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Approximately 3,000 children and adolescents become regular smokers each day, with about six million youth reporting current tobacco use. At least two thirds of adolescents have tried cigarettes, more than one third are currently smoking, and as many as a quarter of these adolescents smoke every day. While adolescent cigarette use has declined since the 1970's, recent research suggests cigarette smoking among teenagers is now on the rise. Given these current rates of tobacco use, at least 5 million children under age 18 will eventually die from smoking-related diseases. Tobacco use accounts for over 450,000 total deaths and 170,000 cancer deaths every year in the United States, and over 30 percent of all cancer deaths are caused by tobacco. Initiation of smoking during adolescence is particularly important to study, especially since approximately 90% of all adult smokers began smoking at or prior to age 18. Many researchers, health practitioners and policy-makers have argued that the reason for adolescents’ engagement in risk behaviors, including tobacco use, is that they perceive themselves as invulnerable to harm. Unfortunately, few studies have followed non-smoking adolescents over time. Such a study would allow for the examination of changes in risk perceptions and perceptions of vulnerability once onset of tobacco use occurs. This research is critical in understanding whether risk judgments motivate behavior or are instead reflective of adolescents’ past behavioral experiences. The ultimate goal of this research is to inform and improve programs that attempt to reduce or prevent adolescent tobacco use.
Following a group of 9th graders, we propose to examine whether: 1) risk judgments influence the onset of tobacco use; 2) the onset of tobacco use plays a role in shaping subsequent risk judgments; 3) risk judgments change once an adolescent has experienced tobacco-related negative outcomes; 4) knowledge of friends’ or family members’ use of tobacco influence risk judgments and tobacco use; and 5) the relationship between risk perceptions and tobacco use varies by gender and race/ethnicity. Studies have indicated that following adolescents from age 14 on appears to be the period from which the majority of changes in smoking behavior will be observed. Therefore, the study population will be approximately 600 9th graders from the Bay Area. These participants will vary by ethnicity. Study participants will be recruited from their 9th grade classes and then surveyed, by mail, every 6 months, for a total of three years. Adolescents will answer questions about their perceptions of risk to tobacco-related negative outcomes, their current and past use of tobacco, experiences with any tobacco-related negative or positive outcomes, vicarious exposure to peers and family members who smoke, and vicarious exposure to tobacco-related negative and positive outcomes. Results from this study will be useful for researchers, health practitioners, and policy makers who are interested in understanding why adolescents onset to tobacco use. Results will also be useful to further the development of effective, theory-based interventions to reduce adolescent tobacco use. |
