Predictors of smoking susceptibility and experimentation among Mexican -American adolescents
Smoking is a major cause of morbidity and mortality worldwide and the leading cause of death in the United States. An overwhelming majority of adult smokers begin smoking before age 18. Smoking is defined as an adolescent behavior and experimentation with cigarettes usually begins early, between 11 and 15 years of age. While several epidemiologic and psychosocial risk factors have been associated with current smoking among adolescents, very little data is available on smoking behavior prior to established smoking. The majority of studies conducting research on adolescent smoking behavior have been carried out in whites. However, there are many unanswered questions in terms of whether these risk factors are common to all races, including adolescents of Mexican-American (MA) descent. The objective of this dissertation was to evaluate whether there are unique patterns of behavioral risk factors in MA adolescents for each smoking transition phase and whether these risk factors can be used to predict an individual's risk for being susceptible to smoking or for experimenting with cigarettes and is presented as two separate manuscripts for publication. Aim I was to develop a quantitative multivariable assessment model for the transition from non-susceptibility to smoking to experimentation with cigarettes in MA adolescents to determine risk factors for each phase of transition and identify high-risk subgroups. Aim II was to test whether baseline smoking status predicts experimentation with cigarettes in MA adolescents over a one-year follow-up period. To achieve these goals, a large, population-based cohort of MA adolescents (age 11-13) residing in Houston, was surveyed to obtain baseline data on 1,329 participants. A wide variety of demographic and psychosocial predictors of smoking behavior in adolescents was assessed, and outcome groups of interest were defined according to smoking behavior. At baseline, 22% of participants were susceptible to smoking and 9% had experimented with cigarettes. There were common and unique predictors of susceptibility for girls and boys. There were no gender-specific predictors of experimentation. The overall susceptibility and experimentation rates at follow-up were 28% and 9%, respectively, and these rates varied by sex and age. The strongest predictor of experimentation for both girls and boys was susceptibility to smoking. Based on this data, susceptibility is the best marker for the transition to experimentation for both MA girls and boys. These findings suggest that conventional prevention strategies attempting to change adolescents' attitudes and expectations regarding smoking via peer influence may not be beneficial in this population. Identifying risk factors associated with susceptibility will aid in the development of more effective smoking prevention programs for MA adolescents.
Spelman, Amy Renfro, "Predictors of smoking susceptibility and experimentation among Mexican -American adolescents" (2007). Texas Medical Center Dissertations (via ProQuest). AAI3284083.