Peers, schools, and adolescent cigarette smoking

Purpose: To investigate the effects of popularity, best friend smoking, and cigarette smoking within the peer networks on current smoking of seventh- through 12th-grade students. These factors were examined for adolescents attending schools with varying rates of student cigarette smoking. Methods: This study used data from the saturated school sample of National Longitudinal Study of Adolescent Health (Add Health), a nationally representative school-based sample. The sample for the present study was 2525 adolescents in Grades 7-12 who completed an in-school questionnaire and an in-home interview. Information from the in-school questionnaire was used to construct measures of school smoking prevalence and popularity. Using peer nominations from the in-home interview best friend smoking, and peer network smoking exposure were constructed using the peers' own reports of their cigarette smoking. Multiple regression techniques were used to estimate the risk of current cigarette smoking as a function of popularity, best friend smoking, peer network smoking, and school smoking prevalence, and all first-order interactions between measures of peer and school smoking prevalence. Results: Adjusting for age, gender, race/ethnicity, parent education, school, and availability of cigarettes in the home, the risk of current smoking was significantly associated with peer networks in which at least half of the members smoked [odds ratio (OR) = 1.91], one or two best friends smoked (OR = 2.00), and with increasing rates of school smoking prevalence (OR = 1.73). In addition, there was a significant interaction of popularity and school smoking prevalence such that risk of current smoking was somewhat greater among popular students in schools with high smoking prevalence than among popular students in schools with low smoking prevalence. Conclusion: Findings suggest that school environments are important contexts for understanding peer group influences on adolescent cigarette smoking. (C) Society for Adolescent Medicine, 2001.