Time spent with friends who smoke and quit attempts among teen smokers

Smoking cessation policy and treatments derived from the protective motivation of smokers: a study on graphic health warning labels

Introduction

Smoking is a leading public health risk. Many countries are reducing the demand for tobacco through graphic health warning labels (GHWLs). This study aims to explore smokers' perceptions of GHWLs and analyze the effect of GHWLs on their behavioral intentions to quit smoking.

Methods

A theoretical model is designed by synthesizing protection motivation theory, an extension of the extended parallel process model, and the theory of planned behavior. We collected a cross-sectional sample of 547 anonymous smokers through a stratified random sampling strategy. GHWLs published in 2011 by the US Food and Drug Administration were used in the survey to assess smokers' responses to them, and then the hypotheses are validated through structural equation models.

Results

The results suggest that perceived severity, perceived vulnerability, response efficacy, and health anxiety have a significant impact on smokers' protection motivation. Furthermore, smokers' protection motivation directly impacts the behavioral intention to quit smoking and indirectly influences intention to quit through attitudes.

Discussion

These findings have practical implications for the implementation and improvement of GHWLs policies. Meanwhile, this study enriches the literature on public health protection measures (i.e., GHWLs) and smokers' behavioral intention to quit smoking.

With a Little Help from My Friends? Asymmetrical Social Influence on Adolescent Smoking Initiation and Cessation

This study investigates whether peer influence on smoking among adolescents is asymmetrical. We hypothesize that several features of smoking lead peers to have a stronger effect on smoking initiation than cessation. Using data from the National Longitudinal Study of Adolescent Health we estimate a dynamic network model that includes separate effects for increases versus decreases in smoking, while also controlling for endogenous network change. We find that the impact of peer influence is stronger for the initiation of smoking than smoking cessation. Adolescents rarely initiate smoking without peer influence but will cease smoking while their friends continue smoking. We discuss the implications of these results for theories of peer influence and health policy.

Adolescent romantic relationships and change in smoking status

Although smoking rates have decreased, smoking among adolescents continues to be a problem. Previous research has shown the importance of peer influences on adolescent smoking behavior but has mostly neglected the impact of adolescent romantic relationships. This study examines the influence of romantic relationships with smokers and non-smokers on smoking initiation and cessation over a one-year period using data from the National Longitudinal Study of Adolescent Health (Add Health). For initial non-smokers, we examined whether the total length of time in romantic relationships with smokers and non-smokers at Wave I, as well as amount of exposure to smoking through romantic partners, predicted smoking initiation at Wave II. Among initial regular smokers, we examined whether these same relationship characteristics predicted smoking cessation at Wave II. These analyses were conducted separately for respondents in any type of romantic relationship, as well as just those respondents in close romantic relationships. Results indicated that, for close romantic relationships, cessation was more likely among smokers with more time in relationships with non-smoking partners. Greater exposure to smoking through romantic partners at Wave I significantly decreased the likelihood of cessation among initial smokers and increased the likelihood of initiation among initial non-smokers. For all relationships, greater exposure to smoking through romantic partners at Wave I significantly reduced the likelihood of cessation. These associations held when controlling for best friend smoking, as well as demographic factors and school-level smoking, suggesting that peer-based smoking programs aimed at adolescents should incorporate a focus on romantic relationships.

Examination of a Process Model of Adolescent Smoking Self-Change Efforts in Relation to Gender

Little information describes how adolescents change their smoking behavior. This study investigated the role of gender in the relationship of motivation and cognitive variables with adolescent smoking self-change efforts. Self-report and semi-structured interview data from a prospective study of smoking self-change efforts were examined among 98 adolescent smokers ages 14-18 (55% female). Social disapproval motives and short-term consequence reasons for quitting, quit self-efficacy and intentions to quit were modeled in relation to prospective self-quit attempts assessed at a 6-month follow-up, separately by gender. Hypothesized mediating relationships were not supported although gender differences were noted. Social influence motives related to intention to quit and prospective self-quit attempts among girls. For boys, intention to quit predicted making a self-quit attempt. Findings emphasize the importance of examining adolescent models separately by gender and contribute to understanding of mechanisms involved in adolescent smoking change efforts.

Tobacco control policy and adolescent cigarette smoking status in the United States

INTRODUCTION

Tobacco policies that limit the sale of cigarettes to minors and restrict smoking in public places are important strategies to deter youth from accessing and consuming cigarettes.

METHODS

We examined the relationship of youth cigarette smoking status to state-level youth access and clean indoor air laws, controlling for sociodemographic characteristics and cigarette price. Data were analyzed from the 2001 to 2002 U.S. Health Behavior in School-Aged Children survey, a cross-sectional survey conducted with a nationally representative sample of 13,339 students in the United States.

RESULTS

Compared with students living in states with strict regulations, those living in states with no or minimal restrictions, particularly high school students, were more likely to be daily smokers. These effects were somewhat reduced when logistic regressions were adjusted for sociodemographic characteristics and cigarette price, suggesting that higher cigarette prices may discourage youth to access and consume cigarettes independent of other tobacco control measures.

DISCUSSION

Strict tobacco control legislation could decrease the potential of youth experimenting with cigarettes or becoming daily smokers. The findings are consistent with the hypothesis that smoking policies, particularly clean indoor air provisions, reduce smoking prevalence among high school students.

The association between DSM-IV nicotine dependence and stressful life events in the National Epidemiologic Survey on Alcohol and Related Conditions

BACKGROUND AND OBJECTIVES

Nicotine dependence (ND) is a pervasive public health concern and a leading cause of preventable mortality. Stressful life events (SLEs), which severely disrupt the lives of individuals experiencing such events, have been posited as correlates of persisting ND. While both ND and SLEs have been studied extensively in relation to other variables, there are few instances in which they have been investigated in concert.

METHODS

In this study, we use data on 18,013 smokers from the 2001-2002 data set of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC, N = 43,093) to examine whether experiencing a SLE in the past 12 months was associated with meeting criteria for ND in the same past 12 months. Logistic regression analyses were conducted while accounting for a variety of covariates.

RESULTS

A majority of the SLEs were associated with past 12 month ND, even after controlling for poverty, psychiatric and substance use disorders, and a prior history of ND (odds-ratios 1.35-2.20). The rates of past 12 month ND were considerably greater in those experiencing more than one SLE.

CONCLUSIONS

While these data do not allow us to make causal interpretations, our results suggest an association between SLE and ND. Potentially, individuals experiencing SLEs may find it difficult to quit smoking; alternatively, directly or via correlated risks (e.g., living in a high risk neighborhood), smoking may increase the likelihood of exposure to SLEs.

Mechanisms of adolescent smoking cessation: roles of readiness to quit, nicotine dependence, and smoking of parents and peers

Multiple levels of influence should be considered in interventions aimed at the adolescent smoker, including psychological, addiction, peer and parental influences. However, the mechanism by which these variables influence the process of smoking cessation in adolescents is not well elucidated. Therefore, this prospective study tested two models among 850 adolescent smokers, specifying the direct and indirect relations between adolescents' readiness to quit smoking, levels of nicotine dependence, and smoking behavior of their parents and friends. One year later smoking cessation was assessed. Results showed that, among adolescent smokers, readiness to quit was positively associated with quit attempts, while nicotine dependence was inversely associated with successful cessation. Instead of a direct relation, parental and peers' smoking were inversely related to smoking cessation through nicotine dependence. The findings emphasize that interventions should be developed and tested within and outside the school setting, as well as within the family situation. In addition, the strong impact of nicotine dependence on successful cessation indicates that a more direct approach is needed to lower nicotine dependence among adolescents.

Adolescent smoking networks: the effects of influence and selection on future smoking

Peer influence and peer selection have both been linked to the smoking behavior of adolescents. The present investigation uses social network analysis methodology to explore the simultaneous effects of both processes on adolescent smoking and smoking susceptibility over two time periods. Results suggest the effects of friendship selection in 6th grade on smoking behavior in 7th grade were primarily direct. Selecting smokers as friends in 6th grade predicted both smoking and smoking susceptibility in 7th grade, and selecting susceptibles predicted future friendship selection and peer influence. Influence processes were indirectly related to smoking. Smokers' influence in 6th grade predicts the selection of smokers as friends in 7th grade. Smokers' influence also demonstrated a protective effect when ties were not reciprocated.

Adolescents in smoking cessation treatment: relationship between externalizing symptoms, smoking history and outcome

Previous research has indicated a potential bi-directional link between youth substance use and externalizing psychiatric comorbidities. We hypothesized that the degree of externalizing symptoms predicts the likelihood of successful smoking cessation (prolonged abstinence) among adolescent smokers participating in a cessation trial. We also explored the association of externalizing symptoms with age at smoking initiation. Ninety one adolescents (mean+/-S.D.; age 15.1+/-1.4 years, cigarettes per day 18.4+/-8.1, Fagerström Test for Nicotine Dependence 7.1+/-1.3) were included. The Child Behavior Checklist/4-18 and Youth Self-Report assessed the degree of externalizing symptoms. Regression analysis indicated that lower CBCL externalizing scores significantly predicted the likelihood of prolonged abstinence. Pearson's correlation analysis indicated a significant association of lower externalizing scores with later onset of smoking initiation. Our findings highlight the importance of addressing externalizing behaviors in adolescent smoking cessation programs.

Factors related to cigarette smoking initiation and use among college students

The purpose of this cross-sectional study was to examine the impact of personality factors (neuroticism, extraversion, openness, agreeableness, and conscientiousness), cognitive factors (sense of coherence and self-efficacy), coping resources (family and friend social support) and demographic factors (gender and ethnicity) on cigarette smoking behaviors (initiation, frequency, and amount of cigarette smoking) among college students. A total of 161 U.S. college students, aged 18-26, who enrolled in an introductory psychology course completed self-report questionnaires. The majority of the students had tried smoking (55%); among those who had tried, 42% were current smokers. The majority (77%) who had smoked a whole cigarette did so at age 16 years or younger. Students who reported lower levels of conscientiousness and self-efficacy had a greater likelihood to had tried cigarette smoking. Also, students who had lower levels of self-efficacy reported smoking more frequently and greater quantities of cigarettes than students with higher levels of self-efficacy. Self-efficacy was the most significant predictor of smoking behaviors. Health promotion programs focused on self-efficacy may be an effective tool for reducing the initiation, frequency, and amount of cigarette smoking among college students.

The impact of self-control indices on peer smoking and adolescent smoking progression

OBJECTIVE

To determine the direct impact of self-control variables on baseline smoking and smoking progression and determine whether self-control had indirect effects on smoking practices through effects on peer smoking.

METHODS

Study participants were 918 adolescents who were followed from 9th through the 12th grade and completed self-report measures of peer smoking, self-control, and cigarette smoking. An exploratory factor analysis (EFA) was conducted to assess the factor structure of a 41-item self-control measure. The EFA indicated a six-factor structure comprising of impulsive control, planning, hostile blaming, attentional disregulation, conscientiousness, and physical aggression.

RESULTS

The results of a latent growth model indicated that conscientiousness (OR = 0.81, CI = 0.73-0.90), hostile blaming (OR = 0.89, CI = 0.81-0.99), and physical aggression (OR = 1.16, CI = 1.06-1.27) had direct effects on baseline smoking, whereas planning (OR = 0.90, CI = 0.82-0.99) and impulse control (OR = 1.15, CI = 1.02-1.28) had indirect effects on adolescent smoking at baseline through baseline peer smoking. There were no significant direct or indirect effects of the self-control indices on smoking progression. There was a direct effect of peer smoking progression (number of peers who smoked) on adolescent smoking progression, such that increases in the number of peers who smoked across time increased the odds that an adolescent would progress to a higher level of smoking.

CONCLUSIONS

Youth smoking prevention and intervention program outcomes may potentially improve by addressing self-control behaviors as they appear to have direct effects on smoking and indirect effects through peers who smoke.