Meanings of smoking and adolescent smoking across ethnicities.
OBJECTIVE
To develop insight into population-specific meanings of smoking in our highly multicultural middle schools in order to provide effective and appropriate tools for smoking prevention efforts.


METHODS
We used focus group interviews to develop the Meanings of Smoking Index (MSI), a nine-item scale that uses a "mark all that apply" strategy to assess what smoking means to children who have tried smoking as well as to those who are susceptible to smoking. In 24 public and parochial middle schools in the greater Los Angeles area, 2336 7th graders (1483 Latino, 565 Asian/ Pacific Islander and 288 white, 55.2% of the sample was female) completed the MSI as part of a school-based trial of culturally-targeted smoking prevention strategies. Items were rank ordered according to salience (rate of endorsement) and relevance (strength of relationship with lifetime smoking) across the entire sample and separately for Hispanic/Latino, Asian/Asian-American and white respondents. Spearman correlation coefficient was used to compare results between ethnicities.


RESULTS
The most frequently endorsed meanings were similar across ethnicities. Magnitude of associations between smoking behaviors and meanings were dissimilar across ethnicities. The meaning with the strongest relationship to lifetime smoking for whites and Latinos was "it helps me study" (OR 3.4 and 2.6 respectively), and for Asians was "don't want to make another smoke alone" (OR 5.4).


CONCLUSIONS
We have shown previously that interventions on meanings of eating behaviors changed dietary behaviors in adolescents. The present findings suggest that meanings are powerful determinants of adolescent smoking in culturally diverse populations and could offer powerful intervention tools to prevent adolescent smoking.
University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Institute of Health Promotion and Disease Prevention, 1000 S. Fremont, Rm. 4101, Alhambra, CA 91803, USA. dmetz@usc.edu
Donna
D
Spruijt-Metz
Peggy E
PE
Gallaher
Jennifer B
JB
Unger
Carl
C
Anderson-Johnson
D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology* / Q000523:psychology; D001213:Asian / Q000523:psychology*; D002648:Child; D005260:Female; D017144:Focus Groups; D006293:Health Promotion; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D009042:Motivation; D010379:Peer Group; D012572:School Health Services; D012907:Smoking / Q000208:ethnology* / Q000523:psychology; D000074606:Smoking Prevention; D040241:Social Marketing; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology*