Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK.
Centre for Evidence and Social Innovation, Queen's University Belfast, University Road, Belfast, BT7 1NN, UK.
BMC Public Health. 2019 Aug 28;19(1):1182. doi: 10.1186/s12889-019-7485-7.
An adolescent's perceptions of their family's and friends' smoking attitudes and behaviour can influence their own uptake of smoking. There are two broad sources of such social influence: observing the behaviour directly, and assimilating attitudes.
We analysed data collected for the evaluation of Dead Cool, a school based smoking prevention intervention in Northern Ireland (n=480 in 20 clusters). The main analysis fits three nested logistic regression models predicting pre-intervention susceptibility to taking up smoking, as reflected in responses to three attitudinal questions. Model 1 includes only personal characteristics as explanatory factors. Model 2 adds the behaviour of friends and family that would provide an opportunity for social influence through observational learning. Model 3 adds the susceptibility of friends.
Each additional group of variables improved the model fit (with reduced AIC and BIC). However, in the final model, only three variables were found to be statistically significant (p<0.05) in predicting susceptibility to smoking initiation: rebelliousness (OR [1.1,1.3]) from the personal characteristics group; and, in the observational learning group, being friends with a smoker (OR [1.0,2.9]) and frequency of being in the same room or car with someone smoking (OR [2.0,9.0] for most frequent). Adding the two measures of diffusion of susceptibility through the friendship network improved the model fit, but neither was found to be statistically significant.
The analysis provides additional evidence to support policies that could reduce children's exposure to smoking behaviour, and potential subsequent smoking initiation. No conclusions could be drawn about the diffusion of smoking attitudes through the school friendship networks of children.
青少年对其家庭和朋友吸烟态度和行为的看法会影响他们自己吸烟的倾向。这种社会影响有两个主要来源：直接观察行为和同化态度。
我们分析了在北爱尔兰进行的基于学校的预防吸烟干预项目“Dead Cool”评估中收集的数据（20 个簇，共 480 名参与者）。主要分析拟合了三个嵌套逻辑回归模型，用于预测干预前开始吸烟的易感性，反映在对三个态度问题的回答中。模型 1 仅包括个人特征作为解释因素。模型 2 添加了朋友和家人的行为，这些行为可以通过观察学习提供社会影响的机会。模型 3 添加了朋友的易感性。
每个额外的变量组都改善了模型拟合（降低了 AIC 和 BIC）。然而，在最终模型中，只有三个变量被发现对预测吸烟起始的易感性具有统计学意义（p<0.05）：个人特征组中的叛逆（OR [1.1,1.3]）；在观察学习组中，与吸烟者为朋友（OR [1.0,2.9]）和与吸烟者在同一房间或车内的频率（最频繁时为 OR [2.0,9.0]）。添加通过友谊网络扩散易感性的两个测量值提高了模型拟合度，但都没有发现具有统计学意义。
分析结果提供了额外的证据，支持可以减少儿童暴露于吸烟行为并潜在减少后续吸烟起始的政策。对于儿童通过学校友谊网络传播吸烟态度的问题，无法得出结论。
