The role of cognitive attributions for smoking in subsequent smoking progression and regression among adolescents in China

Abstract

Previous studies have documented that cognitive attributions are correlated with adolescent smoking. The present study further explored whether cognitive attributions for smoking influenced adolescents’ future smoking behaviors, especially transitions to more advanced stages of smoking. Participants were 12,382 middle and high school students (48.5% males and 51.5% females) in seven large cities in China. They completed two waves of surveys one year apart. Cognitive attributions for smoking and three smoking behavior outcomes (lifetime smoking, past 30-day smoking, and daily smoking) were assessed. Changes in smoking, including progression from lower stages to higher stages and regression from higher stages to lower stages, over a one-year period, were defined longitudinally. Polychotomous logistic regression was used to examine associations between cognitive attributions for smoking and changes in smoking status over one year, adjusting for demographic characteristics and other plausible confounders. Seven out of eight cognitive attributions for smoking were associated with subsequent smoking behaviors (p<0.05). Curiosity, autonomy, social image, social belonging, and coping influenced earlier stages of smoking, whereas mental enhancement and engagement influenced later stages of smoking. Curiosity, autonomy, social image, and mental enhancement preceded smoking progression; social belonging prevented smoking regression; and coping and engagement both preceded smoking progression and prevented smoking regression. This study demonstrates that different cognitive attributions influence smoking at different stages in different ways. These findings could inform smoking prevention and cessation programs targeting Chinese adolescents.

Incidence of Adverse Transition in Smoking Stages among Adolescents of Kinta, Perak

“…This is consistent with other studies (Spelman, 2007;Guo, 2008) that found adverse transitions to be higher among male adolescents. However, there are also studies that found a greater risk of adverse transitions among females (Richmond, 1999;Lloyd-Richardson et al, 2002).…”

Curiosity predicts smoking experimentation independent of susceptibility in a US national sample

“…In both this original study and a more recent international study (Guo, Unger, Palmer, Chou, & Johnson, 2013), curiosity about smoking was associated with receptivity to tobacco industry marketing messages, suggesting that it could be a mediator variable through which marketing influences initiation.…”

“…Building curiosity is a focus for many educational endeavors (Day, 1982; Simon, 2001), as well as the target for marketers promoting experimentation with their particular consumer behavior (Smith & Swinyard, 1988). As such, multiple studies have reported that the majority of smokers, when asked to reflect on why they started to smoke, cite curiosity about smoking (Cronan, Conway, & Kaszas, 1991; Guo et al, 2013). In this study, as in previous studies, pre-teens who were receptive to tobacco industry marketing messages that are known to encourage smoking, were also likely to develop curiosity cognitions.…”

Predictive Validity of the Expanded Susceptibility to Smoke Index

“…10,11 Efforts to further refine identification of the lowest risk teens suggested inquiring about cognitions that may precede formation of intentions about smoking. When current smokers are asked for reasons they initiated smoking, most report that they were motivated by curiosity, 12,13 as people are similarly motivated for many new behaviors. 14 Curiosity has long been considered a primary cognitive motivational state underlying pursuit of novel experiences.…”