title: Attitudinal factors protective against youth smoking: an integrative review.
abstract: OBJECTIVE
  This review examines recent literature with the purpose of uncovering associations between attitudinal factors and smoking among youth populations.
  
  
  METHODS
  Researchers conducted an integrative review of the literature in late 2012 and early 2013. As inclusion criteria, potential articles were measured against the following statement: "There is valid evidence of (an) attitudinal factor(s) potentially associated with smoking among youth."
  
  
  RESULTS
  Researchers employed the salutogenic model as a theoretical framework to analyze search results. The narrative synthesis indicates that primary attitudinal factors protective against smoking among youth include the following: (a) a perception that there is little benefit to smoking, (b) a belief that smoking is likely harmful and addictive in the short term, and (c) a denial that smoking provides stress abatement, makes one look cool or more grown-up, or is common and accepted. Moreover, research signals that youth who smoke often demonstrate essentially the opposite beliefs and attitudes.
  
  
  CONCLUSIONS
  Findings suggest attitudinal factors play a role in protection against youth smoking. Those youth who assign realistic values to smoking risks and benefits are more equipped to engage in the health-protective behavior of not smoking. Youth, adolescents, and young adults appear vulnerable to inappropriate designation of risk and benefit values of smoking. Theoretical interpretation suggests that bolstering attitudinal factors during youth might counteract immature risk assessment. These findings justify further research related to protective mechanisms against youth smoking and youth-based smoking prevention interventions.
  
  
  CONCLUSIONS
  The establishment of associations between attitudinal factors and protection against smoking can help determine interventions effective in reducing smoking among youth.
authors.affiliation: Tau Kappa, Nurse Practitioner, Interventional Pain and Physical Medicine Clinic, Sartell, MN.
authors.forename: Carissa Renée
authors.initials: CR
authors.lastname: Arens
authors.forename: Tiffany Lynn
authors.initials: TL
authors.lastname: White
authors.forename: Nichole
authors.initials: N
authors.lastname: Massengill
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D006801:Humans; D018570:Risk Assessment; D012907:Smoking / Q000523:psychology*; D000074606:Smoking Prevention; D055815:Young Adult
keywords: Attitude; health promotion; prevention; salutogenic; sense of coherence; smoking; youth