Nodora Jesse, Hartman Sheri J, Strong David R, Messer Karen, Vera Lisa E, White Martha M, Portnoy David B, Choiniere Conrad J, Vullo Genevieve C, Pierce John P
Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA, United States; Department of Family and Preventive Medicine, University of California, San Diego, United States.
Center for Tobacco Products, US Food and Drug Administration, Rockville, MD, United States.
Addict Behav. 2014 Dec;39(12):1695-700. doi: 10.1016/j.addbeh.2014.06.002. Epub 2014 Jun 18.
To improve smoking prevention efforts, better methods for identifying at-risk youth are needed. The widely used measure of susceptibility to smoking identifies at-risk adolescents; however, it correctly identifies only about one third of future smokers. Adding curiosity about smoking to this susceptibility index may allow us to identify a greater proportion of future smokers while they are still pre-teens.
We use longitudinal data from a recent national study on parenting to prevent problem behaviors. Only oldest children between 10 and 13years of age were eligible. Participants were identified by RDD survey and followed for 6years. All baseline never smokers with at least one follow-up assessment were included (n=878). The association of curiosity about smoking with future smoking behavior was assessed. Then, curiosity was added to form an enhanced susceptibility index and sensitivity, specificity and positive predictive value were calculated.
Among committed never smokers at baseline, those who were 'definitely not curious' were less likely to progress toward smoking than both those who were 'probably not curious' (ORadj=1.89; 95% CI=1.03-3.47) or 'probably/definitely curious' (ORadj=2.88; 95% CI=1.11-7.45). Incorporating curiosity into the susceptibility index increased the proportion identified as at-risk to smoke from 25.1% to 46.9%. The sensitivity (true positives) for this enhanced susceptibility index for both experimentation and established smoking increased from 37-40% to over 50%, although the positive predictive value did not improve.
The addition of curiosity significantly improves the identification and classification of which adolescents will experiment with smoking or become established smokers.
为了改进吸烟预防工作,需要更好的方法来识别有风险的青少年。广泛使用的吸烟易感性测量方法能够识别有风险的青少年;然而,它只能正确识别大约三分之一未来会吸烟的人。将对吸烟的好奇心加入这个易感性指数中,可能会让我们在未来吸烟者仍处于青春期前时,识别出更大比例的人。
我们使用了一项近期全国性育儿预防问题行为研究的纵向数据。只有年龄在10至13岁之间的最大孩子符合条件。通过随机数字拨号调查确定参与者,并对其进行6年的跟踪。纳入所有基线时从不吸烟且至少有一次随访评估的人(n = 878)。评估对吸烟的好奇心与未来吸烟行为之间的关联。然后,加入好奇心以形成增强的易感性指数,并计算敏感性、特异性和阳性预测值。
在基线时坚定的从不吸烟者中,那些“绝对不好奇”的人比那些“可能不好奇”(ORadj = 1.89;95% CI = 1.03 - 3.47)或“可能/绝对好奇”(ORadj = 2.88;95% CI = 1.11 - 7.45)的人更不容易发展为吸烟。将好奇心纳入易感性指数后,被确定为有吸烟风险的比例从25.1%增加到了46.9%。这个增强的易感性指数对尝试吸烟和已吸烟的敏感性(真阳性)从37 - 40%增加到了50%以上,尽管阳性预测值没有提高。
加入好奇心显著改善了对哪些青少年会尝试吸烟或成为已吸烟者的识别和分类。