Sexual content of advertisements and the smoking process in adolescents.

STUDY OBJECTIVE s: To analyze the perception of sexual content (PSC) of tobacco advertisements and its potential impact on the process of smoking in adolescents. DESIGN, PARTICIPANTS, AND SETTING A questionnaire was administered to 1,186 adolescents at the National Institute of Respiratory Diseases in Mexico City to determine the PSC. In addition, age, gender, susceptibility, receptivity, parental smoking and education, anxiety, depressive symptoms, school category, and grade were determined. INTERVENTIONS AND MEASUREMENTS The images of two advertisements were projected in color onto a screen. One of the images had unquestionable sexual content. The impact of the images was evaluated at the same time in the questionnaire. RESULTS Forty-one percent of participants were nonsmokers (25% nonsusceptible and 16% susceptible), whereas 59% were smokers (47% experimenters and 12% established). Sixty-six percent were receptive to promotions of the tobacco companies. Seventy-two percent perceived sexual contents in the advertisements. A logistic regression model showed that receptivity (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.3 to 3.4), minimal PSC (OR, 2.6; 95% CI, 1.7 to 4.0), and high PSC (OR, 4.4; 95% CI, 2.4 to 8.0) were significantly associated with the status of smokers, whether experimenters or established. The strongest association was found with established smokers. Further analysis showed that male gender was significantly associated with high levels of PSC. CONCLUSIONS These results show that a high percentage of adolescents perceived sexual content in the tobacco advertisement, which, independent of the subject's receptivity, plays a role in the process of smoking, especially in male adolescents.