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...on Adolescent Nicotine Use
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www.ProjectCork.org
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Fall 2007
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Adolescents' time use: Effects on substance use, delinquency and sexual activity.
Barnes GM; Hoffman JH; Welte JW; Farrell MP; Dintcheff BA. Journal of Youth and Adolescence 36(5): 697-710, 2007. (32 refs.)
Using an integration of social control theory and the routine activity perspective, adolescent time use was examined for effects on problem behaviors. We examined a wide variety of time use categories, including homework, extracurricular activities, sports time, alone time, paid work, housework, television watching, as well as indices of family time and peer time, for their effects on heavy alcohol use, cigarette smoking, illicit drug use, delinquency and sexual activity. The study employed a representative household sample of adolescents (n=606) and took into account important sociodemographic factors - gender, age, race (Black and White), and socioeconomic status. The most important predictors of adolescent problem behaviors were family time and peer time. Family time serves as a protective factor against all five problem behaviors while peer time is a highly significant risk factor for all five problem behaviors. Copyright 2007, Springer.
Getting it right: Designing adolescent-centred smoking cessation services.
MacDonald S; Rothwell H; Moore L. Addiction 102(7): 1147-1150, 2007. (25 refs.)
Aims: To demonstrate the importance of identifying adolescent preferences for smoking cessation in order to inform the design of effective adolescent cessation services. Design Structured qualitative interviews drawing on means-end theory. Setting Three youth-clubs and two secondary schools in south-east Wales. Participants: Twenty-five male and female 13-18-year-olds, mainly daily smokers. Findings Interviewees did not assume immediately that a smoking cessation service is something that will be available to them, and therefore they initially encountered difficulties in identifying attributes of such support. With further prompting interviewees were able to express a preference for support attributes, but these were not attributes that traditionally form part of cessation provision. Their main preference was for support from friends and family, access to nicotine replacement therapy and non-school-based, flexible support and guidance. Conclusion: The results re-emphasize the inadequacies of existing cessation provision for meeting adolescent preferences and suggest that developing more adolescent-appropriate support requires a reconceptualization of existing interventions, with service users situated at the core of intervention design. The study highlights a number of service development points for intervention planners including: rethinking the timing and location of provision; placing more emphasis on the selection of facilitators; harnessing support from friends and family; and rooting these developments in broader tobacco control strategies. Copyright 2007, Society for the Study of Addiction to Alcohol and Other Drugs.
do antitobacco campaign advertising and smoking status affect beliefs and intentions? Some similarities and differences between adults and adolescents.
Tangari AH; Burton S; Andrews JC; Netemeyer RG. Journal of Public Policy and Marketing 26(1): 60-74, 2007. (56 refs.)
This article presents two studies that examine similarities and differences with respect to how adults and adolescents process and respond to information in an antitobacco ad campaign. Study 1 examines (1) the effects of anti-tobacco advertising campaign measures (e.g., campaign advertisement integration, perceived strength of ad-based messages, attitude toward the ad campaign) on four key adult antismoking beliefs and (2) the influence of these campaign evaluations and beliefs on smokers' intentions to quit smoking, Hierarchical regression results show that antismoking ad campaign reactions explain substantial additional variance in beliefs about tobacco industry deceptiveness, smoking addictiveness, harmfulness of secondhand smoke, and restrictions on smoking at different public venues. The findings also show that the campaign variables as a whole are positively related to intentions to quit smoking, beyond the variance that is explained by demographics. In Study 2, the authors replicate and extend these findings for the campaign using similar measures and procedures for a sample of more than 900 adolescents. They draw comparisons between these adult and adolescent findings and offer some implications for potential corrective advertising for consumers' beliefs about smoking that may be required of tobacco companies based on U.S. v. Philip Morris USA, Inc. Copyright 2007, American Marketing Association.
Regular daily smoking among 14-year-old adol-escents increases the subsequent risk for suicide: The Northern Finland 1966 Birth Cohort Study.
Riala K; Alaraisanen A; Taanila A; Hakko H; Timonen M; Rasanen P. Journal of Clinical Psychiatry 68(5): 775-780, 2007. (26 refs.)
Objective: To investigate the relationship between adolescent regular daily smoking and later suicides in a prospective longitudinal birth cohort setting. Method: Data from the Northern Finland 1966 Birth Cohort Study (N = 10,934) were linked with national death certificates from Statistics Finland. The information on suicide attempts until the end of 2001 was gathered from the Finnish Hospital Discharge Register (FHDR). The information on adolescent regular daily smoking was gathered via a questionnaire in 1980 and 198 1, when the subjects were age 14 years. Results: Of all cohort males who smoked regularly at age 14 years, 2.6% committed suicide by age 34 years, while the corresponding proportion was 0.8% among experimental smokers and 0.4% among nonsmokers (chi(2) = 15.8, df = 2, p <.001). After adjusting for sociodemographic factors in adolescence and psychiatric morbidity, regular smokers were at a 4.05-fold hazard (95% CI = 1.18 to 13.93, p =.026) for committing suicide at a younger age. Corresponding associations were not found among females. The choice of suicide method was not associated with smoking habits in adolescence. Furthermore, the proportion of suicide attempts was significantly higher among regular daily smokers, among both boys (3.3% vs. 1.2%) and girls (4.2% vs. 1.2%), compared with other adolescents. Conclusion: At the epidemiologic level, adolescent regular smoking was found to be associated with increased risk for suicide among males before the age of 34 years. Further studies are needed to investigate the effects of smoking on neurobiology of depression, self-damaging aggression, and impulsive behavior. Copyright 2007, Physicians Postgraduate Press.
Smoking cessation and stress among teenagers.
Falkin GP; Fryer CS; Mahadeo M. Qualitative Health Research 17(6): 812-823, 2007. (26 refs.)
The authors describe the experience of quitting smoking, focusing on the obstacles youth struggle with, based on individual interviews and focus groups with 54 teenagers in New York City. A major obstacle was the belief that people should stop smoking forever. The youth had to cope with temptation, frequent and often intense urges or cravings for cigarettes, and lack of social support from their family and friends. The young participants not only had to cope with general life stresses without being able to use cigarettes to reduce tensions but also had to contend with new stressful situations, such as friends who put them down for not smoking. In addition, the teens had to give up things that were important to them, such as friendships, during their quit attempts. The study describes how quitting can be a much more stressful experience for youth than research typically acknowledges. The authors discuss public health implications. Copyright 2007, Sage Publications.
Out of the smokescreen II: will an advertisement targeting the tobacco industry affect young people's perception of smoking in movies and their intention to smoke?
Edwards C; Oakes W; Bull D. Tobacco Control 16(3): 177-181, 2007. (41 refs.)
Objective: To evaluate the effect of an antismoking advertisement on young people's perceptions of smoking in movies and their intention to smoke. Subjects/setting: 3091 cinema patrons aged 12-24 years in three Australian states; 18.6% of the sample (n = 575) were current smokers. Design/intervention: Quasi-experimental study of patrons, surveyed after having viewed a movie. The control group was surveyed in week 1, and the intervention group in weeks 2 and 3. Before seeing the movie in weeks 2 and 3, a 30 s antismoking advertisement was shown, shot in the style of a movie trailer that warned patrons not to be sucked in by the smoking in the movie they were about to see. Outcomes: Attitude of current smokers and non-smokers to smoking in the movies; intention of current smokers and non-smokers to smoke in 12 months. Results: Among non-smokers, 47.8% of the intervention subjects thought that the smoking in the viewed movie was not OK compared with 43.8% of the control subjects (p = 0.04). However, there was no significant difference among smokers in the intervention (16.5%) and control (14.5%) groups (p = 0.4). A higher percentage of smokers in the intervention group indicated that they were likely to be smoking in 12 months time (38.6%) than smokers in the control group (25.6%; p < 0.001). For non- smokers, there was no significant difference in smoking intentions between groups, with 1.2% of intervention subjects and 1.6% of controls saying that they would probably be smoking in 12 months time (p = 0.54). Conclusions: This real-world study suggests that placing an antismoking advertisement before movies containing smoking scenes can help to immunise non- smokers against the influences of film stars' smoking. Caution must be exercised in the type of advertisement screened as some types of advertising may reinforce smokers' intentions to smoke. Copyright 2007, BMJ Publishing Group.
Smoking expectancies for flavored and non-flavored cigarettes among college students.
Ashare RL; Hawk LW; Cummings KM; O'Connor RJ; Fix BV; Schmidt WC. Addictive Behaviors 32(6): 1252-1261, 2007. (20 refs.)
Several tobacco companies have introduced specially flavored cigarettes, yet little is known about their appeal among college student nonsmokers, regular smokers, and those susceptible to smoking. Undergraduates (N=424) rated 12 brands of cigarettes on multiple attributes based on manufacturer advertisements. This paper focused on two brands with flavored and non-flavored versions (Camel and Salem). Despite brand, regular smokers and those susceptible to smoking initiation had higher positive expectancies and lower negative expectancies about smoking than nonsmokers. Flavored cigarettes elicited higher positive expectancies than non-flavored counterparts across all groups, including nonsmokers. Indeed, the degree to which flavored Camels had higher positive expectancies than Camel Lights was at least as large in a group of susceptible nonsmokers and experimenters (susceptible/experimenters). Despite being present in nonsmokers and susceptible /experimenters, negative expectancies were significantly lower for flavored versus non-flavored brands. Logistic regressions revealed that positive expectancies predicted "intention to try" each brand for regular smokers and susceptible/ experimenters. These findings suggest that targeting the marketing of positive attributes may be useful in preventing smoking behavior. Copyright 2007, Elsevier Science.
Why smoking prevention programs sometimes fail. Does effectiveness depend on sociocultural context and individual characteristics?
Johnson CA; Cen S; Gallaher P; Palmer PH; Xiao L; Ritt-Olson A et al. Cancer Epidemiology, Biomarkers & Prevention 16(6): 1043-1049, 2007. (58 refs.)
Background: School-based smoking prevention programs sometimes fail in unexpected ways. This study tests the hypotheses that both social/cultural contexts and individual dispositional characteristics may interact with program content to produce effects that are variable in potentially predictable ways. Methods: Students in 24 culturally heterogeneous or primarily Hispanic/Latino middle schools (N = 3,157 6th graders) received a multicultural collectivist-framed social influences (SI) program, an individualist- framed SI program, or a control condition. Three-way linear and nonlinear interactions, program frame x social context x dispositional phenotype, were tested. Results: Three-way interactions were found for the dispositional phenotypes of depression and hostility with social context and program content/frame. In predominantly Hispanic/Latino schools, larger program effects were observed for high depressed and high hostile youth in both the collectivist and individualist framed programs. In culturally mixed schools, prevention effects were greatest for low depressed and low hostile youth, especially in the individualist framed program. In culturally mixed schools, there may have been a negative treatment effect for both programs among adolescents scoring high on depression and hostility. Discussion: Prevention program effects can vary by combination of program content, social setting, and individual dispositional characteristics. The results suggest that prevention program design and implementation should be sensitive to population characteristics at both the individual and sociocultural levels. Copyright 2007, American Association Cancer Research.
Readiness to change smoking behavior in adolescents with psychiatric disorders.
Apodaca TR; Abrantes AM; Strong DR; Ramsey SE; Brown RA. Addictive Behaviors 32(6): 1119-1130, 2007. (45 refs.)
There has been recent increased interest in utilizing motivational interviewing (MI) to increase adolescent readiness to quit smoking, but attempts to impact quit rates have thus far been discouraging. A better understanding of factors associated with adolescent readiness to quit smoking prior to receiving any intervention may provide guidance when tailoring future MI interventions in order to increase their effectiveness with this population. Adolescent smokers (N=191) who had been admitted to a psychiatric hospital and enrolled in a clinical trial evaluating MI completed questionnaires that assessed smoking behavior and variables thought to be related to smoking. Confidence to quit smoking and negative beliefs about smoking were significant predictors of adolescents' baseline readiness to quit smoking. The failure to demonstrate relationships between health consequences and readiness suggest that caution may be warranted in the use of feedback, a common component of MI-based interventions. Such feedback tends to focus on health consequences, which was unrelated to adolescent baseline readiness to change smoking behavior in the current study. Parallels between current results and the Theory of Planned Behavior are discussed in consideration of developing more effective MI-based interventions for adolescent smokers. Copyright 2007, Elsevier Science.
Brief report: The theory of planned behaviour applied to physical activity in young people who smoke.
Everson ES; Daley AJ; Ussher M. Journal of Adolescence 30(2): 347-351, 2007. (10 refs.)
It has been hypothesised that physical activity may be useful as a smoking cessation intervention for young adults. In order to inform such interventions, this study evaluated the theory of planned behaviour (TPB) for understanding physical activity behaviour in young smokers. Regular smokers aged 16-19 years (N = 124), self-reported physical activity and all TPB components. Physical activity behaviour was significantly explained by both intention and perceived behavioural control (PBC), with both intention and PBC making significant contributions to the model. Intention was significantly explained by attitude, subjective norm (SN) and PBC, with attitude, SN and PBC all making significant contributions to the model. The TPB may be a useful framework for guiding physical activity interventions among young smokers. Copyright 2007, Ass, Professionals in Services for Adolescents.
Cultural orientation as a protective factor against tobacco and marijuana smoking for African American young women.
Nasim A; Corona R; Belgrave F; Utsey SO; Fallah N. Journal of Youth and Adolescence 36(4): 503-516, 2007. (77 refs.)
The present study examined cultural orientation as a protective factor against tobacco and marijuana smoking for African American young women (ages 18 to 25). African American college students (N=145) from a predominantly White university were administered subscales from the African American Acculturation Scale-Revised (AAAS-R); the shortened Individualism/Collectivism (INDCOL) Scale; a Tobacco and Drug Use Survey; and a background survey. Multiple logistic regression was conducted using cultural orientation variables as predictors and smoking status (i.e., tobacco and marijuana) as the criterion. It was expected that young women who endorsed traditional African American cultural characteristics (i.e., religious beliefs, health, family values, and socialization) and were collectivistic in their community (i.e., cultural interdependency) and familial (i.e., familial interdependency) interactions would be less likely to smoke. Results show that traditional religious beliefs and practice was protective against tobacco smoking for this sample of young women. Familial interdependency (e.g., supportive exchanges between friends, and consultation and sharing with parents), and traditional religious beliefs and practices surfaced as protective factors against marijuana smoking. Traditional health beliefs and practices was a risk factor for both tobacco and marijuana smoking. The implications signal the need for smoking prevention and cessation programs to focus on interpersonal factors which may strengthen African American young women's religious and familial bonding. Copyright 2007, Springer.
Pediatricians' use of the 5 A's and nicotine replacement therapy with adolescent smokers.
Price JH; Jordan TR; Dake JA. Journal of Community Health 32(2): 85-101, 2007. (41 refs.)
The purpose of this study was to examine pediatricians' use of nicotine replacement therapy (NRT) and the 5 A's counseling method with adol-escent smokers. Using a mail survey, 203 randomly selected pediatricians (52% response rate) responded to a valid and reliable 37-item questionnaire regarding: perceptions of prescribing NRT, confidence in using NRT, perceived barriers to prescribing NRT, sources of information regarding NRT, and use of the 5 A's counseling method. Forty-four percent of pediatricians did not feel competent in helping adolescents quit smoking cigarettes. Less than a fifth (17%) were currently prescribing NRT. A plurality (48%) perceived NRT to be safe for adolescent use but a majority (53%) rated themselves as not confident in their ability to use NRT. Those who prescribed NRT used transdermal patches (81%), nicotine gum (53%), or bupropion (44%). Pediatricians based their decisions on using NRT on whether: the adolescent showed an openness to quitting (78%), the adolescent requested NRT (72%), and if the adolescent had a health problem exacerbated by smoking (56%). The low level of perceived competence in helping adolescents quit smoking may be due to how few pediatricians identified medical school as a major source of information on helping adolescents stop smoking. Even though ample evidence suggests that NRT is safe to use with adolescents, less than half of the responding pediatricians perceived it to be safe, possibly indicating a desire for a more definitive conclusion on its safety before adopting the products or a lack of awareness of existing studies on this topic. Copyright 2007, Springer.
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