Peer smoking was by far the strongest predictor of smoking progression, said the lead author Elizabeth E. Lloyd-Richardson, Ph.D., and co-authors. Students who had at least two friends who smoked were more than six times as likely to transition from experimental smokers (don't smoke regularly) to intermittent smokers (smoking between 1 and 29 out of the past 30 days). And these adolescents were almost ten times as likely to transition from intermittent smokers to regular/established smokers (those that smoked everyday for the past 30 days).
Parental smoking increased the odds of an adolescent being in a higher rather than a lower smoking stage by 26 percent across each transition point for both male and female adolescents, according to the study. Maternal smoking had no effect on male offspring but raised the odds for female offspring to start smoking by 36 percent.
Starting to smoke was more than nine times as likely among students drinking alcohol at least twice a month than it was among abstinent students, said the authors. Furthermore, regular smoking was more than four times as likely among students drinking alcohol at least twice a month than it was among students who didn't drink.
Adolescents from different minority groups (White, African American, Hispanic and Asian) had decreased odds of transitioning to a higher smoking stage than White students. (But adult African Americans are more likely to smoke than Whites, according to the Center for Disease Control). Strong family ties were mildly protective of adolescents transitioning to a higher smoking stage. But, those students who had a poor connection to school were more likely to try smoking and transition to become regular smokers and those in the higher grades were also more likely to transition from trying smoking to regular/established smoking.
By comparing the stages of smoking along a continuum of which youth are more or less susceptible to internal and external influences, said Dr. Lloyd-Richardson, "we can look at ways to identify those individuals that are more likely to progress to higher stages of use and likely dependence. Teens that are already experimenting with smoking, are drinking alcohol, and have several friends who smoke regularly should be targeted with interventions that halt the entrenchment of smoking."
Article: "Differentiating Stages of Smoking Intensity Among Adolescents: Stage-Specific Psychological and Social Influences," Elizabeth E. Lloyd-Richardson, Ph.D., Alessandra Kazura, M.D., Cassandra Stanton, Ph.D., and Raymond Niaura, Ph.D., Brown University School of Medicine; George Papandonatos, Ph.D., Brown University; Journal of Consulting and Clinical Psychology, Vol 70, No. 4.
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Elizabeth E. Lloyd-Richardson, PhD can be reached by telephone at 401-793-8150 or by email at firstname.lastname@example.org and Ray Niaura, PhD at 401-793-8002 or Cassandra Stanton, PhD at (401)793-8193.
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