Perceptions of Second-hand Smoke Risks Predict Future Adolescent Smoking Initiation

University of California, Merced, School of Social Sciences, Humanities, and Arts, Psychological Sciences, Merced, California 95343, USA.
Journal of Adolescent Health (Impact Factor: 3.61). 12/2009; 45(6):618-25. DOI: 10.1016/j.jadohealth.2009.04.022
Source: PubMed


To directly test whether perceptions of second-hand smoke risks deter adolescent smoking initiation.
A longitudinal survey design was utilized in this study. Baseline surveys measuring perceptions of tobacco-related risks and smoking behaviors were administered to 395 high school students, with three follow-up assessments every 6 months.
Perceptions of personal second-hand smoke risks and parental second-hand smoke risks significantly deterred adolescent smoking initiation. Perceptions of personal second-hand smoke risks reduced the odds of smoking by a factor of 0.63 (95% confidence interval [CI]=0.42-0.94) for each quartile increase in perceptions of personal second-hand smoke risks. Adolescents who provided the highest estimates of risks for personal second-hand smoke were 0.25 as likely to smoke as adolescents who provided the lowest estimates of risk. Perceptions of parental second-hand smoke risks reduced the odds of smoking by a factor of 0.64 (95% CI=0.43-0.93) for each quartile increase. Adolescents who perceived the highest estimates of risks associated with parental second-hand smoke were 0.26 as likely to smoke in the future compared to adolescents who provided the lowest estimates of risk. These effects are over three times as large as a smoking peer's influence on a nonsmoking adolescents' risk for smoking initiation, odds ratio [OR]=1.18 (95% CI=1.02-1.35).
Adolescent perceptions of risks of second-hand smoke are strongly associated with smoking initiation. Encouraging adolescents to express their objections to second-hand smoke, as well as encouraging parents to create smoke-free homes, may be powerful tobacco control strategies against adolescent smoking.

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Available from: Stanton Glantz, Dec 15, 2014
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    • "Such changes can lead to increases in the adoption of, and compliance with, smoke-free environments as people become more conscious of the public health benefits of smoke-free air [3]. Parental attitudes and awareness toward SHS and its risks are associated with SHS exposure among youth [4], and greater perceptions of risk from SHS exposure among youth can reduce their likelihood of smoking initiation [5]. Although previous research suggests that a vast majority (95%) of U.S. adults recognize the hazards of youth exposure to SHS [6], no study has examined perceptions about the harm of SHS exposure among a representative sample of U.S. youth. "
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    ABSTRACT: Increased knowledge of the harmful effects of SHS is an evidence-based key indicator for eliminating nonsmokers¿ exposure to SHS. This study assessed the prevalence and predictors of perceptions about the harm of secondhand smoke (SHS) exposure among U.S. middle and high school students. Data were obtained from the 2012 National Youth Tobacco Survey, a nationally representative school-based survey of U.S. students in grades 6¿12. Respondents who reported that they thought breathing smoke from other people¿s cigarettes or other tobacco products causes ¿some¿ or ¿a lot¿ of harm were considered to have the perception that SHS is harmful. Multivariate logistic regression was used to identify predictors of the perception that SHS is harmful. Predictors included sex, race/ethnicity, school grade level, current tobacco use, and whether the respondent currently lived with a tobacco user. Overall, 75.4% of students perceived SHS exposure as harmful. The adjusted odds of perceiving SHS exposure as harmful were higher among non-Hispanic Asians than among non-Hispanic whites, and among students in 10th-12th grades than among students in 8th grade. Adjusted odds were lower among boys than among girls, among non-Hispanic blacks than among non-Hispanic whites, among students living with a tobacco user than among those not, and among those who use combustible tobacco only or both combustible and non-combustible tobacco than among those who use no tobacco. Most middle and high school students perceive SHS exposure as harmful, but efforts are needed to increase the prevalence of this perception in certain subpopulations, particularly tobacco users.
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    • "Public health programs and policies that help to empower youth who live in families in which parents and other family members smoke are needed. Song et al. recommend that encouraging youth to express their objections to second-hand smoke, as well as encouraging smoke-free homes, may be powerful tobacco control strategies against youth smoking [47]. In addition to controlling smoking within households, the findings from this study may be used to move forward tobacco control programs and policies designed to prevent parents and other adults from smoking around youth in locations outside the home where parents and youth interact. "
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    • "Finally, much of the improvement in predicting adolescents' decision making has derived from an expanded consideration of the subjective benefits that adolescents associate with health-risk behaviors. For instance, one study found that adolescents' perceptions of the benefits (e.g., social status, pleasure) of alcohol and tobacco use prospectively predicts their decisions to drink and smoke 6 months later, above and beyond age, experience with the substance , and perceptions of risk (Goldberg et al., 2002; see also Halpern-Felsher, Biehl, Kropp, & Rubinstein, 2004; Meier, Slutke, Arndt, & Cadoret, 2007; Song, Morrell, et al., 2009). A recent meta-analysis of studies predicting sexual activity, alcohol and tobacco use, and nutrition behavior in adolescents ages 10 – 18 found that perceptions of benefits are stronger predictors than risk perceptions of all four behaviors (Peters et al., 2009). "
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