Short communicationCan home smoking restrictions influence adolescents' smoking behaviors if their parents and friends smoke?
Introduction
The smoking behavior of parents and friends are important influences on adolescents' smoking behaviors (Conrad et al., 1992, Tyas & Pederson, 1998). Reducing the opportunities for adolescents to observe the smoking behaviors of these significant others by introducing home smoking bans may reduce adolescent smoking uptake. Only a small number of studies have investigated the association between home smoking bans and the smoking behaviors of adolescents (Farkas et al., 2000, Proescholdbell et al., 2000, Wakefield et al., 2000). While these studies have consistently shown that home smoking bans reduce the likelihood of tobacco experimentation, it is unclear whether they are associated with a reduced likelihood of being a current smoker, and whether associations are moderated by parental smoking status.
An additional question of interest is whether the effect of home smoking bans on adolescent smoking is seen after controlling for smoking behaviors of friends. Adolescents who associate with friends who smoke are at an increased risk of making the transition to experimental and regular use of tobacco (Distefan, Gilpin, Choi, & Pierce, 1998) and recent work has suggested that smoking by friends is more important than parental smoking in predicting adolescent smoking (De Vries, Engels, Kremers, Wetzels, & Muddle, 2003). Despite this, no study has investigated the effects of home smoking bans on smoking uptake after controlling for the effects of peer smoking. Thus it has not yet been shown that the presence of home smoking bans is associated with a reduced likelihood of smoking over and above one of the most important known predictors of smoking uptake.
In this paper we examine the association between home smoking bans and adolescents' smoking after controlling for smoking among friends and parents. We use data collected from adolescents growing up in the Australian State of Victoria. This community may be thought to have strong controls on tobacco with all cigarette advertising except point of sale banned by 1995, health warnings occupying 25% of front of cigarette packs and since the early 1990s bans on smoking in government buildings, and since 2001 in restaurants and cafes.
Section snippets
Design and sample
Data are from a 2002 survey of secondary students from the Australian State of Victoria. A stratified two-stage sample design was used to obtain a random sample of students. First, 72 secondary schools were selected at random, and within each school 80 students were randomly selected. Of the 72 schools approached, 28 declined participation and a further 24 schools were recruited from a pool of equivalent pairs. On an agreed date, members of the research team attended the school to survey
Results
Table 1 shows the characteristics of the sample according to smoking uptake stage. Smoking uptake stage was not associated with gender but was associated with age (χ2 = 290.3, df = 3, p < 0.001), friends' smoking (χ2 = 1074.8, df = 3, p < 0.001), parental smoking (χ2 = 140.8, df = 6, p < 0.001) and having more permissive rules on smoking in the home (χ2 = 105.1, df = 6, p < 0.001).
Table 2 presents the relative odds of being in each stage of smoking uptake compared to being a non-susceptible non-smoker. After adjusting
Discussion
To our knowledge, this is the first study in this area to investigate whether home smoking bans were associated with a reduced likelihood of smoking after controlling for effects of peer smoking. We found that home smoking bans reduced the likelihood of an adolescent trying tobacco regardless of their friends' smoking behavior. The results suggest that home smoking bans can work to counteract some of the influence friends' smoking behaviors may have on adolescent smoking experimentation and
Acknowledgements
Funded by the Victorian Department of Human Services and The Cancer Council Victoria.
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