Factors Associated with Smoking Among an Urban Underserved Adolescent Population

Objectives: To examine predictors of smoking initiation and tobacco use among adolescents, as well as barriers and facilitators for cessation counseling. Methods: A specially designed self-administered survey instrument was constructed by the investigators and reviewed for content, construct and face validity; and then pilot tested for comprehension, readability, and reliability of items. The survey was conducted among adolescents aged 12-21, who were members of a community-based organization which provide social services for the youth. Frequencies and bivariate analyses were conducted using JMP (SAS). Results: The sample consisted of 153 adolescents, of whom 56% were female; mean age 17.7 years (SD=1.6); 49% were Black; 48% identified themselves as Hispanic; 23% were born outside United States; and 80% were currently attending school. Of the participants, 57% reported having ever tried smoking, of whom 29% indicated having smoked daily. Among ever smokers, 44% initiated prior to age 15; 64% indicated having talked with parent/guardian about smoking; 46% had someone at home who currently smoked. There were no significant differences by sex (p=0.2) among smokers. Those that smoked daily were more likely to be Hispanic (p=.005) and having a smoker at home (p=.03). Among all participants, 23% reported receiving smoking prevention and cessation advice at school. Among ever smokers only 9% reported having received such counseling, nevertheless 46% reported having tried to quit. Although parental advice was not significantly related to initiation of smoking (p=0.9), those that received counseling from their parents were more likely to have made quit attempts (p=.02). The majority of the smokers cited oral cancer as the most important oral tobacco effect of concern, and 70% indicated dentist advice would motivate them to stop smoking. Conclusion: These findings highlight the importance of exploring methods to more effectively target tobacco use prevention and cessation efforts among youth within the dental care setting.