The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

PREDICTORS OF SMOKING BEHAVIOR AMONG ADOLESCENTS

Baker RR PhD RRT RPFT, Taft AA PhD RRT, Reyes J BS RRT-NPS, Hall CR MS RRT-NPS RPFT, Hernlen K MBA RRT, Dennison FH MEd RRT RPFT, Dias J PhD. Medical College of Georgia, Augusta, Georgia

Attitudes, Behaviors, and Situations Predicting Smoking Behavior
Attitudes Odds Ratio Significance
Agree That Smoking is Fun 12.1 P<0.001
Neutral That Smoking Will Shorten My Life 1.5 P=0.001
Disagree That Smoking is an Adult Activity 1.9 P=0.001
Behaviors    
Almost All Friends Smoke 28.9 P<0.001
Around Smokers Almost All the Time 14.2 P<0.001
Life Situations    
Siblings Smoke 1.6 P<0.001
Attend a Rural School 1.3 P=0.009
Mother Smokes 1.2 P=0.039



Background:
Cigarette smoking is the leading cause of preventable death in the US. Most smokers become addicted as teenagers, and it is a compelling public health interest to prevent tobacco use initiation. In order to develop effective Tobacco Use Prevention programs for teenagers, it is necessary to understand why they begin to smoke in the first place.

Methods:
A survey was adapted to identify smoking behaviors in school children. All public schools in the 13 counties of the East Central Health District (ECHD) of Georgia were contacted for inclusion in this study. Of the 43 schools in the ECHD, 21 agreed to participate (10 middle schools, 10 high schools, and 1 combined middle/high school). Surveys were distributed to all students in those schools during January and February of 2001.

RESULTS:
10,714 useable surveys were returned (out of a total enrollment of 18,289) for a 59.0% response rate. Logistic regression analysis was used to determine significant factors associated with smoking behavior as well as the relative strength of the association. Students were more likely to report having smoked within the last 30 days given the following attitudes, behaviors and life situations (see Table). The large influence exerted by peer groups (28.9 times more likely to smoke if most friends smoke) compared with the smaller effect exerted by parents (1.2 times more likely to smoke if mom smokes) is of particular interest. 

Conclusions:
Adolescent smoking behavior is most strongly influenced by the behavior and attitudes of peer groups, and is only slightly associated with parental smoking behavior. We conclude that smoking prevention programs aimed at school-aged children should strongly target the influences of peer groups and should begin in early years.

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