Gender differences in the relationship between affect and adolescent smoking uptake

AIMS: To evaluate gender differences in the role of positive and negative affect on smoking uptake. DESIGN: Prospective longitudinal cohort study of adolescent health behaviors. SETTING: Four suburban secondary schools outside Philadelphia, Pennsylvania, USA. PARTICIPANTS: Adolescents (n = 1357) were surveyed every 6 months for 4 years (age 14-18 years). MEASUREMENTS: Smoking and affect were measured via survey at each of the eight time-points. FINDINGS: A two-group associative process latent growth curve model revealed that baseline positive affect was related negatively to smoking progression for females (b = -0.031, Z = -4.00, P < 0.0001) but not for males (P = 0.33). This gender difference was significant, χ(2)((df = 1)) = 8.24, P = 0.0041, indicating that for every standard deviation (SD) decrease in positive affect (SD = 2.90), there was a 10% increase odds ratio (OR) = 1.10, 95% confidence interval (CI) = 1.04, 1.14 in the odds of smoking progression for females. Baseline negative affect was related significantly and positively to smoking progression for males (b = 0.038, Z =2.874, P = 0.004) and females (b = 0.025, Z =3.609, P < 0.0001), but the gender difference was not significant, χ(2)((df = 1)) = 0.82, P = 0.37. Thus, on average, for every standard deviation (SD = 4.40) increase in baseline negative affect there was a 15% (OR = 1.15, 95% CI = 1.06, 1.26) increase in the odds of smoking progression for males and for females. CONCLUSIONS: The impact of affect on adolescent smoking uptake varies by gender. Low positive affect (low experience of positive feelings or emotions) for females and high negative affect (high experience of negative feelings or emotions) for both males and females increases the risk for adolescent smoking.