Abstract
Purpose
Becoming a smoker usually starts during adolescence and is a dynamic process involving experimentation before the establishment of daily smoking. It has been suggested that adolescents who smoke differ from those who do not in their attitudes to smoking. The purpose of this study was to find out whether attitudes related to smoking legislation and restrictions, social pressures in smoking and image of smokers are associated with smoking experimentation, daily smoking and best friends’ smoking.
Method
The data were gathered with a self-administered questionnaire in North Karelia, Eastern Finland and in the Pitkyaranta district, Republic of Karelia, Russia. The respondents were 15-year-old 9th grade pupils in local schools. In Pitkyaranta, the data analyses covered pupils in all eight schools in the area (n = 179). In North Karelia, the data analyses comprised of selected eight schools (n = 601). Data were analysed with exploratory factor analysis.
Results
The models revealed that attitudes related to restrictions and social pressure were significantly associated with experimenting with smoking [OR (95 % CI) 7.923 (5.787–10.847)], daily smoking [OR (95 % CI) 9.575 (6.727–13.628)] and the likelihood of best friends’ smoking [OR (95 % CI) 3.154 (2.579–3.858)]. The stronger the young peoples’ attitudes and opinions, for example, towards restrictions and with more difficulties in refusing smoking, the higher the likelihood for smoking experimentations, daily smoking as well as the likelihood for their best friends’ smoking. The country and factor interactions were not associated with smoking experimentations, daily smoking or best friends’ smoking.
Conclusion
Regardless of cultural background, adolescents who smoke have more positive attitudes to smoking, and perceive more social support for smoking, than do adolescents who do not smoke. The study stresses the similarity of the results in both Karelia’s despite the enormous differences in culture, economy and public policy.
Similar content being viewed by others
References
Ezzati M, Lopez AD. Estimates of global mortality attributable to smoking in 2000. Lancet. 2003;362:847–52.
WHO. Global health risks: mortality and burden of disease attributable to selected major risks. World Health Organization. 2009.
Fergusson DM, Lynskey MT, Horwood LJ. The role of peer affiliations, social, family and individual factors in continuities in cigarette smoking between childhood and adolescence. Addiction. 1995;90:647–59.
Chassin L, Presson CC, Rose JS, Sherman SJ. The natural history of cigarette smoking from adolescence to adulthood: demographic predictors of continuity and change. Health Psychol. 1996;15:478–84.
Prokhorov AV, Pallonen UE, Fava JL, Ding L, Niaura R. Measuring nicotine dependence among high-risk adolescent smokers. Addict Behav. 1996;21:117–27.
Lamkin L, Houston TP. Nicotine dependency and adolescents: preventing and treating. Prim Care. 1998;25:123–35.
Hu MC, Davies M, Kandel DB. Epidemiology and correlates of daily smoking and nicotine dependence among young adults in the United States. AJPH. 2006;96:299–308.
Flay BR, Ockene JK, Tager IB. Smoking: epidemiology, cessation, and prevention. CHEST J. 1992;102:277S–301.
Pallonen UE, Prochaska JO, Velicer WF, Prokhorov AV, Smith NF. Stages of acquisition and cessation for adolescent smoking: an empirical integration. Addict Behav. 1998;23:303–24.
Bell R, Pavis S, Amos A, Cunningham-Burley S. Continuities and changes: teenage smoking and occupational transition. J Adolesc. 1999;22:683–94.
Amos A, Gray D, Currie C. Healthy or druggy? Self-image, ideal image and smoking behavior among young people. Soc Sci Med. 1997;45:847–58.
Waters A, Carter B, Robinson J, Wetter D, Lam C, Cinciripini P. Implicit attitudes to smoking are associated with craving and dependence. Drug Alcohol Depend. 2007;91:178–86.
Hoffman BR, Sussman S, Unger JB, Walente TW. Peer influences on adolescent cigarette smoking: a theoretical review of the literature. Subst Use Misuse. 2006;41:103–55.
Sherman SJ, Chassin L, Presson C, Seo DC, Macy JT. The intergenerational transmission of implicit and explicit attitudes toward smoking: predicting adolescent smoking initiation. JESP. 2009;45:313–9.
Macfadyen L, Amos A, Hastings G, Parkes E. ‘They look like my kind of people’—perceptions of smoking images in youth magazines. Soc Sci Med. 2003;56:491–9.
Bricker BJ, Peterson AV, Andersen MR, Rajan KB, Leroux GB, Sarason IG. Childhood friends who smoke: do they influence adolescents to make smoking transitions? Addict Behav. 2006;31:889–900.
Sergent JD, Dalton M. Does parental disapproval of smoking prevent adolescents from becoming established smokers? Pediatrics. 2001;108:1256–62.
Pinilla J, González B, Barber P, Santana Y. Smoking in young adolescents: an approach with multilevel discrete choice models. J Epidemiol Community Health. 2002;56:227–32.
Andrews JA, Duncan SC. The effect of attitude on the development of adolescent cigarette use. J Subst Abuse. 1998;10:1–7.
Tucker JS, Ellickson PL, Klein DJ. Predictors of the transition to regular smoking during adolescence and young adulthood. J Adolesc Health. 2003;32:314–24.
Tyas SL, Pederson LL. Psychosocial factors related to adolescent smoking: a critical review of the literature. Tob Control. 1998;7:409–20.
Conrad KM, Flay BR, Hill D. Why children start smoking cigarettes: predictors of onset. Br J Addict. 1992;87:1711–24.
WHO. WHO Report on the global tobacco epidemic. Country profiles for Russian Federation and Finland. Geneva: World Health Organisation; 2013. Available from: http://www.who.int/tobacco/surveillance/policy/country_profile/.
Perlman F, Bobak M, Gilmore A, McKee M. Trends in the prevalence of smoking in Russia during the transition to a market economy. Tob Control. 2007;16:299–305.
Baška T, Warren CW, Bašková M, Jones NR. Prevalence of youth cigarette smoking and selected social factors in 25 European countries: findings from the Global Youth Tobacco Survey. IJPH. 2009;54:439–45.
Luopa P, Kivimäki H, Matikka A, Vilkki S, Jokela J, Laukkarinen E, Paananen R. Wellbeing among adolescents in Finland, 2000-2013. Results of the school health survey. [In Finnish]. National Institute for Health and Welfare, report 25/2014. Available from: http://urn.fi/URN:ISBN:978-952-302-280-5
Helldan A, Helakorpi S, Virtanen J. Health behavior and health among the Finnish adult population. 2013. Available from: http://urn.fi/URN:ISBN:978-952-302-051-1.
Vartiainen E, Pallonen U, McAlister A, Puska P. Eight-year follow-up results of an adolescent smoking prevention program: the North-Karelia Youth Project. AJPH. 1990;80:78–9.
Kemppainen U, Tossavainen K, Vartiainen E, Jokela V, Puska P, Pantelejev V, et al. Environmental factors as predictors of smoking among ninth-grade adolescents in Pitkäranta (Russian Karelia) and in Eastern Finland. Res Nurs Health. 2006;29:543–55.
Metsämuuronen J. Tutkimuksen tekemisen perusteet ihmistieteissä. Tutkijalaitos. 2nd edition. International Methelp Ky. Gummerus Oy, Jyväskylä, Finland, 2006. [In Finnish].
Kobus K. Peers and adolescent smoking. Addiction. 2003;98:37–55.
Difranza JR, Rigotti NA, Mcneill AD, Ockene JK, Savageau JA, St Cyr D, et al. Initial symptoms of nicotine dependence in adolescents. Tob Control. 2000;9:313–9.
Sussman S, Moran MB, Pokhrel P. Group identification. In Encyclopedia of adolescence. Springer US. 2012; pp. 1237-40
Glendinning A. Self-esteem and smoking in youth—muddying the waters? J Adolesc. 2002;25:415–25.
Kennedy DP, Tucker JS, Pollard MS, Go MH, Green HD. Adolescent romantic relationships and change in smoking status. Addict Behav. 2011;36:320–6.
Etcheverry PE, Agnew CR. Romantic partner and friend influences on young adult cigarette smoking: comparing close others’ smoking and injunctive norms over time. Psychol Addict Behav. 2008;22:313–25.
Laatikainen T, Vartiainen E, Puska P. Comparing smoking and smoking cessation process in the Rebuplic of Karelia and North Karelia, Finland. JECH. 1999;53:528–34.
Vartiainen E, Seppälä T, Lillsunde P, Puska P. Validation of self-reported smoking by serum cotinine measurement in a community-based study. JECH. 2002;56:167–70.
Prokhorov AK, Murray DM, Whitbeck J. Three approaches to adolescents smoking detection. A comparison for of “expert” assessment, anonymous self-report, and co-measurement. Addict Behav. 1993;18:407–14.
Ennett ST, Bauman KE. The contribution of influence and selection to adolescents peer group homogeneity: the case of adolescent cigarette smoking. J Pers Soc Psychol. 1994;67:653–63.
Acknowledgments
This study belongs to a larger Finnish-Russian collaboration and research project ‘Addressing challenging health inequalities of children and youth between two Karelias, AHIC’ (www.uef.fi/ahic).
Authors’ Contributions
AA, TL and KT planned the study. AA and HI carried out the statistical analyses. AA drafted the manuscript that TL, KT, HI and GL critically reviewed and commented on. All authors have approved the final manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no competing interests.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Eastern Finland Committee on Research Ethics and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Funding
The study is a part of a more extensive project ‘Addressing challenging health inequalities of children and youth between two Karelias 2013-2014 (AHIC)’, which was administered by the University of Eastern Finland and received funding from the Karelia ENPI CBC programme (social wellbeing) by the European Union, the Russian Federation and the Republic of Finland. Corresponding author has received personal research grants from the University of Eastern Finland, Nurses Training Foundation (Finland) the Foundation of Marja-Terttu Korhonen (Finland) and the Foundation of Juho Vainio (Finland).
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Aura, A., Laatikainen, T., Isoaho, H. et al. Adolescents’ Attitudes on Smoking Are Related to Experimentation with Smoking, Daily Smoking and Best Friends’ Smoking in Two Karelias in Finland and in Russia. Int.J. Behav. Med. 23, 679–685 (2016). https://doi.org/10.1007/s12529-016-9566-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12529-016-9566-7