In the present study, the role of cognitive concepts derived from the Theory of Planned Behavior in adolescent smoking reduction, continuation, and progression was investigated. These concepts include pro-smoking attitudes, perceived social norms regarding smoking, and self-efficacy to resist smoking. Logistic regression analyses were performed on data from 397 Dutch adolescents aged 11–15 years, who had at least once tried smoking. Attitudes, perceived social norms, and self-efficacy, including significant interactions between these three concepts, explained up to 41% of variance in smoking behavior cross-sectionally. Longitudinally, an interaction between pro-smoking attitudes and low self-efficacy increased the chance of reduction in smoking, and all three cognitions inclusive of two interactions between pro-smoking perceived soc ial norms and low self-efficacy or positive attitudes towards smoking predicted progression of smoking. Cognitions may play relatively small roles in adolescent smoking reduction, but do seem to be relevant in progression in smoking after experimentation or recent onset. Interactions between positive attitudes towards smoking and prosmoking perceived social norms provide cumulative risks for adolescents to increase their levels of smoking, whereas interactions between less favorable attitudes and high self-efficacy to resist smoking may provide a protective effect for adolescents to reduce or to quit their smoking.
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Notes
Please note that the term ‘grade’ has dissimilar meanings across countries. In the Netherlands, students usually leave elementary school when they are aged 12, varying between 11 and 14, and thereupon continue their educational careers as first graders in secondary school, of which the first and second year will be referred to as ‘first and second grade.’
The reviewers of this paper suggested to control for concurrent cognitions in the longitudinal analyses, to determine whether prior cognitions predict smoking behavior above and beyond concurrent cognitions. If the effects of the prior cognitions would not be diminished if concurrent cognitions were controlled for, this would indicate that once adolescents have taken up smoking, it is too late to intervene on cognition. We found that the effects of prior cognitions diminished if the concurrent cognitions were controlled for in all longitudinal analyses. This suggests that interventions on cognitions may still be effective once teenagers have initiated smoking, even if they have increased their smoking rates.
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ACKNOWLEDGMENTS
This research was supported by a grant from the Dutch Asthma Foundation and a fellowship grant to Rutger Engels from the Dutch Organization of Scientific Research.
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Van Zundert, R.M.P., Engels, R.C. & Van Den Eijnden, R.J. Adolescent Smoking Continuation: Reduction and Progression in Smoking after Experimentation and Recent Onset. J Behav Med 29, 435–447 (2006). https://doi.org/10.1007/s10865-006-9065-4
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DOI: https://doi.org/10.1007/s10865-006-9065-4