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Improving measurement of normative beliefs involving smoking among adolescents

Primack, BA and Switzer, GE and Dalton, MA (2007) Improving measurement of normative beliefs involving smoking among adolescents. Archives of Pediatrics and Adolescent Medicine, 161 (5). 434 - 439. ISSN 1072-4710

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Objectives: To identify different components of smoking normative beliefs and determine if each component is independently associated with 2 clinically relevant measures of smoking in adolescents. Design: Cross-sectional survey. Setting: One large suburban high school. Participants: A total of 1211 high school students aged 14 to 18 years. Outcome Measures: Current smoking and susceptibility to smoking. Results: Of the 1138 students with data on current smoking, 216 (19.0%) reported current smoking, and 342 (38.3%) of the 893 nonsmoking students with susceptibility data were susceptible to future smoking. Factor analysis identified 3 normative belief constructs, labeled "perceived prevalence of smoking," "perceived popularity of smoking among elite/successful elements of society," and "disapproval of smoking by parents/ peers." On average, students believed that 56% of people in the United States smoke cigarettes; 27.7% believed that wealthy people smoke more than poor people. Multiple logistic regression showed that each of the 3 constructs was independently associated with current smoking (adjusted odds ratios, 1.05 [95% confidence interval {CI}, 1.02-1.08], 1.12 [95% CI, 1.02-1.23], and 0.66 [95% CI, 0.59-0.75], respectively), even after controlling for covariates. Students' perceptions of smoking among the successful/ elite and disapproval by parents/peers were independently associated with susceptibility to future smoking (adjusted odds ratios, 1.20 [95% CI, 1.11-1.29] and 0.87 [95% CI, 0.79-0.96], respectively). Conclusions: Adolescents' normative beliefs about smoking are multidimensional and include at least 3 distinct components, each of which was independently related to smoking outcomes. These distinct components should be considered in the design and evaluation of programs related to prevention and cessation of adolescent smoking. ©2007 American Medical Association. All rights reserved.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Primack, BAbprimack@pitt.eduBPRIMACK
Switzer, GEgswitzer@pitt.eduGSWITZER
Dalton, MA
Centers: Other Centers, Institutes, Offices, or Units > Center for Research on Media, Technology, and Health
Date: 1 May 2007
Date Type: Publication
Journal or Publication Title: Archives of Pediatrics and Adolescent Medicine
Volume: 161
Number: 5
Page Range: 434 - 439
DOI or Unique Handle: 10.1001/archpedi.161.5.434
Schools and Programs: School of Medicine > Medicine
School of Medicine > Pediatrics
Refereed: Yes
ISSN: 1072-4710
MeSH Headings: Adolescent; Adolescent Behavior--psychology; Cross-Sectional Studies; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Health Surveys; Humans; Male; Pennsylvania--epidemiology; Perception; Prevalence; Questionnaires; Reference Values; Smoking--epidemiology; Smoking--psychology; Students--psychology
Other ID: NLM NIHMS256358, NLM PMC3013365
PubMed Central ID: PMC3013365
PubMed ID: 17485617
Date Deposited: 28 Jul 2014 17:58
Last Modified: 04 Feb 2019 15:57


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