Adolescents' attempts to influence the smoking behavior of friends: What determines promotion of risk versus protection?

Background: Peers are an important influence on health-related behaviors during adolescence. Most research has examined how peers promote risk, rather than promote health protective behavior. Objectives: We examine (1) adolescents' report of 7 actions to promote or deter friends' smoking, and (2) whether actions vary by gender, having close friendships with peers who smoke daily, and one's own smoking experience. Methods: Data were collected between 2001 and 2004 from an ethnically diverse sample of 9th and 10th grade adolescents attending two public high schools (N=392; 53% female). Results: 15% of adolescents lent money for cigarettes, 12% tried to get a friend to smoke, 14% offered a cigarette, 42% tried to prevent a friend from starting, 46% tried to get a friend to quit, 49% asked a friend not to smoke, and 30% took a cigarette away from a friend. Logistic regression showed that adolescents with smoking experience were more likely than never-smokers to report each action. Girls were more likely than boys to deter smoking. Adolescents reporting close friendships with daily smokers were more likely to promote smoking and to take away cigarettes. Among the 155 adolescents with any smoking experience, those who reported positive consequences of smoking (e.g., felt relaxed, looked cool) were more likely to promote friends' smoking, while those who reported negative consequences (e.g., had a bad cough, got into trouble) were more likely to ask friends not to smoke or encourage quitting. Conclusion: Adolescents who experience negative consequences of risk-taking may be a resource in designing and delivering health promotion interventions.