'It won't happen to me': the knowledge-attitude nexus in adolescent smoking.
BACKGROUND
Behavioral models state that adolescents need not only to know about the dangers of smoking, but also to perceive themselves as susceptible to those dangers prior to modifying their smoking behavior. However, this hypothesis has not been tested in developing world settings where the context of tobacco use may differ.


METHODS
Survey data were collected from a sample of 1294 adolescents 13-20 years of age--from three under-privileged suburbs of Beirut, Lebanon. Scores were calculated to measure the knowledge of and the perceived susceptibility by a series of statements related to the consequences of tobacco use. Bivariate and multivariate methods were used to assess the association of knowledge and perceived susceptibility with smoking, controlling for socio-demographic variables.


RESULTS
A logistic regression model showed that the odds of ever smoking among adolescents who had less knowledge of smoking were 1.9 times those of adolescents with more knowledge. Similar odds were demonstrated for adolescents who did not perceive themselves susceptible to smoking hazards compared with those who did.


CONCLUSIONS
These results suggest that awareness campaigns should focus on raising the perceived susceptibility of adolescents by including items that are more within the realm of an adolescent's frame of mind such as smelly clothes and discolored teeth.
Department of Health Behavior and Education, Faculty of Health Sciences, American University of Beirut, Riad El Solh 1107 2020, Beirut, Lebanon.
Joumana S
JS
Yeretzian
Rema A
RA
Afifi
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003625:Data Collection; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007861:Lebanon; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D000297:Psychology, Adolescent; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000523:psychology*; D012959:Socioeconomic Factors; D013383:Suburban Population; D055815:Young Adult