title: Social influences and self-efficacy as predictors of youth smoking initiation and cessation: a 3-year longitudinal study of vocational high school students in Taiwan.
abstract: OBJECTIVE
  This 3-year longitudinal study examined changes in patterns of risk factors and protective factors of smoking initiation and cessation among vocational high school students in Taipei, Taiwan.
  
  
  METHODS
  In 2000, a total of 2151 10th grade students from 16 vocational high schools were assessed and followed up in the 11th and 12th grades. Self-administered questionnaires were collected in each year to assess the pattern of changes in smoking behaviors, and risk and protective factors.
  
  
  RESULTS
  Of the 1654 non-smokers in the 10th grade, 227 students initiated smoking by the 12th grade. Higher risk factors such as peer smoking, peers offering cigarettes, alcohol use and lower protective factors, such as refusal self-efficacy, antismoking attitude and belief in the 10th grade predicted youth initiation by grade 12. Increases in risk factors and decreases in protective factors during the years from 10th to 12th grades were associated significantly with youth smoking initiation. Of the 494 smokers in the 10th grade, 76 students quit smoking by the 12th grade. Lower risk factors and higher protective factors in 10th grade smokers predict youth smoking cessation by grade 12. Decreases in risk factors and increases in protective factors were associated significantly with youth smoking cessation.
  
  
  CONCLUSIONS
  The risk factors (i.e. social influences) and protective factors (i.e. self-efficacy) examined in this study predict both youth smoking initiation and youth smoking cessation.
authors.affiliation: University of California at Berkeley, CA, USA. fongchingchang@berkeley.edu
authors.forename: Fong-Ching
authors.initials: FC
authors.lastname: Chang
authors.forename: Ching-Mei
authors.initials: CM
authors.lastname: Lee
authors.forename: Hsiang-Ru
authors.initials: HR
authors.lastname: Lai
authors.forename: Jeng-Tung
authors.initials: JT
authors.lastname: Chiang
authors.forename: Pi-Hsia
authors.initials: PH
authors.lastname: Lee
authors.forename: Wen-Jau
authors.initials: WJ
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D020377:Self Efficacy; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology