Which specific components of media literacy are most strongly associated with adolescent smoking?

Background: Media literacy is currently recommended to reduce adolescent smoking. However, media literacy is a multifaceted construct based on a complex theoretical model. The purpose of this study was to determine which particular components of media literacy are most strongly associated with clinically significant measures of smoking.

Methods: We asked all students at a large public high school to respond to items measuring 1) smoking and smoking susceptibility, 2) different components of media literacy based on a reliable and valid scale, and 3) eighteen demographic, intrinsic, and environmental covariates previously shown to be related to smoking. We used logistic regression to determine which media literacy items were independently associated with each smoking outcome.

Results: Of the 1211 participants, 19% were current smokers (N = 216) and 40% of the non-smokers (N = 342) were susceptible to future smoking. In the fully adjusted and trimmed models, the majority of the media literacy items most strongly related to current smoking represented the “representation-reality” domain of media literacy. The vast majority (13 of the 18 items) had significant independent relationships with the outcome of susceptibility to smoking, and these items evenly represented each of the domains of media literacy: “authors and audiences,” “messages and meanings,” and “representation and reality.”

Discussion: It may be valuable for practitioners to teach each of the various domains of media literacy in order to reduce adolescent smoking, but particular emphasis may be appropriately placed on teaching in the “representation-reality” domain when media literacy is used for this purpose.