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How do psychological factors influence adolescent smoking progression? The evidence for indirect effects through tobacco advertising receptivity.

Audrain-McGovern J, Rodriguez D, Patel V, Faith MS, Rodgers K, Cuevas J

Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA. audrain@mail.med.upenn.edu

OBJECTIVES: To determine whether novelty seeking and depressive symptoms had mediated or indirect effects on adolescent smoking progression through tobacco advertising receptivity. METHODS: More than 1000 adolescents were monitored from 9th grade to 12th grade and completed annual surveys that measured demographic characteristics, smoking behavior, tobacco advertising receptivity, novelty-seeking personality, depressive symptoms, family and peer smoking, alcohol use, and marijuana use. RESULTS: Latent growth modeling indicated that novelty seeking had a significant indirect effect on smoking progression through baseline tobacco advertising receptivity. For each 1-SD increase in novelty seeking, the odds of being more receptive to tobacco advertising increased by 12% (ie, being in a specific category or higher), which in turn resulted in an 11% increase in the odds of smoking progression from 9th grade to 12th grade. The indirect effect from depressive symptoms to smoking progression did not reach significance. CONCLUSIONS: These findings may inform future research on other factors that influence tobacco advertising receptivity, as well as programs aimed at preventing adolescent smoking initiation and progression.

Published 4 April 2006 in Pediatrics, 117(4): 1216-25.
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