Association of cigarette smoking and media literacy about smoking among adolescents.

PURPOSE To determine whether media literacy concerning tobacco use is independently associated with two clinically relevant outcome measures in adolescents: current smoking and susceptibility to smoking. METHODS We asked high school students aged 14-18 years to complete a survey that included a validated 18-item smoking media literacy (SML) scale, items assessing current smoking and susceptibility to future smoking, and covariates shown to be related to smoking. We used logistic regression to assess independent associations between the two outcome measures and SML. RESULTS Of the 1211 students who completed the survey, 19% reported current smoking. Controlling for all potential confounders of smoking, we found that an increase of one point (out of 10) in SML was independently associated with an odds ratio for smoking of .84 (95% confidence interval [CI] .71-.99). Compared with students below the median score on the SML scale, students above the median had an odds ratio for smoking of .57 (95% CI .37-.87). Of the students who were nonsmokers, 40% were classified as susceptible to future smoking. Controlling for all potential confounders of smoking, we found that an increase of one point (out of 10) was independently associated with and an odds ratio for smoking susceptibility of .68 (95% CI .58-.79). Compared with students below the median SML, students above the median SML had an odds ratio for smoking susceptibility of .49 (95% CI .35-.68). CONCLUSIONS In this sample of high school students, higher SML is independently associated with reduced current smoking and reduced susceptibility to future smoking.