Factors related to adolescents' estimation of peer smoking prevalence

Although adolescents who overestimate peer smoking prevalence are more likely to smoke, little research has focused on the factors associated with why the majority of adolescents overestimate peer smoking rate. The purpose of this study was to examine demographic, social, environmental and behavioural characteristics related to overestimation of peer smoking prevalence among secondary school students. The current study analysed data collected in two Canadian studies that used the Tobacco Module of the School Health Action, Planning and Evaluation System, a school-based questionnaire. One study surveyed 23 458 students (Grades 9-13) in 29 schools during 2001-02, and the other surveyed 25 452 students in 39 schools in 2003. Results of multiple logistic regression indicate that grade, gender, close friends' smoking, seeing smoking at school, family members' smoking, smoking in the home and smoking status have a clear association with overestimation; school smoking rate and susceptibility to smoking show a tentative relationship and warrant further study. Other factors may also be important for prevalence estimation, and further research is needed to identify these factors. Since adolescents tend to overestimate peer smoking prevalence and perceived prevalence is in turn linked to smoking behaviour, interventions should focus on creating realistic perceptions of smoking prevalence.     

Household smoking bans and adolescent antismoking attitudes and smoking initiation: findings from a longitudinal study of a Massachusetts youth cohort

Objectives. We sought to determine whether adolescents living in households in which smoking was banned were more likely to develop antismoking attitudes and less likely to progress to smoking compared with those living in households in which smoking was not banned.Methods. We completed a longitudinal 4-year, 3-wave study of a representative sample of 3834 Massachusetts youths aged 12 to 17 years at baseline; 2791 (72.8%) were reinterviewed after 2 years, and 2217 (57.8%) were reinterviewed after 4 years. We used a 3-level hierarchical linear model to analyze the effect of a household ban on antismoking attitudes and smoking behaviors.Results. The absence of a household smoking ban increased the odds that youths perceived a high prevalence of adult smoking, among both youths living with a smoker (odds ratio [OR] = 1.56; 95% confidence interval [CI] = 1.15, 2.13) and those living with nonsmokers (OR = 1.75; 95% CI = 1.29, 2.37). Among youths who lived with nonsmokers, those with no home ban were more likely to transition from nonsmoking to early experimentation (OR = 1.89; 95% CI = 1.30, 2.74) than were those with a ban.Conclusions. Home smoking bans may promote antismoking attitudes among youths and reduce progression to smoking experimentation among youths who live with nonsmokers.The proliferation of US smoke-free workplace policies and laws over the past decade has been accompanied by increased attention to private household smoking restrictions. The number of US households with comprehensive rules that make homes smoke free in all areas at all times has increased substantially.¹ The proportion of US households with smoke-free home rules increased from 43% in 1992 to 1993 to 72% in 2003.² Even smokers appear to be increasingly adopting such rules, particularly in homes in which they live with a nonsmoking adult.Although smoke-free home bans are typically implemented to reduce or eliminate environmental tobacco smoke exposure in the household, these bans may have the additional benefit of reducing the initiation of smoking among youths by changing norms about the prevalence and social acceptability of smoking. Very little is known about the specific effect of a household smoking ban on youth smoking behavior or on smoking-related attitudes and norms that may mediate an effect on smoking behavior. In particular, few studies have addressed the independent effect of bans on youths who live with smokers—those who are at the greatest risk for becoming smokers themselves.Recent studies showed that strong smoking regulations in local restaurants and bars were associated with more negative attitudes among youths toward the social acceptability of smoking in restaurants and bars.^3–6 Establishing household smoking bans conveys to youths living within these smoke-free home environments the message that smoking is unacceptable. Some supportive evidence, derived from cross-sectional data, indicates that a household smoking ban is associated with antismoking attitudes and norms. A recent cross-sectional study found that a household ban was associated with a lower perceived prevalence of adult smoking and more-negative attitudes about the social acceptability of smoking, 2 factors that affect the likelihood of smoking initiation.⁷Several cross-sectional studies have reported that a smoking ban in the household was associated with a lower likelihood of being in an earlier stage of smoking and a lower current smoking prevalence among adolescents.^8–11 Conversely, other studies found no statistically significant association between a household smoking ban and reduced adolescent smoking.^12–14 Several factors may account for these conflicting results, including varying sample sizes, age groups, and smoking measures used in these cross-sectional studies.A critical question is whether antismoking socialization occurs when parents themselves smoke. One study found that a household smoking ban was related to lower levels of smoking onset for children with nonsmoking parents but not for children with 1 or more parent who smoked.¹⁵ Another study reported that a household smoking ban was not associated with trying smoking among high school students who had 1 or more parents who were current or former smokers.¹⁶ Only 1 study reported an association between a household smoking ban and a reduced likelihood of smoking among 12th graders whose parents were smokers but not among those whose parents were nonsmokers.¹⁷ In summary, more evidence supports an association between home smoking bans and lower levels of smoking behaviors among youths who live with nonsmokers.Current research on household smoking bans has significant limitations. First, these studies rely on cross-sectional data that limit the ability to indicate causality in the relation between home smoking bans and trajectories of attitudes and smoking. Second, most studies have focused on individual-level predictors of attitudes and smoking behaviors, despite evidence that part of the explanation lies within the community context.¹⁸ Third, few studies have investigated the unique effects of a household smoking ban among adolescents living in home environments with parental smokers compared with those living with nonsmokers.In this study, our goal was to improve existing research by (1) using longitudinal data that followed up a cohort of youths and young adults who lived in parental homes over a 4-year period, with a total of 3 repeated observations for each participant; (2) using a multilevel model that simultaneously examined the effects of individual-level and town-level factors; and (3) investigating separately the effects of a household ban on youths who live with at least 1 smoker and youths who live with nonsmokers.     

Household size related to prevalence of smoking in women in Japan

We investigated the relationship between the prevalence of smoking in females and various social factors, such as household size. Ten thousand and sixty-nine subjects over 20 years of age were randomly selected from the general population of Mie Prefecture. The results showed that the habit of smoking was significantly associated with household size in women (P< 0.01), but not in men. Regarding household size, current smoking rate of women aged 20-59 who live in three-generation household was lower than those who live in others. Therefore, the steady replacement of the traditional three-generation household by smaller households in Japan may lead to an increase in the number of young women who smoke.     

Correlates of home smoking bans among Mexican-Americans

PURPOSE: This study examines the individual and environmental correlates of home smoking bans among a population-based sample of Mexican-Americans. Design. A telephone survey on tobacco use and home policies was conducted using stratified, random sampling of listed phone numbers. SETTING: Surveys were completed by telephone in San Diego, California. SUBJECTS: The sample consisted of San Diego adult residents of Mexican descent (N=1103). MEASURES: The interview included questions on home rules regarding smoking in the household and a number of potential correlates, based on the Behavioral Ecological Model (BEM). This model emphasizes the influence of family, social, and cultural factors on health behaviors. RESULTS: Overall, 90.6% of all respondents reported a ban on smoking in the home. Multivariate analyses indicated that home bans on smoking are more likely among individuals that do not smoke, live with children, are more acculturated to U.S. society, report greater aversion to ETS, and/or report more social pressure against indoor smoking. In contrast, smoking bans are less likely among Mexican Americans who live with smokers. CONCLUSIONS: Individual and environmental factors play a protective role by increasing the likelihood of smoking bans in the home of Mexican-descent individuals. These factors should be considered for the design of interventions to sustain and promote the adoption of smoking bans in the home among this and other populations.     

Home smoking bans in Finland and the association with child smoking

BACKGROUND: Few studies in Europe have investigated home smoking bans and their association with child smoking. METHODS: A nationwide survey of 12 to 18-year olds in 2005 (n = 6503, response rate 66%) was used to study home smoking bans in Finland. Multinomial logistic regression analyses were used to study association of home smoking bans and child smoking. RESULTS: Of the respondents, 58% reported a total ban, 27% a partial ban, 4% reported no ban and 10% chose the option 'I cannot say'. The lack of total ban was strongly associated with living in non-intact families, parents' lower educational level, parental smoking and parents' permissive attitude towards child smoking. Moreover, partial or no ban increased the likelihood of being a daily smoker. In the multinomial logistic regression model, the odds ratios (ORs) for children's daily smoking, adjusted for sociodemographic factors, parental smoking and their permissive attitude, were OR 2.9 [95% confidence interval (CI) 2.3-3.6] for partial ban and OR 14.3 (8.6-23.7) for no ban. In families where both parents smoked, the adjusted ORs were correspondingly 1.5 (95% CI 0.7-3.0) and 2.9 (95% CI 1.1-7.8). CONCLUSIONS: Home smoking bans will contribute towards a reduced risk of child smoking even when parents smoke. Tobacco control legislation needs to be enhanced with measures promoting awareness of the benefits achievable through strict home smoking bans. Families characterized by lower socioeconomic status and smoking parents are particular target groups.     

Household context and youth smoking behaviour: prevalence, frequency and tar yield

Labour Force Smoking Survey data were used to examine the impact of household environment on the smoking behaviour of youth and young adults. Three indicators of older adult smoking behaviour were used to classify the smoking environment of households. The indicators were smoking prevalence, the mean number of cigarettes smoked per day, and the mean tar yield of cigarettes. Within households, the probability that a young person smokes, how much they smoke, and the type of cigarette they smoke is closely associated with the smoking behaviour of older adults in the household. Household smoking patterns contribute to the overall exposure of family members to the hazards of cigarette smoking and may influence the outcome of smoking cessation programs. Smoking cessation and prevention programs should consider the potential effect of family and household environments.     

Household smoking restrictions and adolescent smoking

PURPOSE: To examine the association between household smoking restrictions and adolescent smoking, controlling for parental smoking, peer smoking, and tobacco marketing. DESIGN: Cross-sectional analysis of 1999 data from the Growing Up Today Study, a longitudinal cohort of adolescents. SETTING: Self-report questionnaire. SUBJECTS: 10,593 adolescents aged 12 to 18 years. MEASURES: The dependent variable was established smoking (smoking > or = 100 cigarettes). Variables of interest were household smoking restrictions, parental smoking, peer smoking, and tobacco promotional item (TPI) possession. RESULTS: Four percent of participants reported that their households permitted smoking. Parental smoking, peer smoking, and TPI possession were significantly associated with established smoking In logistic regression models adjusted for age, gender, peer smoking, and TPI possession, adolescent smoking was inversely related to the presence of a restrictive household policy (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.48-0.93); however, when parental smoking was added to this model, the association was attenuated (OR = 0.94, CI = 0.65-1.35). When only one parent in the household smoked, smoking restrictions were more common when this parent was the father. CONCLUSIONS: Although household smoking restrictions offer health benefits, they do not appear to be associated with adolescent smoking after accounting for other factors. Prior studies did not include parental smoking, peer smoking, and marketing influences. This analytic difference may explain apparent contradictions in the literature.     

Prevalence of workplace smoking bans in Victoria

Abstract: Restrictions on smoking in the Victorian workplace have been measured since 1988. This paper investigates whether the trend of increasing prevalence of total bans found between 1988 and 1992 has continued. Estimates are based on workers' reports of the restrictions on smoking that apply at their workplaces. For indoor workers a total ban on smoking restrictions in the workplace has increased from 58% in 1992 to 66% in 1995. White collar workers continue to enjoy a higher rate of protection than blue collar workers. Factories, warehouses, hotels and restaurants are the worksites least likely to have restrictions. Bans result in considerable exiled smoking: half the smokers reported going out to smoke during working hours on their last work day. ( Aust N Z J Public Health 1997; 21: 694–8)     

Total smoking bans in psychiatric inpatient services: a survey of perceived benefits,barriers and support among staff

Background  

The introduction of total smoking bans represents an important step in addressing the smoking and physical health of people with mental illness. Despite evidence indicating the importance of staff support in the successful implementation of smoking bans, limited research has examined levels of staff support prior to the implementation of a ban in psychiatric settings, or factors that are associated with such support. This study aimed to examine the views of psychiatric inpatient hospital staff regarding the perceived benefits of and barriers to implementation of a successful total smoking ban in mental health services. Secondly, to examine the level of support among clinical and non-clinical staff for a total smoking ban. Thirdly, to examine the association between the benefits and barriers perceived by clinicians and their support for a total smoking ban in their unit.     

Promoting reduced smoking rates in the context of workplace smoking bans

A randomized study was conducted in 41 workplaces to determine the potential of self-help and group-based programs to encourage reduced smoking in workplaces that have implemented smoking bans. The trial had limited success in recruiting smokers, attrition was an important limitation, and the study outcomes were modest. The authors conclude that more research is needed on effective strategies that help smokers minimize smoking at work.     

Associations of smoking prevalence with individual and area level social cohesion

STUDY OBJECTIVE: To discover if area level social cohesion, neighbourhood safety, and home safety are associated with current cigarette smoking among adults after adjustment for concentrations of poverty and low education. DESIGN: Cross sectional survey of a random sample of adults, stratified by 19 geographical areas. SETTING: SHAPE, Survey of the Health of Adults, the Population, and the Environment-conducted in 1998 by the Hennepin County Community Health Department and the Minneapolis Department of Health and Family Support in Minnesota. PARTICIPANTS: 5256 men and 4806 women, 18 years and older, randomly selected from 19 geographical areas in an urban county. MAIN RESULTS: Overall, 21.2% of survey respondents reported current cigarette smoking. Both higher area level social cohesion (OR = 0.85, 95% CI = 0.74 to 0.98) and higher individual social cohesion (OR = 0.96, 95% CI = 0.92 to 0.99) were associated with lower likelihoods of smoking. Similar models were obtained for neighbourhood safety and home safety. CONCLUSIONS: These findings contribute to the growing literature on the important role of social cohesion and other area level characteristics on smoking behaviour among adults.     

Individual and contextual determinants of perceived peer smoking prevalence among adolescents in six European cities

BackgroundYoung people perceiving a high peer smoking prevalence are more likely to initiate smoking. It is unclear which factors contribute to perceived peer smoking prevalence and if these factors vary according to education. This study aimed to assess the determinants of perceived smoking prevalence and assessed its variation at school and country-level.MethodsData of 10,283 14–17-year-old students in 50 secondary schools in six European cities were derived from the 2013 SILNE survey. The outcome was the perceived smoking prevalence score among peers at school (0–10 scale, 10 represented 100% smoking prevalence). Multilevel linear regression models estimated the associations of factors with perceived prevalence score and variance at school and country-levels. Analyses were also stratified by academic achievement of the adolescent and parental education.ResultsDeterminants of a higher perceived prevalence score were female sex, ever smoking, having friends who smoke, low academic achievement, low parental educational level, and higher actual prevalence of smoking in the school. The perceived prevalence score was not associated with school policies or with the availability of cigarettes near the school. Determinants were very similar across levels of academic achievement and parental education. Perceived prevalence scores substantially varied between schools and countries: 10% and 11% of total variance was related to schools and countries respectively.ConclusionAcross educational levels, perceptions of peer smoking are strongly determined by both individual characteristics and school and national contexts. Future studies should assess why perceived smoking prevalence varies between schools and countries and identify modifiable factors.     

Effects of workplace smoking bans on cigarette consumption.

A sample of staff working in the Australian Public Service (n = 2113) were surveyed two to four weeks before a mandated total ban on workplace smoking was introduced, and again five to six months later. Among the 391 smokers on whom complete data were available, the workplace smoking bans were associated with reduced rates of smoking, particularly among heavier smokers where the reduction in consumption was over 25 percent.     

The association between workplace smoking bans and self-perceived,work-related stress among smoking workers

Background  

There is substantial empirical evidence on the benefits of smoking bans; however, the unintended consequences of this anti-smoking measure have received little attention. This paper examines whether workplace smoking bans (WSB's) are associated with higher self-perceived, work-related stress among smoking workers.     

Tobacco use behaviors and household smoking bans among Chinese Americans

PURPOSE: To assess the relationship between household smoking restrictions and smoking patterns among Chinese American adults. DESIGN: This is a cross-sectional analysis based on a National Institutes of Health-funded population-based household and telephone survey of 2537 Chinese American adults. SETTING: Two communities in New York City. SUBJECTS: The analyses focused on male current smokers (N = 600). MEASURES: Demographic characteristics, smoking status, household smoking restrictions, cigarettes smoked per day, and past quit attempts were based on self-reported data. RESULTS: Among current smokers, 37% reported living in a home with a complete smoking ban. Smokers with a full household smoking ban smoked fewer cigarettes on weekdays and weekends than smokers with no household smoking ban (p < or = .05) and were 3.4 times (p < .01) more likely to report having at least one quit attempt in the past 12 months. Smokers with knowledge of the dangers of environmental tobacco smoke (ETS) exposure were 2.8 times (p < or = .01) more likely to have at least one quit attempt in the last 12 months compared with those who were unaware of the danger of ETS and more likely to live in a smoke-free household. CONCLUSIONS: Smoke-free home policies and interventions to raise awareness among smokers of the dangers of ETS have the potential to significantly reduce tobacco use and exposure to household ETS among this immigrant population.     

Parent's socioeconomic status,adolescents' disposable income,and adolescents' smoking status in Massachusetts

OBJECTIVES: This study examined the association between parental socioeconomic status (SES) and adolescent smoking. METHODS: We conducted telephone interviews with a probability sample of 1308 Massachusetts adolescents aged 12 to 17 years. We used multiple-variable-adjusted logistic regression models. RESULTS: The risk of adolescent smoking increased by 28% with each step down in parental education and increased by 30% for each step down in parental household income. These associations persisted after adjustment for age, sex, race/ethnicity, and adolescent disposable income. Parental smoking status was a mediator of these associations. CONCLUSIONS: Parental SES is inversely associated with adolescent smoking. Parental smoking is a mediator but does not fully explain the association.     

Relationship between perceived life satisfaction and adolescents' substance abuse.

PURPOSE: To explore the relationship between perceived global life satisfaction and selected substance use behaviors among 5032 public high school students. METHODS: The 1997 South Carolina Youth Risk Behavior Survey substance abuse and life satisfaction variables were used. An adjusted polychotomous logistic regression analysis utilizing SAS/SUDAAN, revealed a significant race/gender interaction. Subsequent multivariate models were constructed individually for four race/gender groups. Adjusted odds ratios and 95% confidence intervals were calculated to assess the magnitude of risk for selected substance abuse behaviors and their association with reduced global life satisfaction. RESULTS: Cigarette smoking, chewing tobacco, marijuana, cocaine, regular alcohol use, binge drinking, injection drug, and steroid use were significantly (p < .05) associated with reduced life satisfaction for specific race/gender groups (white males; black males; white females; and black females). In addition, age (< or = 13 years) of first alcohol drink, first marijuana use, first cocaine use, and first cigarette smoked were also significantly (p < .05) associated with reduced life satisfaction. CONCLUSION: Longitudinal studies are needed to determine whether dissatisfaction with life is a consequence or determinant of substance abuse behavior for adolescents.