Home-based sourcing of tobacco among adolescents
Introduction
Adolescents obtain cigarettes from commercial and social sources (Harrison et al., 2000, Croghan et al., 2003, Johnston et al., 2004). Sources of tobacco may differ by demographic characteristics, such as gender and ethnicity (Robinson et al., 1998, Ma et al., 2003), or smoking frequency (Robinson et al., 2006, Emery et al., 1999). Younger and less frequent smokers, and females, tend to rely more on social sources than older, regular smokers, and males (Harrison et al., 2000, Forster et al., 1997, Gratias et al., 1999, Castrucci et al., 2002).
Acquisition from commercial sources has been extensively examined, and many countries worldwide have attempted to reduce minors' access to tobacco through these sources by implementing tobacco sale bans (Lantz et al., 2000, Stead and Lancaster, 2005). Generally, tobacco sale bans have been considered successful in reducing adolescent purchases from commercial sources (Rimpelä and Rainio, 2004), but not in reducing smoking prevalence (Fichtenberg and Glantz, 2002, Staff et al., 2003). Our earlier study assessing the effects of tobacco sale bans on tobacco purchases among underage Finnish adolescents showed a marked decrease in commercial purchases, yet the overall impact on youth access to tobacco was negligible as the usual profile was to obtain tobacco from social sources instead (Rimpelä and Rainio, 2004).
Social sources increase both the supply and demand for cigarettes (Turner et al. 2004). Adolescents may obtain cigarettes through friends, family, or other adult suppliers (Harrison et al., 2000, Robinson et al., 2006, DiFranza and Coleman, 2001, Shive et al., 2001, Klonoff et al., 2001). While research has shown that friends are the most important suppliers of cigarettes among adolescents, tobacco acquisition through other social sources, especially home-based, has received limited attention (Williams and Mulhall, 2005). Acquisition patterns from different sources vary widely. The most common pattern among commercial sources is purchasing, but the scope of acquisition patterns from social sources is more diverse including e.g. receiving, stealing, borrowing, exchanging, and purchasing tobacco. Knowledge of the users and the extent of use of the various sources are important to achieve a comprehensive understanding of tobacco acquisition among the youth, and for assessing the existing tobacco control strategies. The present study is concerned with home-based sourcing.
Using a nationally representative sample of 14 to 16-year-old adolescents, this study explores to what extent daily and experimental smokers obtain tobacco from home-based sources (parents, siblings, taking it from home), and determines family factors associated with obtaining tobacco from these sources.
Section snippets
Sampling and participants
This study is based on the nationwide Adolescent Health and Lifestyle Survey (AHLS), a postal survey conducted biennially in Finland since 1977. Nationally representative samples of 14 and 16-year-olds were obtained from the Population Register Center. All Finns born on the sample days were included. For this study, the AHLS surveys of 1999, 2003, and 2007 were included. The Ethical Committees of the University of Helsinki and the Pirkanmaa Hospital District, Finland, approved the study
Sources of tobacco
Daily smokers obtained tobacco broadly from all three types of home-based tobacco sources, whereas the majority of occasional and experimental smokers relied on other social sources (Table 2). Girls in all smoking groups relied on home-based and other social sources more often than boys did. Differences by age were minimal.
In additional analysis (data not shown) to determine the source of tobacco among daily smokers who had not reported any tobacco purchase from commercial sources, 46.9%
Discussion
Home-based sourcing to obtain tobacco is particularly common among adolescent daily smokers, although other social sources and commercial sources are used more often. Parental smoking and absence of total home-smoking ban play an important role in determining whether adolescent smokers obtain tobacco from sources at home or not.
Our findings concerning home-based sourcing largely support the earlier findings regarding use of social sources (Croghan et al., 2003, Johnston et al., 2004, Robinson
Conclusions
Home-based sourcing is common among adolescent smokers. In light of our findings, home-based sourcing should be understood as an important determinant in the persistence of adolescent smoking, and thus an obvious target when discussing restrictions of youth access to tobacco. Parents should be provided with guidance about the consequences of home-based sourcing. When parents accept the use of home-based sources, they also undermine the efforts made to restrict adolescent access to tobacco from
Conflict on interest statement
None.
Acknowledgments
This study was financially supported by the Ministry of Social Affairs and Health (the §27 Appropriation of the Tobacco Act), The Competitive Research Funding of the Pirkanmaa Hospital District, and the Juho Vainio Foundation. We thank Marja Vajaranta and Virginia Mattila, MA, both from the University of Tampere, Finland, for their assistance with language revision, and Lasse Pere for data management.
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