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BMJ Open. 2012; 2(5): e000767.
Published online Sep 1, 2012. doi:  10.1136/bmjopen-2011-000767
PMCID: PMC3437428
A comparison of individual versus community influences on youth smoking behaviours: a cross-sectional observational study
Anna M Adachi-Mejia,1–4 Heather A Carlos,2 Ethan M Berke,3–5 Susanne E Tanski,1–3 and James D Sargent1–3
1Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
2Dartmouth-Hitchcock Norris Cotton Cancer Center, Lebanon, New Hampshire, USA
3Cancer Control Research Program, Norris Cotton Cancer Center, Lebanon, New Hampshire, USA
4The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
5Community & Family Medicine, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
Correspondence to Dr Anna M Adachi-Mejia; anna.adachi-mejia/at/dartmouth.edu
Received March 6, 2012; Accepted July 30, 2012.
Abstract
Objectives
To compare individual with community risk factors for adolescent smoking.
Design
A cross-sectional observational study with multivariate analysis.
Setting
National telephone survey.
Participants
3646 US adolescents aged 13–18 years in 2007 recruited through a random digit-dial survey.
Outcome measures
Ever tried smoking and, among experimental smokers, smoking intensity (based on smoking in past 30 days).
Results
One-third of participants (35.6%, N=1297) had tried smoking. After controlling for individual risk factors, neither tobacco outlet density nor proximity were associated with tried smoking or smoking intensity. Associations with trying smoking included age (adjusted OR (AOR)=1.23, 95% CI 1.16 to 1.31), lower socioeconomic status (AOR=0.82, 95% CI 0.74 to 0.91), sibling smoking (AOR=2.13, 95% CI 1.75 to 2.59), friend smoking (AOR=2.60, 95% CI 2.19 to 3.10 for some and AOR=7.01, 95% CI 5.05 to 9.74 for most), movie smoking exposure (AOR=2.66, 95% CI 1.95 to 3.63), team sports participation (AOR=0.69, 95% CI 0.54 to 0.89) and sensation seeking (AOR=7.72, 95% CI 5.26 to 11.34). Among experimental smokers, age (AOR=1.32, 95% CI 1.21 to 1.44), minority status (AOR=0.48, 95% CI 0.30 to 0.79 for Black; AOR=0.46, 95% CI 0.31 to 0.69 for Hispanic; AOR=0.53, 95% CI 0.43 to 0.85 for mixed race/other), friend smoking (AOR=3.37, 95% CI 2.37 to 4.81 for some; AOR=20.27, 95% CI 13.22 to 31.08 for most), team sports participation (AOR=0.38, 95% CI 0.26 to 0.55) and sensation seeking (AOR=6.57, 95% CI 3.71 to 11.64) were associated with smoking intensity.
Conclusions
The study suggests that interventions and policies to prevent and reduce youth smoking should focus on individual risk factors for smoking, including supporting participation in team sports, minimising exposure to movie smoking, addressing the social influence of friend smoking and addressing experience seeking among high sensation-seekers.
Keywords: Preventive Medicine, Paediatrics, Community child health, Public Health
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