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Patterns & risk factors for adolescent smoking progression

Institution: University of Southern California
Investigator(s): Chaoyang Li, MPH
Award Cycle: 2000 (Cycle 9) Grant #: 9DT-0199 Award: $47,521
Subject Area: Epidemiology
Award Type: Dissertation Awards

Initial Award Abstract
Cigarette smoking is the number one preventable cause of death and disease in the United States. Despite increased public health knowledge about the adverse health effects of smoking, adolescents still experiment with tobacco use. Nationwide, the percentage of adolescents who smoke has increased during the1990s. The number of adolescents who started smoking increased by 30% and who started daily smoking increased by 50% between 1988 –1996. In California, the percentage of adolescents who smoke was stable from 1990 to 1993 but, since then, has been increasing. Cigarette smoking among White, Hispanic, and Asian adolescents is increasing more rapidly than that among Black adolescents.

Identifying different patterns of smoking progression is an important issue because such difference have important implications for prevention and research. Adolescent smoking has been described as consisting of several stages (never smoke, preparatory, trial, experimental, regular use, and nicotine addiction), but not all adolescents smoke or progress from trial smoking to addictive use. Intentions and favorable attitudes toward use predict trial use; refusal self-efficacy may predict onset and escalation of smoking; peer and parent use appear to predict some progression beyond trial use, but predictors of addictive smoking are not altogether clear. Meanwhile, smoking prevention programs that have countered these personal and social influences have shown success in preventing onset and progression from trial to more regular use, but relatively little is known about the capacity of such programs to offset progression to addictive use. A study of the relationships of demographic, personal, and social factors to progression of smoking beyond trial use would help inform future prevention programs.

This study has the following specific aims: (a) to examine patterns of smoking development Among California adolescents by gender and ethnicity; (b) to determine the relative importance of social influence, personal, and demographic factors in predicting development of adolescent smoking; (c) to test potential interactions among social influence and demographic predictors for development of adolescent smoking; and (d) to test potential indirect effects of social influences on development of adolescent smoking mediated through personal factors. The fulfillment of these specific aims will enhance our understanding of gender and race differences of smoking development and related risk factors in California adolescents.

This study will conduct further data analyses using the longitudinal data from an ongoing TRDRP funded tobacco prevention project (the Tobacco Program and Policy project, Pentz, PI) that has being been conducted among junior high school students in Orange County, California since 1997. A total of 2,335 students who completed all investigations at three time points will be analyzed. The investigated students comprise of 49.8% males and 50.2% females; 39.9% White - not Hispanic, 27.2% Hispanic, 16.2% Asian, 2.3% Black, and 14.4% others. This research will enhance our understanding of gender and race differences in smoking development, as well as explore ways to reduce tobacco dependence among diverse groups. The findings of this study will inform public health decision-making and improve smoking prevention strategies.

Effects of low birth weight on the insulin resistance syndrome in Caucasian and African-American children.
Periodical: Diabetes Care Index Medicus:
Authors: Li C, Johnson M, Goran M ART
Yr: 2001 Vol: 24 Nbr: 12 Abs: Pg: 2035-2042

Stressful life events among adolescents in Whan, China: associations with smoking, alcohol use, and depressive symptoms.
Periodical: International Journal of Behavioral Medicine Index Medicus:
Authors: Unger JB, Li Y, Johnson CA, Gong J, Chen X, Li C, Trinidad DR, Tran NT, Lo AT ART
Yr: 2001 Vol: 8 Nbr: 1 Abs: Pg: 1-18

Attrition in a longitudinal drug abuse prevention study.
Periodical: International Journal of Mental Health Promotion Index Medicus:
Authors: Fan AZ, Pentz MA, Dwyer J, Bernstein K, Li C ART
Yr: 2002 Vol: 4 Nbr: 2 Abs: Pg: 15-23

Parental substance use as modifier of adolescent substance use risk.
Periodical: Addiction Index Medicus:
Authors: Li C, Pentz MA, Chou C-P ART
Yr: 2002 Vol: 97 Nbr: Abs: Pg: 1537-1550

Youths' exposure to environmental tobacco smoke (ETS): associations with health beliefs and social pressure.
Periodical: Addictive Behaviors Index Medicus:
Authors: Li C, Unger JB, Schuster D, Rohrbach LA, Howard-Pitney B, Norman G ART
Yr: 2003 Vol: 28 Nbr: 1 Abs: Pg: 39-53

Parallel developmental trajectories of sensation seeking and regular substance use in adolescents.
Periodical: Psychology of Addictive Behaviors Index Medicus:
Authors: Crawford AM, Pentz MA, Chou CP, Li C, Dwyer JH ART
Yr: 2003 Vol: 17 Nbr: 3 Abs: Pg: 179-192

Relationship of substance use and associated predictors to aggression in early, middle, and late adolescence.
Periodical: Journal of Child and Adolescent Substance Abuse Index Medicus:
Authors: Weiner MD, Pentz MA, Skara SN, Li C, Chou C-P, Dwyer JH ART
Yr: 2004 Vol: 13 Nbr: 2 Abs: Pg: 61-81

Using the health belief model and perceived social norms to predict youth's exposure to environmental tobacco smoke (ETS).
Periodical: Annals of Behavioral Medicine Index Medicus:
Authors: Li C, Unger JB, Rohrbach LA, Howard-Pitney B, Norman G ABS
Yr: 2000 Vol: Nbr: 22 Abs: Pg: S093

Effects of insulin resistance syndrome on carotid intema-media thickness and lesions: the Los Angesles Artherosclerosis Study.
Periodical: American Journal of Epidemiology Index Medicus:
Authors: Li C, Dwyer KM< Merz CNB, Dwyer JH ABS
Yr: 2001 Vol: 153 Nbr: 11 Abs: Pg: S49

Birth weight modifies the relationship between systolic blood pressure, pubertal development, and body mass in adolescents.
Periodical: Annals of Epidemiology Index Medicus:
Authors: Li C, Cruz ML, Huang TT, GOran MI ABS
Yr: 2002 Vol: 12 Nbr: 7 Abs: Pg: 518-519

BIrth weight, pubertal development, current wight, and progression of blood pressure in children.
Periodical: Annals of Behavioral Medicine Index Medicus:
Authors: Li C, Goran MI ABS
Yr: 2002 Vol: 24 Nbr: Abs: Pg: S075

Intrapersonal and interpersonal influences on the progression of adolescent addictive smoking.
Periodical: Nicotine and Tobacco Research Index Medicus:
Authors: Li C, Pentz MA ABS
Yr: 2002 Vol: 4 Nbr: 3 Abs: Pg: 381-382

Maternal smoking during pregnancy, birth weight, and childhood overweight: a suppression effect model.
Periodical: Annals of Epidemiology Index Medicus:
Authors: Li C, Mayo MS, Ahluwalia JS ABS
Yr: 2003 Vol: 13 Nbr: 8 Abs: Pg: 569