206903 Social and Environmental Predictors of Smoking Initiation in Diverse Maryland Adolescents

Sunday, November 8, 2009

Carolyn Voorhees, MS, PhD , Department of Public and Community Health, University of Maryland School of Public Health, College Park, MD
Cong Ye, MS , Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD
Olivia Carter-Pokras, PhD , Department of Epidemiology & Biostatistics, University of Maryland, Silver Spring, MD
Guangyu Zhang, PhD , School of Public Health - Epidemiolgy and Biostatistics, University of Maryland, College Park, MD
Mariano Kanamori, MA , PhD Program. Department of Epidemiology and Biostatistics., University of Maryland College Park School of Public Health, College Park, MD
Robert Fiedler , Family Health Administration, Maryland Department of Health and Mental Hygiene, Baltinore, MD

Little is known regarding social and environmental factors that may be associated with smoking onset. Further understanding may aid in prevention efforts consistent with HP 2010 objectives.


This study investigates multiple factors associated with adolescent initiation in the Maryland Youth Tobacco Survey, one of the largest and most diverse school-based surveys in the U.S.(308 middle and high schools; n=82,500) including 1,969 American Indians, 3,226 Asians, 20,739 Blacks, 3,898 Hispanics, and 1,015 Native Hawaiian/Pacific Islanders. The questionnaire was administered in paper-and-pencil format either in individual classrooms or in alternative locations using CDC protocols.


Black youth were less likely to initiate smoking during the past year compared to White or Hispanic youth. Bivariate analyses show that youth living with current smokers were significantly more likely to initiate smoking as were youth reporting second hand smoke exposure in rooms or car, reporting exposure to Internet or other advertisements for commercial tobacco products, having more friends that smoke, having friends offer tobacco products, or using other tobacco products such as smokeless tobacco and cigars. Multivariate analyses results show that composite measures for peer influence, advertising exposure and home exposure to second hand smoke were significantly related to smoking initiation in this diverse sample. Differences stratified by racial ethnic group will also be reported.


Many social and environmental factors influence smoking initiation, are common to all racial/ethnic groups in this study, and need to be addressed by a combination of targeted public awareness, education and media campaigns directed at parents/gaurdians.

Learning Objectives:
Describe factors associated with smoking initiation for diverse groups of adolescents Compare how multiple level risk factors differ or are similar among racial/ethnic groups Discuss potential strategies and partnerships needed to meet HP 2010 objectives

Keywords: Adolescent Health, Smoking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a coinvestigator on this study and have extensive research experience with issues related to smoking initiation in youth
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.