Tobacco Use and Smoking Intentions Among U.S. Fifth-Grade Students
Published in: Journal of Adolescent Health, v. 55, no. 3, Sep. 2014, p. 445-451
Posted on RAND.org on November 01, 2013
- What are the risk factors for smoking among fifth-graders?
- How can policies be best designed to reduce smoking behavior?
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.
- Preadolescent fifth-graders share some of the same risk factors for smoking as do older adolescents, including friends smoking, trouble with schoolwork, and parents not attending college.
- Parental communication of disapproval of smoking might dampen future intentions to smoke.
- Preventive school-based anti-smoking programs and mass media campaigns might have similar benefits.
Preventive school-based anti-smoking programs and mass media campaigns should target preadolescents as well as adolescents and should encourage parents to voice disapproval of smoking.