文章基本信息

标题：The Social Context of Adolescent Smoking: A Systems Perspective
本地全文：下载
作者：Cynthia M. Lakon ; John R. Hipp ; David S. Timberlake 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2010
卷号：100
期号：7
页码：1218-1228
DOI：10.2105/AJPH.2009.167973
语种：English
出版社：American Public Health Association
摘要：We used a systems science perspective to examine adolescents' personal networks, school networks, and neighborhoods as a system through which emotional support and peer influence flow, and we sought to determine whether these flows affected past-month smoking at 2 time points, 1994–1995 and 1996. To test relationships, we employed structural equation modeling and used public-use data from the National Longitudinal Study of Adolescent Health (n = 6504). Personal network properties affected past-month smoking at both time points via the flow of emotional support. We observed a feedback loop from personal network properties to emotional support and then to past-month smoking. Past-month smoking at time 1 fed back to positively affect in-degree centrality (i.e., popularity). Findings suggest that networks and neighborhoods in this system positively affected past-month smoking via flows of emotional support. Adolescent cigarette smoking remains a complex public health problem in the United States. Although lifetime smoking and current frequency of smoking among adolescents decreased between the late 1990s and 2003, prevalence remained unchanged from 2003 through 2005.¹ Smoking prevalence among adolescents is currently estimated to be around 23%,¹ posing ongoing challenges for tobacco-control efforts. Several streams of literature suggest that adolescent smoking is inextricably connected to the social context in which it occurs. Literature shows that an adolescent's smoking behavior will tend to be similar to that of his or her peers.^{2 – 6} There is a longstanding debate over why this similarity occurs; some studies suggest that it is caused by peer influence on an individual adolescent's smoking,^{7 , 8} whereas others suggest that it is caused by the individual's selection of smoking peers,⁸ and still others attribute the cause to both influence and selection.² Some of the literature implicating adolescents’ social contexts in their smoking behavior examines youths’ social networks of friends and peers from a structural perspective. Such studies focus on how structural and positional characteristics of these networks relate to adolescent smoking. Structural characteristics reflect information about linkages among individuals, and positional characteristics indicate the significance of occupying different network positions. In general, studies find that isolated youths are likely to smoke, although some studies have found that popular youths are likely to smoke.^{3 – 5 , 9 – 12} Implicit in each study is the notion that adolescents’ social context of friends and peers plays a critical role in their own smoking behavior. Given the relevance of adolescents’ social context to their smoking behavior, it is important to understand how to conceptualize and measure this context. Previous research has used ecological models to inform the theoretical specification of the context of adolescent smoking and other substance-use behaviors.¹³ Ecological models allow this context to be theoretically partitioned into levels of influence. Although there are valuable insights yet to be gained from such models, more theoretically informed research is necessary to elaborate the complexity of the social context of adolescent smoking. Moreover, because various theories are often integrated at different levels in such models, it is difficult to ensure that conceptual coherence is achieved across and within levels, given the possibility that the theories applied at each level make incongruous assumptions. Furthermore, such models do not provide specific guidance about mechanisms through which levels of influence relate to outcomes such as adolescent smoking. There is a need for theoretical models that more specifically and holistically elaborate features of the social context of adolescent smoking and how they act in concert.