title: Identifying demographic and psychosocial factors related to the escalation of smoking behavior among Mexican American adolescents.
abstract: Cigarette smoking is the leading preventable cause of death in the United States; smoking in Mexican American adolescents, a rapidly growing population, remains a major concern. Factors associated with escalation or progression along the smoking trajectory have not been studied in adolescent Mexican Americans. A better understanding of escalation is needed for cancer prevention and overall health. N=1,328 Mexican American adolescents joined a cohort in 2005-06. At baseline participants provided demographic, acculturation and psychosocial data, and reported their smoking status using the Minnesota Smoking Index. Those that never tried a cigarette or only had a few puffs in their life were included in this study. The primary outcome of interest, escalation in smoking status, was defined as moving up the Minnesota Smoking Index by 2010-2011. The current analysis is based on 973 participants of whom 48.2% were male, mean age=11.8 (SD=0.8), and 26.0% were born in Mexico. By 2010-2011, 283 (29%) escalated their smoking status and 690 (71%) remained the same. Being older (OR=1.30; CI=1.07-1.57), male (OR=1.88, CI=1.40-2.53), having higher levels of anxiety (OR=1.03, CI=1.02-1.05), intending to smoke (OR=1.70, CI=1.18-2.46), having friends who smoke (OR=1.73, CI=1.12-2.70) and having parents' friends who smoke (OR=1.38, CI=1.02-1.88) increased risk for smoking escalation. Higher levels of subjective social status (OR=0.91, CI=0.83-0.99) were protective against smoking escalation. Contrasting previous work in smoking experimentation, parents' friends influence was a stronger predictor than the family household influence. Preventative interventions for Mexican American youth could address this risk factor to reduce smoking escalation.
authors.affiliation: Trinity University, San Antonio, TX, USA.
authors.forename: Sahil S
authors.initials: SS
authors.lastname: Shete
authors.affiliation: The University of Texas School of Public Health, Michael and Susan Dell Center for Healthy Living, Austin, TX, USA. Electronic address: anna.v.wilkinson@uth.tmc.edu.
authors.forename: Anna V
authors.initials: AV
authors.lastname: Wilkinson
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D015331:Cohort Studies; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000523:psychology*; D008800:Mexico / Q000208:ethnology; D010379:Peer Group; D012907:Smoking / Q000523:psychology*; D012931:Social Environment; D014481:United States
keywords: Adolescent smoking; Mexican American youth; Minnesota Smoking Index; Smoking escalation