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Teenage smoking behavior influenced by friends' and parents' smoking habits

New research from the Keck School of Medicine of USC highlights opportunities for smoking intervention programs

The company you keep in junior high school may have more influence on your smoking behavior than your high school friends, according to newly published research from the University of Southern California (USC).

The study, which appears in the April 12 issue of the Journal of Adolescent Health, identifies how friends' and parental influence on cigarette smoking changes from junior high to high school.

The research indicates that intervention targets to counteract friends' influence may have more of an effect in junior high than in high school, and that parents remain influential on smoking behavior through high school, indicating another possible intervention target, the researchers said.

"Based on social developmental model research, we thought friends would have more influence on cigarette use during high school than junior high school," said first author Yue Liao, M.P.H., Ph.D., a student in the department of preventive medicine's Institute for Health Promotion and Disease Prevention Research (IPR) at the Keck School of Medicine of USC. "But what we found was friends have greater influence during junior high school than high school. We think the reason may be that friends' cigarette use behavior may have a stronger influence on youth who start smoking at a younger age. During high school, cigarette use might represent the maintenance of behavior rather than a result of peer influence."

Researchers analyzed the first seven waves of longitudinal data from 1,001 adolescents who participated in the Midwestern Prevention Project (MPP), a community-based substance abuse prevention program. Mary Ann Pentz, Ph.D., professor of preventive medicine and director of the Institute for Health Promotion and Disease Promotion, is the primary investigator of that trial, and a co-author of the current study. MPP is the longest running substance use prevention, randomized controlled trial in the U.S.; its multi-component community-based program is listed on several national registries for evidence-based substance use prevention. The full trial followed adolescents from age 11 to adulthood, specifically age 37. Participants were first observed in the seventh grade – during junior high school – and then again after six months, and then annually through the 12th grade, during high school. Students were asked to indicate the number of close friends and parents, or two important adults, who smoked cigarettes. They were also asked how many cigarettes they had smoked in the last month. The effects of friends' and parents' cigarette use on self-use were assessed from early to late adolescence in order to identify changes in trends and magnitude.

Results confirmed that overall, both friends' and parental cigarette use had significant effects on adolescents' cigarette use during both junior high school and high school. However, while friends' influence was generally higher in junior high school than in high school, parental influence remained relatively stable between these two periods, with a decreasing trend from 10th to 12th grade. This finding confirms previous research that suggests social units, such as school or community, may exert more influence on youth behavior than parents in high school.

The researchers also observed gender differences in friends' and parental influence. Friends' influence on cigarette smoking was greater for girls than boys during ninth and 10th grade. However, there was an increasing trend in friends' influence from ninth to 11th among boys whereas friends and parents had less influence on girls from 10th to 12th grade.

"Boys tend to foster friendship by engaging in shared behaviors, whereas girls are more focused on emotional sharing. So, it is possible that boys are adopting their friends' risky behaviors, like smoking, as the groups grow together over time," Liao said.

The observations from this study present opportunities for intervention and may help to guide the implementation of adolescent smoking prevention programs, Liao said.

"We observed a big dip in friends' effect on smoking behavior from eighth to ninth grade. Thus, the first year of high school represents an opportunity for interventions to counteract peer influence and to continue to target parents as their behavior remains influential through the end of high school," Liao said. "In addition, teaching students refusal skills during junior high school could be effective in decreasing cigarette use at the beginning of high school. Programs could also promote positive parenting skills to protect children from deviant peer influence."

Liao suggests future research on sibling effects for a more complete picture of familial influence. The current study assessed sibling behavior only during junior high school.

Other USC co-authors include Zhaoqing Huang, M.D., M.A, Ph.D., a student in the department of preventive medicine, Institute for Health Promotion and Disease Prevention Research; Jimi Huh, Ph.D., assistant professor of research for the Institute for Health Promotion and Disease Prevention Research; and Chih-Ping Chou, Ph.D., professor of preventive medicine.

Funding for the research came from the National Institutes of Health (grant number R01-DA-027226, Chou, PI).

Liao, Y., Zhaoqing, H., Huh, J., Pentz, M.A., Chou, C.P. (2013) Changes in friends' and parental influences on cigarette smoking from early through late adolescence. Journal of Adolescent Health. Published online April 12, 2013.

Molly Rugg | EurekAlert!
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