. ACTA ACUST UNITED AC 2009; 169:1742-4. [PMID: 19858429 DOI: 10.1001/archinternmed.2009.315] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Rebecca E Schane
- Department of Medicine and Cardiovascular Research Institute, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA 94143-1390, USA
| | | | | |
Collapse
|
21
|
Abstract
AIMS To examine differential effects of smoking in films and tobacco advertising on adolescent smoking. We hypothesize that movie smoking will have greater effects on smoking initiation, whereas tobacco advertising receptivity will primarily affect experimentation. DESIGN Longitudinal observational study of adolescents. SETTING School-based surveys conducted in Schleswig-Holstein, Germany. PARTICIPANTS A total of 4384 adolescents age 11-15 years at baseline and re-surveyed 1 year later; ever smoking prevalence was 38% at time 1. MEASUREMENTS The main outcome variable combined two items assessing life-time and current smoking (alpha = 0.87). Baseline never smokers were analyzed separately from those who had tried smoking (ever smokers). Exposure to smoking in 398 internationally distributed US movies was modeled as a continuous variable, with 0 corresponding to the 5th percentile and 1 to the 95th percentile of exposure. Tobacco marketing receptivity consisted of naming a brand for a favorite tobacco advertisement. Ordinal logistic regressions controlled for socio-demographics, other social influences, personality characteristics of the adolescent and parenting style. FINDINGS Whereas 34% of ever smokers were receptive to tobacco marketing at time 1, only 6% of never smokers were. Among time 1 never smokers, exposure to movie smoking was a significantly stronger predictor of higher time 2 smoking level [adjusted proportional odds ratio = 2.76, 95% confidence interval (1.84, 4.15)] than was tobacco marketing receptivity (1.53 [1.07, 2.20]). Among time 1 ever smokers, both tobacco marketing receptivity and exposure to movie smoking predicted higher levels of time 2 smoking [2.17 (1.78, 2.63) and 1.62 (1.18, 2.23), respectively], and the two estimates were not significantly different. CONCLUSIONS In this longitudinal study, exposure to movie smoking was a stronger predictor of smoking initiation than tobacco marketing receptivity, which was more common among ever smokers. The results suggest that entertainment media smoking should be emphasized in programs aimed at preventing onset, and both exposures should be emphasized in programs aimed at experimental smokers.
Collapse
Affiliation(s)
- James D Sargent
- Norris Cotton Cancer Center, Dartmouth Medical School, Lebanon, NH 03756, USA.
| | | |
Collapse
|
22
|
Husten CG. How should we define light or intermittent smoking? Does it matter? Nicotine Tob Res 2009; 11:111-21. [PMID: 19246425 DOI: 10.1093/ntr/ntp010] [Citation(s) in RCA: 175] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Corinne G Husten
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| |
Collapse
|
23
|
Soza-Vento RM, Tubman JG. Tobacco Use Prevention Education (TUPE) Programs in the State of Florida. ACTA ACUST UNITED AC 2008; 20:43-63. [PMID: 15914378 DOI: 10.1300/j045v20n01_03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In Florida, data from telephone surveys were used to identify correlates and predictors of teachers' perceptions of the effectiveness of tobacco use prevention education (TUPE) prior to the implementation of the Tobacco Pilot Project (TPP). A 40% random sample of public middle and high schools yielded 296 middle school teachers (MST) and 282 high school teachers (HST). Higher perceived program effectiveness ratings were associated with: using peer leaders, frequent evaluations, parental involvement, few barriers, high student interest, and low tolerance norms for tobacco use. The importance of program features and implementation contexts to teachers' perceived program effectiveness ratings is highlighted.
Collapse
Affiliation(s)
- Rita M Soza-Vento
- University of Miami Sylvester Comprehensive Cancer Center, Population Research Core, FL 33136, USA.
| | | |
Collapse
|
24
|
Maggi S. Changes in smoking behaviours from late childhood to adolescence: 4 years later. Drug Alcohol Depend 2008; 94:251-3. [PMID: 18055134 DOI: 10.1016/j.drugalcdep.2007.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Revised: 08/03/2007] [Accepted: 09/24/2007] [Indexed: 11/30/2022]
Abstract
The purpose of this short report is to estimate trajectories documenting changes in the frequency of cigarette smoking between 10-11 and 20-21 years of age for 3959 participants to the Canadian National Longitudinal Survey of Children and Youth. This study is a follow up to Maggi, Hertzman, and Vaillancourt [Maggi, S., Hertzman, C., Vaillancourt, T., 2007. Changes in smoking behaviours from late childhood to adolescence: insights from the Canadian National Longitudinal Survey of Children and Youth. Health Psychol. 26, 232-240] who found that there are five distinct trajectories of acquisition of smoking from 10-11 to 16-17 years of age. While findings from this study replicate those reported in Maggi, Hertzman, and Vaillancourt [Maggi, S., Hertzman, C., Vaillancourt, T., 2007. Changes in smoking behaviours from late childhood to adolescence: insights from the Canadian National Longitudinal Survey of Children and Youth. Health Psychol. 26, 232-240], they provide a more accurate representation of the possible outcomes of the smoking acquisition process by indicating what specific trajectories of experimentation may lead to daily smoking, occasional smoking or non-smoking.
Collapse
Affiliation(s)
- Stefania Maggi
- Department of Psychology and Institute of Interdisciplinary Studies/Child Studies, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6, Canada.
| |
Collapse
|
25
|
Kalyva E. Prevalence and influences on self-reported smoking among adolescents with mild learning disabilities, attention deficit hyperactivity disorder, and their typically developing peers. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2007; 11:267-79. [PMID: 17846049 DOI: 10.1177/1744629507080790] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Many adolescents take up the smoking habit despite its well-documented adverse health effects. This study explores the prevalence and influences on smoking among 89 adolescents with mild learning disabilities, 108 with attention deficit hyperactivity disorder (ADHD), and 124 typically developing peers aged 12-16 years. All the participants were attending mainstream secondary schools and they were asked to complete a self-report questionnaire on smoking. It was found that adolescents with ADHD smoked more than adolescents with mild learning disabilities, who in turned smoked more than adolescents not diagnosed with any disability. More adolescents with ADHD reported that the majority of their friends smoked and they were less well informed about the health effects of smoking. No differences were identified between the three groups in terms of the smoking behaviour of their parents and the perceived attitudes of their parents and friends towards smoking. Findings are discussed and suggestions are made for further research.
Collapse
Affiliation(s)
- Efronsini Kalyva
- City Liberal Studies, Affiliated Institution of the University of Sheffield, 24 Proxenou Koromila Street, Thessaloniki, Greece.
| |
Collapse
|
26
|
Huver RME, Engels RCME, Breukelen GV, Vries HD. Parenting style and adolescent smoking cognitions and behaviour. Psychol Health 2007. [DOI: 10.1080/14768320600976182] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
27
|
Côté F, Godin G, Gagné C. Efficiency of an Evidence-Based Intervention to Promote and Reinforce Tobacco Abstinence Among Elementary Schoolchildren in a School Transition Period. HEALTH EDUCATION & BEHAVIOR 2006; 33:747-59. [PMID: 16740516 DOI: 10.1177/1090198105285616] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study reports the evaluation of an intervention designedto reinforcetobacco abstinence amongelementary schoolchildren in a school transition period. This intervention was developed according to the principles of Intervention Mapping. A total of 765 grade 5 students (ages 10-12) was recruited in 32 elementary schools. A quasi-experimental longitudinal design was used to evaluate the outcomes. Results observed 2 and 8 months postintervention are reported here. It is shown that although the behavior remained largely unchanged by the intervention, some of its determinants were modified. Behavioral intention, behavioral and normative beliefs, perceived self-efficacy, and role beliefs were changed at one or both postintervention measures. An interesting feature of these results relates to the fact that the most positive outcomes were seen among at-risk children. Discussion considers the advisability to develop, implement, and evaluate evidence-based interventions targeting the psychosocial factors underlying maintenance of tobacco smoking abstinence in elementary school.
Collapse
Affiliation(s)
- Françoise Côté
- Research Group on Behaviors in the Health Field, Paul-Comtois Building, Room 4108, Laval University, Québec, G1K 7P4 Canada.
| | | | | |
Collapse
|
28
|
Castrucci BC, Gerlach KK. Understanding the Association Between Authoritative Parenting and Adolescent Smoking. Matern Child Health J 2006; 10:217-24. [PMID: 16555139 DOI: 10.1007/s10995-005-0061-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2005] [Accepted: 08/09/2005] [Indexed: 10/24/2022]
Abstract
BACKGROUND Research on adolescent cigarette smoking has attempted to measure the role of parents in preventing smoking experimentation and uptake. However, aspects of parental influence have often been limited to parental smoking behavior or antismoking socialization. Only a limited number of studies considered the hypothesis that the influence of parenting on adolescent current cigarette smoking may extend beyond parental behavior and antismoking socialization to consider broader measures of the parent-child relationship, such as parenting style. METHODS The sample was nationally representative and included 17,287 high school students nationwide. Data were used to categorize the parenting style--authoritative, permissive, autocratic, and unengaged--experienced by each respondent. Logistic regression analysis was used to assess the association between parenting style and adolescent current cigarette smoking. RESULTS Authoritative parenting was associated with a reduction in the odds of adolescent current cigarette smoking (OR: 0.74, 99% CI: 0.58, 0.95). When authoritative parenting is simultaneously considered with believing parents' opinions about smoking are important, authoritative parenting was no longer a significant correlate of adolescent current cigarette smoking, while believing parents' opinions about smoking are important was associated with a 45% (99% CI: 0.48, 0.64) reduction in the odds of adolescent current cigarette smoking. Authoritative parenting was associated with a more than three-fold increase (OR: 3.65, 99% CI: 2.87, 4.66) in the odds of believing parents' opinions about smoking are important. DISCUSSION Interventions may want to educate parents about authoritative parenting, which includes the importance of having appropriate and routine conversations with their children, requiring chores, and implementing general rules and boundaries.
Collapse
|
29
|
Krainuwat K. Smoking Initiation Prevention Among Youths: Implications for Community Health Nursing Practice. J Community Health Nurs 2005; 22:195-204. [PMID: 16245971 DOI: 10.1207/s15327655jchn2204_2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Cigarette smoking among youths has long been documented as a national problem affecting health and economic status in the United States. A number of studies have documented that cigarette-smoking initiation occurs primarily between late childhood and young adolescence. This evidence has brought about the need for awareness among community health nurses to find and deliver effective antismoking programs to reduce the prevalence of youth smoking initiation. Generally, community health nurses are in an excellent position to help the nation achieve its goals in terms of reducing the incidence of youth smoking initiation. However, current knowledge about community health nursing practice and smoking initiation interventions is limited. This article raises awareness about smoking initiation prevention in youth and the need to implement effective smoking prevention programs in practice settings and encourages community health nurses to increase their involvement in antismoking initiation research and interventions.
Collapse
|
30
|
Parvizy S, Nikbahkt A, Pournaghash Tehrani S, Shahrokhi S. Adolescents' perspectives on addiction: Qualitative study. Nurs Health Sci 2005; 7:192-8. [PMID: 16083482 DOI: 10.1111/j.1442-2018.2005.00237.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Given that the adolescence period is one of the most crucial stages of development during one's lifetime and adolescents are prone to engage in behaviors which may negatively impact their health, it is very important to have a clear and transparent understanding of adolescents' health needs and problems. A content analysis with a qualitative approach was conducted and 41 healthy adolescents were interviewed. The results of this study revealed the following themes: addiction causes and prevalence; unhealthy friendship and communication and increased rates of cigarette smoking; alcohol and drugs; barriers to and factors in addiction and health; family and addiction. The findings showed worrying attitudes of adolescents to addiction and its prevalence are alarming. It is concluded that exploring adolescents' perspectives is not only important but is useful for maintaining a healthy society, and thus policy makers should develop effective prevention and intervention programs based on these themes.
Collapse
Affiliation(s)
- Soroor Parvizy
- Nursing and Midwifery Faculty, Iran University of Medical Sciences, Rashid Vali Asr Street, Yasami Street, Tehran, Iran.
| | | | | | | |
Collapse
|
31
|
Abstract
OBJECTIVE To describe short term patterns of smoking acquisition exhibited by adolescent smokers. DESIGN Interview records from the prospective development and assessment of nicotine dependence in youth study were examined retrospectively. Interviews were conducted three times per year over 30 months. SUBJECTS 164 students in grades 7-9 (ages 12-15 years, 86 girls, 78 boys) who had used cigarettes at least twice. MAIN OUTCOME MEASURES A continuous timeline of smoking activity, beginning with the subject's first use of tobacco and continuing through follow up, was translated into six patterns--abstinent, sporadic, occasional, daily, escalating, and intermittent. Outcome measures were the proportion of subjects starting/ending in each pattern, and the number of transitions per subject between patterns. RESULTS There was a general but discontinuous progression from infrequent to more frequent use, with many interspersed periods of not smoking. Escalation to daily smoking was common after the development of dependence symptoms, but was rare among those who did not have symptoms. After the appearance of symptoms, both transitions to heavier daily smoking and attempts at cessation increased. CONCLUSIONS Movement to heavier, more frequent smoking is generally unidirectional, although many youths attempt to quit one or more times. The appearance of any symptom of dependence altered the subsequent pattern of smoking behaviour. Future investigators might consider using more frequent data points and a continuous timeline to track smoking behaviour.
Collapse
Affiliation(s)
- R J Wellman
- Fitchburg State College, Fitchburg, Massachusetts, USA
| | | | | | | |
Collapse
|
32
|
Kenford SL, Wetter DW, Welsch SK, Smith SS, Fiore MC, Baker TB. Progression of college-age cigarette samplers: what influences outcome. Addict Behav 2005; 30:285-94. [PMID: 15621399 DOI: 10.1016/j.addbeh.2004.05.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Experimental and occasional cigarette use among college students is widespread. Little is known about what differentiates the occasional college smoker who becomes a regular smoker from the one who does not. Possible risk factors include peer smoking, lifestyle factors, such as lack of exercise, and health/addiction concerns. The current study investigated the progression of smoking in a cohort of 321 low-level/occasional smokers. Over the course of 4 years, 45% of low-level/occasional users had become nonsmokers, 35% became occasional smokers, and 20% became daily smokers. Baseline exercise patterns, addiction beliefs, and smoking pervasiveness were modestly related to distal smoking outcome. The level of baseline smoking was strongly related to smoking outcome. These results support the wisdom of limiting access and exposure to cigarettes among the college population.
Collapse
Affiliation(s)
- Susan L Kenford
- Department of Psychology, Xavier University, 3800 Victory Parkway, Cincinnati, OH 45207-6411, USA.
| | | | | | | | | | | |
Collapse
|
33
|
Maggi S, Linn G, Marion SA. Are questions from the Italian National Health Survey adequate to measure prevalence of smoking among teens. Subst Use Misuse 2005; 40:779-88. [PMID: 15974139 DOI: 10.1081/ja-200030563] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Studies on the prevalence of smoking among Italian adolescents have generated inconsistent estimates. Notably, the Italian National Health Survey (INHS) generates relatively lower estimates than estimates reported in other studies. The INHS asks adults and adolescents if they are smokers or nonsmokers. Research has shown that adolescent smoking is unstable compared to that of adults, and that adolescents may acquire their identity as smokers only after smoking becomes more established. We hypothesized that the INHS prevalence estimates of adolescent smoking could be improved by adding questions on smoking behavior. METHODS During the school year 1993-1994, 471 participants responded to a brief survey on smoking experiences. We compared the prevalence of smoking behavior with the prevalence of smoking identity of participants (mean age = 16.18) who attended five high schools in two Northern Italian cities, Padova and Bergamo. RESULTS Measures of smoking behavior generated higher prevalence estimates than did measures of identity, particularly among occasional smokers. CONCLUSIONS The INHS should add behavioral measures of smoking to maximize the accuracy of prevalence estimates.
Collapse
Affiliation(s)
- Stefania Maggi
- Centre for Early Education and Development Studies, Thompson Rivers University, Kamloops, British Columbia, Canada.
| | | | | |
Collapse
|
34
|
Abstract
Cigarette smoking among adolescents remains one of the most important public health challenges. Despite much attention to research on the etiology of smoking, notably the examination of factors that differentiate adolescent smokers from never smokers, much less is known about factors that predict the development of dependence once an adolescent tries smoking. This paper reviews individual and contextual influences on the progression of smoking among adolescents. Highlights include a consideration of multiple levels of influence, from intra-individual factors, such as genetics, demographics, temperament and comorbidities, to social influences, such as families and peers, to the more macro, societal/cultural levels of influence, including advertising and tobacco-related policies. More recent work examining microcontextual influences through the use of Ecological Momentary Assessments is also discussed. Finally, the need to consider both developmental and transdisciplinary approaches to understanding the development of nicotine dependence in adolescents is emphasized.
Collapse
Affiliation(s)
- Lindsey Turner
- Health Research and Policy Centers, 1747 W. Roosevelt Road, Room 558, Chicago, IL 60608, USA.
| | | | | |
Collapse
|
35
|
Kremers SPJ, Mudde AN, de Vries H. Development and longitudinal test of an instrument to measure behavioral stages of smoking initiation. Subst Use Misuse 2004; 39:225-52. [PMID: 15061560 DOI: 10.1081/ja-120028489] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A dearth of longitudinal research has been observed regarding the measurement of the behavioral process of adolescent smoking initiation. The present study operationalizes the leading model on the process of smoking initiation, including two stages of nonpersistent smoking behavior that were previously unlabelled. An instrument was developed that distinguished six distinct stages of smoking initiation (i.e., never smoker, trier, experimenter, regular smoker, nonsmoking decider, and quitter). Data were gathered longitudinally in 1998 and 1999. The results indicated the applicability of the instrument in a large cross-cultural population of early European adolescents from Finland, Denmark, the United Kingdom, The Netherlands, Spain, and Portugal (n = 7899). Stage transitions had taken place in the expected sequence and progression to daily smoking at 12 months follow-up was successfully predicted. The theory-driven assessment of the process of adolescent smoking initiation may contribute to the development of a generally accepted measure of adolescent smoking initiation.
Collapse
Affiliation(s)
- S P J Kremers
- Department of Health Education and Health Promotion, Universiteit Maastricht, Maastricht, The Netherlands.
| | | | | |
Collapse
|
36
|
Curry SJ, Hollis J, Bush T, Polen M, Ludman EJ, Grothaus L, McAfee T. A randomized trial of a family-based smoking prevention intervention in managed care. Prev Med 2003; 37:617-26. [PMID: 14636795 DOI: 10.1016/j.ypmed.2003.09.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Each day more than 2000 youth under age 18 become daily smokers and the age of tobacco initiation has been going down. Health care settings can partner with families to encourage parent-child interactions that prevent youth tobacco use. This study evaluates a smoking prevention intervention package for parents and children (aged 10-12) provided through their managed care organization. METHODS A two-arm (usual care vs intervention) randomized trial was employed. The intervention included a mailed parental smoking prevention kit, outreach follow-up telephone calls to the parent by a health educator, child materials, medical record cues for physicians to deliver prevention messages, and parent newsletter. Outcome measures were susceptibility to smoking, experimentation with smoking, and smoking in the past 30 days as assessed by 20-month follow-up surveys of children. RESULTS A total of 4,026 families enrolled in the study. The response rate to the 20-month follow-up was 88%. There were no significant effects of the intervention on any of the primary outcomes. The intervention was associated with modest but statistically significant increases in parent-child discussions of smoking related topics. CONCLUSIONS A minimal-intensity family-based prevention program did not significantly reduce rates of susceptibility or tobacco use among youth aged 10-12 at baseline and 11 to 14 at follow-up. Development and evaluation of innovative approaches to tobacco use prevention must continue, despite our disappointing results. Parents and health care systems are too important to abandon as channels for prevention messages.
Collapse
Affiliation(s)
- Susan J Curry
- Center for Health Studies, Group Health Cooperative, Seattle, WA, USA.
| | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
Nicotine is the crucial component in tobacco that underlies smoking behavior; however, the effects of nicotine can vary in both human and animal studies. Recent data from knockout mouse studies, neurotransmitter release studies and electrophysiological experiments support the hypothesis that conflicting behavioral effects elicited by nicotine can result from the activation of different subtypes of nicotinic acetylcholine receptors and the stimulation of antagonistic neuronal pathways. Thus, small differences in the activation state, connectivity or sensitivity of neuronal pathways among individuals might result in large differences in behavioral responses to nicotine. An understanding of the molecular and cellular processes that oppose nicotine reinforcement will be crucial for the development of new interventions to initiate smoking cessation or to prevent the transition from occasional smoking to dependence.
Collapse
Affiliation(s)
- Marina R Picciotto
- Department of Psychiatry, Yale University School of Medicine, 34 Park Street-3rd Floor Research, New Haven, CT 06508, USA.
| |
Collapse
|
38
|
Blitstein JL, Robinson LA, Murray DM, Klesges RC, Zbikowski SM. Rapid progression to regular cigarette smoking among nonsmoking adolescents: interactions with gender and ethnicity. Prev Med 2003; 36:455-63. [PMID: 12649054 DOI: 10.1016/s0091-7435(02)00041-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND While the correlates and predictors associated with transition through the stages of smoking acquisition have received substantial attention, the identification of factors associated with the time course of progression remain generally unexplored. METHODS We identified adolescents escalating from nonsmoking to regular smoking in 1 year as rapid progressors (n = 98) and those escalating from nonsmoking to experimental smoking in 1 year as slow progressors (n = 555). We entered demographic and psychosocial variables, initial reactions to smoking variables, and their interactions with gender and ethnicity into a logistic regression analysis comparing rapid progressors to slow progressors. RESULTS At baseline, rapid progressors reported more friends who smoked regularly. Girls who reported more concern with dieting and less social success were more likely to progress to regular smoking within 1 year; these variables did not influence progression in boys. Those who associated positive feelings with their initial smoking experience were more likely to progress to regular smoking. Differences between white and African American youth emphasize the importance of physiological interpretations of initial smoking experiences. CONCLUSIONS Our findings suggest that even as nonsmokers, adolescents likely to progress quickly to regular smoking can be identified. Researchers designing prevention programs should take these factors into account.
Collapse
|
39
|
Abstract
PURPOSE To investigate whether parenting style is an independent risk factor of smoking initiation and experimentation among adolescents, and whether there is a relationship between parenting style and readiness to quit, or nicotine dependence among smokers. METHODS The 84-item Health and Smoking Questionnaire, which assesses demographics, smoking status and smoking history, perceptions of risk and risk reduction, risk factors for tobacco use, and parenting style, was administered to 816 adolescents in grades 7 to 12 (mean age, 15.1 years) of whom 22.6% (n = 182) were smokers. Parenting style was measured by the brief, non-retrospective version of the Family of Origin Scale (FOS). Higher scores on the FOS indicated more positive perceived parenting style with high levels of intimacy and autonomy, characteristics of healthy parent-child relationships. Data were analyzed using a model-building approach to logistic regression with demographic and other psychosocial variables in the first two steps, and with parenting style as the last step. RESULTS Results from two logistic regression models indicate that although parenting style is not a significant risk factor for smoking experimentation [odds ratio (OR) =.998; confidence interval (CI) =.977-1.019; p =.820], it is a significant independent risk factor for smoking initiation (OR =.950; CI =.930-.970; p =.000). Smokers who were more ready to quit had higher parenting style scores than those who were not ready to quit, and smokers who had made a serious quit attempt (an indicator of nicotine addiction) had higher parenting style scores than those who had not made a quit attempt. Moreover, nonsmokers who reported they would smoke a cigarette if their best friend offered had significantly lower parenting style scores than those who reported they would not smoke a cigarette. CONCLUSIONS Additional research on parenting style and its impact on adolescent smoking with a more economically and ethnically diverse sample is warranted. If future research confirms the strength of the relationship between parenting style and adolescent smoking, teaching positive parenting, including facilitating intimate yet autonomous relationships, may be considered as part of smoking prevention and cessation programs.
Collapse
|
40
|
Teachers' Perceptions of Tobacco Use Prevention Education (TUPE) Programs in Florida: Relations with Perceived Barriers and Other Contextual Factors. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2002. [DOI: 10.1300/j029v11n03_04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
41
|
White HR, Pandina RJ, Chen PH. Developmental trajectories of cigarette use from early adolescence into young adulthood. Drug Alcohol Depend 2002; 65:167-78. [PMID: 11772478 DOI: 10.1016/s0376-8716(01)00159-4] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study identified developmental trajectories of cigarette smoking from early adolescence into young adulthood, and delineated whether risk factors derived from a social learning-problem behavior framework could differentiate among trajectories. Participants (N=374) were interviewed five times from age 12 until age 30/31. Using growth mixture modeling, three trajectory groups were identified--heavy/regular, occasional/maturing out, and non/experimental smokers. Being a female, having higher disinhibition, receiving lower grades, and more frequent use of alcohol or drugs significantly increased the probability of belonging to a smoking trajectory group compared with being a nonsmoker. Higher disinhibition and receiving lower grades also differentiated regular smokers from the rest of the sample. None of the risk factors distinguished occasional from regular smokers. When models were tested separately by sex, disinhibition, other drug use, and school grades were associated with smoking for both sexes. On the other hand, environmental factors, including socioeconomic status, parent smoking and friend smoking, were related to smoking for females but not for males. Sex differences in developmental trajectories and in smoking behavior among regular smokers were notable. Future research should examine transitions and turning points from adolescence to adulthood that may affect cessation and escalation differently for males and females.
Collapse
Affiliation(s)
- Helene Raskin White
- Center of Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854-8001, USA.
| | | | | |
Collapse
|
42
|
Kemppainen U, Tossavainen K, Vartiainen E, Pantelejev V, Puska P. Smoking patterns among ninth-grade adolescents in the Pitkäranta district (Russia) and in eastern Finland. Public Health Nurs 2002; 19:30-9. [PMID: 11841680 DOI: 10.1046/j.1525-1446.2002.19005.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study describes how ninth-grade adolescents' smoking behavior in the Pitkäranta district (Russia) differs from their eastern Finland counterparts. Cross-sectional data from the second North Karelia Youth Study and the Pitkäranta Youth Study were used. Subjects were all (n=385) ninth-grade students in 10 comprehensive schools in Pitkäranta and all (n=2098) students of the same age in 24 comprehensive schools in eastern Finland. Students were asked about their smoking status, intentions to smoke, smoking situations, acquisition of tobacco products, and opportunity to smoke in the school area. The results showed very large differences in the smoking prevalence between Pitkäranta and eastern Finland. For boys, the prevalence of daily smoking was 29% and 19% in Pitkäranta and eastern Finland, respectively. The differences in girls were adverse: 7% and 21% of girls in Pitkäranta and eastern Finland, respectively, were daily smokers. However, as many as one third of the nonsmoking girls in Pitkäranta stated that they may experiment or start smoking later. Boys in Pitkäranta had vaguer attitudes about remaining nonsmokers than boys in eastern Finland. This situation anticipates worsening of the smoking epidemic in Pitkäranta and requires an effective prevention policy and cooperation between different groups in society.
Collapse
Affiliation(s)
- Ulla Kemppainen
- Department of Nursing Science, University of Kuopio, Kuopio, Finland.
| | | | | | | | | |
Collapse
|
43
|
How do Adolescents Process Smoking and Antismoking Advertisements? A Social Cognitive Analysis with Implications for Understanding Smoking Initiation. REVIEW OF GENERAL PSYCHOLOGY 2001. [DOI: 10.1037/1089-2680.5.4.429] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Youth tobacco use has increased substantially in the United States during the past decade. This increase can be attributed, in part, to the potency of cigarette advertising and relative ineffectiveness of antismoking advertising. In this article, the authors argue that an understanding of the effects of these 2 competing forms of advertising on youth smoking is limited in current theoretical treatments and that an integrative theoretical perspective has yet to be advanced. The authors argue that the elaboration likelihood model ( R.E. Petty & J.T. Cacioppo, 1986 ) offers a framework with sufficient explanatory power in this domain. Prevention and legislative interventions may benefit from this analysis, which ultimately may help to decrease youth tobacco use.
Collapse
|
44
|
Tubman JG, Soza Vento R. Principal and teacher reports of strategies to enforce anti-tobacco policies in Florida middle and high schools. THE JOURNAL OF SCHOOL HEALTH 2001; 71:229-235. [PMID: 11512490 DOI: 10.1111/j.1746-1561.2001.tb01323.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study describes anti-tobacco policies implemented by middle and high schools in Florida. All schools had in place formal anti-tobacco policies but implementation of those policies was more rigorous at the middle school level. Principals and tobacco use prevention education teachers reported the formal and informal strategies used to enforce their school's anti-tobacco policies. Punitive enforcement strategies were more commonly reported than nonpunitive strategies. Enforcement strategies were significantly associated with several features of school settings including number of supports for teachers' efforts, teachers' perceptions of program success, and training opportunities for teachers. Middle school staff reported using significantly more enforcement strategies than high school staff, and their strategies were more likely to be associated with school context variables. Implications of these findings for the maintenance of anti-tobacco programs in secondary schools are discussed.
Collapse
Affiliation(s)
- J G Tubman
- Office of Tobacco Control, University of Miami School of Medicine, P.O. Box 016960, (D4-11) Miami, FL 33101, USA.
| | | |
Collapse
|
45
|
Holmen TL, Barrett-Connor E, Holmen J, Bjermer L. Adolescent occasional smokers, a target group for smoking cessation? the Nord-Trøndelag Health Study, Norway, 1995-1997. Prev Med 2000; 31:682-90. [PMID: 11133335 DOI: 10.1006/pmed.2000.0750] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Adolescent smokers are often unsuccessful in quitting and difficult to retain in cessation programs. In health promotion, focusing on the right target groups is essential. Aim. The aim was to examine if adolescent occasional smokers differ from daily smokers, and if possible differences could be useful for targeted smoking cessation programs. METHODS Ninety-one percent of all teenagers attending junior high or high schools participated in a cross-sectional study, conducted in Nord-Trøndelag County, Norway, 1995-1997, including 8,460 students 13-18 years old. Information on smoking habits, education, after school activities, and parents was obtained by self-administered questionnaires. RESULTS Fifty-four percent of boys and 57% of girls had tried at least one cigarette. Of these, 36% of boys and 41% of girls were current smokers, half of whom reported occasional smoking. Students who had quit smoking had more often been occasional than daily smokers. Compared to daily smokers, occasional smokers participated in higher academic courses, were more engaged in organized activities and sports, had been drunk less often, and had better family role models. CONCLUSION Differences support potential utility of focusing on occasional smokers as a special target group in smoking cessation programs.
Collapse
Affiliation(s)
- T L Holmen
- National Institute of Public Health, Community Medicine Research Unit, Verdal, Norway.
| | | | | | | |
Collapse
|
46
|
Abstract
Many researchers have conceptualized smoking uptake behavior in adolescence as progressing through a sequence of developmental stages. Multiple social, psychological, and biological factors influence this process, and may play different functions at different points in the progression, and play different roles for different people. The major objective of this paper is to review empirical studies of predictors of transitions in stages of smoking progression, and identify similarities and differences related to predictors of stages and transitions across studies. While a number of factors related to stage of progression replicated across studies, few variables uniquely predicted a particular stage or transition in smoking behavior. Subsequently, theoretical considerations related to stage conceptualization and measurement, inter-individual differences in intra-individual change, and the staged or continuous nature of smoking progression are discussed.
Collapse
Affiliation(s)
- K P Mayhew
- Health Research and Policy Centers, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
| | | | | |
Collapse
|
47
|
Bauman A, Phongsavan P. Epidemiology of substance use in adolescence: prevalence, trends and policy implications. Drug Alcohol Depend 1999; 55:187-207. [PMID: 10428361 DOI: 10.1016/s0376-8716(99)00016-2] [Citation(s) in RCA: 178] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This paper reviews the epidemiology of substance use among adolescents. There is a public health imperative in all countries to assess the population rates of tobacco, alcohol and illicit drug use among adolescents. In addition, monitoring trends over time may reflect the net effects of activities and programs carried out to prevent adolescent substance use. School based surveys provide prevalence estimates of substance use, but do not capture street and homeless youth and other high risk adolescents not found in the school environment. Overall, the results of this review suggest that tobacco, hazardous alcohol use, and most categories of illicit drug use have shown consistent increases in prevalence since about 1990 in most developed countries, for school-based adolescents, suggesting that the substance use problem among adolescents remains unsolved. These trends are remarkably similar across substance use behaviours, and among most developed countries, although limited data has emanated from adolescents in the developing world. Interventions to reduce or prevent substance use have shown mixed results, with those focusing on the adolescents' social environment showing the most promise. Broader public health approaches, including the linkage to community-wide prevention, and greater enforcement or regulatory and legislative approaches to tobacco and alcohol access are future directions for research and practice.
Collapse
Affiliation(s)
- A Bauman
- School of Community Medicine, University of New South Wales, Sydney, Australia
| | | |
Collapse
|
48
|
Tyas SL, Pederson LL. Psychosocial factors related to adolescent smoking: a critical review of the literature. Tob Control 1999; 7:409-20. [PMID: 10093176 PMCID: PMC1751465 DOI: 10.1136/tc.7.4.409] [Citation(s) in RCA: 541] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To extend the analysis of psychosocial risk factors for smoking presented in the United States surgeon general's 1994 report on smoking and health, and to propose a theoretical frame of reference for understanding the development of smoking. DATA SOURCES General Science Index, Medline, PsycLIT, Sociofile, Sociological Abstracts, and Smoking and Health. Holdings of the Addiction Research Foundation of Ontario Library as well as the authors' personal files. STUDY SELECTION Reviewed literature focused on studies that examined the association of sociodemographic, environmental, behavioural, and personal variables with smoking. DATA SYNTHESIS Adolescent smoking was associated with age, ethnicity, family structure, parental socioeconomic status, personal income, parental smoking, parental attitudes, sibling smoking, peer smoking, peer attitudes and norms, family environment, attachment to family and friends, school factors, risk behaviours, lifestyle, stress, depression/distress, self-esteem, attitudes, and health concerns. It is unclear whether adolescent smoking is related to other psychosocial variables. CONCLUSIONS Attempts should be made to use common definitions of outcome and predictor variables. Analyses should include multivariate and bivariate models, with some attempt in the multivariate models to test specific hypotheses. Future research should be theory driven and consider the range of possible factors, such as social, personal, economic, environmental, biological, and physiological influences, that may influence smoking behaviour. The apparent inconsistencies in relationships between parental socioeconomic status and adolescent disposable income need to be resolved as does the underlying constructs for which socioeconomic status is a proxy.
Collapse
Affiliation(s)
- S L Tyas
- Centre on Aging, University of Manitoba, Winnipeg, Canada
| | | |
Collapse
|
49
|
Price JH, Beach P, Everett S, Telljohann SK, Lewis L. Evaluation of a three-year urban elementary school tobacco prevention program. THE JOURNAL OF SCHOOL HEALTH 1998; 68:26-31. [PMID: 9553904 DOI: 10.1111/j.1746-1561.1998.tb03483.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The longitudinal study compared effects of varying amounts of tobacco instruction (one, two, and three years) on the knowledge, attitudes, and behavioral intentions of urban elementary students. A three-year, fourth-through-sixth grade tobacco prevention curriculum was developed based on the Centers for Disease Control and Prevention's Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. The curriculum comprised five, 45-minute lessons per year. The same trained instructor taught the curriculum all three years. Six intervention schools were taught the curriculum, and two control schools were not. A 49-item questionnaire was used to assess tobacco knowledge, attitudes, and behavioral intentions. The experimental group's posttest knowledge and attitude scores were significantly higher than the control group's posttest scores. No significant differences occurred in posttest behavioral intention scores between the control and intervention groups.
Collapse
Affiliation(s)
- J H Price
- Dept. of Health Promotion, University of Toledo 43606, USA
| | | | | | | | | |
Collapse
|