A Multilevel Approach on Determinants of Smoking Behavior for Individual, School and Neighborhood Effects among White and African American Adolescents: Focused on Parental and Peer Smoking and School Education and State Policy for Adolescent Smoking

The purpose of this study is to identify determinants of smoking behavior among White and African American adolescents. The sample includes 7694 White and 3238 African American adolescents in grades 7 to 12 that participated in Wave I of the National Longitudinal Study of Adolescent Health as a nationally representative data. Hierachical Linear Model and SAS 9.1 are employed to define determinants of adolescent smoking behavior. White and Black adolescents having parents with smoking more cigarettes are more likely to engage in cigarette smoking (White: OR=1.52, Black: OR=1.28). The strongest determinant is the friends' smoking in both ethnicities (White: OR=2.28, Black: OR=1.51). Older adolescents are more smoking cigarettes in White (OR=1.16) and Black (OR=1.07) adolescents. Adolescents with higher religiosity smoke less cigarettes (White: OR=0.81, Black: OR=0.73). White adolescents (OR= 1.00) who live in areas with lower level of median household income smoke more cigarettes than others, whereas, Black adolescents are not associated with this factor. Gender, total crime rates, school type (private & public) and school location (urban & rural) are not associated with smoking behavior. The requirement of school education for smoking prevention, recommendations from State about concerning tobacco use policies in State and including rules against student smoking in school are not associated with smoking cigarettes in both ethnicities. The implications of these findings of parent and peer smoking toward adolescent smoking behavior must be considered for implementing interventions and education. School education and policies in school and State should be evaluated to reduce adolescent smoking behavior.