Visual Media Influences on Adolescent Smoking Behavior (Y10-14 Renewal)

描述（由申请人提供）：吸烟是美国成年人肺癌的主要原因，也是其他疾病死亡的重要原因。吸烟开始于青春期。研究提供了大量的社会影响对入会的影响，特别是父母和同伴的影响。九年前，我们在新英格兰北部5000多名青少年中开始研究电影吸烟对青少年早期吸烟行为的影响，并在6500多名具有全国代表性的美国青少年的纵向样本中继续研究。我们证明并证实了电影吸烟与青少年开始吸烟之间的横断面关联，并且在从不吸烟的青少年中，支持更积极的期望和更高水平的吸烟易感性。我们在1-2年后对每个队列中的不吸烟者进行了随访，结果显示，电影吸烟的基线暴露可以预测未来吸烟的开始，强调控制混杂因素，并在最近的研究中包括多达21个协变量。在这个竞争更新申请中，涵盖从2007年5月开始的5年期间，我们建议将重点转移到理解观察到的关联的过程上。继续跟踪10-14岁的全国青少年样本，我们将测试关于吸烟开始的调解和调节（种族和社会风险）假设。建议的调解包括吸烟风险原型和应对预期。此外，我们还将建立吸烟依赖途径模型，作为持续接触电影吸烟的函数，检查多种吸烟依赖结构：频率/数量测量、自主性丧失和自我吸烟者的感知。为了实现这些目标，我们将每两年跟踪我们的纵向队列，再进行3个波（波5-7），直到组的年龄达到18至22岁。样本中还将加入非裔美国青少年，以便更好地研究一个在青春期早期对电影吸烟对行为的影响表现出抵抗力的群体。本研究为进一步研究电影吸烟对青少年吸烟行为影响的潜在机制提供了一个无与伦比的机会。由于美国电影在世界各地销售和发行，这项研究可能对世界各地的青少年产生深远的公共健康影响。

DESCRIPTION (provided by applicant): Smoking is the primary cause of lung cancer in US adults, and also an important cause of mortality from other conditions. Onset of smoking occurs during adolescence. Research provides extensive documentation of social influence effects on initiation, especially influence of parents and peers. We began studying the impact of movie smoking on early adolescent smoking behavior nine years ago in a sample of over 5000 Northern New England adolescents, and have continued the research with a longitudinal sample of over 6500 nationally representative US adolescents. We demonstrated and confirmed a cross-sectional association between exposure to movie smoking and adolescent smoking initiation and, among never smokers, endorsement of more positive expectancies and higher levels of susceptibility to smoking. We have followed up never-smokers in each cohort 1-2 years later, showing that baseline exposure to movie smoking predicted onset of smoking in the future, emphasizing controlling for confounding, and including up to 21 covariates in the most recent study. In this competing renewal application, covering the 5-year period beginning May 2007, we propose to shift our emphasis to understanding the process for the observed association. Continuing to follow our national sample of adolescents who were 10-14 years at baseline, we will test mediation and moderation (race and social risk) hypotheses with respect to smoking initiation. Proposed mediators include smoking risk prototypes, and coping expectancies. Additionally, we will model pathways to tobacco dependence as a function of ongoing exposure to movie smoking, examining multiple smoking dependence constructs: frequency/quantity measures, loss of autonomy, and perception of self as a smoker. To accomplish these goals, we will follow our longitudinal cohort biannually for 3 more waves (waves 5-7), until the group is 18 to 22 years of age. The sample will be enriched with African-American adolescents, to better study a group that appears in early adolescence to be resistant to the movie smoking effect on behavior. This study provides an unsurpassed opportunity to further investigate the mechanisms underlying the effect of exposure to movie smoking on smoking behavior in adolescents and young adults. Because U.S. movies are marketed and distributed all over the world, this research could have far-reaching public health implications for adolescents everywhere.