Healthy or druggy? Self-image, ideal image and smoking behaviour among young people

The relationship between mental representations of self and social evaluation: Examining the validity and usefulness of visual proxies of self-image

Reverse correlation (RC) method has been recently used to visualize mental representations of self. Previous studies have mainly examined the relationship between psychological aspects measured by self-reports and classification images of self (self-CIs), which are visual proxies of self-image generated through the RC method. In Experiment 1 (N = 118), to extend the validity of self-CIs, we employed social evaluation on top of self-reports as criterion variables and examined the relationship between self-CIs and social evaluation provided by clinical psychologists. Experiment 1 revealed that the valence ratings of self-CIs evaluated by independent raters predicted social evaluation after controlling for the effects of self-reported self-esteem and extraversion. Furthermore, in Experiment 2 (N = 127), we examined whether a computational scoring method - a method to assess self-CIs without employing independent raters - could be applied to evaluate the valence of participants' self-CIs. Experiment 2 found that the computational scores of self-CIs were comparable to independent valence ratings of self-CIs. We provide evidence that self-CIs can add independent information to self-reports in predicting social evaluation. We also suggest that the computational scoring method can complement the independent rating process of self-CIs. Overall, our findings reveal that self-CIs are a valid and useful tool to examine self-image more profoundly.

“(Meth) Will Hurt You and Hurt Your Teeth”: Teen, Parent, and Dental Practitioner Perspectives on Implementing Crystal Meth Use Prevention Messaging in the Dental Office Setting

Objectives

Crystal methamphetamine (“meth”) use among youth living in rural areas is higher than the national average. Given how drastically meth affects teeth (i.e., “meth mouth”), engaging dental professionals as one of multiple channels in rural areas to deliver meth prevention messaging is a novel approach. The objective of this research was to assess the feasibility and acceptability of incorporating meth use prevention messaging into dental visits with teenagers.

Methods

We conducted phenomenological, qualitative research with dental practitioners, teens, and parents/guardians in three communities in North Idaho, from 2015 to 2016. We recruited practitioners using a snowball sampling strategy and placed phone calls to dental practices and contacted teens and parents through schools, libraries, local sporting events, and word-of-mouth. Using NVivo 12-Plus, parent- and teen-specific codebooks and themes were developed from guides and transcripts. Transcripts of the dentists and hygienists were reviewed to ascertain the main ideas and themes.

Results

Overall, practitioner, teen, and parent participants viewed meth prevention messages delivered by dental professionals as acceptable and feasible. Compared to those in private practice, public health dental providers were invested in meth prevention and were eager to help. Barriers to overall acceptability and feasibility included hygienists' low self-efficacy to deliver a communication-based intervention, infrequency of dental visits impacting the ability to reach enough teens through this venue, and the fact that teens could feel “targeted” by providers. Teens also raised concerns about scary messages exacerbating preexisting dental visit anxiety. Facilitators included the following: dental practitioners already engaging in health education with their patients, parents, and teens seeing dental professionals as appropriate purveyors of antimeth messaging and support for increased meth prevention efforts given the impact of meth use in their communities.

Conclusions

Well-crafted, developmentally appropriate meth prevention messages would likely be well received by teens and supported by parents in dental offices. These data are being used to develop a novel, theory-based communication and behavioral strategy to integrate dental professionals into the delivery of messages aimed at preventing the initiation of meth use among rural Idaho teens.

The Mirror of Mind: Visualizing Mental Representations of Self Through Reverse Correlation

The reverse correlation (RC) method has been widely used, because it allows visualization of mental representations without a priori assumptions about relevant dimensions. We employed the RC method to visualize mental representations of self and examined their relationships with traits related to self-image. For this purpose, 110 participants (70 women) performed a two-image forced choice RC task to generate a classification image of self (self-CI). Participants perceived their self-CIs as bearing a stronger resemblance to themselves than did CIs of others (filler-CIs). Valence ratings of participants who performed the RC task (RC sample) and of 30 independent raters both showed positive correlations with self-esteem, explicit self-evaluation, and extraversion. Moreover, valence ratings of independent raters were negatively correlated with social anxiety symptoms. On the other hand, valence ratings of the RC sample and independent raters were not correlated with depression symptoms, trait anxiety, or social desirability. The results imply that mental representations of self can be properly visualized by using the RC method.

Development of a resilience scale for Thai substance-dependent women: A mixed methods approach

The purpose of this study was to develop a resilience scale based on the experiences of substance-dependent women in Thailand and evaluate its validity and reliability. A sequential exploratory mixed methods design was employed as the main methodology to develop the resilience scale according to the results from qualitative data by analyzing focus group discussions of 13 participants. Then, the scale was administered to 252 substance-dependent women from four substance-treatment centers. The psychometric properties were explored with an index of item objective congruence (IOC), Pearson correlation, second-order confirmatory factor analysis and Cronbach's alpha coefficient to estimate the quantitative data. The qualitative results showed that resilience is defined by three themes: individual, family and community factors, consisted of 13 different categories. The quantitative results also revealed that all 71 items in the resilience scale passed the IOC criteria, convergence and construct validity. The goodness-of-fit indices demonstrated that the resilience model was consistent with the empirical data. (Chi-square=74.28, df=59, p-value=0.08, RMSEA=0.03, SRMR=0.04, NNFI=0.99, CFI=0.99, GFI=0.96). The internal consistency, assessed by a Cronbach's alpha score of 0.92, can be interpreted as demonstrating high reliability. Furthermore, the structure of the resilience scale was confirmed by the available resilience literature. This study can help clinicians gain a more comprehensive understanding regarding the complex process of resilience among substance-dependent women and aid them in providing these women with the appropriate interventions.

Adolescents' Attitudes on Smoking Are Related to Experimentation with Smoking, Daily Smoking and Best Friends' Smoking in Two Karelias in Finland and in Russia

PURPOSE

Becoming a smoker usually starts during adolescence and is a dynamic process involving experimentation before the establishment of daily smoking. It has been suggested that adolescents who smoke differ from those who do not in their attitudes to smoking. The purpose of this study was to find out whether attitudes related to smoking legislation and restrictions, social pressures in smoking and image of smokers are associated with smoking experimentation, daily smoking and best friends' smoking.

METHOD

The data were gathered with a self-administered questionnaire in North Karelia, Eastern Finland and in the Pitkyaranta district, Republic of Karelia, Russia. The respondents were 15-year-old 9th grade pupils in local schools. In Pitkyaranta, the data analyses covered pupils in all eight schools in the area (n = 179). In North Karelia, the data analyses comprised of selected eight schools (n = 601). Data were analysed with exploratory factor analysis.

RESULTS

The models revealed that attitudes related to restrictions and social pressure were significantly associated with experimenting with smoking [OR (95 % CI) 7.923 (5.787-10.847)], daily smoking [OR (95 % CI) 9.575 (6.727-13.628)] and the likelihood of best friends' smoking [OR (95 % CI) 3.154 (2.579-3.858)]. The stronger the young peoples' attitudes and opinions, for example, towards restrictions and with more difficulties in refusing smoking, the higher the likelihood for smoking experimentations, daily smoking as well as the likelihood for their best friends' smoking. The country and factor interactions were not associated with smoking experimentations, daily smoking or best friends' smoking.

CONCLUSION

Regardless of cultural background, adolescents who smoke have more positive attitudes to smoking, and perceive more social support for smoking, than do adolescents who do not smoke. The study stresses the similarity of the results in both Karelia's despite the enormous differences in culture, economy and public policy.

Household and school-level influences on smoking behavior among Korean adolescents: a multilevel analysis

BACKGROUND

Trends in adolescent smoking rates in South Korea have not shown substantial progress due to a lack of effective anti-smoking interventions and policies in school settings.

METHODS AND FINDINGS

We examined individual- and school-level determinants of adolescent smoking behavior (ever smoking, current smoking, and daily smoking) using the nationally representative fifth Korean Youth Risk Behavior Web-based Survey conducted in 2009. We found that students in coeducation schools or vocational high schools had greater risks of smoking for each type of smoking behavior than those in single-sex schools or general high schools, respectively even after controlling for individual-level factors. Higher family affluence and higher weekly allowances were associated with greater risks of ever smoking, current smoking and daily smoking even after controlling for parental education and other confounders.

CONCLUSIONS

Whilst caution is required in interpreting results given the cross-sectional nature of the study, our findings suggest that in addition to raising the price of cigarettes, youth anti-smoking interventions in South Korea may benefit from focusing on coeducation schools and vocational high schools.

Preventing youthful substance use and harm--between effectiveness and political wishfulness

Drinking, smoking, and drug use are symbolic behaviors for young people, often involving a claim for adult status, and set against a "social clock" of expectations about appropriate behavior for a given age. Use is set in a social world of youth sociability, which young people strive to control themselves. Hence, it is difficult to prevent or delay use through adult-run institutions such as schools. Youth-oriented prevention initiatives succeed best when in tune with general social trends, so that youth cannot so easily feel hypocritically singled out. Regulatory approaches that apply to all have had some success in limiting and shaping youthful use and problems. Well-evaluated trials of efforts to insulate youthful use from harm are needed.

A brief image-based prevention intervention for adolescents

The authors evaluated the efficacy of a brief image-based prevention intervention and assessed current drug use as a moderator of intervention effects. In a clinical trial, 416 high school-age adolescents were randomized to either the brief intervention or usual care control, with data collected at baseline and 3-month follow-up. The brief intervention consisted of a tailored in-person communication and a series of parent/guardian print materials based on the behavior-image model. Health behavior goal setting increased for participants receiving the brief intervention, with an effect size in the small range (d = 0.33). Overall effect sizes for cigarette smoking frequency and quantity and alcohol use frequency and quantity were small (ds = 0.16-0.21) and in favor of the brief intervention. However, adolescents reporting current substance use who received the brief intervention reduced their frequency and heavy use of alcohol, frequency and quantity of cigarette smoking, and reported fewer alcohol/drug problems, with larger effects ranging from small to approaching medium in size (ds = 0.32-0.43, ps < .01). This study suggests that brief image-based messages may increase health behavior goal setting and reduce substance use, particularly among drug-using older adolescents.

A Symbolic Interaction Approach to Cigarette Smoking: Smoking Frequency and the Desire to Quit Smoking

This study applies a symbolic interaction perspective to the investigation of smoking frequency and a person's desire to quit smoking cigarettes. Data derived from 485 Atlanta area adult smokers provide a diverse, community-based sample of married and single men and women, aged 18 to 70 years old with a range of income, education, and occupational experiences. Multiple regression was used to analyze the data in order to explore the influence of social demographic characteristics, social interaction, subjective assessments of health, self conceptions, and smoker identity on smoking frequency and quitting smoking. Findings include: (1) the relationship with a non-smoker and hiding smoking negatively impacted smoking frequency, while perceiving positive consequences from smoking has a positive effect on smoking frequency; and (2) perceiving positive consequences of smoking was negatively related to the desire to quit smoking, while a negative smoker identity has a positive influence on the desire to quit. Taken as a whole, the symbolic interaction-inspired variables exerted strong and independent effects on both smoking frequency and quitting smoking. Future smoking interventions should focus on meanings and perceived consequences of smoking in general, and on the smoker identity in the development of campaigns to encourage quitting cigarette smoking.

Associations between smoking and media literacy in college students

Organizations recommend media literacy to reduce tobacco use, and higher media literacy has been associated with lower smoking among high school students. The relationship between smoking media literacy and tobacco use, however, has not been systematically studied among college students. The purpose of this study was to determine the association between smoking and smoking media literacy among college students. We conducted the National College Health Assessment (NCHA) at a large, urban university, adding six items measuring smoking media literacy. A total of 657 students responded to this random sample e-mail survey. We used multiple logistic regression to determine independent associations between smoking media literacy items and current smoking. The media literacy scale was internally consistent (alpha = 0.79). Of the respondents, 21.5% reported smoking cigarettes over the past 30 days. In a fully adjusted multivariate model, participants with medium media literacy had an odds ratio (OR) for current smoking of 0.45 (95% CI = 0.29, 0.70), and those with high media literacy had an OR for current smoking of 0.38 (95% CI = 0.20, 0.70). High smoking media literacy is independently associated with lower odds of smoking. Smoking media literacy may be a valuable construct to address in college populations.

Using the Prototype/Willingness model to predict smoking behaviour among Norwegian adolescents

This paper examines cognitive antecedents of non-smoking among adolescents who reported smoking less than 1-2 times a week, and reported non-smoking intentions and willingness, in the framework of the Prototype/Willingness model. Two waves of data were obtained from a nation-wide sample of 760 Norwegian adolescents who responded to a school-based survey on smoking. Structural equation modelling was used to evaluate the predictive power of the social reaction pathway (prototype and willingness) of the P/W model, and in addition, the constructs from the Theory of Reasoned Action (subjective norm, attitude and intention). Results demonstrated the unique importance of the social reaction path when examining smoking behaviour among non-smoking adolescents. Implications of the findings and possible applications are discussed.

Efficacy of a brief image-based multiple-behavior intervention for college students

BACKGROUND

Epidemiologic data indicate most adolescents and adults experience multiple, simultaneous risk behaviors.

PURPOSE

The purpose of this study is to examine the efficacy of a brief image-based multiple-behavior intervention (MBI) for college students.

METHODS

A total of 303 college students were randomly assigned to: (1) a brief MBI or (2) a standard care control, with a 3-month postintervention follow-up.

RESULTS

Omnibus treatment by time multivariate analysis of variance interactions were significant for three of six behavior groupings, with improvements for college students receiving the brief MBI on alcohol consumption behaviors, F(6, 261) = 2.73, p = 0.01, marijuana-use behaviors, F(4, 278) = 3.18, p = 0.01, and health-related quality of life, F(5, 277) = 2.80, p = 0.02, but not cigarette use, exercise, and nutrition behaviors. Participants receiving the brief MBI also got more sleep, F(1, 281) = 9.49, p = 0.00, than those in the standard care control.

CONCLUSIONS

A brief image-based multiple-behavior intervention may be useful in influencing a number of critical health habits and health-related quality-of-life indicators of college students.

Brief Image-based Health Behavior Messages for Adolescents and Their Parents

This study tested the efficacy of brief image-based print mediated parent/caregiver and adolescent messages integrating physical activity with alcohol use avoidance. A total of 684 high school students were randomly assigned to either the parent postcard or adolescent flyer arm, with baseline and four-month post-intervention data collections. A significant repeated measures interaction (group × time) was found (F(4,344)=2.48, p=.04), with univariate tests showing less alcohol use frequency and problems (p's<.05) among adolescents exposed to parent materials. Repeated measures factorial MANOVAs for group × time × prior current drug use were significant, with drug using adolescents receiving parent print messages showing less alcohol initiation and frequency, and marijuana initiation and frequency (p's<.05). Very brief print materials sent to parents/caregivers may hold some promise for influencing substance use among adolescents, particularly those already using drugs.

Gender identity and substance use among students in two high schools in Monterrey, Mexico

This study explored relationships between several hypothesized dimensions of gender identity and substance use outcomes within a non-probability sample of adolescents in Monterrey, Mexico. Based on Mexican concepts of machismo and marianismo, four gender identity constructs were measured: aggressive masculinity, assertive masculinity, affective femininity and submissive femininity. The study assessed how well these gender identity measures predicted substance use behaviors, substance use intentions, expectancies, and normative approval, and exposure and vulnerability to substance offers. Data were drawn from questionnaires completed by 327 students from 2 Monterrey secondary schools. Multivariate ordered logistic and linear regression analyses, adjusted for school level effects, indicated that aggressive masculinity was associated with higher risk of drug use on most outcomes, while affective femininity was associated with lower risk on selected outcomes. Assertive masculinity was associated with only one of the outcomes examined and submissive femininity with none of them. Most gender identity effects persisted after controlling for biological sex, academic performance, age, and other gender identity measures. For two of the outcomes, the gender identity measures had significantly stronger effects for males than for females. The findings are interpreted in light of males' higher risk for drug use and changes in gender roles and gendered behavior that are now occurring in Mexico as in the U.S.

Brief multiple behavior interventions in a college student health care clinic

PURPOSE

This study examined the effects of brief image-based interventions, including a multiple behavior health contract, a one-on-one tailored consultation, and a combined consultation plus contract intervention, for impacting multiple health behaviors of students in a university health clinic.

METHODS

A total of 155 college students attending a major southern university were recruited to participate in a study evaluating a health promotion program titled Project Fitness during the fall 2005 and spring 2006. Participants were randomly assigned to one of three treatments as they presented at the clinic: 1) a multiple behavior health contract, 2) a one-on-one tailored consultation, or 3) a combined consultation plus contract intervention. Baseline and 1-month post-intervention data were collected using computer-assisted questionnaires in a quiet office within the student health clinic.

RESULTS

Omnibus repeated-measures analyses of variance were significant for drinking driving behaviors, F(2,136) = 4.43, p = .01, exercise behaviors, F(5,140) = 6.12, p = .00, nutrition habits, F(3,143) = 5.37, p = .00, sleep habits, F(2,144) = 5.03, p = .01, and health quality of life, F(5,140) = 3.09, p = .01, with improvements on each behavior across time. Analysis of group-by-time interaction effects showed an increase in the use of techniques to manage stress, F(2,144) = 5.48, p = .01, and the number of health behavior goals set in the last 30 days, F(2,143) = 5.35, p = .01, but only among adolescents receiving the consultation, or consultation plus contract. Effect sizes were consistently larger across health behaviors, and medium in size, when both consult and contract were used together.

CONCLUSIONS

Brief interventions using a positive goal image of fitness, and addressing a number of health habits using a contract and consultation strategy alone, or in combination, have the potential to influence positive changes in multiple health behaviors of college students attending a university primary health care clinic.

Focus groups of Alaska Native adolescent tobacco users: preferences for tobacco cessation interventions and barriers to participation

Tobacco cessation interventions developed for Alaska Native adolescents do not exist. This study employed focus group methodology to explore preferences for tobacco cessation interventions and barriers to participation among 49 Alaska Natives (61% female) with a mean age of 14.6 (SD = 1.6) who resided in western Alaska. Using content analysis, themes from the 12 focus groups were found to be consistent across village, gender, and age groups. Program location or site (e.g., away from the village, hunting, fishing), a group-based format, and inclusion of medication and personal stories were reported to be important attributes of cessation programs. Motivators to quit tobacco were the perceived adverse health effects of tobacco, improved self-image and appearance, and the potential to be a future role model as a non-tobacco user for family and friends. Parents were perceived as potentially supportive to the adolescent in quitting tobacco. The findings will be used to develop tobacco cessation programs for Alaska Native youth.

Prototype perception and smoking: are negative or positive social images more important in adolescence?

It is suggested that a more profound understanding of cigarette smoking among adolescents should include the social images they have of smokers. The main goal of the present study was to investigate the role of smoker prototypes in adolescents' smoking status and to compare the role of negative and positive smoker images. Data were collected from high school students in two counties of the Southern Plain Region of Hungary (N=548; ages between 14 and 21 years). The self-administered questionnaires contained items on sociodemographics, smoking occurrence, and smoker prototypes. Factor analysis revealed three smoker prototypes: a negative prototype (e.g., dull, childish), a positive social appearance prototype (e.g., cool, popular), and a positive individual competence prototype (such as smart, independent) all with satisfactory reliability. Odds ratios suggest that the role of the negative prototypes for nonsmokers is greater than the role of positive prototypes for smokers. For boys, positive individual competence prototype also seems to be important. Health promotion programs should focus on fostering negative social images in prevention.

Ideal self-image congruency as a motivator for smoking: the moderating effects of personality traits

A content analysis showed that cigarette advertising in Taiwan from June 2001 to May 2003 portrayed smokers as masculine, adventurous, pleasure-loving, and sociable. A survey of 1,490 high school students further indicated that smokers and nonsmokers differ in the congruency between their ideal self-images and the perceived smoker image on these 4 image dimensions. The self-smoker image congruency was greater for smokers than for nonsmokers and was positively associated with attitudes toward cigarette advertising Most important, this study demonstrated that participants' personality traits moderated self-smoker image congruency effects on smoking attitudes. Implications and suggestions for antismoking campaigns are discussed.

Adolescents and tobacco use: systematic review of qualitative research methodologies and partial synthesis of findings

After a brief overview of adolescent tobacco control, methodological features and content areas of 78 qualitative studies of adolescent smoking published in English prior to September 2002 were assessed. Narrative syntheses of three content areas - peer influences, access/sales issues, and dependence/addiction - were also undertaken. Many studies failed to provide sufficient sampling and subject characterization details and more effort was required to demonstrate data validity and reliability. Syntheses of the content areas revealed important common themes. Relationships to quantitative research were informative and suggested other research questions. The review highlights the heuristic value of qualitative research on adolescent smoking. Funding was provided by The Cancer Council New South Wales and NSW Health/Hunter Medical Research Institute.

The social context of smoking: the next frontier in tobacco control?

A better understanding of the social context of smoking may help to enhance tobacco control research and practice.

The relationship between smoker and nonsmoker prototypes and smoking status among 14-year-old Norwegians

The present study examined adolescents' perception of three smoking targets: a typical boy who smokes, a typical girl who smokes, and a typical nonsmoker, using 12 characteristics. Data were collected nationally from school classes among 14-year-old Norwegians in 2001 (N = 2153). Factor analysis indicated three correlated factors (Social attraction, Positive, and Negative) across the prototypes, but only the Social attraction scale had satisfactory reliability (Cronbach's alpha > 0.70). In addition, results show that the nonsmoker prototype may represent a goal state for nonsmokers when based on all three subscales, whereas for smokers, the prototypical smoker only represented a goal state for the Social attraction scale. Implications of the findings and methodological considerations are discussed.

Making sense of focus groups

CONTEXT

This paper provides an overview of the contribution of medical education research which has employed focus group methodology to evaluate both undergraduate education and continuing professional development.

PRACTICALITIES AND PROBLEMS

It also examines current debates about the ethics and practicalities involved in conducting focus group research. It gives guidance as to how to go about designing and planning focus group studies, highlighting common misconceptions and pitfalls, emphasising that most problems stem from researchers ignoring the central assumptions which underpin the qualitative research endeavour.

PRESENTING AND DEVELOPING FOCUS GROUP RESEARCH

Particular attention is paid to analysis and presentation of focus group work and the uses to which such information is put. Finally, it speculates about the future of focus group research in general and research in medical education in particular.

The influence of smoking imagery on the smoking intentions of young people: testing a media interpretation model

PURPOSE

To assess a theoretical model of adolescents' exposure to films, perceptions of smoking imagery in film, and smoking intentions.

METHODS

A structured questionnaire was completed by 3041 Year 8 (aged 12 years) and Year 12 (aged 16 years) students from 25 schools in Auckland, New Zealand. The survey assessed the relationships among exposure to films, attitudes about smoking imagery, perceptions of smoking prevalence and its acceptability, and expectations of smoking in the future. Measures included exposure to films, perceived pervasiveness of, and nonchalant attitudes about smoking imagery, identification of positive smoker stereotypes in films, perceived smoking prevalence, judgment of smoking acceptability, and smoking expectations. Path analytic techniques, using multiple regression analyses, were used to test the pattern of associations identified by the media interpretation model.

RESULTS

Hierarchical regression analyses revealed that film exposure predicted higher levels of perceived smoking prevalence, perceived imagery pervasiveness, and nonchalant attitudes about smoking imagery. Nonchalant attitudes, identification of positive smoker stereotypes, and perceived smoking prevalence predicted judgments of smoking acceptability. Acceptability judgments, identification of positive stereotypes, and perceived smoking prevalence were all positively associated with smoking expectations. The media interpretation model accounted for 24% of the variance in smoking expectations within the total sample.

CONCLUSIONS

Smoking imagery in film may play a role in the development of smoking intentions through inflating the perception of smoking prevalence and presenting socially attractive images.

Who am I? The role of self-conflict in adolescents' responses to cigarette advertising

Cigarette advertising may be partly responsible for adolescent smoking initiation, but few studies have investigated the advertising and individual difference factors that may be responsible. This study evaluated whether individual differences in the number of self-conflicts (i.e., conflicts between personality attributes experienced as part of self-concept development) interacts with stage of development (early versus middle adolescence) to predict responses to cigarette advertising imagery. One hundred and one never smoking adolescents judged the self-relevance of various cigarette advertisements. As predicted, self-conflict was related to judgments of self-relevance for early adolescents only; early adolescents who are having the most difficulty defining themselves are more likely to look to the powerful images displayed by cigarette advertisements for help. These results have implications for understanding the impact of cigarette advertising on smoking initiation for some adolescents.

Adolescents' responses to the gender valence of cigarette advertising imagery: the role of affect and the self-concept

The studies presented in this manuscript evaluated the role that affect and the self-concept play in adolescent never smokers' reactions to the gender valence of cigarette advertising imagery. Study 1 (n=29; 59% female) revealed that adolescent females have more positive affective reactions to female-valenced cigarette advertising imagery compared to male-valenced cigarette advertising imagery. Study 2 (n=101; 56% female) revealed that adolescent females viewed female-valenced cigarette advertising imagery as more relevant to their self-concepts compared to male-valenced cigarette advertising imagery. Across both studies, male adolescents did not respond differently as a function of the gender valence of cigarette advertising imagery. Thus, female-valenced cigarette advertising imagery may have specific effects on never smoking female adolescents by enhancing positive affect and suggesting that women who smoke hold the same characteristics as do the young women themselves.

Interpretations of smoking in film by older teenagers

Research testifies that images of tobacco use in popular films are highly pervasive and typically glamorised. There are concerns that these images may promote motivations to smoke in adolescents, but little is known about how these images are interpreted by members of this age group. A qualitative study was conducted to explore how older teenagers interpret and decode smoking imagery in film. This study builds on earlier work with a younger age group (12 and 13 years) to explore how various interpretations of smoking imagery shape and support common understandings about smoking among older teenagers. Data were collected through focus groups. Eighty-eight 16 and 17 year old students were interviewed at school. Participants discussed their recollections of and responses to recently viewed films. Older teens were receptive to smoking imagery when it was used in a credible manner to portray an emotional state, sub-culture affiliation, and lifestyle. Experience as a smoker appeared to inflate the credibility of realistic smoking images, particularly those presented in gritty realism/drama film. Older teens perceived realistic images, as opposed to stereotypical images, as a salient reference to their own lives. Stereotypical images were also readily recalled and appeared to perform an important role in supporting misconceptions about smoking and contributing to popular ideologies about tobacco use. Stereotypical images presented in comedy and action genre also serve to present paradoxical and contradictory messages about tobacco use. In particular, participants recalled tobacco use in film as associated with stress and anxiety, drug use, and seduction. Film images of tobacco use in specific contexts appear to hold specific and significant meanings for older teens. Realistic images offered salient representations of the perceived reality of smoking for this group. Pervasive and credible smoking scenes in film may offer support and reassurance to older teens who currently smoke or hold ambivalent views about smoking. Consistent with younger adolescents, older teens presented a predominantly nonchalant response to smoking imagery in film, which is a powerful indicator of the pervasiveness and acceptability of smoking in general. In contrast with younger adolescent, older teens tend to draw upon their own experience with tobacco use when interpreting smoking images in film.

'They look like my kind of people'--perceptions of smoking images in youth magazines

Ten years ago research showed that pro-smoking images were prevalent in British youth magazines, whereas there was little coverage of smoking and health. Since then there has been a great expansion in the number of youth magazines, and particularly those aimed at young men. Titles such as FHM and Loaded, which did not exist at the time of the previous research, are now market leaders. New qualitative and quantitative research has therefore been conducted to examine the prevalence and impact of smoking images in this revitalised youth style magazines market. This paper presents the findings of the qualitative element of this research, which examined British first year students' perceptions of the pro-smoking imagery found in the magazines and explored the relationship between this and their own smoking images and identities. The research found that: (a) this imagery was perceived to be, on the whole, attractive, sociable and reassuring; (b) that it supported young people's perceptions of smoking and reinforced their smoker identities; and (c) that it has the potential to be more powerful than advertising imagery.

Strategic marketing in the UK tobacco industry

Tobacco-industry marketing has played a central part in the global spread of tobacco use and addiction. Although the absolute size of the tobacco market has dwindled, the industry is still immensely successful, largely due to sophisticated and manipulative marketing strategies. The UK tobacco industry identifies target groups and builds enduring relationships based on careful brand management. Potential customers are exposed to brands which are likely to appeal to them most. Tobacco companies tailor their products to target markets by altering the content of tar and nicotine, and by adding flavourings to produce a distinctive taste. Marketing strategies ensure that the products are promoted heavily at the point of sale, and directed advertising and sponsorship agreements are used to increase the visibility of the brand and strengthen its image. Tobacco companies also target non-consumer organisations such as retailers and policy makers with the aim of creating the best possible business environment for tobacco sales. We review published evidence, internal-advertising-agency documents, and observational data about tobacco promotion, and discuss the use of targeted marketing strategies in the UK.

Determinants of youth smoking--evidence from Turkey

This paper investigates the determinants of smoking among middle- and high-school students in Ankara, Turkey. Data were collected from 4800 students in the second semester of the 1997-98 academic year to investigate substance use prevalence among young people. In addition to classical independent variables, factors which are not frequently used in the literature--such as school type, neighborhood, family religiosity, and factors reflecting the cultural background of the students--are included in the analysis. The results of binomial logistic regression offer evidence for the effects of school type, a smoking-related attitude, presence of a stepmother, father's use of alcohol, sister and brother who smoke, student's alcohol use, and participation in art activities.

How do Adolescents Process Smoking and Antismoking Advertisements? A Social Cognitive Analysis with Implications for Understanding Smoking Initiation

Youth tobacco use has increased substantially in the United States during the past decade. This increase can be attributed, in part, to the potency of cigarette advertising and relative ineffectiveness of antismoking advertising. In this article, the authors argue that an understanding of the effects of these 2 competing forms of advertising on youth smoking is limited in current theoretical treatments and that an integrative theoretical perspective has yet to be advanced. The authors argue that the elaboration likelihood model ( R.E. Petty & J.T. Cacioppo, 1986 ) offers a framework with sufficient explanatory power in this domain. Prevention and legislative interventions may benefit from this analysis, which ultimately may help to decrease youth tobacco use.

Inter-ethnic differences in youth tobacco language and cigarette brand preferences

OBJECTIVE

To describe and understand variations in cigarette brand preferences between adolescents from varying ethnic and gender groups around the US.

DESIGN

A qualitative study where adolescents, both smokers and nonsmokers, were interviewed individually in depth.

SETTING

Schools and recreation centers in four sites: urban Maryland (Baltimore), urban Texas (Houston), rural Alabama and rural New Mexico.

PARTICIPANTS

121 adolescent volunteers 13-19 years of age, representing African American, white, American Indian and Hispanic ethnic groups, from both genders.

RESULTS

Considerable geographic and ethnic variation exists in terminology used by youth to refer to cigarettes and to their use. Clear patterns in brand preference by ethnic group were found that follow patterns of targeted marketing by ethnicity. White teens preferred Marlboro brand cigarettes, while African-American teens who smoke preferred Newports. Hispanic and American Indian teens were more likely to smoke Marlboro or Camel cigarettes. Hispanic teens were most likely to mention low price as a reason for choosing a particular brand or to state that the brand does not matter. Tobacco advertisements targeting ethnic groups and the use of promotional items to encourage teen smoking were also recognized as factors influencing brand preferences.

CONCLUSIONS

These findings have implications for the design of intervention programs aimed at curbing teen smoking. When working with teens who already smoke, using youth language to target messages at perceived characteristics of commonly used brands may be more effective and meaningful than talking about cigarette use in general. Another implication of this work is to shed light on what impact an advertising ban would have on teen brand preferences, brand loyalty, and prevalence of smoking.