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Competence skills help deter smoking among inner city adolescents
  1. Jennifer A Epstein,
  2. Kenneth W Griffin,
  3. Gilbert J Botvin
  1. Institute for Prevention Research, Cornell University Medical College, New York, USA
  1. Dr Jennifer A Epstein, Institute for Prevention Research, Cornell University Medical College, 411 East 69th Street, KB 201, New York, NY 10021, USA;jepstein{at}


OBJECTIVE To test whether higher levels of general competence are linked to more frequent use of refusal assertiveness that is in turn related to less subsequent smoking among inner city adolescents.

METHODS Longitudinal study conducted during three year middle school or junior high school period. A sample of 1459 students attending 22 middle (ages 11–14 years) and junior high (ages 12–15 years) schools in New York City participated. Students completed surveys at baseline, one year follow up, and two year follow up. The students self reported smoking, decision making skills, personal efficacy, and refusal assertiveness. Teams of three to five data collectors administered the questionnaire following a standardised protocol. These data were collected in school during a regular 40 minute class period.

RESULTS Based on the tested structural equation model, decision making and personal efficacy (that is, general competence) predicted higher refusal assertiveness and this greater assertiveness predicted less smoking at the two year follow up. The tested model had a good fit and was parsimonious and consistent with theory.

CONCLUSIONS Adolescent smoking prevention programmes often teach refusal skills in order to help youth resist peer pressure to smoke. The present findings suggest that teaching general competence skills as well may help to reduce smoking because youth with better personal efficacy and decision making skills are better able to implement smoking refusal strategies.

  • adolescent smoking
  • competence skills
  • refusal assertiveness
  • peer pressure

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