title: Ethnic differences in adolescent smoking prevalence in California: are multi-ethnic youth at higher risk?
abstract: OBJECTIVE
  Although ethnic differences in adolescent smoking have been well documented, smoking among multi-ethnic adolescents has received little research attention. This study examined smoking prevalence and tobacco related psychosocial risk factors among multi-ethnic adolescents in California, as compared with white, African American, Asian American, and Hispanic adolescents.
  
  
  METHODS
  This study used a cross sectional design. Data were obtained from the independent evaluation of the California Tobacco Control, Prevention, and Education Program.
  
  
  METHODS
  Students completed a paper-and-pencil survey in their classrooms.
  
  
  METHODS
  Data were collected from a stratified random sample of 5072 eighth grade students (age 13-14 years) in California during the 1996-97 school year. The data were weighted by school enrollment in analyses to make the estimates representative of the population of California students attending public schools.
  
  
  METHODS
  Outcome variables included self reported smoking prevalence, susceptibility to smoking, access to tobacco, and related attitudes, beliefs, and behaviours. Ethnicity was assessed with a self reported, "check all that apply" question.
  
  
  RESULTS
  Results indicated that multi-ethnic adolescents were at higher risk than single-ethnic adolescents on several variables, including 30 day cigarette smoking prevalence, lifetime smokeless tobacco use, buying cigarettes, receiving cigarette offers, and expected friends' reaction if the respondent smoked. For several other variables (lifetime cigarette smoking prevalence, susceptibility to smoking, and number of friends who smoked), Hispanic adolescents were at higher risk than all other ethnic groups including multi-ethnic adolescents. Although susceptibility to smoking was highest among Hispanics, multi-ethnic adolescents scored significantly higher on susceptibility than the three other single-ethnic groups.
  
  
  CONCLUSIONS
  Multi-ethnic adolescents may be at increased risk for smoking and may have easier access to cigarettes. Culturally targeted smoking prevention interventions for adolescents should address the unique social challenges faced by multi-ethnic adolescents that may increase their risk for smoking.
authors.affiliation: Institute for Health Promotion and Disease Prevention Research, University of Southern California School of Medicine, Los Angeles, CA 90033, USA. unger@hsc.usc.edu
authors.forename: J B
authors.initials: JB
authors.lastname: Unger
authors.forename: P H
authors.initials: PH
authors.lastname: Palmer
authors.forename: C W
authors.initials: CW
authors.lastname: Dent
authors.forename: L A
authors.initials: LA
authors.lastname: Rohrbach
authors.forename: C A
authors.initials: CA
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002140:California / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*