Social network characteristics and daily smoking among young adults in Sweden

E-cigarette use among early adolescent tobacco cigarette smokers: testing the disruption and entrenchment hypotheses in two longitudinal cohorts

OBJECTIVE

Using longitudinal data from two large-scale cohorts in the UK and USA, we examine whether e-cigarette use steers adolescent early smokers away from tobacco cigarettes (disruption hypothesis) or deepens early patterns of tobacco smoking (entrenchment hypothesis) in comparison with early smokers who do not use e-cigarettes.

METHODS

Youth who smoked tobacco cigarettes by early adolescence (before age 15) were selected from the ongoing UK Millennium Cohort Study (n=1090) and the US Population Assessment of Tobacco and Health (n=803) study. In regression models, the focal predictor was lifetime use of an e-cigarette by early adolescence and the primary outcome was current tobacco use by late adolescence (before age 18). Logistic and multinomial models controlled for early adolescent risk factors and sociodemographic background, and were weighted for attrition and adjusted for complex survey designs.

RESULTS

Among youth who were early cigarette smokers, 57% of UK and 58% of US youth also used e-cigarettes. The odds of later adolescent smoking among early smoking youth were significantly higher among e-cigarette users relative to those who had not used e-cigarettes (adjusted OR (AORUK)=1.45; AORUSA=2.19). In both samples, multinomial models indicated that early smoking youth who used e-cigarettes were more likely to be frequent smokers relative to not smoking (AORUK=2.01; AORUSA=5.11) and infrequent smoking (AORUK=1.67; AORUSA=2.11).

CONCLUSIONS

Despite national differences in e-cigarette regulation and marketing, there is evidence e-cigarette use among early adolescent smokers in the UK and USA leads to higher odds of any smoking and more frequent tobacco cigarette use later in adolescence.

The Viewpoints of Urban High School Male Students, Parents and Teachers About Cigarette Smoking by Adolescents: A Social Marketing-Based Qualitative Study, Shiraz, Iran

Background: Smoking is one of the greatest challenges for public health. It is estimated that 7% - 25% of adolescents have experienced smoking in Iran. Objectives: The present study aimed to investigate the viewpoints of high school male students, their parents, and teachers about smoking by adolescents based on four components of the social marketing mix. Methods: A qualitative study with a phenomenological approach was conducted via 12 focus group sessions in Persian language. To this end, 82 participants (30 students, 28 parents, and 24 teachers) were selected based on purposive sampling method in 2015.The data were analyzed through directed content analysis. Results: All the three studied groups viewed “looking older” as the major cause of adolescent smoking, other factors included getting others’ attention, looking smart person, calmness, decreasing pain, and attractive packaging of cigarette. Some differences were observed between the viewpoints of students, parents, and teachers about the complications of cigarette. The students focused on the social consequences of smoking, but the parents and teachers were more worried about its long term physical side effects and addictive properties. Unlike parents, the teachers and students considered imitating from parents and famous people as the main socio-environmental factor of smoking. All three groups believed that people’s negative social image and negative attention towards smokers should be included in smoking prevention educational programs. However, some differences were reported between their ideas in other educational subjects. Conclusions: Evaluating factors related to tobacco use from three different perspectives can provide a more comprehensive view of these factors and show the reason for the failure of many efforts to prevent student tobacco use and develop a more effective program to promote health.

A cross-sectional study of the relationship of proximal smoking environments and cessation history, plans, and self-efficacy among low-income smokers

Introduction

Proximal environments could facilitate smoking cessation among low-income smokers by making cessation appealing to strive for and tenable.

Aims

We sought to examine how home smoking rules and proximal environmental factors such as other household members' and peers' smoking behaviors and attitudes related to low-income smokers' past quit attempts, readiness, and self-efficacy to quit.

Methods

This analysis used data from Offering Proactive Treatment Intervention (OPT-IN) (randomized control trial of proactive tobacco cessation outreach) baseline survey, which was completed by 2,406 participants in 2011/12. We tested the associations between predictors (home smoking rules and proximal environmental factors) and outcomes (past-year quit attempts, readiness to quit, and quitting self-efficacy).

Results

Smokers who lived in homes with more restrictive household smoking rules, and/or reported having 'important others' who would be supportive of their quitting, were more likely to report having made a quit attempt in the past year, had greater readiness to quit, and greater self-efficacy related to quitting.

Conclusions

Adjustments to proximal environments, including strengthening household smoking rules, might encourage cessation even if other household members are smokers.

Link between perceived smoking behaviour at school and students smoking status: a large survey among Italian adolescents

OBJECTIVES

To investigate a possible link between sociodemographic factors, the perception of smoking habits at school and smoking status of Italian adolescents attending secondary school.

STUDY DESIGN

The study was a cross-sectional study.

METHODS

An anonymous online survey was employed to gather information on age, gender, smoking status and to examine the perception of smoking behaviour on the school premises. Chi-squared and Kruskal-Wallis tests were performed for the univariate analysis and logistic and multinomial regressions for the multivariate analysis.

RESULTS

The statistical analyses included 1889 students. Univariate analysis showed significant differences concerning knowledge between smoker and non-smoker concerning the harmfulness of smoking (P < 0.001). According to the multivariate analysis smokers had a higher perception of teacher, principal or janitor smoking at school (odds ratio: 1.54 [95% confidence interval 1.26-1.89]). Students older than 19 years most often begin smoking because their friends smoke compared with younger students (adjusted odds ratio: 1.18 [95% confidence interval 0.48-2.89]).

CONCLUSION

School environment and behaviour of role models play a crucial part in student smoking. To prevent and reduce youth tobacco smoking, not merely the presence of preventive measures is important but greater attention needs to be placed on the enforcement of smoking policies.

The Influence of Social Network Characteristics on Peer Clustering in Smoking: A Two-Wave Panel Study of 19- and 23-Year-Old Swedes

OBJECTIVES

The present study examines how the composition of social networks and perceived relationship content influence peer clustering in smoking, and how the association changes during the transition from late adolescence to early adulthood.

METHODS

The analysis was based on a Swedish two-wave survey sample comprising ego-centric network data. Respondents were 19 years old in the initial wave, and 23 when the follow-up sample was conducted. 17,227 ego-alter dyads were included in the analyses, which corresponds to an average response rate of 48.7 percent. Random effects logistic regression models were performed to calculate gender-specific average marginal effects of social network characteristics on smoking.

RESULTS

The association of egos' and alters' smoking behavior was confirmed and found to be stronger when correlated in the female sample. For females, the associations decreased between age 19 and 23. Interactions between network characteristics and peer clustering in smoking showed that intense social interactions with smokers increase egos' smoking probability. The influence of network structures on peer clustering in smoking decreased during the transition from late adolescence to early adulthood.

CONCLUSIONS

The study confirmed peer clustering in smoking and revealed that females' smoking behavior in particular is determined by social interactions. Female smokers' propensity to interact with other smokers was found to be associated with the quality of peer relationships, frequent social interactions, and network density. The influence of social networks on peer clustering in smoking decreased during the transition from late adolescence to early adulthood.

Social impacts on adult use of tobacco: findings from the International Tobacco Control Project India, Wave 1 Survey

BACKGROUND

Social impacts on tobacco use have been reported but not well quantified. This study investigated how strongly the use of smoked and smokeless tobacco may be influenced by other users who are close to the respondents.

METHODS

The International Tobacco Control Project (TCP), India, used stratified multistage cluster sampling to survey individuals aged ≥15 years in four areas of India about their tobacco use and that of their close associates. The present study used logistic regression to calculate odds ratios (ORs) for tobacco use for each type of close associate.

RESULTS

Among the 9780 respondents, tobacco use was significantly associated with their close associates' (father's, mother's, friends', spouse's) tobacco use in the same form. After adjusting for confounding variables, women smokers were nine times more likely to have a mother who ever smoked (OR: 9.0; 95% confidence interval [CI]: 3.3-24.7) and men smokers five times more likely (OR: 5.4; 95% CI: 2.1-14.1) than non-smokers. Men smokers were seven times more likely to have close friends who smoked (OR: 7.2; 95% CI: 5.6-9.3). Users of smokeless tobacco (SLT) were five times more likely to have friends who used SLT (OR: 5.3; 95% CI: 4.4-6.3 [men]; OR: 5.0; 95% CI: 4.3-5.9 [women]) and four times more likely to have a spouse who used SLT (OR: 4.1; 95% CI: 3.0-5.8 [men]; OR: 4.3; 95% CI: 3.6-5.3 [women]), than non-users. The ORs for the association of the individuals' tobacco use, whether smoked or smokeless, increased with the number of close friends using it in the same form.

CONCLUSION

The influence of family members and friends on tobacco use needs to be appropriately addressed in tobacco-control interventions.

Transitions in Smokers' Social Networks After Quit Attempts: A Latent Transition Analysis

INTRODUCTION

Smokers' social networks vary in size, composition, and amount of exposure to smoking. The extent to which smokers' social networks change after a quit attempt is unknown, as is the relation between quitting success and later network changes.

METHODS

Unique types of social networks for 691 smokers enrolled in a smoking-cessation trial were identified based on network size, new network members, members' smoking habits, within network smoking, smoking buddies, and romantic partners' smoking. Latent transition analysis was used to identify the network classes and to predict transitions in class membership across 3 years from biochemically assessed smoking abstinence.

RESULTS

Five network classes were identified: Immersed (large network, extensive smoking exposure including smoking buddies), Low Smoking Exposure (large network, minimal smoking exposure), Smoking Partner (small network, smoking exposure primarily from partner), Isolated (small network, minimal smoking exposure), and Distant Smoking Exposure (small network, considerable nonpartner smoking exposure). Abstinence at years 1 and 2 was associated with shifts in participants' social networks to less contact with smokers and larger networks in years 2 and 3.

CONCLUSIONS

In the years following a smoking-cessation attempt, smokers' social networks changed, and abstinence status predicted these changes. Networks defined by high levels of exposure to smokers were especially associated with continued smoking. Abstinence, however, predicted transitions to larger social networks comprising less smoking exposure. These results support treatments that aim to reduce exposure to smoking cues and smokers, including partners who smoke.

IMPLICATIONS

Prior research has shown that social network features predict the likelihood of subsequent smoking cessation. The current research illustrates how successful quitting predicts social network change over 3 years following a quit attempt. Specifically, abstinence predicts transitions to networks that are larger and afford less exposure to smokers. This suggests that quitting smoking may expand a person's social milieu rather than narrow it. This effect, plus reduced exposure to smokers, may help sustain abstinence.

Social Networks and Smoking in Rural Women: Intervention Implications

OBJECTIVES

We characterized the social network characteristics of women in Ohio Appalachia according to smoking status.

METHODS

Women ≥18 years of age were recruited from 3 Ohio Appalachian counties to complete a cross-sectional survey. Sociodemographic and smoking-related information was collected by face-to-face interview. A description of women's time (ie, spends time with) and advice (ie, gets support and advice) social network ties were obtained. An egocentric social network analysis was completed, according to the woman's smoking status.

RESULTS

Of the 408 women enrolled, 20.1% were current smokers. Time networks were larger (p < .001), more dense (p < .001), and more redundant (p < .001) than advice networks. Current smokers had a greater proportion of smoking ties in their networks compared to non-smokers (p < .001). Daily face-to-face contact with non-smoking ties was greater in time compared to advice networks (p < .001). Current smokers in advice networks tended to have less daily contact with non-smoking ties than non-smokers (p = .06).

CONCLUSIONS

Differences existed in characteristics of time versus advice egocentric networks. Smoking status was associated with these differences. Results will assist with future development of a network-based smoking cessation intervention.

Social Network Characteristics, Social Support, and Cigarette Smoking among Asian/Pacific Islander Young Adults

Cigarette smoking may be one of the factors contributing to the high levels of cancer-related mortality experienced by certain Asian/Pacific Islander (A/PI) subgroups (e.g., Native Hawaiian). Given the collectivist cultural orientation attributed to A/PI groups, social strategies are recommended for substance abuse or smoking cessation treatment among A/PI. However, research examining how social network characteristics and social support relate to smoking across A/PI subgroups has been lacking. This study investigated the associations between social network characteristics (e.g., size, composition), perceived social support, and recent cigarette use across Native Hawaiian, Filipino, and East Asian (e.g., Japanese, Chinese) young adults (18-35 year old). Cross-sectional, self-report data were collected from N = 435 participants (M age = 25.6, SD = 8.3; 61% women). Ethnic differences were found in a number of pathways linking social network characteristics, perceived social support, and cigarette smoking. Larger network size was strongly associated with higher perceived social support and lower recent cigarette smoking among Native Hawaiians but not Filipinos or East Asians. Higher perceived social support was associated with lower recent smoking among East Asians and Filipinos but not Native Hawaiians. Implications are discussed with regard to smoking prevention and cessation among A/PI.

Effect of network social capital on the chances of smoking relapse: a two-year follow-up study of urban-dwelling adults

OBJECTIVES

We sought to examine the prospective influence of social capital and social network ties on smoking relapse among adults.

METHODS

In 2010, a 2-year follow-up study was conducted with the 2008 Montreal Neighborhood Networks and Healthy Aging Study (MoNNET-HA) participants. We asked participants in 2008 and 2010 whether they had smoked in the past 30 days. Position and name generators were used to collect data on social capital and social connections. We used multilevel logistic analysis adjusting for demographic and socioeconomic factors to predict smoking relapse in 2010.

RESULTS

Of the 1400 MoNNET-HA follow-up participants, 1087 were nonsmokers in 2008. Among nonsmokers, 42 were smokers in 2010. Results revealed that participants with higher network social capital were less likely (odds ratio [OR] = 0.68; 95% confidence interval [CI] = 0.47, 0.96), whereas socially isolated participants (OR = 3.69; 95% CI = 1.36, 10.01) or those who had ties to smokers within the household (OR = 4.22; 95% CI = 1.52, 11.73) were more likely to report smoking in 2010.

CONCLUSIONS

Social network capital reduced the chances of smoking relapse. Smoking cessation programs might aim to increase network diversity so as to prevent relapse.

A systematic review protocol: social network analysis of tobacco use

BACKGROUND

Tobacco use is the single most preventable cause of death in the world. Evidence indicates that behaviours such as tobacco use can influence social networks, and that social network structures can influence behaviours. Social network analysis provides a set of analytic tools to undertake methodical analysis of social networks. We will undertake a systematic review to provide a comprehensive synthesis of the literature regarding social network analysis and tobacco use. The review will answer the following research questions: among participants who use tobacco, does social network structure/position influence tobacco use? Does tobacco use influence peer selection? Does peer selection influence tobacco use?

METHODS

We will follow the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines and search the following databases for relevant articles: CINAHL (Cumulative Index to Nursing and Allied Health Literature); Informit Health Collection; PsycINFO; PubMed/MEDLINE; Scopus/Embase; Web of Science; and the Wiley Online Library. Keywords include tobacco; smoking; smokeless; cigarettes; cigar and 'social network' and reference lists of included articles will be hand searched. Studies will be included that provide descriptions of social network analysis of tobacco use.Qualitative, quantitative and mixed method data that meets the inclusion criteria for the review, including methodological rigour, credibility and quality standards, will be synthesized using narrative synthesis. Results will be presented using outcome statistics that address each of the research questions.

DISCUSSION

This systematic review will provide a timely evidence base on the role of social network analysis of tobacco use, forming a basis for future research, policy and practice in this area. This systematic review will synthesise the evidence, supporting the hypothesis that social network structures can influence tobacco use. This will also include exploring the relationship between social network structure, social network position, peer selection, peer influence and tobacco use across all age groups, and across different demographics. The research will increase our understanding of social networks and their impact on tobacco use, informing policy and practice while highlighting gaps in the literature and areas for further research.