Tobacco Use and Smoking Intentions Among US Fifth-Grade Students

• Type of Material: Article
• Authors: Joseph A. Ladapo, New York University; Marc N. Elliott, RAND Corporation; David E. Kanouse, RAND Corporation; Susan R. Tortolero, University of Texas Health Science Center; Michael Windle, Emory University; Paula M. Cuccaro, University of Texas Health Science Center; Susan L. Davies, University of Alabama Birmingham; Mark A. Schuster, Children's Hospital Boston
• Language: English
• Date: 2014-09-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 Society for Adolescent Health and Medicine. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jadohealth.2014.03.008
• Title of Journal or Parent Work: Journal of Adolescent Health
• ISSN: 1054-139X
• Volume: 55
• Issue: 3
• Start Page: 445
• End Page: 451
• Grant/Funding Information: Funding was provided by Cooperative Agreement Numbers CCU409679, CU609653, and CCU915773 from the Centers for Disease Control and Prevention.
• Keywords: Psychology, Developmental; LATE CHILDHOOD; ALCOHOL-USE; Science & Technology; BEHAVIOR; Tobacco; SMOKERS; CESSATION; Public, Environmental & Occupational Health; PREDICTORS; Smoking; Pediatrics; Social Sciences; Life Sciences & Biomedicine; COMMUNICATION; Psychology; ANTISMOKING PARENTING PRACTICES; ADOLESCENT SMOKING; UNITED-STATES; Preadolescent children
• Research Categories: Psychology, Developmental; Health Sciences, Public Health; Psychology, Behavioral

Abstract

Purpose: To identify the risk and protective factors for cigarette smoking and future intentions among racially/ethnically diverse preadolescent children. Methods: We analyzed data from 5,119 fifth-grade children and their parents living in three U.S. metropolitan areas. Using the multivariate logistic regression models, we examined how cigarette smoking and intentions to smoke within 1 year are associated with (1) number of friends who smoke, (2) parental disapproval of smoking, (3) parental communication about not smoking, (4) performance in school, and (5) educational aspirations. Results: Twenty-nine percent of the children were black, 44% were Hispanic, 22% were white, and 5% were of another race/ethnicity. Mean age was 11.1 years. The prevalence of ever smoking a cigarette among black, Hispanic, and white children was 9.8%, 5.6%, and 4.9%, respectively. In adjusted analyses, children were more likely to have smoked a cigarette if their friends smoked (adjusted odds ratio [aOR] 5.1, 95% confidence interval [CI] 3.8-6.9), they frequently had trouble with schoolwork (aOR 2.1, 95% CI 1.5-3.1), or their parents were not college graduates (aOR 2.0, 95% CI 1.2-3.5 for high school graduate). They were less likely to have smoked cigarettes if their parents disapproved of smoking (aOR.3, 95% CI.1-.6). Parental communication (aOR.1, 95% CI.0-.6) and disapproval (aOR.2, 95% CI.1-.7) had protective associations for future intentions among children who had ever and had never smoked, respectively. Conclusions: Fifth-graders share many of the same risk factors for smoking identified in older adolescents, some of which are modifiable. Antismoking policies and programs should be designed for preadolescents as well as adolescents, and campaigns targeting parents should place greater emphasis on communication and expressed disapproval of smoking.