Influence of subjective social status on the relationship between positive outcome expectations and experimentation with cigarettes.
OBJECTIVE
In Texas, Mexican American (MA) adolescents, and in particular boys, are at increased risk for experimenting with cigarettes compared with their black or white counterparts. Positive outcome expectations (POE), that is, the functional social significance ascribed to cigarettes, and subjective social status (SSS), that is, the adolescents' subjective views of where they lie in the school-based social hierarchy, are independent predictors of smoking. The goal of this study was to test the hypothesis that SSS moderates the relationship between POE and experimentation with cigarettes.


METHODS
Moderating effects of SSS were examined using a between-subjects, 2 x 2 analysis of variance and unconditional logistic regression analyses. Using a prospective study design, we followed 1142 MA adolescents aged 11-13 years. Participants completed a baseline survey at home, which assessed POE, SSS, and smoking and were followed via telephone at 6-month intervals over a 12-month period to assess changes in smoking behavior.


RESULTS
At follow-up, there were 99 new experimenters. Consistent with our hypothesis, adolescents who reported moderate-low SSS and who held POE at baseline were more likely to have experimented with cigarettes at either follow-up evaluation than their peers with moderate-low SSS who held less POE (odds ratio [OR], 1.92, 95% confidence interval [95% CI], 1.02-3.58). There was no association between outcome expectations and experimenting among adolescents with high SSS (OR, 1.79, CI, .73-4.36). Low SSS boys were more likely to experiment than girls and high SSS boys.


CONCLUSIONS
The results of this study indicate that adolescents with moderate-low SSS hold different outcome expectations about smoking than their higher SSS peers. The results underscore the possibility that moderate-low SSS adolescents view behaviors such as smoking as a way to achieve higher SSS and thereby increase their peer social standing. Our results suggest that, in addition to tailoring intervention efforts by gender, placing adolescents of similar social standing to one another within the school into intervention groups that are led by a peer-nominated peer may increase the overall effectiveness of these peer-led prevention efforts.
Wilkinson
Anna V
AV
Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77230-1439, USA. awilkins@mdanderson.org
Shete
Sanjay
S
Vasudevan
Vandita
V
Prokhorov
Alexander V
AV
Bondy
Melissa L
ML
Spitz
Margaret R
MR
D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D017058:Mexican Americans; D010379:Peer Group; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D012938:Social Perception; D013781:Texas / Q000453:epidemiology