Exposure to friends who smoke significantly increased the likelihood of experimental smoking among adolescents compared to those without such exposure.
Cross-Sectional (n=1,937)
Yes
Social norms, positive outcome expectations, anti-smoking self-efficacy, and attitudes toward control tobacco policies are associated with adolescent smoking behaviors, highlighting the need for multi-level prevention programs.
Effect estimate: OR 3.24 (95% CI 1.85-5.68)
p-value: p=<0.001
Introduction China has the largest youth population in the world. To better implement the Smoke-free School Initiative, this study aims to examine the protective and risk factors for different smoking behaviors (never smoked, experimental smoking, and current smoking) among school adolescents based on social cognitive theory. Methods This research was a secondary analysis of a cross-sectional survey of middle schools in Huli District of Xiamen, China. The final sample consisted of 1937 participants with an average age of 15.41 (SD = 1.64). Descriptive statistics were used to summarize the sociodemographic characteristics of the sample. Multivariate multinomial logistic regression analysis was performed using four models. Results Of the respondents, 1685 (86.99%) were never smokers, 210 (10.84%) were experimental smokers, and 42 (2.17%) were current smokers. Social norms, positive outcome expectations, anti-smoking self-efficacy, and attitudes toward control tobacco policies were associated with adolescents' smoking behaviors. The number of smoking family members, classmates smoking, the perception that smoking is cool and attractive, and attitudes toward control tobacco policies were the predictors of current smoking behavior ( p 0.05). In contrast, friends smoking and individual and social relationship motivation were associated with only experimental smoking ( p 0.05). Discussion The relationship of social norms, positive outcome expectations, anti-smoking self-efficacy, and attitudes toward control tobacco policies varied across smoking behaviors. Family, school, society and the government need to cooperate in prevention and intervention programs for adolescent smoking. The relationships between these factors and adolescents' different smoking behaviors needs to be further verified.
Lin et al. (2023) conducted a cross-sectional in Adolescent smoking behaviors (n=1,937). Exposure to friends smoking vs. No exposure to friends smoking was evaluated on Experimental smoking (OR 3.24, 95% CI 1.85-5.68, p=<0.001). Exposure to friends who smoke significantly increased the likelihood of experimental smoking among adolescents compared to those without such exposure.