Examining the Utility of the Theory of Planned Behavior Psychosocial Factors Associated with Tobacco Use Intentions Among Youth: Examining the Utility of the Theory of Planned Behavior Brian N. Smith1, Ilene S. Speizer2, Karen S. Mitchell1, Melanie K. Bean1, Elizabeth A. Fries1 1Department of Psychology, 2Department of Preventive Medicine and Community Health, Virginia Commonwealth University, Richmond, VA, USA Method Tobacco-related behaviors and characteristics of students from three high schools were assessed at two time points – pre- and post-intervention. The present research involves only the baseline data. Procedure and Participants Participants completed a 16-page baseline survey just before the beginning of tobacco-related interventions (approximate completion time was 20-35 minutes). Upon completion of the instrument… participants placed their survey in a blank envelope and sealed it turned sealed envelopes over to instructor instructors then returned sealed envelopes to the YTEP Surveys were returned from 99% of the eligible participants (1002 out of 1117) for the present analysis Due to missing data issues (i.e., incomplete surveys), the final sample was 940. Demographic characteristics of participants are shown in Table 1. Results Smoking Intentions by Grade Figure 1 summarizes the responses for intentions to try smoking in the next 6 months by grade. Grade in school did not have a significant effect on behavioral intentions to try smoking Psychosocial Predictors of Smoking Intentions Table 2 and Figure 2 summarize the results for the logistic regression model used to predict intentions to try smoking among the non-smokers (N=730). All predictor variables were entered simultaneously. The following covariates were included in the model, but did not yield significant effects: Ethnicity, grade in school, whether a mother or female guardian is present in the home, and sex. Whether a male guardian is present in the home was the only significant covariate, such that having a male guardian is associated with decreased odds of having intentions to try smoking Results of Logistic Analysis Attitudes: more positive attitudes toward remaining “tobacco-free” are associated with a significantly decreased odds of having intentions to try smoking Perceived Risk (long-term consequences): not significant Subjective Norms: marginally significant finding (p=.07)indicates that perceiving that friends’ do not want individual to smoke is associated with decreased odds of having intentions to try smoking Smoking Among Friends: higher perceived proportion of friends who smoke is associated with a significantly increased odds of having intentions to smoke Perceived Prevalence in community among age-group: not significant Perceived Behavior Control to Quit Smoking: greater perceptions of control to quit are associated with significantly increased odds of having intentions to try smoking Perceived Behavioral Control to Avoid Smoking: not significant Discussion Findings & Conclusions 11% of non-smoking youth indicated intentions to try smoking within 6 months 22% of all youth surveyed either currently smoke or intend to try it in the next 6 months Smoking intentions did not vary significantly by grade Findings regarding the roles of the TPB constructs are consistent with theory attitudes and perceived behavioral control were significant predictors of smoking intentions, and subjective norms was marginally significant Consistent with prior research, (Smith & Stasson, 2000), perceived behavioral control was the strongest independent predictor of intentions to engage in health-related behavior. Limitations Missing data, though response rates were good overall Correlational design – causality cannot be inferred Implications One approach to reducing the incidence of adolescent tobacco use may be to facilitate positive attitudes with regards to remaining tobacco-free Further research examining social influence processes may provide insight regarding how to address peer use, and the role of normative influence on tobacco use and other risky behaviors Teaching adolescents to be appreciative of the addictive properties of nicotine may decrease inclinations to experiment with smoking. Overview As part of the Youth Tobacco Evaluation Project’s (YTEP) assessment of state-wide tobacco-prevention programming in Virginia, participants from three high schools in rural Virginia were surveyed using a comprehensive instrument to assess smoking-related characteristics and behaviors at baseline. Guided by the Theory of Planned Behavior (TPB; Ajzen, 1985, 1991), the focus of the present research was to examine the roles of attitudes, subjective norms (and other normative factors), and perceived behavioral control in explaining adolescents’ behavioral intentions to try smoking. Background Tobacco use is cited as the most preventable cause of death in the United States. Most adult smokers began smoking during adolescence, making tobacco prevention among youth an especially important mission in health research. In the U.S., 28.5% of high school students currently smoke cigarettes; and, 13.8% are frequent current smokers, defined as having smoked on at least 20 of the 30 days preceding the survey (MMWR, 2002) Given the robust addictive properties of nicotine, it is important to identify factors that may be related to, and predictive of, adolescents’ intentions to try smoking. According to the TPB, an individual’s behavioral intention represents the most immediate influence on behavior; further, intentions are dependent on three sets of variables: attitudes toward the behavior, subjective norms regarding the behavior, and perceived behavioral control. Table 2. Odds Ratios and Confidence Intervals for Predictors of Behavioral Intentions to Try Smoking Psychosocial Predictor Intentions to Try Smoking Odds Ratio 95% C.I. Attitudes (Tobacco-Free)* Perceived Risks (Long-Term) Subjective Norms Smoking Among Friends* Perceived Prevalence PBC to Quit Smoking** PBC to Avoid Smoking Father or Male Guardian* Present .55 .34-.92 .84 .54-1.32 .78 .60-1.02 1.43 1.04-1.95 1.13 .83-1.55 1.50 1.17-1.93 .80 .59-1.10 .24 .08-.76 *p<.05, **p<.001 Table 1. Participant Characteristics Characteristics of Sample Percentage in Group Total N = 940 Grade In School 9th 10th 11th 12th 23.3 21.4 29.5 25.9 Sex Girl Boy 53.2 46.8 Ethnicity African American Caucasian Hispanic/other 12.9 71.6 5.1 Intend to Try Smoking Within the Next 6 Months No Yes Already Smokes 68.9 8.7 13.3 Intend to Try Smoking Within the Next 30 Days 71.0 6.7 Current Research Key Variables (from the TPB): Attitudes toward remaining tobacco free 7-item index on 5-pt continuum Subjective Norms regarding tobacco use single item index on 5-pt continuum Perceived behavioral control to quit smoking among non-smokers; single item index on 5-pt continuum Perceived behavioral control to avoid smoking once deciding not to smoke; single item index on 5-pt continuum Intentions to try smoking in the next 6 months among non- smokers; single item index on 5-pt continuum The following variables were also assessed to expand on the TPB constructs: Attitudes / Perceived Risks regarding long-term consequences of smoking 4-item index on 5-pt continuum Proportion of friends that smoke Single-item index on 5-pt continuum: “none-few-half-most-all” Perceived prevalence of smoking among age group References Ajzen, I. (1985). From intentions to actions: A Theory of Planned Behavior. In J. Kuhl & J. Beckman (Eds.) Action-control: From cognition to behavior (pp. 11-39). Heidelber, Germany: Springer. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211. Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley. MMWR – Trends in Cigarette Smoking Among High School Students – United States, 1991-2001, 51 (19). May 17, 2002. Smith, B.N., & Stasson, M.F. (2000). A comparison of health-behavior constructs: Social Psychological Predictors of Aids-Preventive Behavioral Intentions. Journal of Applied Social Psychology, 30, 443-462. Acknowledgements: Funding for this project was provided by the Virginia Tobacco Settlement Foundation (VTSF)