Perceived Accessibility as a Predictor of Youth Smoking

Article Figures & Data

Table 1.

Cumulative Incidence of Tobacco Use

	Yearly Study Periods From Date of First Interview
Characteristics	1 No. (%)	2 No. (%)	3 No. (%)	4 No. (%)
Note: Because of a loss to follow-up, the denominators vary across the 4 years of the study. The denominators for study years 1 through 4 were 1,027, 989, 944, and 890, respectively, for smoking initiation; and 1,195, 1,157, 1,112, and 1,058, respectively, for the regular smoking outcome.
Smoking initiation	41 (4.0)	92 (9.3)	151 (16.0)	177 (19.9)
Regular tobacco use	68 (5.7)	87 (7.5)	97 (8.7)	109 (10.3)

Table 2.

Unadjusted Associations of Tobacco Use With Perceived Accessibility

	Smoking Events, Hazard Ratio (95% CI)
Accessibility	Initiation (n=1,027)	Regular Smoking (n=1,195)	Progression Among Initiators (n=345)
CI=confidence interval; ref = reference group.
Note: All estimates shown were derived from city-stratified Cox proportional hazards model to account for clustering within students’ city of residence.
“It would be easy for me to get a cigarette”
Strongly disagree	ref	ref	ref
Disagree a little	1.52 (0.99–2.34)	1.66 (0.77–3.61)	1.01 (0.46–2.24)
Neither agree nor disagree	1.65 (0.93–2.95)	3.19 (1.46–6.99)	1.82 (0.85–3.87)
Agree a little	1.86 (1.2–2.87)	3.82 (2.08–7.01)	1.36 (0.75–2.45)
Strongly agree	3.28 (2.16–4.97)	9.58 (5.61–16.37)	2.13 (1.26–3.59)

Table 3.

Impact of Peer and Parental Smoking on the Relationship of Perceived Accessibility and Smoking

	Smoking Events, Hazard Ratio (95% CI)
Characteristics	Initiation (n=1,027)	Regular Smoking (n=1,195)	Progression Among Initiators^a (n=345)
CI = confidence interval.
^a Estimates for this outcome were derived from analyses on initiators, including those who had previously initiated but not progressed to weekly smoking at the date of the baseline interview.
Perceived accessibility alone	2.06 (1.51–2.81)	4.62 (3.10–6.89)	1.59 (1.07–2.35)
Adjusted for parental smoking only	1.79 (1.31–2.45)	3.76 (2.47–5.73)	1.53 (1.03–2.27)
Adjusted for peer smoking only	1.59 (1.15–2.20)	2.54 (1.68–3.82)	1.26 (0.86–1.86)
Adjusted for both parental and peer smoking	1.44 (1.04–1.99)	2.25 (1.48–3.43)	1.20 (0.81–1.78)

Table 4.

Relationship Between Perceived Accessibility, Peer Smoking, and Smoking Outcomes

	Smoking Outcome, Hazard Ratio (95% CI)^a
Characteristics	Initiation		Regular Smoking		Progression Among Initiators
	Unadjusted	Adjusted^b	Unadjusted	Adjusted^c	Unadjusted	Adjusted^c
CI = confidence interval; ref = reference group.
^a All estimates shown were derived from city-stratified Cox proportional hazards model to account for clustering within students’ city of residence.
^b Model was adjusted for age, sex, parental smoking, perceived parental approval of smoking, concerns about weight, anger coping, parental permissiveness of watching R-rated movies, and school disaffection.
^c Model was adjusted for age, sex, parental smoking, perceived parental approval of smoking, having a favorite cigarette advertisement, parental involvement, anger coping, and impulsivity.
^d The categories were the 4 possible combinations of perceived accessibility and peer smoking.
Neither perceived accessibility nor peer smoking	ref	ref	ref	ref	ref	ref
Has perceived accessibility but no peer smokers	2.00 (1.31–3.06)	1.53 (0.98–2.41)	2.32 (1.07–5.02)	1.16 (0.49–2.75)	0.83 (0.39–1.75)	0.64 (0.28–1.44)
Peer smoking but no perceived accessibility	5.60 (3.76–8.36)	4.04 (2.66–6.15)	9.53 (4.92–18.47)	4.85 (2.35–10.02)	2.98 (1.55–5.75)	2.24 (1.09–4.62)
Both perceived accessibility and peer smokers	6.82 (4.53–10.29)	3.65 (2.26–5.9)	27.63 (15.61–48.91)	8.27 (4.23–16.19)	4.74 (2.69–8.35)	3.08 (1.64–5.78)