Psychosocial determinants of the onset and escalation of smoking: Cross-sectional and prospective findings in multiethnic middle school samples

Purpose: To investigate a broad range of social influence-related and globa l determinants of smoking to aid in the design of comprehensive multiethnic interventions by testing the most important factors of initiation and esca lation of smoking across various subgroups. Methods: Cross-sectional (N = 2546) and cohort (N = 736) samples of multiet hnic middle school students near a large Southwestern metropolis were surve yed through self-report questionnaires. The confidential questionnaires inc luded information on demographics, risk factors, and smoking behavior and w ere administered in class by trained data collectors. Multivariable logisti c regression analysis was used to examine the statistical significance and strength of the factors. Results: Those lower in self-esteem and higher in social assertiveness appe ared to be most at risk for the onset of smoking, whereas those low in opti mism appeared to be the most at risk for the escalation of smoking. Attitud es, friends' norms, parents' norms, perceived behavioral control, and perce ived prevalence were consistent predictors of all smoking status outcomes. Conclusions: The behavioral-specific determinants of smoking: appear to be important predictors of smoking status outcomes in all demographic subgroup s. The relationships of the global determinants were more dependent on the smoking outcome variable and subgroup examined. The findings may serve to h elp facilitate the targeting of comprehensive interventions aimed at reduci ng adolescent smoking in multiethnic and ethnic group-specific populations. (C) Society for Adolescent Medicine, 2000.