Young People and Smoking

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Young People and Smoking

• Professor Amanda Amos
• Public Health Sciences
• University of Edinburgh

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Key questions

• What are current patterns and trends in youth
  smoking?
• What do we know about why young people start and
  continue to smoke?
• Which interventions are effective in preventing
  and/or reducing youth smoking?
• What are the implications for tobacco control
  policy and practice at national and local levels?

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1. What are the current patterns and trends in
youth smoking?
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Scottish Smoking Prevention Targets
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2. What do we know about why young people start
and continue to smoke?
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Becoming a smoker is a process
Pre-contemplation ? Contemplation ? Action/Experim
entation ? Habituation/Addiction ? Maintenance/Reg
ular/ Adult smoking
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Becoming a smoker

• Not always uni-directional progression
• Variable length and time
• Dependence/addiction can be rapid
• Extends into late teens
• Young people v adult v our understandings
• being a smoker
• addiction
• quitting

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Influences on smoking uptake

• Individual
• Social (inter-personal) and community
• Societal

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Addiction Knowledge Attitudes
Beliefs Self-image/Identity
Self-esteem INDIVIDUAL Age Gender SES
Ethnicity Educational attainment Other
behaviours Money
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SOCIAL AND COMMUNITY
Friends

Parents

School
Parenting

style Peer
groups
Other family

members
Neighbourhood
Addiction Knowledge Attitudes
Beliefs Self-image/Identity
Self-esteem INDIVIDUAL Age Gender SES
Ethnicity Educational attainment Other
behaviours Money
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HBSC 2005/6 gender and social inequalities

• 15 year old girls (34) more likely than boys
  (25) to report that had first smoke at 13yrs or
  younger, and significantly higher in girls from
  low affluent families
• Regular smoking significantly higher in low
  affluence girls and boys
• Regular smokers twice as likely to get free
  school meals

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Social worlds- 15 year olds

• Spend 5 or more evenings with friends- 68
  smokers v 32 non-smokers
• Hang around the street- 87 smokers v 50
  non-smokers
• Do sport
• males 68 smokers v 82 non-smokers
• - females 35 smokers v 56 non-smokers
• Truanted more than 10 times- 27 v 5
• Expect to go to university- 19 smokers v 49
  non-smokers

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SOCIETAL
Social

Mass attitudes

media
and norms




Price Religion

Access
Social
disadvantage
Media campaigns

Tobacco promotion/marketing

SOCIAL AND COMMUNITY
Friends

Parents

School
Parenting

style Peer
groups
Other family

members
Neighbourhood
Addiction Knowledge Attitudes
Beliefs Self-image/Identity
Self-esteem INDIVIDUAL Age Gender SES
Ethnicity Educational attainment Other
behaviours Money
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Some policy and practice implications

• Address all three levels of influence
• Congruent with adolescent girls and boys
  experiences of smoking (eg role, meanings) and
  wider social worlds eg media, peer education,
  schools
• Integrate within wider health promotion to
  support youth in transitions
• Link with addressing inequalities

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3. Which interventions are effective in
preventing/reducing youth smoking?

• The prevention challenge is to make cigarettes
• and smoking
• Less aspirational/desirable (meaning, role)
• Less acceptable (meaning and context)
• Less accessible (context)
• Deal with addiction (cessation)

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Aspirational

• Stop all tobacco marketing- point of sale,
  packaging

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Aspirational

• Stop all tobacco marketing- point of sale,
  packets
• Reduce positive media images of smoking

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FHM August
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Aspirational

• Stop all tobacco marketing- point of sale,
  packets
• Reduce positive media images of smoking
• Health promotion campaigns and programmes at
  national and local levels

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Health promotion

• Comprehensive, well resourced, sustained- most
  effective
• National level- well designed mass media
• campaigns are
  effective
• Local level - educational setting (school,
  college)
• can be effective (eg
  ASSIST)
• - community setting (eg
  youth) ??
• New media- promising (eg EC Help campaign)

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Acceptability- social norms

• Reduce adult smoking
• Media campaigns- adults and young people
• Smokefree public places
• Smokefree homes and cars

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Access and availability

• Price- highly price sensitive
• Size of pack (10s??)
• Enforce age of sale
• Illegal/smuggled
• Social sources- family and friends

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Addiction

• Cessation support and young people
• Challenges reach and effectiveness
• Guidelines on ways of working with young people
• No clear evidence on effectiveness

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4. What are the implications for tobacco
control policy and practice?

• Comprehensive
• Evidence based
• But also innovation
• Tailored
• Partnership working
• Resourced
• Evaluation
• Research and understanding
• Not just tobacco