Social Influences, and Attitudes and Beliefs Associated with Smoking among Border Latino Youth
Chalela, Patricia, Velez, Luis F., Ramirez, Amelie G., Journal of School Health
Tobacco use continues to be the leading cause of preventable death, disease, and excess health care costs. Smoking accounts for 440,000 annual deaths in the United States. Despite these facts, about 4400 children start experimenting with smoking every day, and of those, approximately 2000 will become addicted daily smokers into adulthood. (1-3)
Adolescent smoking rates have declined among all ethnic groups since the late 1990s. However, despite the recent declines and intervention efforts, today smoking remains a serious problem among youth, with a quarter of adolescents being current smokers by the time they complete 12th grade. (4) This problem is particularly prevalent among Latino youth, who have among the highest rates of lifetime and past-30-day use. (5,6)
National surveys have found current smoking prevalence rates for Latino 12th graders of 23.8%, compared to 35.3% for whites and 13.3% for African Americans. Lifetime use rates are 66.5% for white, 62.7% for Latino, and 44.6% for black 12th-grade students. (6,7) The 2001 Texas Youth Tobacco Survey revealed that among Latino youth, 15% of middle school students and 27% of high school students were current smokers. Lifetime use for middle and high school students was 35% and 64%, respectively. (8)
A study conducted among nonborder and border secondary students in Texas found similar prevalence rates for lifetime (51% and 52%, respectively) and current smoking (22% and 23%, respectively) among both groups. (9) Among Latino children, lifetime and current use of tobacco increased linearly and peaked at grade 11 or 12, with an average age at first use of 12.3 years. (9)
Previous epidemiological research on the etiology of smoking has focused on the psychosocial predictors of tobacco use. (10-20) These predictors are based on psychosocial models of human behavior, such as Social Cognitive Theory and the Theory of Planned Behavior, (21,22) and include a combination of social and personal factors: social bonds (families, school, religion), exposure to prosmoking social influences (peers, family, media), engagement in problem behavior, intentions to smoke in the future, and prosmoking attitudes and beliefs. (10-20) Social and commercial sources of cigarettes also play a significant role in the smoking behavior of youth. (23) Although all states have laws prohibiting the sale of tobacco products to minors, national studies have shown that 60-70% of youth were not asked for proof of age and successfully purchased cigarettes from commercial sources. (23,24)
Despite the large body of research, there is a lack of investigation into the association of social influences, and attitudes and beliefs with tobacco use among Mexico-US border Latino youth. Border communities are considered at greater risk for tobacco use due to the high concentration of low-income Latino youth and the geographic location, which facilitates the access of youth to tobacco products.
The aim of this study was to identify lifetime and past-30-day smoking prevalence rates and examine the association between psychosocial factors (including family and friends), attitudes and beliefs, and the smoking behavior of Latino youth living along the border. Such factors could guide the design of effective prevention and control programs tailored to the specific characteristics of this group.
Data Source This study uses baseline data from Sin Fumar, a smoking prevention program conducted among middle and high school students from a border school district in Texas from May 2000 to August 2001. Student involvement with smoking, alcohol, and drugs had been reported, but the real magnitude of the problems was unknown. After institutional review board approval for the study, 6 schools (2 high schools and 4 middle schools) were selected to participate, with about 4000 mostly Latinos (98%) students between the ages of 11 and 18 years.
In September 2000, a self-administered in-school questionnaire with no identifiers was given to all 7th through 12th graders whose parents authorized their participation. …