Impact of Environmental Factors on Smoking Initiation in Caribbean Adolescents

Background: Adolescent smoking is a global public health concern as only approximately half of smokers ever quit. Further, early initiation of smoking and tobacco use leads to many significant health issues including heart disease and lung cancer.

Methods: Participants included 1,369 adolescents (mean age=15.54, sd=1.56; 45.8% male and 52.9% female) enrolled in faith-based secondary schools in the Caribbean. Participants completed an IRB approved anonymous survey that included items regarding family situation and smoking behaviors.

Results: A logistic regression was performed on Smoking Status (never vs. have tried) and two predictor variables: Parental Monitoring, Social Circle Smokers. The model singificantly predicted Smoking Status, c²(2)=69.69, p<.001. Individually, Parental Monitoring significantly predicted smoking initiation; the more definitive rules parents placed on the adolescent, the less likely they were to have smoked, OR = .927, (95% CI=.880, .975). Social Circle Smokers also significantly predicted smoking initiation; as the number of smokers in the participant's social circle increased, the odds of the participant being a smoker also increased, OR = 1.38, (95% CI = 1.27, 1.50).

Conclusions: The study results suggest that the more parental monitoring (i.e. social/leisure time, appearance, and family involvement), the less likely adolescents are to initiate smoking. Conversely, the more smokers in an adolescent's family and peer group, the more likely they are to initiate smoking. This suggests that implementing definitive rules regarding social and familial behaviors as well as decreasing the amount of smokers in an adolescent's social circle may be important factors in prevention of youth smoking initiation.