Gritz Ellen R, Prokhorov Alexander V, Hudmon Karen Suchanek, Mullin Jones Mary, Rosenblum Carol, Chang Chung-Chi, Chamberlain Robert M, Taylor Wendell C, Johnston Dennis, de Moor Carl
The University of Texas M. D., Anderson Cancer Center, Houston, TX 77030, USA.
Nicotine Tob Res. 2003 Aug;5(4):493-506. doi: 10.1080/1462220031000118568.
This report describes a longitudinal study of the natural course of smoking initiation in a school-based, ethnically diverse (42% White, 37% African American, 20% Hispanic) sample of adolescents in grades 5, 8, and 12 who were followed prospectively for 1 year. A cohort of 659 students was identified who were never smokers at baseline and who completed questionnaires both at baseline and at 1-year follow-up. From this cohort, predictor variables were used to identify ethnic-specific risk factors for (a) "susceptibility to smoking" among the 509 students who were nonsusceptible, never smokers at baseline and (b) "ever smoking" among all 659 students who were never smokers at baseline (both susceptible and nonsusceptible). Logistic regression analyses revealed that parental and household influences (parental education, marital status, household smoking) were important predictors of ever smoking, but not of susceptibility to smoking, for African Americans. Hispanic adolescents were significantly influenced by environmental influences, namely smoking by other household members (ever smoking) and by peers (susceptibility and ever smoking), although peer pro-tobacco influences (friends who smoke or friends' approval of smoking) were important predictors of susceptibility to smoking or ever smoking for all three ethnic groups. Exposure to tobacco-related advertising was a risk factor for White (susceptibility and ever smoking) and African American (susceptibility only) adolescents but not for Hispanic adolescents. Inclusion of the susceptibility to smoking variable in the model predicting ever smoking substantially reduced the importance of other predictors in the model, suggesting that susceptibility to smoking was not an independent risk factor for ever smoking but rather a potential mediating variable. The results of this study offer important insights for designing ethnic-specific strategies for preventing smoking during adolescence.
本报告描述了一项纵向研究，该研究以一个种族多样化（42%为白人、37%为非裔美国人、20%为西班牙裔）的5年级、8年级和12年级青少年样本为对象，对吸烟起始的自然过程进行了前瞻性跟踪研究，为期1年。确定了一组659名学生，他们在基线时从不吸烟，并在基线和1年随访时都完成了问卷调查。从这个队列中，预测变量被用于确定（a）在基线时不敏感、从不吸烟的509名学生中“吸烟易感性”的种族特异性风险因素，以及（b）在基线时从不吸烟的所有659名学生（包括敏感和不敏感的学生）中“曾经吸烟”的种族特异性风险因素。逻辑回归分析显示，对于非裔美国人来说，父母和家庭影响（父母教育程度、婚姻状况、家庭吸烟情况）是曾经吸烟的重要预测因素，但不是吸烟易感性的预测因素。西班牙裔青少年受到环境影响的显著影响，即其他家庭成员吸烟（曾经吸烟）和同龄人（易感性和曾经吸烟），尽管同龄人对烟草的影响（吸烟的朋友或朋友对吸烟的认可）是所有三个种族群体吸烟易感性或曾经吸烟的重要预测因素。接触烟草相关广告是白人（易感性和曾经吸烟）和非裔美国青少年（仅易感性）的风险因素，但不是西班牙裔青少年的风险因素。在预测曾经吸烟的模型中纳入吸烟易感性变量，大大降低了模型中其他预测因素的重要性，这表明吸烟易感性不是曾经吸烟的独立风险因素，而是一个潜在的中介变量。本研究结果为设计针对青少年预防吸烟的种族特异性策略提供了重要见解。
