Positive and negative outcome expectations of smoking: Implications for prevention

Background. To inform the development of messages for tobacco prevention pr ograms, we examined seven positive and five negative outcome expectations o f smoking as risk factors for smoking uptake. Methods. A cross-sectional, self-administered survey of 471 students in gra des 6-12 who were never or experimental smokers was performed. Logistic reg ression was used to examine the relationship between outcome expectations a nd susceptibility to becoming a smoker in the future, a measure of intent a nd resistance to peer smoking. Results. A total of 36.1% of the sample was susceptible to smoking, All pos itive outcome expectations showed a strong and significant association with susceptibility. Students were most likely to be susceptible if they believ ed they would enjoy smoking (OR = 29.4). Three of the five negative outcome expectations were significantly associated with susceptibility, but the st rength of these associations was much lower than that observed for the posi tive expectations (OR = 0.5 to 0.6). A strong belief in the negative outcom es of smoking did not alter the association between susceptibility and posi tive outcome expectations. Conclusions. These findings suggest that teaching adolescents and teens abo ut the negative consequences of smoking is unlikely to change their intent to smoke. Preventive efforts should identify ways to address the positive e xpectations adolescents have about smoking, possibly by offering alternativ e means for achieving these outcomes, (C) 1999 American Health Foundation a nd Academic Press.