Young adult smoking behavior: implications for future population health

Social branding to decrease smoking among young adults in bars

OBJECTIVES

We evaluated a Social Branding antitobacco intervention for "hipster" young adults that was implemented between 2008 and 2011 in San Diego, California.

METHODS

We conducted repeated cross-sectional surveys of random samples of young adults going to bars at baseline and over a 3-year follow-up. We used multinomial logistic regression to evaluate changes in daily smoking, nondaily smoking, and binge drinking, controlling for demographic characteristics, alcohol use, advertising receptivity, trend sensitivity, and tobacco-related attitudes.

RESULTS

During the intervention, current (past 30 day) smoking decreased from 57% (baseline) to 48% (at follow-up 3; P = .002), and daily smoking decreased from 22% to 15% (P < .001). There were significant interactions between hipster affiliation and alcohol use on smoking. Among hipster binge drinkers, the odds of daily smoking (odds ratio [OR] = 0.44; 95% confidence interval [CI] = 0.30, 0.63) and nondaily smoking (OR = 0.57; 95% CI = 0.42, 0.77) decreased significantly at follow-up 3. Binge drinking also decreased significantly at follow-up 3 (OR = 0.64; 95% CI = 0.53, 0.78).

CONCLUSIONS

Social Branding campaigns are a promising strategy to decrease smoking in young adult bar patrons.

Nondaily smoking patterns in young adulthood

PURPOSE

Many young adult smokers routinely smoke less than daily. Prospective, longitudinal data are needed to describe and predict the influences on smoking patterns among nondaily young adult smokers.

METHODS

Latent class growth analysis was used to examine developmental trajectories and predictors of nondaily cigarette smoking among young adults aged 18 to 21 in the Upper Midwestern United States.

RESULTS

There were three distinct groups of nondaily smokers during young adulthood (n=519). College status, previous quit attempts, attitudes toward the meanings of cigarettes, and situational factors influencing smoking were significant predictors of group membership.

CONCLUSIONS

Nondaily smoking in young adulthood may result in several discrete patterns of smoking between age 18 and 21. Predictors that differentiate smoking trajectories may be useful to promote cessation or reduction in young adult smoking.

Predictive value of readiness, importance, and confidence in ability to change drinking and smoking

Background

Visual analog scales (VAS) are sometimes used to assess change constructs that are often considered critical for change. Aims of Study: 1.) To determine the association of readiness to change, importance of changing and confidence in ability to change alcohol and tobacco use at baseline with the risk for drinking (more than 21 drinks per week/6 drinks or more on a single occasion more than once per month) and smoking (one or more cigarettes per day) six months later. 2.) To determine the association of readiness, importance and confidence with alcohol (number of drinks/week, number of binge drinking episodes/month) and tobacco (number of cigarettes/day) use at six months.

Methods

This is a secondary analysis of data from a multi-substance brief intervention randomized trial. A sample of 461 Swiss young men was analyzed as a prospective cohort. Participants were assessed at baseline and six months later on alcohol and tobacco use, and at baseline on readiness to change, importance of changing and confidence in ability to change constructs, using visual analog scales ranging from 1–10 for drinking and smoking behaviors. Regression models controlling for receipt of brief intervention were employed for each change construct. The lowest level (1–4) of each scale was the reference group that was compared to the medium (5–7) and high (8–10) levels.

Results

Among the 377 subjects reporting unhealthy alcohol use at baseline, mean (SD) readiness, importance and confidence to change drinking scores were 3.9 (3.0), 2.7 (2.2) and 7.2 (3.0), respectively. At follow-up, 108 (29%) reported no unhealthy alcohol use. Readiness was not associated with being risk-free at follow-up, but high importance (OR 2.94; 1.15, 7.50) and high confidence (OR 2.88; 1.46, 5.68) were. Among the 255 smokers at baseline, mean readiness, importance and confidence to change smoking scores were 4.6 (2.6), 5.3 (2.6) and 5.9 (2.7), respectively. At follow-up, 13% (33) reported no longer smoking. Neither readiness nor importance was associated with being a non-smoker, whereas high confidence (OR 3.29; 1.12, 9.62) was.

Conclusions

High confidence in ability to change was associated with favorable outcomes for both drinking and smoking, whereas high importance was associated only with a favorable drinking outcome. This study points to the value of confidence as an important predictor of successful change for both drinking and smoking, and shows the value of importance in predicting successful changes in alcohol use.

Trial registration number

ISRCTN78822107

Late-onset smokers: How many, and associations with health behaviours and socioeconomic status

Aims: Adolescence is considered a critical phase for smoking initiation, while smoking initiation in adulthood has received less attention. In the present study, we investigated smoking initiation in early adulthood, with an additional focus on how socioeconomic status (SES) relates to late-onset smoking. Methods: The Norwegian Longitudinal Health Behaviour Study followed a representative sample of adolescents ( n=530) from age 13 (7th grade) to age 30 (years 1990–2007) through 9 waves of data collection. Information was collected on the adolescents’ gender, smoking, alcohol use, cannabis use, physical activity, and SES. Those reporting to be smokers at age 30, but not at age 18, were defined as “late-onset smokers”. Results: At age 30, 21% were daily smokers, of which 45% met our definition of late-onset smoking. Participants with a low SES had a higher odds ratio for late-onset smoking (OR=3.42) and a lower odds ratio for quitting smoking (OR=0.40) after adjusting for confounders. Conclusions: Early adulthood is an additional critical phase for daily smoking initiation. The clear and consistent negative association between SES and late-onset smoking, as well as the positive association between SES and smoking cessation, contribute to the association between SES and smoking in the general adult population.

Factors associated with commencing smoking in 12-year-old students in Catalonia (Spain): a cross-sectional population-based study

Background

Over the last decade notable progress has been made in developed countries on monitoring smoking although experimenting with cigarettes and smoking in young people remains a serious public health problem. This paper reports a cross-sectional study at the beginning of the 3-year follow-up community study TA_BES. The aim was to study the prevalence of smoking in addition to determining predictive factors for when smoking commences in a representative population of 12-year-old first year compulsory secondary education students.

Methods

Twenty-nine secondary schools (N = 29) from an area of Catalonia participated in the study. In these schools 2245 students answered a questionnaire to study the attitudes, behaviors, and tobacco consumption in the subject's surrounding circle and family in relation to smoking; carbon monoxide measurements were taken by means of co-oximetry on 2 different occasions. A smoker was defined as a student who had smoked daily or occasionally in the last 30 days. For non-smokers the criteria of not considering was set up for those who answered that in the future they would not be smokers and considering those who answered that they did not rule out becoming a smoker in the future.

Results

Among the total 2245 students included in the analysis 157(7%) were classified as smokers. Among non-smokers we differentiated between those not considering smoking 1757 (78.3%) and those considering smoking 288 (12.8%).

Age is among the factors related to commencing smoking. The risk of becoming a smoker increases 2.27 times/year. The influence of the group of friends with a very high risk for boys OR 149.5 and lower, albeit high, in girls OR 38.1. Tobacco consumption of parents produces different effects in young people. A smoking father does not produce alterations in the smoking behavior of young people. However having a smoking mother or former smoking is a risk factor for boys and a protective factor for girls.

We detected a gradual risk of becoming a smoker by means of the co-oximetry test. A boy/girl with a test between 6 p.p.m and 10 p.p.m increased the probability of smoking by 2.29 and co-oximetry values > 10 p.p.m multiplied the risk 4 times over.

Conclusions

Results indicate that the age of commencing smoking is maintained in spite of prevalence having decreased in the last few years. The risk factors identified should be used to involve families and the educational community by offering them tobacco weaning programmes.