Selected Studies* and Reports on Teen Smoking

Underage Smoking Rates and Measurement

"Among [underage smoking] experimenters (l989), 25.7% of whites and 10.3% of blacks had progressed to current smoking (l993)."

"This suggested that individuals who were nonsmokers or regular smokers were classified with better than 95% accuracy on the basis of report data. However, the reporting accuracy of occasional smoking was poor, with 42% of occasional smokers being falsely classified as nonsmokers."

"This [media] campaign supplements a school smoking prevention program and shares educational objectives with the school program but is otherwise independent. It comprises various television and radio 30- and 60-sec ‘spot’ messages. The campaign development process includes identifying educational objectives and strategies for appealing to young people; conducting diagnostic surveys and focus groups to determine target audience interests and perceptions about smoking and media content; suggesting approaches to producers to create preliminary television and radio messages for testing; conducting formative pretests with target groups to select optimal messages and suggest improvements to those messages; producing final messages for media presentation; and developing a media exposure plan to place messages in local media at optimal times for reception by target audiences."

"The radio campaign had a modest influence on the expected consequences of smoking and friend approval of smoking, the more expensive campaigns involving television were not more effective than those with radio alone, the peer-involvement component was not effective, and any potential smoking effects could not be detected."

"The results presented in this paper indicate that the Minnesota initiative dramatically increased Minnesota schoolchildren’s reported exposure to the anti-smoking messages in the mass media but had little effect on smoking-related beliefs or smoking behaviors. CONCLUSIONS. These results, together with the findings from other recent studies, suggest that even dramatic increases in exposure to anti-tobacco messages in the mass-media, in the absence of a substantial and sustained school-based tobacco prevention measures [sic], may be insufficient to generate reductions in adolescent tobacco use."

". . .frequency of exposure to anti-tobacco advertisements was correlated with an increased likelihood of smoking."

In l992 California spent approximately $16 million on its anti-tobacco media campaign. The percentage of California children 12-17 years old who reported smoking regularly was under 9% that year. In l996 when California stepped up its anti-tobacco media campaign and increased funding to nearly $26 million, the percentage of 12-17 year olds who reported smoking regularly was just under 12%, a shocking 30% rise. The campaign has failed to stem rising youth smoking rates in the state.

"We find there is a direct correlation between funding and support for tobacco control programs and reducing the use of tobacco."

"[California] has spent an average of $135 million during each of the past eight years urging adults and teens alike not to smoke. For a while, the smoking rate there declined slightly but, more recently, it has begun increasing again. According to officials from the U.S. Centers for Disease Control and Prevention who met with Florida legislators last week, no one really knows whether the California ad campaign did any good, and if it did, how."

"In December [l993], John Pierce of the University of California-San Diego, reported at the first scientific conference of the California Tobacco-Related Disease Research Program in San Francisco that ‘while adults have dropped it like a stone,’ smoking by teenagers suddenly began to rise in l988 after declining about one percent a year over the previous 15 years."

"This article presents the results of a meta-analysis designed to test the prevailing view that we largely understand why adolescents start to smoke and how to delay it. This view has developed even though none of the major reviews of the last 12 years has adjusted for the important methodological problems that all of those reviews identified as common in the published literature. School-based smoking prevention programs based on peer or social-type programs, published between l974 and l991, were included in this meta-analysis. . . . The results suggest that the average effect for peer or social-type programs is likely to be quite limited in magnitude, and that the reduction in smoking may be only 0.10 standard deviation units, or perhaps 5%. Even under optimal conditions, the reduction in smoking may be only 0.50 to 0.76 standard deviation units, or perhaps 20% to 30%."

In Project Toward No Tobacco Use, a prevention program funded by the National Cancer Institute and tested on 7,000 12-year-olds by [Steve] Sussman’s group, researchers found that teaching assertion skills can help young people refuse offers of tobacco."

"Analyses indicated that each of the component programs were effective in decreasing both the initial and the weekly use of cigarettes except for the curriculum in which refusal skills were taught," [emphasis added].

"The Health of the nation aims ‘to reduce the number of young people who start to smoke.’ Smokebusters is a specific health promotion approach with the aim of encouraging non-smoking as the norm and developing a non-smoking peer group [target group: 10-13-year-olds]. . . .CONCLUSIONS: Membership of Smokebusters does not seem to reduce the smoking prevalence among young people."

"Our data allowed us to directly examine the impact of changes in tax rates on youth smoking behavior and our results indicate this impact is small or nonexistent."

"CONCLUSION: Availability of cheaper cigarettes is not likely to be a cause of increased smoking initiation by adolescents."

"Enforcing tobacco-sales laws improved merchants’ compliance and reduced illegal sales to minors but did not alter adolescents’ perceived access to tobacco or their smoking. Test purchases of tobacco do not accurately reflect adolescents’ self-reported access to tobacco, and reducing illegal sales to less than 20 percent of attempts -- the goal of a new federal law -- may not decrease young people’s access to or use of tobacco."

"The availability of cigarettes to minors remained high in l998, according to both eighth- and 10th-graders. (Twelfth-graders are not asked the question, since availability for them is assumed to be nearly universal.) Nearly three out of every four eighth-graders (73.6 percent), and nine of every ten 10th-graders (88.1 percent) say that cigarettes would be ‘fairly easy’ or ‘very easy’ to get if they wanted some. As high as these rates are, they actually reflect some decline from even higher levels two years ago. Cigarette availability has declined by 3.3 percentage points among eighth-graders and 3.2 percentage points among 10th-graders since l996."

"Merchant sales rates in Woodridge decreased from a baseline of 70% before legislation to less than 5% in 1.5 years of compliance checking after legislation. Student surveys showed that the rates of cigarette experimentation and regular use of cigarettes by adolescents were reduced by over 50%."

"CONCLUSIONS: This study provides compelling evidence that policies designed to reduce youth access to tobacco can have a significant effect on adolescent smoking rates."

"Students’ knowledge of health risks of smoking exceeded 95 percent but was of little concern for 70 percent of the smokers."

"Greater knowledge of cigarette package warning labels was significantly associated with higher levels of smoking."

School-based Tobacco Prevention Programs

"Massachusetts spends six times as much money as Michigan on anti-tobacco education, but more Boston teen-agers smoke than those in Detroit."

"In short, American kids have been exposed in recent years to the most intense antismoking campaign in history. The result? An explosion of teenage smoking."

"At the end of fifth grade, only 4.8% of the subjects indicated that they had experimented with tobacco. School intervention condition [school-based program] was not a factor in the prediction of experimentation. Those whose best friend or sibling smoked, or who had ready access to cigarettes in the home, were more likely to have experimented with smoking."

"The data show a strong and progressive relationship between indicators of ‘alienation’ from school, and health compromising behaviours among school students from Australia and Wales. This relationship is most obvious with the ‘abusive’ behaviours of smoking and alcohol misuse. Summary data for nine other countries in the WHO study indicate that this relationship is found consistently in all countries in the study."

"These findings suggest that the intervention [school-based eating disorder prevention program] had been counterproductive since it led to an increase in dietary restraint [eating disorder]. They imply that school-based prevention programs may do more harm than good."

"School-based social influence programs to prevent adolescent smoking are having limited success in the long term. . . .[A]uthoritative parenting was inversely related to rates of child smoking intention and behaviors. . . ."