Social Influences on Adolescents ' Smoking Progress : A Longitudinal Analysis

The purpose of this study was to examine social factors that predicted adolescent smoking transition from nonsmoking or experimental smoking to more advanced stages of smoking behavior during a three-year span. A national cohort sample of adolescents (N=7,960) who participated in the 1989 and 1993 Teenage Attitudes and Practices Survey (TAPS I and TAPS II, respectively) was used for this study. The information obtained from this survey included measures of smoking behavior and a series of factors related to smoking models in the respondents' social environment. Results showed that the smoking behavior of best friends was the only consistent and significant factor in predicting adolescent smoking progress to more advanced stages of acquisition. Overall, the ability of social factors to predict adolescent smoking progress was weak. The findings of this study did not support the concept of the social learning theory in adolescent smoking behavior. Article: Despite the increasing efforts of smoking prevention interventions targeting adolescents, the prevalence of cigarette smoking among this population remains high.( 1) Literature has indicated that any smoking by an adolescent, including experimental smoking, dramatically increases the risk of that adolescent becoming a regular adult smoker.( 2) In relationship to becoming a regular smoker, cigarette-smoking behavior follows a complex developmental process. Flay and colleagues( 3) have identified a model to explain the smoking acquisition process, which is composed of five distinct behavioral stages. This stage model begins with the preparation stage (never smoked) and involves transitions to the initiation stage (trying the first cigarette), progressing to the experimentation stage (repeatedly trying cigarettes), moving to the habituation stage (becoming a regular smoker), and finally remaining in the maintenance stage (addictive smoking).( 3) Though this smoking acquisition process usually proceeds from one stage to the next, adolescents may remain in the same stage or move back to previous stages once they have initiated smoking. To incorporate the most effective strategies for smoking-prevention/intervention programs, it is important for researchers and smoking prevention practitioners (e.g., school health education teachers) to understand those factors that differentiate between those adolescents who are likely to proceed to regular smoking from those who are likely to maintain non-smoking behaviors. Furthermore, the stage model of smoking indicates that smoking interventions targeting the adolescent at the preparation and experimentation stage are more effective than interventions targeting more advanced stages (i.e., habituation and maintenance) when smoking has become a confirmed addictive behavior.( 3) A number of human behavioral theories have been adopted to delineate the determinants for smoking acquisition. One of the most promising models applied to the explanation of smoking behavior is social learning model.( 4, 5) This theory emphasizes the reciprocal interaction between an individual's behavior and the social environment. Smoking behaviors of adults (i.e., parents) and peers (i.e., friends) influence adolescent smoking behavior by providing role models that demonstrate the social consequences and acceptance of cigarette smoking.( 3) Conrad, Flay, and Hill summarized the findings of 27 prospective studies on the onset of smoking and a number of studies have examined the social influences on adolescent smoking behavior.( 6) However, limited information is available about the processes and factors involved in the transition from nonsmoking and experimental smoking towards becoming a regular smoker using the social influence model, especially with a national representative sample. The purpose of this study was to examine the social factors that may influence adolescent smoking acquisition over a 3-year period. A U.S. national cohort sample of adolescents who participated in the 1989 and 1993 Teenage Attitudes and Practices Surveys (TAPS I and TAPS II, respectively) was used for this study.( 7)