Identifying demographic and psychosocial factors related to the escalation of smoking behavior among Mexican American adolescents

Cigarette smoking is the leading preventable cause of death in the United States; smoking in Mexican American adolescents, a rapidly growing population, remains a major concern. Factors associated with escalation or progression along the smoking trajectory have not been studied in adolescent Mexican Americans. A better understanding of escalation is needed for cancer prevention and overall health. N=1,328 Mexican American adolescents joined a cohort in 2005-06. At baseline participants provided demographic, acculturation and psychosocial data, and reported their smoking status using the Minnesota Smoking Index. Those that never tried a cigarette or only had a few puffs in their life were included in this study. The primary outcome of interest, escalation in smoking status, was defined as moving up the Minnesota Smoking Index by 2010-2011. The current analysis is based on 973 participants of whom 48.2% were male, mean age=11.8 (SD=0.8), and 26.0% were born in Mexico. By 2010-2011, 283 (29%) escalated their smoking status and 690 (71%) remained the same. Being older (OR=1.30; CI=1.07-1.57), male (OR=1.88, CI=1.40-2.53), having higher levels of anxiety (OR=1.03, CI=1.02-1.05), intending to smoke (OR=1.70, CI=1.18-2.46), having friends who smoke (OR=1.73, CI=1.12-2.70) and having parents' friends who smoke (OR=1.38, CI=1.02-1.88) increased risk for smoking escalation. Higher levels of subjective social status (OR=0.91, CI=0.83-0.99) were protective against smoking escalation. Contrasting previous work in smoking experimentation, parents' friends influence was a stronger predictor than the family household influence. Preventative interventions for Mexican American youth could address this risk factor to reduce smoking escalation.

How Do My Friends Matter? Examining Latino Adolescents' Friendships, School Belonging, and Academic Achievement

Are Latino adolescents' friendships an untapped resource for academic achievement or perhaps one of the reasons why these youth struggle academically? Using data from the National Longitudinal Study of Adolescent Health (N = 6782; 7th through 12th graders; 52.9 % female), we examined whether the process of Latino students' school belonging mediated the relationships between the context of friendships (i.e., friendship network indicators) and their academic outcomes (i.e., a context-process-outcomes model), and tested whether the process-context link varied by friends' characteristics (i.e., GPA and problem behavior; social capital). Moreover, we tested whether all relationships varied across the four largest Latino subgroups in the U.S. (i.e., Mexican, Central/South American, Puerto Rican, and Cuban). Our findings indicate that being nominated as a friend by peers and perceiving to have friends exerted both direct effects on school belonging in all but one of the Latino ethnic samples (i.e., Puerto Rican samples) and indirect effects on academic achievement in the full Latino, Mexican, and Central/South American samples. As such, school belonging was more likely to explain the links between academic achievement with nominations by peers as a friend and perceived friends than with having close-knit friendship groups. However, having a close-knit group of average or low-achieving friends predicted more school belonging for Mexican youth, but less school belonging for Cubans. Our findings suggest that friendships may be particularly beneficial for the school belonging process of highly marginalized groups in the U.S. (i.e., Mexican-origin).

Socioeconomic Determinants of Inequality in Smoking Stages: A Distributive Analysis on a Sample of Male High School Students

The effect of socioeconomic status on adolescent smoking behaviors is unclear, and sparse studies are available about the potential association. The present study aimed to measure and explain socioeconomic inequality in smoking behavior among a sample of Iranian adolescents. In a cross-sectional survey, a multistage sample of adolescents ( n = 1,064) was recruited from high school students in Zanjan city, northwest of Iran. Principal component analysis was used to measure economic status of adolescents. Concentration index was used to measure socioeconomic inequality in smoking behavior, and then it was decomposed to reveal inequality contributors. Concentration index and its 95% confidence interval for never, experimental, and regular smoking behaviors were 0.004 [-0.03, 0.04], 0.05 [0.02, 0.11], and -0.10 [-0.04, -0.19], respectively. The contribution of economic status to measured inequality in experimental and regular smoking was 80.0% and 68.8%, respectively. Household economic status could be targeted as one of the relevant factors in the unequal distribution of smoking behavior among adolescents.

Socioeconomic differences in smoking among Finnish adolescents from 1977 to 2007

PURPOSE

Persistence of socioeconomic differences in smoking among adolescents over time is unexplored. We investigated the changes in smoking among 12-18-year-old Finns from 1977 to 2007 using multiple indicators of socioeconomic status (SES) to determine whether differences between socioeconomic groups increase over time, with reduced smoking in higher socioeconomic groups.

METHODS

Nationwide biennial surveys were conducted since 1977 (response rate, 59%-88%; N = 96,747) using familial and individual social position (school performance/career) indicators. Associations between socioeconomic indicators and smoking were evaluated using logistic regression analysis.

RESULTS

Socioeconomic differences in smoking measured by familial SES or individual social position persisted over time, with higher rates in lower SES groups. Individual social position was more strongly related to smoking than familial SES. Differences between groups assessed by individual social position increased over time: the difference in smoking prevalence between groups with the lowest and highest individual social position among 12-14-year-old girls and boys, respectively, was 22% and 28% in 1977-1983, and 45% and 34% in 2001-2007; and in 16-18-year-old girls, 33% in 1977-1983 and 48% in 2001-2007. Smoking differences in relation to father's education increased over time: the difference in 12-14-year-old girls and boys, respectively, between the lowest and highest SES groups was 6% and 5% in 1977-1983 and 9% and 8.5% in 2001-2007; and in 16-18-year-old girls and boys, respectively, 7% and 10% in 1977-1983 and 13% and 14.5% in 2001-2007.

CONCLUSIONS

Differences between socioeconomic groups among Finnish adolescents persisted or increased over 30 years, and predict differences in smoking-related diseases between socioeconomic groups in adulthood.

Correlates of susceptibility to smoking among Mexican origin youth residing in Houston, Texas: a cross-sectional analysis

Background

Survey data suggest that in Texas Latino youth exhibit higher rates of susceptibility to smoking than youth from other ethnic groups. In this analysis we examined the relationship between susceptibility to smoking and well-known risk factors associated with smoking initiation among a cohort of 11 to 13 year old Mexican origin youth residing in Houston, Texas.

Methods

We analyzed cross-sectional survey data from 1,187 participants who reported they had never smoked, even a puff of a cigarette. The survey assessed peer and family social influence, school and neighborhood characteristics, level of family acculturation and socioeconomic status, and attitudes toward smoking. Bivariate associations, Student's t-tests, and logistic regression analysis were used to examine predictors of susceptibility.

Results

Overall, 22.1% of the never-smokers were susceptible to smoking. Boys were more likely to be susceptible than girls (25.6% vs. 18.9%), and susceptible children were slightly older than non-susceptible children (12.1 vs. 11.8 years). In addition, multivariate analyses revealed that positive expectations about smoking exerted the strongest influence on susceptibility status (odds ratio = 4.85). Multivariate analyses further revealed that compared to non-susceptible participants, susceptibles were more likely to report peer influences supportive of smoking, lower subjective social status and more detentions at school, more temptations to try smoking and to have a mother and a brother who smokes.

Conclusion

Our findings suggest that interventions that target positive expectations about smoking may be useful in this population. Furthermore, because youth encounter smoking-initiation risk factors in different social environments, our results underscore the continued need for both family- and school-based primary prevention programs to adequately combat their influence. The results also can be used to inform the development of culturally sensitive programs for Mexican origin youth.

Which psychosocial factors moderate or directly affect substance use among inner-city adolescents?

Past etiology of adolescent substance use research concentrated on the main effects of various risk factors. The purpose of this study was to also longitudinally predict interactions on poly-drug use intensity and future smoking among inner-city adolescents. A panel sample of baseline, 1-year and 2-year follow-ups (N=1459) from the control group of a longitudinal smoking prevention trial participated. We focused on the main effects, as well as, interaction effects between psychosocial protective factors and various risk factors, including perceived norms of friends, peers and adults to use drugs. Significant effects were identified for intensity of poly-drug use and future smoking. The analysis of the poly-drug use outcome indicated that refusal assertiveness undermined perceived friends' drug use and siblings' smoking, and that low risk-taking undermined perceived friends' drug use. There was a main effect for low psychological wellness. The significant interactions between perceived friends' drug use with refusal assertiveness and decision-making skills were observed for future smoking. Moreover, perceived peer smoking norms, siblings' smoking, and high risk-taking also showed significant main effects for increasing future smoking.

Promoting Positive Adolescent Development for At-Risk Students with a Student Assistance Program

This study evaluated the psycho-educational small-group component of the CASPAR Youth Services Student Assistance Program with a randomized-controlled trial. Two cohorts of at-risk sixth graders from six schools in two communities were randomly assigned to intervention or control conditions and tested one and a half years later at the end of the seventh grade. A generalized estimating equations model yielded a significant intervention effect on all three composite outcome variables. The results support the effectiveness of prevention strategies aimed at promoting positive youth development and a social influence process for adolescents that creates trusting relationships as the foundation for helping youth improve key skills, exert greater control over their lives, and make informed decisions about substances. EDITOR'S STRATEGIC IMPLICATIONS: School administrators should be aware of this promising approach (pending replication) of using student assistance counselors to promote children's intrinsic motivation and potential for positive decision making.

The Role of Psychosocial Factors in the Transition to Substance Use: Are They Protective Among Urban Minority Adolescents?

Changes in psychosocial risk and protective factors associated with the onset of substance use were examined in a sample of 556 urban public school sixth graders. General linear modeling analyses indicated that students who did not use substances by the end of sixth grade consistently had higher scores on protective factors than did students who were already using substances at the beginning of sixth grade. Students who began to use during the school year were in flux with scores similar to nonusers at Time 1 and scores closer to early users by Time 2. These findings suggest that interventions which focus on skill enhancement during the transition to middle school may be effective at delaying the onset of substance use. Editors' Strategic Implications: The authors find the same protective factors in this urban, primarily African American sample that are typical in suburban, White samples. Developmentalists and school officials will find interesting the changing effects of protective factors against early substance use during the transitional sixth grade year.

Impact analysis and mediation of outcomes: the Going Places program

The purpose of the study was to evaluate the impact of the Going Places Program and mediation of treatment effects. Seven middle schools were randomized to intervention or comparison conditions and students (n=1,320) in two successive cohorts provided five waves of data from sixth through eighth grade. The Going Places Program included classroom curriculum, parent education, and school environment components. Latent growth curve analyses demonstrated significant treatment group effects on outcome expectancies, friends who smoke, and smoking. Friends who smoke mediated the program effect on adolescents' smoking progression. The protective effect of the Going Places Program on smoking progression was due in part to the prevention of increases in friends who smoke.

Influence of socio-economic status, parents and peers on smoking behaviour of adolescents

With the aim of analysing the importance of psycho-social factors in predicting adolescents' smoking behaviour, a model of the interrelations between socio-economic status, parents', peers' and adolescents' own smoking behaviours was tested. The sample consisted of 2,616 adolescents. LISREL analyses were used to support the model; males and females were evaluated separately. Peers' smoking is the strongest predictor of adolescent smoking. Parents' smoking behaviour influences adolescents' smoking directly, but also indirectly through the parents' influence on peers' smoking behaviour. Socio-economic status influences adolescent smoking indirectly through its influence on parents' and peers' smoking behaviour. Our model is significant in both males and females and explains 42-51% of the variance in adolescent smoking behaviour. Accentuation of peers' influence on adolescents' smoking behaviour without considering the interrelations between the influence of socio-economic status, parents and peers may lead us to incorrect conclusions in research as well as in prevention.

Why is lone-motherhood so strongly associated with smoking?

OBJECTIVE

Lone mothers are among the most disadvantaged groups in many countries. Smoking prevalence among this demographic group is considerably higher than the general population. Previous work has shown that only part of this difference can be explained by age, not having a partner, living alone, and socio-economic factors. This study examined the contribution of mental health, the social environment, and the lifecourse in explaining the effect of lone motherhood on smoking status.

METHODS

Cross-sectional data from the 1995 National Health Survey and 2001 National Drug Strategy Survey were used. Smoking was defined as daily smoking. Mental health was assessed using a 14-item scale from the SF-36. Proportion of friends who smoke was used as an indicator of the social environment. Age started smoking daily (< or = 18 and > 18) was used as a lifecourse factor.

RESULTS

Mental health, proportion of friends who smoke and age of smoking initiation had strong associations with smoking status. However, they accounted for a small part of the association of being a lone mother and a smoker. After controlling for these factors, the odds of being a smoker among lone mothers were still twice those of mothers with partners (OR 2.1, 95% CI 1.7-2.7).

CONCLUSIONS AND IMPLICATIONS

Improving the socio-economic status (SES), mental health and the social environment of lone mothers could help reduce their high smoking prevalence. However, much of the effect of being a lone mother remains even after controlling for these factors. More research is needed to discover why prevalence is so high among this demographic group.

Public education campaign heightens awareness that youth model authorities' tobacco use

To evaluate whether people changed their views about acceptability of authority figures smoking after an anti-tobacco initiative, randomly selected southeastern U.S. voters (801 in 2001; 806 in 2002) responded to a 20-minute telephone interview. Acceptability attitudes held steady: most (80.8%) said that any authority figures' smoking in front of youth is unacceptable, with women, minorities, and never-smokers even surer than their counterparts. However, there was a change in 2002, with respondents more strongly recognizing that youth model adults' tobacco behaviors and attitudes. An implication is that media campaigns may benefit from emphasizing that youth model adults' tobacco use.