Anti-Tobacco Socialization and Youth Smoking Initiation

Objective : This three-study dissertation project explores the impact of tobacco-specific socialization on youth smoking initiation. The primary aims of this research were to investigate the influences of [1] parent and child agreement that their home was smoke-free home, [2] parent and child agreement about youth risk for smoking, and [3] child report of favorite pro- and anti- tobacco advertisements on youth smoking initiation. Methods : In 2003, parents with an oldest child aged 10-13 were enrolled into a study exploring the influence of parenting on youth risk behaviors (N=1036). Parent and child baseline surveys were completed in 2003-04, 960 youth reported being never smokers. Follow-up for baseline never smoking youth was completed in 2007-08 (N=704, 73.3%). For each study, participants with missing data were excluded ( ≤5%). Studies employed descriptive statistics, chi- square analysis, and simple and multivariate logistic regression. Results : Approximately 25% of youth reported smoking initiation in 2007-08. [1] The majority of dyads agreed their home was smoke-free. Overall, adolescents in dyads who did not agree their home was smoke free were 60% more likely to initiate smoking (OR=1.6, 95%C.I.:1.0-2.4). The effect was only significant in non-smoking households (OR=1.8, 95%C.I.: 1.1-3.2). [2] Adolescents reported youth smoking risk more frequently than did parents, both assessments were independent predictors of future smoking initiation (parent: OR=2.3, 95%C.I.:1.3-3.9; child: OR=2.0, 95%C.I.:1.3-3.0). Concordance that the child was at risk increased later initiation fourfold over concordance that the child was not at risk (OR=4.1, 95%C.I.: 2.0-8.5), however, any report of risk was predictive of future initiation. Evidence is provided for a youth anti-tobacco belief scale to predict dyad agreement. [3] Adolescents reported favorite tobacco industry (43%) and tobacco control (58%) advertisements, of these 30% reported both. Compared to having a favorite tobacco industry advertisement, having only a favorite tobacco control advertisement reduced initiation by 63% (OR: 0.37, 95%C.I. : 0.20-0.69). Those with a favorite advertisement from both sides appeared to have an initiation rate midway between. Conclusions : The study results indicate that tobacco-related socialization occurring in pre- and early- adolescence may reduce the probability that youth will initiate smokin