title: Tobacco use and smoking intentions among U.S. fifth-grade students.
abstract: OBJECTIVE
  To identify the risk and protective factors for cigarette smoking and future intentions among racially/ethnically diverse preadolescent children.
  
  
  METHODS
  We analyzed data from 5,119 fifth-grade children and their parents living in three U.S. metropolitan areas. Using the multivariate logistic regression models, we examined how cigarette smoking and intentions to smoke within 1 year are associated with (1) number of friends who smoke, (2) parental disapproval of smoking, (3) parental communication about not smoking, (4) performance in school, and (5) educational aspirations.
  
  
  RESULTS
  Twenty-nine percent of the children were black, 44% were Hispanic, 22% were white, and 5% were of another race/ethnicity. Mean age was 11.1 years. The prevalence of ever smoking a cigarette among black, Hispanic, and white children was 9.8%, 5.6%, and 4.9%, respectively. In adjusted analyses, children were more likely to have smoked a cigarette if their friends smoked (adjusted odds ratio [aOR] 5.1, 95% confidence interval [CI] 3.8-6.9), they frequently had trouble with schoolwork (aOR 2.1, 95% CI 1.5-3.1), or their parents were not college graduates (aOR 2.0, 95% CI 1.2-3.5 for high school graduate). They were less likely to have smoked cigarettes if their parents disapproved of smoking (aOR .3, 95% CI .1-.6). Parental communication (aOR .1, 95% CI .0-.6) and disapproval (aOR .2, 95% CI .1-.7) had protective associations for future intentions among children who had ever and had never smoked, respectively.
  
  
  CONCLUSIONS
  Fifth-graders share many of the same risk factors for smoking identified in older adolescents, some of which are modifiable. Antismoking policies and programs should be designed for preadolescents as well as adolescents, and campaigns targeting parents should place greater emphasis on communication and expressed disapproval of smoking.
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, New York. Electronic address: joseph.ladapo@nyumc.org.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Ladapo
authors.affiliation: RAND, Santa Monica, California.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Elliott
authors.affiliation: RAND, Santa Monica, California.
authors.forename: David E
authors.initials: DE
authors.lastname: Kanouse
authors.affiliation: Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Tortolero
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia.
authors.forename: Michael
authors.initials: M
authors.lastname: Windle
authors.affiliation: Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Cuccaro
authors.affiliation: Department of Health Behavior, University of Alabama-Birmingham School of Public Health, Birmingham, Alabama.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Davies
authors.affiliation: Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Boston, Massachusetts; Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schuster
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: Preadolescent children; Smoking; Tobacco