Adolescent smoking cessation: how effective have we been?

The Korean prediction model for adolescents' future smoking intentions

OBJECTIVES

The purpose of this study was to develop a prediction model for future smoking intention among Korean adolescents aged 13 to 15 in order to identify the high risk group exposed to future smoking.

METHODS

The data was collected from a total of 5940 students who participated in a self-administrated questionnaire of a cross-sectional school-based survey, the 2004 Korea Global Youth Tobacco Survey. Chi-square tests and logistic regression analyses were carried out to identify the relevant determinants associated with intentions of adolescents' future smoking. Receiver Operation Characteristic (ROC) assessment was applied to evaluate the explanation level of the developed prediction model.

RESULTS

8.4% of male and 7.2% of female participants show their intentions of future smoking. Among non-smoking adolescents; who have past smoking experience [odds ratio (OR) 2.73; 95% confidence interval (CI) 1.92 - 3.88]; who have intentions of smoking when close friends offer a cigarette (OR 31.47; 95% CI = 21.50 - 46.05); and who have friends that are mostly smokers (OR 5.27; 95% CI = 2.85 - 9.74) are more likely to be smokers in the future. The prediction model developed from this study consists of five determinants; past smoking experience; parents smoking status; friends smoking status; ownership of a product with a cigarette brand logo; and intentions of smoking from close friends' cigarette offer. The area under the ROC curve was 0.8744 (95% CI=0.85 - 0.90) for current non-smokers.

CONCLUSIONS

For efficiency, school-based smoking prevention programs need to be designed to target the high risk group exposed to future smoking through the prediction model developed by the study, instead of implementing the programs for all the students.

Peer and role model influences for cigarette smoking in a young adult military population

Previous research has shown that 8% to 10% of nonsmokers initiated smoking during their first year of military service despite a period of forced abstinence during boot camp. To our knowledge, no studies have looked at the influence of peers and role models on the initiation of smoking among U.S. Air Force personnel who recently completed boot camp. This cross-sectional study examined the role of perceived peer norms, roommate influence, role model influence, perceived norms of all active duty personnel, and depressive symptoms in the initiation and reinitiation of smoking among 2,962 Air Force technical training students. Previous nonsmokers were more likely to initiate smoking if they perceived that the majority of their classmates smoked (OR = 1.67, 95% CI[1.05-2.67]) and if they reported that their military training leader or classroom instructor used tobacco products (OR = 1.69, 95% CI[1.12-2.56]). Additionally, previous nonsmokers were more likely to initiate smoking if their roommate smoked (OR = 1.67, 95% CI[1.09-2.56]). Similar results were seen with previous smokers who perceived that the majority of their classmates smoked (OR = 1.63, 95% CI[1.03-2.58]) and if they reported that their military training leader or classroom instructor used tobacco products (OR = 1.95, 95% CI[1.29-2.94]). Our study suggests that military role models who use tobacco, peer smoking behavior, and perceived smoking norms increase the likelihood of smoking initiation among newly enlisted military personnel who have recently undergone a period of forced abstinence.

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.

Alcohol use, smoking, and feeling unsafe: health risk behaviors of two urban seventh grade classes

Health risk behaviors undertaken in adolescence, such as drinking alcohol and smoking, can have a lasting consequence on both short-term and long-term health. To better describe the health risk behaviors being undertaken by an urban adolescent population, a study was conducted at two parochial, middle schools in the Southwest section of Philadelphia, Pennsylvania, USA. The study purpose was to describe the types of health risk behaviors being undertaken by a seventh grade student population, the frequency of health risk behaviors, and the age of initiation of the health risk behavior.A descriptive, correlational study was undertaken with 105 seventh graders (ages of 11 to 13 years) from two middle schools using the Youth Risk Behaviors Surveillance System (YRBSS) Questionnaire. Information was collected about health risk behaviors such as alcohol use and tobacco use and feeling safe. Findings indicated that these adolescent students reported increased incidence of health risk behaviors including alcohol use, smoking, and carrying weapons to combat their feeling unsafe in their neighborhoods. Interestingly, there were differences between schools in the type of health risk behaviors in which the students participated. Nurses are often in an ideal position to assess the health and behaviors of adolescents and to offer education, health promotion, and support to this at-risk population.