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Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1216-1225 (doi:10.1542/peds.2005-0808)
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How Do Psychological Factors Influence Adolescent Smoking Progression? The Evidence for Indirect Effects Through Tobacco Advertising Receptivity

Janet Audrain-McGovern, PhD, Daniel Rodriguez, PhD, Vaishali Patel, BA, Myles S. Faith, PhD, Kelli Rodgers, BA, Jocelyn Cuevas, BA

Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania

OBJECTIVES. To determine whether novelty seeking and depressive symptoms had mediated or indirect effects on adolescent smoking progression through tobacco advertising receptivity.

METHODS. More than 1000 adolescents were monitored from 9th grade to 12th grade and completed annual surveys that measured demographic characteristics, smoking behavior, tobacco advertising receptivity, novelty-seeking personality, depressive symptoms, family and peer smoking, alcohol use, and marijuana use.

RESULTS. Latent growth modeling indicated that novelty seeking had a significant indirect effect on smoking progression through baseline tobacco advertising receptivity. For each 1-SD increase in novelty seeking, the odds of being more receptive to tobacco advertising increased by 12% (ie, being in a specific category or higher), which in turn resulted in an 11% increase in the odds of smoking progression from 9th grade to 12th grade. The indirect effect from depressive symptoms to smoking progression did not reach significance.

CONCLUSIONS. These findings may inform future research on other factors that influence tobacco advertising receptivity, as well as programs aimed at preventing adolescent smoking initiation and progression.

Key Words: smoking • tobacco advertising • adolescents

Abbreviations: CI—confidence interval • OR—odds ratio • CES-D—Center for Epidemiologic Studies Depression Scale • CFI—comparative fit index • WRMR—weighted root mean residual • RMSEA—root mean square error of approximation • LGM—latent growth curve modeling

Accepted Aug 31, 2005.


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