Predictors of smoking prevalence among New York Latino youth

Cigarette and Smokeless Tobacco Use among Migrant and Nonmigrant Mexican American Youth

Increase in smoking/tobacco-related diseases among the Hispanic population calls for an examination of its use among this population. This study examined the relationship between gender, level of cultural identification, migrant status, and grade level and tobacco use and perception of its harn among Mexican American youth. Results showed males more likely to use cigarettes (occasional and daily) and smokeless tobacco than females when grade, cultural identification, and migrant status of parents are held constant. No gender effect was found for lifetime cigarette use. The odds of using cigarettes and smokeless tobacco increase substantially across grades. Effects were foundfor Mexican American/Spanish and AnglolWhite American cultural identification and daily cigarette use. Youths who belonged to nonmigrant families or who identified with a traditional Mexican American/Spanish culture were more likely to consider regular tobacco use as harmful. These and other findings are discussed from the perspective offuture research and prevention and intervention efforts.

National trends in smoking behaviors among Mexican, Puerto Rican, and Cuban men and women in the United States

OBJECTIVES

We examined trends in smoking behaviors across 2 periods among Mexicans, Puerto Ricans, and Cubans in the United States.

METHODS

We analyzed data from the 1992-2007 Tobacco Use Supplements to the Current Population Survey. We constructed 2 data sets (1990s vs 2000s) to compare smoking behaviors between the 2 periods.

RESULTS

Significant decreases in ever, current, and heavy smoking were accompanied by increases in light and intermittent smoking across periods for all Latino groups, although current smoking rates among Puerto Rican women did not decline. Adjusted logistic regression models revealed that in the 2000s, younger Mexicans and those interviewed in English were more likely to be light and intermittent smokers. Mexican and Cuban light and intermittent smokers were less likely to be advised by healthcare professionals to quit smoking. Mexicans and Puerto Ricans who were unemployed and Mexicans who worked outdoors were more likely to be heavy smokers.

CONCLUSIONS

Increases in light and intermittent smoking among Mexican, Puerto Rican, and Cuban Americans suggest that targeted efforts to further reduce smoking among Latinos may benefit by focusing on such smokers.

A survey on smoking habits and attitudes among adolescents in Greece

The objective of the present study was to investigate smoking habits among 699 secondary school students, along with their attitudes toward smoking and their perceptions on the consequences of tobacco use in their health. Our results indicate that Greek adolescents begin to smoke mainly due to curiosity and for stress reasons. Furthermore, having friends who smoke is highly associated with smoking and intention for smoking. Likewise, paternal smoking seems to reinforce students' intention for smoking. On the contrary, parental disapproval of smoking leads to anti-smoking behavior. Adolescents' attitudes toward smoking are also related to a series of similar factors such as parental educational status, parental smoking, and parental disapproval of smoking, friends who smoke, and, finally, adolescents' age, smoking behavior, and intention for smoking. The impact of tobacco use in human health seems to be understood better by older students. All these factors must be taken into account for a successful implementation of an anti-smoking intervention program.

Which sociodemographic factors are important on smoking behaviour of high school students? The contribution of classification and regression tree methodology in a broad epidemiological survey

BACKGROUND

The purpose of this study is to evaluate the most important sociodemographic factors on smoking status of high school students using a broad randomised epidemiological survey.

METHODS

Using in-class, self administered questionnaire about their sociodemographic variables and smoking behaviour, a representative sample of total 3304 students of preparatory, 9th, 10th, and 11th grades, from 22 randomly selected schools of Mersin, were evaluated and discriminative factors have been determined using appropriate statistics. In addition to binary logistic regression analysis, the study evaluated combined effects of these factors using classification and regression tree methodology, as a new statistical method.

RESULTS

The data showed that 38% of the students reported lifetime smoking and 16.9% of them reported current smoking with a male predominancy and increasing prevalence by age. Second hand smoking was reported at a 74.3% frequency with father predominance (56.6%). The significantly important factors that affect current smoking in these age groups were increased by household size, late birth rank, certain school types, low academic performance, increased second hand smoking, and stress (especially reported as separation from a close friend or because of violence at home). Classification and regression tree methodology showed the importance of some neglected sociodemographic factors with a good classification capacity.

CONCLUSIONS

It was concluded that, as closely related with sociocultural factors, smoking was a common problem in this young population, generating important academic and social burden in youth life and with increasing data about this behaviour and using new statistical methods, effective coping strategies could be composed.

Cigarette smoking in the adolescent children of drug-abusing fathers

OBJECTIVE

This study examined the longitudinal predictors of cigarette smoking in a sample of at-risk adolescents whose fathers were drug abusers (N = 296).

METHODS

At time 1, structured interviews were administered, separately and in private, to male and female youth (X age = 16.3) and their fathers; adolescents were reinterviewed approximately 1 year later (at time 2). Structural equation modeling was used to examine the interrelationship of time 1 paternal tobacco and illicit drug use, father-child relations, adolescent psychological adjustment, and peer group factors and adolescent smoking at time 2. A supplementary analysis assessed the same model with control on the adolescent's age, gender, frequency of contact with the father, and the father's treatment status.

RESULTS

The structural equation model showed a mediational pathway linking paternal tobacco and drug use to a weak and conflictual father-child relationship, which was associated with greater adolescent maladjustment, which in turn was related to deviant peer affiliations, which predicted adolescent smoking at time 2. There was also a direct path from paternal tobacco and drug use to adolescent time 2 smoking. The supplementary analysis found no significant differences between the models with and without control.

CONCLUSIONS

Findings provide evidence of the mechanisms that underlie the association between paternal drug use characteristics and smoking in the adolescent child. Clinical implications suggest the importance of the father-child relationship to smoking prevention programs for at-risk youth.

Role of parents and peers in influencing the smoking status of high school students in Taiwan

OBJECTIVES

To assess parental influence on smoking behaviour by high school students in an Asian culture and to compare the relative importance of parental and peer influence.

METHODS

A 5% nationally representative sample, including 44 976 high school students in 10th to 12th grade (aged 15-18 years) in Taiwan, were surveyed in 1995. Each completed a long self administered questionnaire. Parental influence was measured by examining both parental behaviour (smoking status) and attitudes (perceived "tender loving care" (TLC) by adolescents). Changes in smoking status were used to determine peer influence, defined as the increase in the likelihood of smoking from grade 10 to 12 in a steady state environment. Odds ratios (ORs) were calculated for parental and peer influence, using logistic regression.

RESULTS

Adolescents of smoking parents with low TLC had the highest smoking rates and those of non-smoking parents with high TLC had the lowest. The difference was more than twofold in boys and more than fourfold in girls. When either parental smoking status or TLC alone was considered, parental influence was similar to peer influence in boys, but larger than peer influence in girls. However, when smoking status and TLC were considered jointly, it became larger than peer influence for both groups (OR 2.8 v 1.8 for boys and OR 3.9 v 1.3 for girls).

CONCLUSION

When parental influence is taken as parental behaviour and attitude together, it plays a more important role than peer influence in smoking among high school students in Taiwan. This study, characterising such relationships among Asian populations for the first time, implies that future prevention programmes should direct more efforts toward the parental smoking and parent-child relationships, and not aim exclusively at adolescents in schools.

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.

Prevalence and correlates of initiation of smoking behavior among preteen black and white children

This study estimated smoking prevalence and identified factors associated with initiation among preteens in Nashville, TN. An anonymous, self-administrated questionnaire was given to 238 fifth- and sixth-graders in a middle-class neighborhood school. The mean age at initiation was 8.5 years (range 6-11 years). Overall, 10.5% of students had ever smoked; 16.1% of blacks and 9.3% of whites. Eighty-six percent continued to smoke. Black sixth-graders smoked (26.9%) four times the rate of black fifth-graders and 2.5 times that of white sixth-graders. Relatives initiated 78% of blacks while friends initiated 68% of whites. One-quarter of smokers got their cigarettes at home. Regular attendees of religious services had a lower smoking rate (6.9% versus 16.4%; p=0.01). Smoking rates decreased with increased knowledge of risks (p=0.00001). Among smokers, none believed that smoking is a risk factor for heart disease, 96% did not believe that smoking has any short-term health effects or is a risk factor for stroke. Few ever-smokers had a complete understanding of the health risks. Targeted messages and curriculum should be developed to teach preteens about the short- and long-term dangers of smoking. Clinicians can play a major role in educating their clients about the risks of smoking.

Impact of a Drug Abuse Resistance Education (D.A.R.E) program in preventing the initiation of cigarette smoking in fifth- and sixth-grade students

An alarmingly high number of children become addicted to tobacco use. To teach children the skills to resist the influences surrounding the initiation of tobacco and other drug use, a Drug Abuse Resistance Education (D.A.R.E.) program is being implemented in three fourths of the schools in the United States. The purpose of this study is to examine the impact of this program in preventing smoking. A survey was conducted among 236 fifth and sixth graders in Nashville, Tennessee. Of the students included in the survey, 88% graduated from D.A.R.E. Approximately 11.6% of respondents had ever smoked cigarettes; 86% of them continued to smoke. The D.A.R.E. group had a significantly lower rate of smoking compared with their non-D.A.R.E. counterparts (8.7% vs. 28.0%; p = 0.0001). Logistic regression analysis shows that the D.A.R.E. group was five times (odds 4.9; p = 0.003; 95% CI: 1.7, 14.0) less likely to initiate smoking compared with the non-D.A.R.E. group. The D.A.R.E. group had a significantly (p = 0.002) higher knowledge score on the risk of smoking. The knowledge score has strong opposite correlation to smoking behavior (p = 0.00001). Students with top-quartile knowledge scores had a substantially lower rates of smoking (1.4% vs. 14.4%; p = 0.001). This finding is consistent for both African-American (0% vs. 19.6%; p = 0.001) and white children (1.9% vs. 13%; p = 0.001). The D.A.R.E. program may have an impact in preventing the initiation of smoking behavior.

Religiousness and substance use in children of opiate addicts

PURPOSE

To investigate among children of opiate addicts a potential protective effect of religiousness (broadly defined in the literature to include religious beliefs, practice, and tradition) against onset of substance use.

METHODS

Subjects were 161 opiate-addicted biological parents recruited from methadone maintenance programs in the New York metropolitan area, their 279 children, and 63 non-opiate-addicted parents with whom the child had daily contact. Childhood onset of substance use was assessed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS); parental DSM-III-R diagnosis of opiate addiction was assessed using the SADS-Lifetime Version (SADS-L).

RESULTS

Religiousness in children of opiate addicts was associated with a substantially decreased likelihood of onset of substance use. Parent-child concordance of religiousness showed additional protective qualities with respect to religious denomination in opiate-addicted parent and with respect to the personal importance of religion and frequent attendance of religious services in non-opiate-addicted parents.

CONCLUSION

Religiousness protects against substance use among children of opiate addicts.

The effect of data collection mode on smoking attitudes and behavior in young African American and Latina women. Face-to-face interview versus self-administered questionnaires

Evaluating smoking prevention and cessation programs requires valid data collection. This study examined two survey modes--face-to-face (FTF) interview and self-administered questionnaire (SAQ)--comparing response rates, sample characteristics, data quality, and response effects. From two family planning clinics, 601 female Latina and African American clients ages 12 to 21 were recruited and randomized to either group. Results reveal that neither mode is superior to the other. The SAQ may therefore be preferable for this population, despite its higher rate of incompletes, because it yields results similar to the FTF yet is more cost effective and less disruptive to clinic routines.

The pediatrician's role in reducing tobacco exposure in children

OBJECTIVE

Pediatricians have a unique and important role to play in the prevention and treatment of childhood and adolescent tobacco use, the protection of patients from the harmful effects of environmental tobacco smoke, and the encouragement of smoking cessation among parents. However, because recent research indicates that physician training in tobacco dependence is woefully weak and lacks a model for training, this article constructs a useful approach to this problem.

METHODOLOGY

A comprehensive review of the literature served as the basis for the development of a new model for pediatrician training in tobacco dependence.

RESULTS

A comprehensive model is presented for training pediatricians in the areas of reducing infant and child exposure to environmental tobacco smoke, preventing youth smoking initiation, and providing smoking cessation assistance for adolescents and parents.

CONCLUSIONS

Pediatricians have been called on to play an active role in the antitobacco arena. Because of their unique opportunity to interact with children, adolescents, and parents, pediatricians can and should be antitobacco interventionists. For this to occur, however, additional guidance should be provided to pediatricians during their training to better prepare them to carry out effective assessment and intervention practices. smoking initiation, smoking prevention, smoking cessation, environmental tobacco smoke, pediatricians.

Maximizing qualitative responses about smoking in structured interviews

This article addresses the important methodological issue of whether face-to-face or self-administered interviews elicit better qualitative data on reasons for smoking and quitting among 173 current and former smokers. The data are from a study of smoking behaviors among 601 African American and Latina women age 14 to 21 years recruited from family planning clinics in Los Angeles from 1995 to 1996. Results suggest that responses to closed questions about smoking behavior are similar in both methods but that self-administered surveys elicit more responses to open-ended questions than face-to-face interviews. The authors encourage the use of self-administered surveys in smoking research because they are cheaper to administer, yield similar data on closed-question items, and elicit richer and more provocative responses to open-ended questions.

Religiosity and substance use and abuse among adolescents in the National Comorbidity Survey

OBJECTIVE

To replicate previous findings among adults of an inverse association between religiosity and substance use among a nationally representative sample of adolescents.

METHOD

Subjects were 676 (328 female and 348 male) adolescents in the National Comorbidity Survey who were assessed for substance use and abuse with the Composite International Diagnostic Interview. Religiosity was assessed through affiliation with religious denomination and through response to 7 questions concerning belief and practice.

RESULTS

Confirmatory factor analyses replicated in adolescents the 2 religiosity factors of personal devotion and personal conservatism previously identified by Kendler among adults, although the 2 factors were more highly correlated in adolescents than in adults. Personal devotion (a personal relationship with the Divine) and affiliation with more fundamentalist religious denominations were inversely associated with substance use and substance dependence or abuse across a range of substances (alcohol, marijuana, cocaine, or any contraband drug). Personal conservatism (a personal commitment to teaching and living according to creed) was inversely associated with use of alcohol only.

CONCLUSION

Low levels of religiosity may be associated with adolescent onset of substance use and abuse.

Substance use in high school students in New South Wales, Australia, in relation to language spoken at home

PURPOSE

To examine for the first time adolescent substance use by ethnicity, given the high proportion of migrants from non-English-speaking countries in New South Wales, (NSW), Australia.

METHODS

Data from four surveys of NSW secondary school students in 1983, 1986, 1989, and 1992 were used for this analysis. The prevalence of substance use by whether English was spoken at home was stratified by sex and age using data from the most recent survey year. Adjusted odds ratios and 95% confidence intervals were produced by simultaneous logistic regression, adjusting for sex, age group, and the interaction term of sex and age for each of these substances, and for each survey year separately. Data from 1989 and 1992 were pooled together to examine rates of substance use by ethnic subgroups which reflect migration patterns.

RESULTS

The prevalence of smoking and alcohol and illicit drug use was consistently lower among NSW adolescents speaking a language other than English at home, compared with those speaking English at home in all survey years. Only the prevalence of solvent sniffing was higher among younger adolescents speaking a language other than English at home. Students from Southeast Asia showed consistently lower rates of usage of all substances compared to all other groups.

CONCLUSIONS

There may be different opportunities for the prevention of adolescent substance use among native English speakers to be gained from non-English-speaking cultures.

Taking a first puff: cigarette smoking experiences among ethnically diverse adolescents

OBJECTIVES

To study the social contexts and physiological consequences of an initial cigarette smoking experience among adolescents from four ethnic groups (African American, European American, Hispanic, Native American) who vary by gender and locale (e.g. urban vs rural).

METHOD

A qualitative study using individual interviews and focus groups.

RESULTS

Results both amplify and reinforce conclusions about peer and family influences on adolescent smoking initiation reported in quantitative studies of teen smoking. Within the broader themes of peers and family, several important sub-themes emerged. The study findings suggest that peer influence can be characterized as social conformity or social acceptance. Males were more likely than females to describe experiences involving peers exerting strong messages to conform to smoking behaviors. Roles played by family members in the initiation process were complex and included those of initiator, prompter, accomplice, and inadvertent source of cigarettes. European American and Hispanic girls provided descriptions of parents/family members as instigators of their first smoking experience. Hispanic adolescents descripted instances in which family members prompted cigarette use at a young age by encouraging the young person to light the adult's cigarette. Finally, ethnic differences in the physiological responses to initial smoking suggest the need to further explore the role of brand preference and variations in inhaling among ethnically diverse adolescents.

CONCLUSION

In order to design effective cigarette smoking prevention programs for adolescents, it is important to understand the meaning of smoking behaviors for adolescents from different ethnic and social backgrounds.

Psychosocial factors related to adolescent smoking: a critical review of the literature

OBJECTIVE

To extend the analysis of psychosocial risk factors for smoking presented in the United States surgeon general's 1994 report on smoking and health, and to propose a theoretical frame of reference for understanding the development of smoking.

DATA SOURCES

General Science Index, Medline, PsycLIT, Sociofile, Sociological Abstracts, and Smoking and Health. Holdings of the Addiction Research Foundation of Ontario Library as well as the authors' personal files.

STUDY SELECTION

Reviewed literature focused on studies that examined the association of sociodemographic, environmental, behavioural, and personal variables with smoking.

DATA SYNTHESIS

Adolescent smoking was associated with age, ethnicity, family structure, parental socioeconomic status, personal income, parental smoking, parental attitudes, sibling smoking, peer smoking, peer attitudes and norms, family environment, attachment to family and friends, school factors, risk behaviours, lifestyle, stress, depression/distress, self-esteem, attitudes, and health concerns. It is unclear whether adolescent smoking is related to other psychosocial variables.

CONCLUSIONS

Attempts should be made to use common definitions of outcome and predictor variables. Analyses should include multivariate and bivariate models, with some attempt in the multivariate models to test specific hypotheses. Future research should be theory driven and consider the range of possible factors, such as social, personal, economic, environmental, biological, and physiological influences, that may influence smoking behaviour. The apparent inconsistencies in relationships between parental socioeconomic status and adolescent disposable income need to be resolved as does the underlying constructs for which socioeconomic status is a proxy.

Psychosocial predictors of cigarette smoking among adolescents living in public housing developments

BACKGROUND

Adolescents residing in low-income public housing developments in inner-city regions may be particularly vulnerable to a variety of risk factors associated with cigarette smoking.

OBJECTIVE

To elucidate the aetiology of cigarette smoking among adolescents living in public housing developments.

DESIGN, SETTING, AND SUBJECTS

We examined predictors of smoking from four domains: background characteristics, social influences, behavioural control, and psychosocial characteristics using a sample of seventh graders (mean age 12.9 years) who reside in public housing developments in New York City (n = 624). The addresses of participants in a larger investigation of the aetiology and prevention of smoking were checked to determine if they lived in one of 335 public housing developments in New York City. All participants living in public housing developments were included in the current study.

MAIN OUTCOME MEASURES

African-American and Hispanic students completed questionnaires about their cigarette use, social pressures to smoke, smoking attitudes, smoking knowledge, and smoking resistance skills. Students also provided information on demographic and behavioural control (such as church and school attendance).

RESULTS

Logistic regression analyses indicated that social influences from friends and family members predicted smoking. Psychosocial characteristics such as advertising resistance skills, anti-smoking attitudes, and refusal skills lowered the odds of smoking.

CONCLUSIONS

These findings suggest that smoking prevention approaches targeted at these young people should increase their awareness of social pressures to smoke, correct misperceptions about the prevalence of smoking among friends, and teach relevant psychosocial skills.

Smoking prevalence and risk factors for smoking in a population of United States Air Force basic trainees

OBJECTIVE

To provide a comprehensive assessment of smoking prevalence and risks for smoking in an entire population of United States Air Force (USAF) military basic trainees (n = 32,144).

DESIGN

Population-based survey with every individual entering the USAF enlisted force from August 1995 to August 1996.

SETTING

USAF Basic Military Training (BMT) facility at Lackland Air Force Base, Texas. All trainees were assessed during the first week of BMT.

MAIN OUTCOME MEASURES

A 53-item questionnaire was developed to assess four domains: demographics, smoking history, risk factors for smoking, and other health behaviours.

RESULTS

Approximately 32% of the trainees smoked regularly before basic training and a small percentage of the trainees (7.6%) described themselves as ex-smokers. Men, Euro-Americans, and those from lower educational backgrounds were more likely to smoke than other trainees. On average, smokers had smoked for approximately four years and had low nicotine dependence scores. Individuals who had smoked before BMT were more likely to use other drugs (such as alcohol, binge drinking, smokeless tobacco), and were less physically active than never-smokers. These findings were particularly strong for those who smoked up to basic training but were also evident for ex-smokers.

CONCLUSIONS

Smoking is a prevalent risk factor among individuals entering the USAF. Furthermore, smoking was related to other risk factors believed to lower military readiness, including alcohol use and decreased physical activity. Comprehensive tobacco control policies aimed at reducing smoking among military trainees are needed.

Tobacco smoking and alcohol and drug consumption in a large, young healthy population

The relationships between tobacco smoking and both alcohol and drug consumption were investigated in 2 431 healthy individuals aged 18-29 y. We used a questionnaire to evaluate smoking habits and alcohol and drug intake, and these parameters (i.e., cotinine-to-creatinine concentration ratio, amphetamines, cannabinoids, opiates, and cocaine) were quantified via urine analyses. Urinary cotinine concentration was significantly higher in current smokers (mean +/- standard deviation: 717 +/- 61 ng/mg creatinine, n = 881) than in non- or exsmokers (32 +/- 16 ng/mg creatinine, n = 1550). Information gleaned from the questionnaires revealed that there was a greater proportion of current smokers among consumers of alcohol than among nonconsumers. Significantly (p < .001) more current smokers than non- or exsmokers self-reported that they consumed sedatives, stimulants, or illegal drugs. Urinary cotinine concentrations were highest in consumers of alcohol and in self-reported consumers of sedatives (p < .0001), stimulants (p = .01), and illegal drugs (p < .0001). We found higher urinary cotinine concentrations in subjects who had positive urinary amphetamines, cannabinoids, or opiates. Even though the prevalence of alcohol and drug consumption remained low in the population we studied, such behaviors were clearly related to tobacco smoking.

A longitudinal study of smoking in year 7 and 8 students speaking English or a language other than English at home in Sydney, Australia

OBJECTIVE

To compare the rates and predictors of smoking uptake between adolescents speaking English and those speaking a language other than English (LOTE) at home.

DESIGN

A cross-sectional survey of year 7 and 8 students (aged 12 and 13 years) was conducted in 1994 and repeated 12 months later. A cohort of students was identified with respondents at baseline matched at follow up. chi 2 and logistic regression were used for analysis.

SETTING

38 schools in southern, east, and northern Sydney, Australia.

SUBJECTS

Year 7 and 8 students in the schools were included and examined on two occasions, with complete data for 5947 (80%) students at baseline and 6177 (98%) students at a 12-month follow up. Records were able to be matched perfectly for 3513 respondents (59%).

MAIN OUTCOME MEASURES

Smoking rates and predictors of smoking uptake among students speaking English or a LOTE at home.

RESULTS

At baseline, 6.1% of students surveyed were smokers. Twelve months later, 15.8% of student surveyed were smokers. There were significantly lower smoking rates among students speaking a LOTE at home compared with those speaking English at home at baseline and at 12 months. Using matched data, for students speaking English at home, five variables were significant predictors of smoking uptake: thinking it acceptable to smoke, perceived benefits of smoking, and having a brother, sister, or close friend who smokes. For students speaking a LOTE, the only predictor was the smoking status of close friends.

CONCLUSIONS

Despite the higher smoking prevalence among men with a non-English-speaking background, and the reported strong association between fathers' smoking status and smoking onset of their children, adolescents speaking a LOTE at home were significantly less likely to be smokers than their English-speaking counterparts. Thus, there would seem to be a delay of smoking onset among students speaking a LOTE at home. The smoking rates among respondents speaking a LOTE at home in this study are lower than those obtained from the studies conducted in Europe and the United States. Effective smoking prevention interventions need to be implemented at an early stage of adolescence.

Self-esteem and self-efficacy as predictors of success in smoking cessation

The purpose of this study was to compare psychological, biophysical, and socioeconomic variables as predictors of success in smoking cessation adherence among adults who have participated in a smoking cessation program. The purposive sample (N = 75) was selected from participants of 10 smoking cessation programs in Texas who were measured for self-esteem and self-efficacy at the beginning of their program using the Rosenberg Self-Esteem Scale and Stanton's revised Self-Efficacy for Smoking Cessation Questionnaire. Subjects self-reported their smoking/nonsmoking status and use/nonuse of the nicotine patch at the end of their program via postcards and at 3 months later through a phone interview with the researcher. Using discriminant analysis, the psychological variables correctly classified 75% of the subjects at the 3-month follow-up as smoking or nonsmoking (based on their preprogram scores of self-esteem and self-efficacy). With this sample, the biophysical and socioeconomic variables were insignificant in their ability to predict smoking cessation adherence.

Social influence predictors of alcohol use among New York Latino youth

We examined demographic and social influence predictors of adolescent drinking among New York City Latino adolescents, including specific Latino subgroups (i.e., Puerto Rican, Dominican, Colombian, and Ecuadorian). Sixth- and seventh-grade students (N = 3129) who identified themselves as Latino or Hispanic on the survey questionnaire comprised our Latino sample. The survey included self-reported frequency of alcohol use, demographic items, and measures of social influences for drinking. Logistic-regression analyses revealed that social influences (how many friends drink, attitudes of parents and friends toward respondent's drinking) are strong predictors of current drinking (defined as drinking at least once a month) for the overall sample of Latino youth, as well as for Puerto Rican youth and Dominican youth. Findings are discussed in terms of their implications for prevention.

Cultural diversity in the predictors of adolescent cigarette smoking: the relative influence of peers

A culturally diverse sample of 4375 adolescents completed a self-report inventory assessing their current amount of smoking, and several psychosocial predictors of smoking (e.g., depression, anger, stress, smoking among peers, etc). Results revealed that Whites smoke more than Blacks, Asians, and less acculturated Latinos but not more than highly acculturated Latinos. Stepwise regression analyses of the predictors of smoking found significant ethnic and acculturation differences in the relative predictive power of 18 well-known risk factors. Smoking among peers was the best predictor of smoking for White adolescents (accounting for 23.5% of the variance) but accounted for only 15% of the variance for Latino youth, 9.6% of the variance for Asian youth, and none of the variance for Black youth. Results are discussed in terms of their implications for smoking prevention programs that focus on resisting peer influences.

Smoking behavior, knowledge and opinion of medical students

A questionnaire survey on smoking was conducted among 395 medical students (40% males, 60% females) at the School of Medical Sciences, University Sains Malaysia at Kubang Kerian, Kelantan. Thirty-five students (9%), all of them males, were current smokers. Twenty-eight percent of the smokers smoked more than ten cigarettes per day and 88% began smoking before entering the medical school. Social influence and cigarette advertisements were the main reasons given for starting smoking. Both smokers and nonsmokers were adequately informed of the common adverse effects of smoking. Ninety percent of smokers had tried to give up smoking but failed. Among the ex-smokers and nonsmokers, the main reasons given for not smoking was that smoking was useless. Among the female students, one-third felt that cigarette smoking was socially unacceptable among females. This was one of the three main reasons for not smoking. Very few of the students (4.6%) considered that doctors' advice would play an important role in smoking prevention.

The relationship between language spoken and smoking among Hispanic-Latino youth in New York City

This study was designed to examine the relationship between language spoken and smoking (at least once a month) among New York City Hispanic-Latino adolescents, using a large sample of specific Hispanic-Latino subgroups (Puerto Rican, Dominican, Colombian, and Ecuadorian youth) and controlling for social and environmental factors. The sample included 3,129 Hispanic-Latino students in 47 New York City public and parochial schools. Of the total sample, 43 percent were Puerto Rican, 20 percent Dominican, 7 percent Colombian, and 7 percent Ecuadorian. The students completed questionnaires that were designed to assess social and environmental influences on their smoking and determine what languages they spoke (English and Spanish) with parents and friends. Self-reported smoking data were collected by means of the bogus pipeline to enhance the veracity of self-reports. In the logistic regression model, including background, social influence, and language use variables, 101 students were smokers. Logistic regression analysis indicated that being bicultural (speaking both English and Spanish) at home and with friends appeared to increase the odds of currently smoking. Separate logistic regression analyses for girls and boys revealed that being bicultural at home increased the odds of currently smoking for boys but not girls. Results are discussed in terms of their implications for prevention.

Prevalence and sociobehavioral correlates of tobacco use among Hispanic children: the Tobacco Resistance Activity Program

To examine tobacco use patterns and its sociobehavioral correlates among Hispanic in-school youth, a tobacco use and knowledge survey was administered to 660 children from fourth through sixth grade classes, of which 69% (n = 453) were of Hispanic origin. Male Hispanics were more exposed to previous tobacco use (38% vs. 20%, p < .01), reported more current smoking, had more smoking friends, received more cigarette offers, and wanted to try a cigarette compared to females (all p < .05). Also, more previous alcohol use was noted in the previous tobacco users, indicating its potential as a "gateway drug." From multivariate analyses, being offered cigarettes was the strongest environmental indicator of previous tobacco usage, followed by having adult smokers in the house, smoking friends, (all p < .01), and being around other smoking youth (p < .05). This study offers additional knowledge about factors that may cause Hispanic youth to initiate smoking, and suggests the need to address peer and social influences in school-based substance abuse programs.

Assertiveness in Hispanic adolescents: relationship to alcohol use and abuse

An investigation was carried out on the relation of assertiveness to use of alcohol among 3129 Hispanic junior high school students. Data were obtained through questionnaires administered in 47 public and parochial schools in New York City to 5501 students. An 18-item modified version of the Gambrill-Richey Assertiveness Inventory was used to assess assertiveness. Factor analysis of the inventory identified five assertiveness factors of substance awareness, mastery of cognitive skills, individual rights, dating, and social skills. Significant gender differences were observed. Multiple regression analysis showed that substance awareness was negatively associated with alcohol use while dating, social skills, and individual rights factors were positively associated with alcohol use. Acculturation with peers was also a significant predictor of alcohol use or abuse. The findings provide a basis for design of alcohol prevention programs that specifically focus on Hispanic youth.

Patterns of drug use among Cuban-American, African-American, and white non-Hispanic boys

This study examined initiation into drug use during grade school years in a sample of Cuban-American, Black, and White non-Hispanic students in the greater Miami, Fla, area. Findings indicate that first use of alcohol occurs in fifth grade and cigarettes in sixth grade for all subgroups except White non-Hispanics, who peak in the fifth grade. White non-Hispanics had the highest life-time levels of alcohol and cigarette use. Foreign-born Cuban Americans had a lower lifetime prevalence of alcohol and cigarette use than US-born Cuban Americans. Higher acculturation level was related to first use of alcohol. One important implication of this study is that alcohol interventions should begin no later than third grade and smoking interventions no later than fourth grade.

Lung cancer rates in the Hispanic population of Connecticut, 1980-88

To identify lung cancer patients of Hispanic ethnicity, surnames in the Connecticut Tumor Registry were matched with the 1980 Spanish surname list of the U.S. Bureau of the Census. Also death certificates for women with lung cancer in the registry were examined to ascertain maiden names. For women Hispanic surnames in the registry were not good indicators of ethnicity; their sensitivity was only 58 percent when compared with the decedent's maiden name. Estimated age-specific incidence rates for lung cancer during the 1980-88 period among Hispanic men, using surnames in the registry, were lower than the rates for non-Hispanic men, as expected from studies of Hispanic mortality in the Northeast. The distribution of histologic types, including those most strongly associated with smoking, was similar for Hispanic and non-Hispanic men. Although estimated lung cancer mortality rates were low for Hispanic men defined by surname, higher standard mortality ratios for Puerto Rican-born versus other Hispanic men suggested heterogeneity in lung cancer death rates of the Hispanic population of Connecticut. Lung cancer incidence and mortality rates should continue to be monitored in the Hispanic population of Connecticut, in view of anticipated increases attributable to trends in smoking behavior, and interventions should be planned to counteract anticipated increases.