Perceptions of Second-hand Smoke Risks Predict Future Adolescent Smoking Initiation
Received 1 November 2008; accepted 25 April 2009. published online 29 June 2009.
Abstract
Purpose
To directly test whether perceptions of second-hand smoke risks deter adolescent smoking initiation.
Methods
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.
Results
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).
Conclusions
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.
aUniversity of California, Merced, School of Social Sciences, Humanities, and Arts, Psychological Sciences, Merced, California
bUniversity of California, San Francisco, Center for Tobacco Control Research and Education, Institute for Health Policy Studies, and Department of Medicine, San Francisco, California
cUniversity of California, San Francisco, Center for Tobacco Control Research and Education and Department of Pediatrics, Division of Adolescent Medicine, San Francisco, California
Address correspondence to: Bonnie L. Halpern-Felsher, Ph.D., Division of Adolescent Medicine, Department of Pediatrics, UCSF, 3333 California St., Ste. 245, Box 0503, San Francisco, CA 94118.
Address correspondence to: Anna V. Song, Ph.D., School of Social Sciences, Humanities, and Arts, Psychological Sciences Section, University of California, Merced, 5200 North Lake Road, Merced CA 95343.
ABSTRACT