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A Multilevel Analysis Examining the Relationship Between Social Influences for Smoking and Smoking Onset

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Objectives: To examine how older smoking peers at school and the smoking behavior of friends and family members are related to youth smoking. Methods: The School Smoking Profile was used to collect data on tobacco use and determinants of tobacco use from 22,091 students from 29 secondary schools in Ontario, Canada. Correlates of occasional and regular smoking were examined using multilevel logistic regression analyses. Results: Students are at increased risk for smoking if they (a) have smoking friends, (b) have smoking family members, and (c) attend a school with a relatively high senior-student smoking rate. Conclusion: These findings suggest that prevention programs should target both at-risk schools and at-risk students.

Keywords: school environment; smoking onset; smoking prevention; social influences

Document Type: Research Article


Affiliations: 1: Cancer Care Ontario, Division of Preventive Oncology; Department of Health Studies and Gerontology, University of Waterloo; Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada. 2: Department of Health Studies and Gerontology, University of Waterloo, Waterloo ON, Canada. 3: Centre for Behavioural Research and Program Evaluation, National Cancer Institute of Canada and the Canadian Cancer Society, Lyle S. Hallman Institute, University of Waterloo, Waterlo, ON, Canada. 4: Department of Statistics and Actuarial Science, University of Waterloo, Waterloo ON, Canada.

Publication date: 2005-11-01

More about this publication?
  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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