Social contexts of regular smoking in adolescence: towards a multidimensional ecological model

Using data from the Longitudinal Study of Adolescent Health (Add Health), this study investigates factors at the individual, family, peer, school, neighborhood, and state levels that are important for subsequent adolescent cigarette regular smoking after controlling for the baseline smoking behavior and individual characteristics. Our analysis shows that time spent with peers and smoking of significant others (i.e., peers and families) are associated with higher risk of an adolescent becoming a regular smoker. Protective factors that may mitigate or prevent adolescents from becoming regular smokers were closeness with parents, attending a private school, attending a school with strong concentration of Hispanic students, self-perceived fitting at school, and living in a neighborhood where neighbors watch out for one another. Because we controlled for the baseline smoking behavior and a wealth of individual factors, these associations may represent causal effects of social contexts on adolescent smoking as a risky behavior that can have a lifelong harmful impact. A take home message from this study is that social contexts are important for understanding individual smoking behavior in adolescence. An ecological model that incorporates overlapping and interacting social systems is more helpful than single-system models to reveal etiology of adolescent smoking. More studies are needed to implement these ecological models to study human behavior.