Correlates of susceptibility to smoking among Mexican origin youth residing in Houston, Texas: A cross-sectional analysis
BMC Public Health
Correlates of susceptibility to smoking among Mexican origin youth residing in Houston, Texas: A cross-sectional analysis
Anna V Wilkinson 2
Andrew J Waters 1
Vandita Vasudevan 2
Melissa L Bondy 2
Alexander V Prokhorov 0
Margaret R Spitz 2
0 Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center , Houston, Texas , USA
1 Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences , 4301 Jones Bridge Road Bethesda, MD 20814 , USA
2 Department of Epidemiology, Unit 1340, The University of Texas M. D. Anderson Cancer Center , P.O. Box 301439, Houston, TX 77230- 1439 , USA
Background: Survey data suggest that in Texas Latino youth exhibit higher rates of susceptibility to smoking than youth from other ethnic groups. In this analysis we examined the relationship between susceptibility to smoking and well-known risk factors associated with smoking initiation among a cohort of 11 to 13 year old Mexican origin youth residing in Houston, Texas. Methods: We analyzed cross-sectional survey data from 1,187 participants who reported they had never smoked, even a puff of a cigarette. The survey assessed peer and family social influence, school and neighborhood characteristics, level of family acculturation and socioeconomic status, and attitudes toward smoking. Bivariate associations, Student's t-tests, and logistic regression analysis were used to examine predictors of susceptibility. Results: Overall, 22.1% of the never-smokers were susceptible to smoking. Boys were more likely to be susceptible than girls (25.6% vs. 18.9%), and susceptible children were slightly older than nonsusceptible children (12.1 vs. 11.8 years). In addition, multivariate analyses revealed that positive expectations about smoking exerted the strongest influence on susceptibility status (odds ratio = 4.85). Multivariate analyses further revealed that compared to non-susceptible participants, susceptibles were more likely to report peer influences supportive of smoking, lower subjective social status and more detentions at school, more temptations to try smoking and to have a mother and a brother who smokes. Conclusion: Our findings suggest that interventions that target positive expectations about smoking may be useful in this population. Furthermore, because youth encounter smokinginitiation risk factors in different social environments, our results underscore the continued need for both family- and school-based primary prevention programs to adequately combat their influence. The results also can be used to inform the development of culturally sensitive programs for Mexican origin youth.
-
Background
The construct of cognitive susceptibility to smoking,
defined as lacking a firm commitment not to smoke in the
future or if offered a cigarette by a friend, integrates
behavioral intentions and expectations for future behavior [1].
Over the past decade, the construct has consistently
demonstrated strong predictive abilities and has become
widely accepted. In prospective studies, conducted in
various geographic areas of the US among adolescents from
differing ethnic backgrounds, adolescents identified as
susceptible to smoking were two to three times more
likely to have experimented with cigarettes than their
nonsusceptible peers at follow-up [2-5]. Moreover, results
from a community-based tobacco prevention study
indicated that susceptibility to smoking is amenable to
interventions [6]. In this Texas-based study, an intervention
reduced susceptibility to smoking among teens by 24.6%.
Collectively, these studies suggest that identifying and
characterizing susceptible adolescents who have never
smoked will be critical to optimizing primary smoking
prevention efforts among youth.
Mexican origin youth, aged 12 to 17 years, report higher
rates of susceptibility to smoking (28.8%) compared to
their non-Hispanic white (20.8%) and non-Hispanic
black (23.0%) counterparts [7]. Moreover, results from
two large population-based surveys of middle and high
school students lend support to the predictive validity of
the susceptibility construct [8,9]. In Texas, Latino youth
exhibit the highest rates of experimentation with
cigarettes [8] and of current smoking [9], among all ethnic
groups. In 2001 in Houston, Latino middle and high
school students had the highest rate of experimenting
with cigarettes (68.2%; 95% confidence interval [CI]:
64.272.2%) followed by whites (63.8%; 95% CI: 52.3
75.3%) and African Americans (53.4%; 95% CI: 48.4
58.4%). In addition, statewide in 2001, 14.5% (95% CI:
12.316.7%) of all Latino middle school students
reported currently smoking compared to only 8.2% (95%
CI: 6.310.2%) of white and 6.5% (95% CI: 4.58.4%) of
African Americans middle school students. By high
school, smoking rates among Latinos and whites were
similar and significantly higher than smoking rates
among African American and Asian students. Given that
individuals of Mexic (...truncated)