School of Nursing, Taipei Medical University, Taipei, Taiwan.
Health Administration, Virginia Commonwealth University, Richmond, Virginia, USA.
BMJ Open. 2024 Nov 17;14(11):e081807. doi: 10.1136/bmjopen-2023-081807.
Adolescence represents a pivotal period for the initiation of smoking behaviours. While family, peer and social groups serve as significant reference groups influencing adolescents' decision-making process, there remains a paucity of research that examines how diversified reference groups influence their smoking decisions.
The objective is to compare normative and informative influences given by different reference groups on adolescents' smoking decision-making.
This study applied reference group theory and used the card sorting technique. Adolescents were presented with 16 cards portraying various reference groups and 27 cards portraying different types of reference group influences. They were asked to construct sentences as smoking-elicited and smoking-inhibited cues and ranked these influences based on their relevance to their smoking decision-making.
The participants were recruited from four cities in the North, Central, South and East regions of Taiwan. The study sample consisted of 297 Taiwanese 11th graders drawn from high schools, vocational high schools and night schools.
The most influential reference group among smokers, former smokers and never smokers.
Our results of multivariable logistic regression show that for current smokers, having a smoking best friend (aOR=7.58, <0.01), having a smoking colleague (aOR=3.83, <0.01) and participating in ceremonial dance performances (aOR=4.62, <0.01) are more likely to smoke. Peers play an important role in providing smoking-elicited cues for current smokers. Families provided the most smoking-inhibited cues for former and never smokers. Normative influences such as encouraging adolescent smoking provided more cues for adolescents than informative influences such as releasing stress by smoking.
Adolescent smoking behaviour was influenced by peer norms, while former and non-smoking behaviours are associated with family norms. Therefore, tobacco prevention efforts should focus more on family-level interventions to discourage smoking initiation. Smoking cessation programmes for current smokers should address the reduction of peer pressure to smoke. Moreover, schools and community partners should collaborate to develop effective smoking cessation strategies, particularly for high-risk groups such as adolescents who involved in ceremonial dance performance.
青春期是开始吸烟行为的关键时期。虽然家庭、同伴和社会团体是影响青少年决策过程的重要参照群体，但仍缺乏研究来考察多元化的参照群体如何影响他们的吸烟决定。
比较不同参照群体对青少年吸烟决策的规范和信息影响。
本研究应用参照群体理论，采用卡片分类技术。向青少年展示 16 张代表不同参照群体的卡片和 27 张代表不同类型参照群体影响的卡片。要求他们构建作为吸烟诱发和吸烟抑制线索的句子，并根据这些影响与他们吸烟决策的相关性对其进行排名。
参与者来自台湾北部、中部、南部和东部的四个城市。研究样本由来自高中、职业高中和夜校的 297 名台湾 11 年级学生组成。
吸烟者、前吸烟者和从不吸烟者中最具影响力的参照群体。
多变量逻辑回归的结果表明，对于当前吸烟者，有吸烟最好的朋友（优势比[OR]=7.58，<0.01）、有吸烟同事（OR=3.83，<0.01）和参加仪式舞蹈表演（OR=4.62，<0.01）更有可能吸烟。同伴在为当前吸烟者提供吸烟诱发线索方面发挥着重要作用。家庭为前吸烟者和从不吸烟者提供了最多的吸烟抑制线索。鼓励青少年吸烟等规范性影响为青少年提供的线索多于通过吸烟释放压力等信息性影响。
青少年吸烟行为受到同伴规范的影响，而前吸烟者和不吸烟者的行为与家庭规范有关。因此，烟草预防工作应更侧重于家庭层面的干预，以阻止吸烟的开始。针对当前吸烟者的戒烟计划应解决减少吸烟压力的问题。此外，学校和社区合作伙伴应合作制定有效的戒烟策略，特别是针对参与仪式舞蹈表演等高危群体的策略。
