Susceptibility to smoking among South East Asian youth: A multilevel analysis

Centre for Health Economics and Policy Analysis, Health Sciences Centre 3H1, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5.
Tobacco control (Impact Factor: 5.93). 07/2008; 17(3):190-7. DOI: 10.1136/tc.2007.022285
Source: PubMed


To estimate the extent to which susceptibility to smoking is associated with between-context differences (schools and classes) and to identify factors at school, class and individual levels that influence individual susceptibility to smoking among young never-smokers in South East Asia.
Cross-sectional data from the Global Youth Tobacco Survey conducted in Cambodia (2002), Laos (2003) and Vietnam (2003) are used to conduct multilevel analyses that account for the nesting of students in classes and classes in schools. The outcome variable is smoking susceptibility, defined as the absence of a firm decision not to smoke. Explanatory variables include school-level (current tobacco use prevalence in school, exposure to anti-smoking media messages and exposure to tobacco billboard advertising), class-level (classroom prevention) and individual-level influences (parents' and friends' smoking behaviour, knowledge of the harmful effects of and exposure to secondhand smoke at home, age, sex and pocket income).
Multilevel analyses indicate that 4.5% and 4.2% of the variation in smoking susceptibility is associated with school and class differences, respectively. Students who have parents or friends who smoke, who are exposed to secondhand smoke at home and those who have access to pocket income are found to be more susceptible while greater knowledge of the harmful effects of secondhand smoke appears to diminish susceptibility to smoking. For girls only, billboard tobacco advertising increases the risk of susceptibility and classroom prevention decreases risk while for boys only, attendance at schools with higher prevalence of tobacco use increases risk of susceptibility and anti-smoking media messages decreases risk.
This study highlights a number of modifiable factors associated with smoking susceptibility and identifies interactions between teen sex and several factors associated with the susceptibility to smoking. This finding provides support for the call to move beyond gender-blind tobacco control policies.

4 Reads
  • Source
    • "revention strategies , but there is a lack of empirical studies examining the relative ef - fects of multiple intrapersonal and interpersonal variables on different stages of smoking cigarettes among Asian American youths . Of the above - mentioned studies , there are only few studies using a sample of Asian American youths ( Chen & Unger , 1999 ; Guindon et al . , 2008 ; Ma , Shive , et al . , 2003 ) . To our knowledge , this is the only study to examine how the im - pacts of multiple intrapersonal and interpersonal predictors that have not been well examined ( e . g . , perception of safety of smoking for only 1 year , awareness of the harmful effects of secondhand smoking , refusal of cigarettes fro"
    [Show abstract] [Hide abstract]
    ABSTRACT: Asian American youth are one of the fastest growing populations in the United States. This present study examined intrapersonal and interpersonal determinants of smoking status among Asian American adolescents. Using data from the 2006 National Youth Tobacco Survey, 1,368 Asian American adolescents in Grades 6 through 12 were selected. Findings revealed that one eighth (12%) experimented with cigarettes, 3% smoked occasionally, and 2% smoked regularly. High school students reported higher rates for experimental, occasional, and regular smoking than middle school students. More male than female youth reported the three types of smoking status. Multivariate analyses showed that, compared with nonsmoking, age, weekly income, family members' smoking, refusal of cigarettes from best friends predicted experimental smoking; and positive images of smoking, perception of safety of smoking for only 1 year, awareness of the harmful effects of secondhand smoking, refusal to smoke, and absence from school predicted occasional smoking. Age interacted with refusal to smoke in predicting occasional smoking. Male gender, awareness of the harmful effects of secondhand smoking, refusal to smoke, absence from school, and receptivity to tobacco marketing were determinants of regular smoking. This study uniquely examined how the impacts of multiple intrapersonal and interpersonal predictors differed by various stages of smoking in a nationally representative sample of Asian American adolescents. Our findings underscore that smoking treatment and prevention programs should consider predictors of risk for different stages of adolescent smoking.
    Nicotine & Tobacco Research 08/2010; 12(8):801-9. DOI:10.1093/ntr/ntq100 · 3.30 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Heterosis es quizás uno de los mayores logros prácticos de la ciencia del mejoramiento de plantas y ha sido extensivamente usada en el mejoramiento de los cultivos. Por lo tanto, un conocimiento de su base genética potencial es imperativo. Se han realizado extensivos estudios en plantas cultivadas incluyendo el arroz para elucidar los factores genéticos que causan la heterosis. Varios grupos de investigación han propuesto la dominancia, la sobredominancia y la epistasis como principales bases genéticas de la heterosis y avances recientes en biología molecular han ayudado a validar estos descubrimientos en varias especies cultivadas. A pesar de los avances tremendos en las técnicas de marcadores moleculares, análisis de QTLs y análisis genómico, una evidencia conclusiva en soportar una de estas teorías todavía no se ha definido, como todos estos factores parecen ser mutualmente no exclusivos. En la actualidad, el enfoque está moviéndose rápidamente hacia el estudio de la heterosis a nivel genómico para identificar las regiones genómicas que induzcan el efecto heterótico e introducir tales regiones dentro de líneas elites de arroz para desarrollar híbridos con altos rendimientos. Se han realizado también avances en el perfil de expresión y relacionar diferencias en el contenido repetitivo y del transposon en líneas parentales para efecto heterótico.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Tobacco use is the leading cause of noncommunicable disease morbidity and mortality. Most smokers initiate the smoking habit as adolescents or young adults. Survey data from the 2007 Lusaka (Zambia) Global Youth Tobacco Survey were used to estimate the prevalence of current cigarette smoking and assess whether exposure to pro-tobacco media and perception of the potential harm of secondhand smoke are associated with adolescents' smoking. Logistic regression analysis was used to estimate the associations. Altogether, 2378 students, of whom 56.8% were females, participated in the study. Overall, 10.5% of the students (9.3% among males and 12.1% among females) smoked cigarettes in the 30 days prior to the survey. Students who favored banning smoking in public places were 33% (OR = 0.67; 95% CI [0.47, 0.96]) less likely to smoke cigarettes compared to those who were not in favor of the ban. Seeing actors smoking in TV shows, videos or movies was positively associated with smoking (OR = 1.90; 95% CI [1.26, 2.88]). However, possessing an item with a cigarette brand logo on it, seeing advertisements of cigarettes on billboards and being ever offered a free cigarette by a cigarette sales representative were negatively associated with smoking (OR=0.39, 95% CI [0.26, 0.58]; OR=0.63, 95% CI [0.43, 0.92]; and OR=0.43, 95% CI [0.29, 0.65], respectively). Findings from this study indicate that TV advertisement-promotion-sponsorship was positively associated with smoking, while it was the opposite with other forms of advertisement; there is a need for further studies.
    12/2009; 8(4):229-35. DOI:10.4103/1596-3519.59577
Show more