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...on Adolescent Nicotine Use
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www.ProjectCork.org
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Winter 2008
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Weight-related concerns associated with smoking in young children.
Kendzor DE; Copeland AL; Stewart TM; Businelle MS; Williamson DA. Addictive Behaviors 32(3): 598-607, 2007. (43 refs.)
Studies have shown that weight concern is associated with smoking in adolescents. However, little is known about the relationship between weight concern and smoking in younger children. Analyses were conducted to determine whether children in elementary school who had tried smoking would possess greater weight concern than those who had not tried smoking. Results indicated that smokers possessed more general weight concern, F(1, 640) = 5.619, p=.018, reported more dieting, F(l, 707)=11.757, p=.001, and endorsed greater concern with body size, F(1, 707)=4.113, p=.043, than non-smokers. Similar to adolescents, these results suggest that young children who have tried smoking are more concerned about weight than children who have not tried smoking. Copyright 2007, Elsevier Science.
Disentangling social selection and social influence effects on adolescent smoking: The importance of reciprocity in friendships.
Mercken L; Candel M; Willems P; de Vries H. Addiction 102(9): 1483-1492, 2007. (48 refs.)
Aims: The goal of this study was to examine social selection and social influence within reciprocal and non-reciprocal friendships, and the role of parents and siblings, as factors explaining similarity of smoking behaviour among adolescent friends. A new social selection-social influence model is proposed. Design: Longitudinal design with two measurements. Setting Data were gathered among Dutch high school students in the control group of the European Smoking prevention Framework Approach (ESFA) study. Participants: The sample consisted of 1886 adolescents with a mean age of 12.7 years. Measurements The main outcome measures were the smoking behaviours of the respondents, best friends, parents and siblings. We tested the social selection-social influence model with structural equation modelling techniques. Findings: Social selection and social influence both played an important role in explaining similarity of smoking behaviour among friends. Within non-reciprocal friendships, only social selection explained similarity of smoking behaviour, whereas within reciprocal friendships, social influence and possibly also social selection explained similarity of smoking behaviour. Sibling smoking behaviour was a more important predictor of adolescent smoking behaviour than parental smoking behaviour. Conclusions: Social selection and social influence both promote similarity of smoking behaviour, and the impact of each process differs with the degree of reciprocity of friendships. These insights may contribute to further refinement of smoking prevention strategies. Copyright 2007, Society for the Study of Addiction to Alcohol and Other Drugs.
Susceptibility to nicotine dependence: The development and assessment of nicotine dependence in youth 2 study.
DiFranza JR; Savageau JA; Fletcher K; Pbert L; O'Loughlin J; McNeill AD et al. Pediatrics 120(4): e974-e983, 2007. (93 refs.)
OBJECTIVES. The purpose of this work was to identify characteristics that predict progression from the first inhalation of a cigarette to dependence. We studied a cohort of 1246 public school 6th-graders in 6 Massachusetts communities (mean age at baseline: 12.2 years). METHODS. We conducted a 4-year prospective study using 11 interviews. We assessed 45 risk factors and measured diminished autonomy over tobacco with the Hooked on Nicotine Checklist and evaluated tobacco dependence according to the International Classification of Diseases, 10th Revision. Cox proportional-hazards models were used. RESULTS. Among 217 youths who had inhaled from a cigarette, the loss of autonomy over tobacco was predicted by feeling relaxed the first time inhaling from a cigarette and depressed mood. Tobacco dependence was predicted by feeling relaxed, familiarity with Joe Camel, novelty seeking, and depressed mood. CONCLUSIONS. Once exposure to nicotine had occurred, remarkably few risk factors for smoking consistently contributed to individual differences in susceptibility to the development of dependence or loss of autonomy. An experience of relaxation in response to the first dose of nicotine was the strongest predictor of both dependence and lost autonomy. This association was not explained by trait anxiety or any of the other measured psychosocial factors. These results are discussed in relation to the theory that the process of dependence is initiated by the first dose of nicotine. Copyright 2007, American Academy of Pediatrics.
Symptoms of tobacco dependence after brief intermittent use: The development and assessment of nicotine dependence in youth-2 study.
DiFranza JR; Savageau JA; Fletcher K; O'Loughlin J; Pbert L; Ockene JK et al. Archives of Pediatrics & Adolescent Medicine 161(7): 704-710, 2007. (45 refs.)
Objective: To extend the findings of the first Development and Assessment of Nicotine Dependence in Youth study by using diagnostic criteria for tobacco dependence and a biochemical measure of nicotine intake. The first study found that symptoms of dependence commonly appeared soon after the onset of intermittent smoking. Design: A 4-year prospective study. Setting: Public schools in 6 Massachusetts communities. Participants: A cohort of 1246 sixth-grade students. Interventions: Eleven interviews. Main Outcome Measures: Loss of autonomy over tobacco as measured by the Hooked on Nicotine Checklist, and tobacco dependence as defined in International Classification of Diseases, 10th Revision (ICD-10). Results: Among the 217 inhalers, 127 lost autonomy over their tobacco use, 10% having done so within 2 days and 25% having done so within 30 days of first inhaling from a cigarette; half had lost autonomy by the time they were smoking 7 cigarettes per month. Among the 83 inhalers who developed ICD-10-defined dependence, half had done so by the time they were smoking 46 cigarettes per month. At the interview following the onset of ICD-10-defined dependence, the median salivary cotinine concentration of current smokers was 5.35 ng/mL, a level that falls well below the cutoff used to distinguish active from passive smokers. Conclusions: The most susceptible youths lose autonomy over tobacco within a day or 2 of first inhaling from a cigarette. The appearance of tobacco withdrawal symptoms and failed attempts at cessation can precede daily smoking; ICD-10-defined dependence can precede daily smoking and typically appears before consumption reaches 2 cigarettes per day. Copyright 2007, American Medical Association.
Disentangling social selection and social influence effects on adolescent smoking: The importance of reciprocity in friendships.
Mercken L; Candel M; Willems P; de Vries H. Addiction 102(9): 1483-1492, 2007. (48 refs.)
Aims: The goal of this study was to examine social selection and social influence within reciprocal and non-reciprocal friendships, and the role of parents and siblings, as factors explaining similarity of smoking behaviour among adolescent friends. A new social selection-social influence model is proposed. Design: Longitudinal design with two measurements. Setting Data were gathered among Dutch high school students in the control group of the European Smoking prevention Framework Approach (ESFA) study. Participants: The sample consisted of 1886 adolescents with a mean age of 12.7 years. Measurements The main outcome measures were the smoking behaviours of the respondents, best friends, parents and siblings. We tested the social selection-social influence model with structural equation modelling techniques. Findings: Social selection and social influence both played an important role in explaining similarity of smoking behaviour among friends. Within non-reciprocal friendships, only social selection explained similarity of smoking behaviour, whereas within reciprocal friendships, social influence and possibly also social selection explained similarity of smoking behaviour. Sibling smoking behaviour was a more important predictor of adolescent smoking behaviour than parental smoking behaviour. Conclusions: Social selection and social influence both promote similarity of smoking behaviour, and the impact of each process differs with the degree of reciprocity of friendships. These insights may contribute to further refinement of smoking prevention strategies. Copyright 2007, Society for the Study of Addiction to Alcohol and Other Drugs.
Outdoor alcohol advertising near schools: What does it advertise and how is it related to intentions and use of alcohol among young adolescents?
Pasch KE; Komro KA; Perry CL; Hearst MO; Farbakhsh K. Journal of Studies on Alcohol and Drugs 68(4): 587-596, 2007. (48 refs.)
Objective: The objectives of this study were to (1) document and describe all outdoor alcohol advertisements surrounding schools and (2) examine the association between exposure to alcohol advertising in sixth grade and youth alcohol use, intentions, norms, and attitudes in eighth grade. Method: All outdoor alcohol advertisements within 1,500 feet of 63 Chicago school sites were documented and coded for content and theme. Longitudinal mixed-effects regression analysis was used to determine the association between number of alcohol advertisements around a school in sixth grade and student alcohol behaviors, intentions, norms, and attitudes at the end of eighth grade, 2 years later. Participants included 2,586 sixth-grade students in the 2002-2003 school year. The sample was 37% black, 33% Hispanic, and 15% white. Gender was evenly distributed, and the average age was 12.2 at the end of sixth grade. Results: A total of 931 alcohol advertisements were found within 1,500 feet of the 63 school sites. Exposure to alcohol advertising around schools at the end of sixth grade was found to predict alcohol intentions at the end of eighth grade. This finding held true even for those students who were nonusers of alcohol in sixth grade. Conclusions: Exposure to outdoor alcohol advertising around schools is associated with subsequent youth intentions to use alcohol. The association between exposure to alcohol advertising and youth alcohol-use intentions was found even among sixth-grade nonusers of alcohol, suggesting that even those who have not used alcohol are still influenced by alcohol advertising. These findings suggest that restrictions in alcohol advertising near schools may be warranted. Copyright 2007, Alcohol Research Documentation.
Physical activity in adolescence and smoking in young adulthood: a prospective twin cohort study.
Kujala UM; Kaprio J; Rose RJ. Addiction 102(7): 1151-1157, 2007. (33 refs.)
Aims: To control for familial confounds, we studied the association between adolescent physical activity and later smoking in twin siblings discordant for their baseline physical activity. Design and measurements: In this prospective population-based twin study, we asked whether persistent physical activity/inactivity in adolescence (assessed at 16, 17 and 18.5 years) predicted questionnaire-reported daily smoking at ages 22-27. Twins who, on the three baseline questionnaires, consistently reported frequent leisure physical activity (more than three times weekly) were classified as persistent exercisers, those who exercised less than three times monthly were called persistently inactive, others were occasional exercisers. Setting Finland. Participants: A total of 4240 individuals, including 1870 twin pairs. Findings: In analyses of individual twins, compared to persistent activity, persistent physical inactivity predicted increased risk of daily smoking (age- and sex-adjusted odds ratio 5.53, 95% confidence interval 3.88-7.88, P < 0.001). The risk remained elevated even after excluding all those who had smoked 50 cigarettes or more life-time at baseline and adjusted for educational level in adolescence. In within-pair analyses compared to the active members of discordant twin pairs, the physically inactive co-twins had increased risk of future daily smoking (sex-adjusted odds ratio 3.39, 95% confidence interval 1.56-7.39, P = 0.002). Conclusions: Persistent physical inactivity in adolescence relates to adult smoking, even after familial factors are taken into account. Copyright 2007, Society for the Study of Addiction to Alcohol and Other Drugs.
Retail point-of-scale guardianship and juvenile tobacco purchases: Assessing the prevention capabilities of undergraduate college students.
Gilbertson T. Journal of Drug Education 37(1): 1-30, 2007. (14 refs.)
This randomized experiment evaluates the attitudes and behavioral intentions of 458 undergraduate college students about intervening with the intent of preventing an illegal retail purchase of tobacco products by a minor after exposure to a factorial combination of three pieces of information. MANOVA results show that none of the treatment conditions, considered alone, are correlated with increased attitudes or behavioral intentions; however, there is a significant interaction effect on attitudes when information portraying a potentially annoying situation is combined with information about the costs associated with youth tobacco use. Post-hoc t tests suggest that this effect is concentrated among non-tobacco using respondents. Copyright 2007, Baywood Publishing.
Smoking during teenage pregnancies: Effects on behavioral problems in offspring.
Cornelius MD; Goldschmidt L; DeGenna N; Day NL. Nicotine & Tobacco Research 9(7): 739-750, 2007. (104 refs.)
We prospectively examined the relationship between prenatal tobacco exposure (PTE) and child behavior in a birth cohort of 357 offspring of teenage mothers. PTE was defined as any exposure across pregnancy and, in separate analyses, exposure within each trimester. Outcomes included measures of behavior problems, activity, and attention. On average, the children were 6.4 years of age, 48% were females, and 69% were Black. Data on maternal tobacco and other substance use were collected prenatally and postnatally: 46% of the mothers smoked in the first trimester and 58(% smoked 6 years later. Child urinary cotinine measured exposure to environmental tobacco smoke (ETS). Stepwise multiple regressions were run. PTE predicted significantly increased offspring activity; impulsivity; and aggression, externalizing, and total behavior problems in step 1. PTE remained a significant predictor of increased activity when maternal psychological characteristics, home environment, and ETS were added. The results were similar when PTE was examined by trimesters, although later pregnancy tobacco exposure predicted the most behavioral outcomes. In the final model, PTE (all three trimesters) and PTE (second trimester) were significant predictors of increased activity and attention problems, respectively. Other predictors of child behavior included maternal anxiety, depression, hostility, and home environment. ETS was not a significant predictor of child behavior when PTE was considered. Smoking during pregnancy among adolescents is a significant predictor of increased activity and attention problems in their offspring after controlling for covariates in the prenatal and current environments. Smoking cessation interventions are recommended for this population to avoid the effects of PTE on the offspring of pregnant adolescents. This is particularly important because these mothers will likely become pregnant again and many will increase their level of tobacco use as they mature. Copyright 2007, Taylor & Francis.
The role of schoolmates' smoking and non-smoking in adolescents' smoking transitions: A longitudinal study.
Bricker JB; Andersen MR; Rajan KB; Sarason IG; Peterson AV. Addiction 102(10): 1665-1675, 2007. (43 refs.)
Aims: The first longitudinal investigation of the extent to which same-age and older schoolmates' smoking and non-smoking are associated with adolescents' smoking transitions during three grade intervals. Design: Same-age and older schoolmates' smoking and non-smoking were assessed when adolescents were at grades 5 (age 10), 7 (age 12) and 9 (age 14). Adolescents' smoking transitions were assessed at three grade intervals: 5th-7th (age 10-12), 7th-9th (age 12-14) and 9th-12th (age 14-17). Setting Forty Washington State school districts. Participants and Measurements: Smoking questionnaire data were gathered on a cohort of adolescents (n = 4354 for same-age schoolmate analysis; n = 1833 for older schoolmate analysis) that was 49% female and 91% Caucasian. Findings: No significant evidence that same-age schoolmates' smoking or non-smoking was associated with any of the adolescent smoking transitions at any of the three grade intervals. In contrast, the probability that each older schoolmate's smoking was associated with the adolescent making the transition to trying smoking was 1% (95% CI: 0.4%, 1.5%) and with the transition from trying to monthly smoking was also 1% (95% CI: 0.2%, 2.0%) during the 7th-9th grade (age 12-14) interval. Moreover, each older schoolmate's non-smoking was associated with a 1.001-1.006 (all P < 0.05) relative risk of an adolescent not trying smoking or escalating from trying to monthly smoking at several grade intervals. Conclusions: Interventions should perhaps focus on the influence of both smoking and non-smoking older schoolmates during late childhood and early adolescence. Copyright 2007, Society for the Study of Addiction to Alcohol and Other Drugs.
Five-year prospective prediction of self-initiated quitting of cigarette smoking of high-risk youth.
Sussman S; Dent CW. Addictive Behaviors 32(5): 1094-1098, 2007. (7 refs.)
This paper provides a 5-year replication-extension of a previous 1-year follow-up study of the same sample of southern California alternative high school youth. Demographic, behavioral, psychosocial, and emerging adult function predictors of adolescent self-initiated smoking cessation were investigated. Based on the first (1-year) prospective study and this follow-up, one may speculate that smoking cessation programs for adolescents should include counteraction of problem-prone attitudes, assistance with job aspirations and information about drug-free workplaces, motivation to quit strategies, and assistance with overcoming withdrawal symptoms. Copyright 2007, Elsevier Science.
Gender differences in adolescents' responses to themes of relaxation in cigarette advertising: Relationship to intentions to smoke.
DiRocco DN; Shadel WG. Addictive Behaviors 32(2): 205-213, 2007. (32 refs.)
Studies have shown that increased exposure to cigarette advertising increases adolescents' risk of smoking and moreover, that gender may play an important role in moderating how cigarette advertisements are viewed and processed. However, information about the particular features of cigarette advertising that interact with gender to promote smoking among adolescents is scarce. The purpose of this study was to examine if gender moderates the degree to which the relaxation valence (i.e., degree to which relaxing themes are emphasized) of cigarette advertisements is related to smoking intentions in a sample of never smoking adolescents. Regardless of brand type (of the seven brands studied), cigarette advertisements that displayed highly relaxing images were associated with increased intentions to smoke among female adolescents only. These results have implications for understanding what features of cigarette advertisements have the most influence among different groups of adolescents. Copyright 2007, Elsevier Science.
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