title: Perceptions of second-hand smoke risks predict future adolescent smoking initiation.
abstract: OBJECTIVE
  To directly test whether perceptions of second-hand smoke risks deter adolescent smoking initiation.
  
  
  METHODS
  A longitudinal survey design was utilized in this study. Baseline surveys measuring perceptions of tobacco-related risks and smoking behaviors were administered to 395 high school students, with three follow-up assessments every 6 months.
  
  
  RESULTS
  Perceptions of personal second-hand smoke risks and parental second-hand smoke risks significantly deterred adolescent smoking initiation. Perceptions of personal second-hand smoke risks reduced the odds of smoking by a factor of 0.63 (95% confidence interval [CI]=0.42-0.94) for each quartile increase in perceptions of personal second-hand smoke risks. Adolescents who provided the highest estimates of risks for personal second-hand smoke were 0.25 as likely to smoke as adolescents who provided the lowest estimates of risk. Perceptions of parental second-hand smoke risks reduced the odds of smoking by a factor of 0.64 (95% CI=0.43-0.93) for each quartile increase. Adolescents who perceived the highest estimates of risks associated with parental second-hand smoke were 0.26 as likely to smoke in the future compared to adolescents who provided the lowest estimates of risk. These effects are over three times as large as a smoking peer's influence on a nonsmoking adolescents' risk for smoking initiation, odds ratio [OR]=1.18 (95% CI=1.02-1.35).
  
  
  CONCLUSIONS
  Adolescent perceptions of risks of second-hand smoke are strongly associated with smoking initiation. Encouraging adolescents to express their objections to second-hand smoke, as well as encouraging parents to create smoke-free homes, may be powerful tobacco control strategies against adolescent smoking.
authors.affiliation: University of California, Merced, School of Social Sciences, Humanities, and Arts, Psychological Sciences, Merced, California 95343, USA. anna.song@ucmerced.edu
authors.forename: Anna V
authors.initials: AV
authors.lastname: Song
authors.forename: Stanton A
authors.initials: SA
authors.lastname: Glantz
authors.forename: Bonnie L
authors.initials: BL
authors.lastname: Halpern-Felsher
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001294:Attitude to Health; D002140:California / Q000453:epidemiology; D002648:Child; D003657:Decision Making; D005163:Factor Analysis, Statistical; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology; D014028:Tobacco Smoke Pollution
chemical_list: D014028:Tobacco Smoke Pollution