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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.137679v1 99/3/487    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Song, A. V. Articles by Halpern-Felsher, B. L. Search for Related Content PubMed PubMed Citation Articles by Song, A. V. Articles by Halpern-Felsher, B. L. Related Collections Adolescent Health Surveys Other Tobacco Tobacco and Health

Anna V. Song, PhD, Holly E. R. Morrell, PhD, Jodi L. Cornell, MSW, MA, Malena E. Ramos, EdM, Michael Biehl, MA, Rhonda Y. Kropp, MPH and Bonnie L. Halpern-Felsher, PhD

At the time of the study, Anna V. Song, and Holly E. R. Morrell were with the Center for Tobacco Control Research and Education, University of California, San Francisco. Michael Biehl was with the Department of Psychology, University of California, Davis. Jodi L. Cornell, Malena E. Ramos, Rhonda Y. Kropp, and Bonnie L. Halpern-Felsher were with the Division of Adolescent Medicine, Department of Pediatrics, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Bonnie L. Halpern-Felsher, Division of Adolescent Medicine, Department of Pediatrics, UCSF, 3333 California St, Ste 245, Box 0503, San Francisco, CA 94118 (e-mail: halpernfelsherb{at}peds.ucsf.edu).

Objectives. The predictive value of perceptions of smoking-related risks and benefits with regard to adolescent smoking initiation has not been adequately established. We used prospective, longitudinal data to directly test whether smoking-related perceptions predict smoking initiation among adolescents.

Methods. We administered surveys assessing perceptions of smoking-related risks and benefits to 395 high school students, beginning at the start of their ninth-grade year. We conducted follow-up assessments every 6 months until the end of 10th grade, obtaining 4 waves of data.

Results. Adolescents who held the lowest perceptions of long-term smoking-related risks were 3.64 times more likely to start smoking than were adolescents who held the highest perceptions of risk. Adolescents who held the lowest perceptions of short-term smoking-related risks were 2.68 times more likely to initiate. Adolescents who held the highest perceptions of smoking-related benefits were 3.31 times more likely to initiate.

Conclusions. Findings from this study provide one of the first sets of empirical evidence to show that smoking initiation is directly related to smoking-related perceptions of risks and benefits. Thus, efforts to reduce adolescent smoking should continue to communicate the health risks of smoking and counteract perceptions of benefits associated with smoking.