Adolescent-derived definitions of smoker types

Youth-centered smoking prevention strategies have often relied on communicating heath messages that “smoking is unhealthy,” and that “smokers should quit.” This approach may be problematic, as research-based definitions of what constitutes smoking may differ from adolescent-derived definitions. We investigated how adolescents define different smoking labels (smoker, non-smoker, addicted smoker, regular smoker, experimental smoker, casual smoker, heavy smoker, and social smoker) using multiple indicators of smoking behaviors, including smoking frequency, amount of cigarettes smoked, place of smoking, and length of time smoking, and whether differences exist by gender, race/ethnicity, and smoking experience. Data were from a school-based study of adolescents (N=372) in northern California. Preliminary analyses indicate that while the majority of adolescents characterize a non-smoker as never smokes (87.6%), smokes 0 cigarettes (90.1%), and smokes nowhere (91.1%), there is a large variation in other categories of smoker types. Adolescents do not distinguish between 1) smoker and regular smoker and 2) addicted smoker and heavy smoker in terms of smoking frequency, amount of cigarettes smoked, and place of smoking. In addition, the concept of nicotine addiction may not be fully understood among adolescents: 54.0% of adolescents characterized an addicted smoker as having smoked for more than a few years, which may have implications for adolescents' susceptibility to initiate cigarette smoking and their perceived risk and/or ease of cessation. Our initial results suggest that greater attention be directed to understanding the nuances of how adolescents define smoking in order to maximize the effectiveness of youth-centered smoking prevention and cessation messages.