title: Adolescents' Attitudes on Smoking Are Related to Experimentation with Smoking, Daily Smoking and Best Friends' Smoking in Two Karelias in Finland and in Russia.
abstract: Becoming a smoker usually starts during adolescence and is a dynamic process involving experimentation before the establishment of daily smoking. It has been suggested that adolescents who smoke differ from those who do not in their attitudes to smoking. The purpose of this study was to find out whether attitudes related to smoking legislation and restrictions, social pressures in smoking and image of smokers are associated with smoking experimentation, daily smoking and best friends' smoking.
  
  
  
  The data were gathered with a self-administered questionnaire in North Karelia, Eastern Finland and in the Pitkyaranta district, Republic of Karelia, Russia. The respondents were 15-year-old 9th grade pupils in local schools. In Pitkyaranta, the data analyses covered pupils in all eight schools in the area (n = 179). In North Karelia, the data analyses comprised of selected eight schools (n = 601). Data were analysed with exploratory factor analysis.
  
  
  
  The models revealed that attitudes related to restrictions and social pressure were significantly associated with experimenting with smoking [OR (95 % CI) 7.923 (5.787-10.847)], daily smoking [OR (95 % CI) 9.575 (6.727-13.628)] and the likelihood of best friends' smoking [OR (95 % CI) 3.154 (2.579-3.858)]. The stronger the young peoples' attitudes and opinions, for example, towards restrictions and with more difficulties in refusing smoking, the higher the likelihood for smoking experimentations, daily smoking as well as the likelihood for their best friends' smoking. The country and factor interactions were not associated with smoking experimentations, daily smoking or best friends' smoking.
  
  
  
  Regardless of cultural background, adolescents who smoke have more positive attitudes to smoking, and perceive more social support for smoking, than do adolescents who do not smoke. The study stresses the similarity of the results in both Karelia's despite the enormous differences in culture, economy and public policy.
authors.affiliation: Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland. annamari.aura@uef.fi.
authors.forename: Annamari
authors.initials: A
authors.lastname: Aura
authors.affiliation: National Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland.|Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.|Hospital District of North Karelia, Tikkamäentie 16, 80210, Joensuu, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Laatikainen
authors.affiliation: Statcon Ltd., Salo, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Isoaho
authors.affiliation: State Budgetary Health Care Institution of the Republic of Karelia, Pitkyaranta, Russia.
authors.forename: Galina
authors.initials: G
authors.lastname: Lazutkina
authors.affiliation: Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
authors.forename: Kerttu
authors.initials: K
authors.lastname: Tossavainen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001290:Attitude; D005260:Female; D005387:Finland; D033062:Friends / Q000523:psychology*; D006801:Humans; D008297:Male; D012426:Russia; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: Adolescents; Attitudes; Peer; Smoking