An “Epidemic” Model of Adolescent Cigarette Smoking

Abstract

The prevalence of regular smoking increases rapidly during adolescence. We applied modeling methods from the study of epidemic infectious disease to smoking behavior. Our “epidemic” models dealt with the process of transition among four states: nonsmoker (susceptible), trier (exposed), regular smoker (infected), and ex‐smoker (recovered). The best fitting model was one in which the transition from nonsmoker to trier was a social contagion process where nonsmokers contacted either triers or regular smokers. All other transitions were treated as constant rate processes in which a constant proportion of eligible individuals made the transition in a given year. The recursive equation model embodying these assumptions was able to predict accurately the proportion of adolescents in each state in Grades 6–11. Our results support a “stage” model of smoking, suggesting that different psychological and physiological processes are involved in the initiation of smoking than in developing a habit of regular smoking. A possible sex difference was found in the non‐contact transition between trier and smoker states, with the transition being more probable in females than in males.

Predictors of nicotine dependence symptoms among never-smoking adolescents: A longitudinal analysis from the Nicotine Dependence in Teens Study

“…This result is consistent with previous studies showing that the relative influence of family members and friends varies by age, with family members having a greater influence in childhood and friends having a greater influence in adolescence (e.g., Vitaro et al, 2004). Social contagion theory (Rowe et al, 1992) may explain the observation that never-smokers come to believe that they (should) experience cravings when friends talk openly about their cravings. To our knowledge, smoking by school personnel has never been evaluated as a risk factor for ND among never-smokers.…”

Psychosocial factors related to adolescent smoking: a critical review of the literature

“…Modelling, direct pressure, and normative beliefs167have been suggested as mechanisms of influence and investigated along with the potential importance of levels of social interactions, as suggested in the works of Eiser et al  157 and Sussman et al 115. Of particular interest is research suggesting that initiation to smoking is best modelled as a prevalence-driven behaviour depending upon the degree to which an adolescent comes in contact with others displaying the behaviour 168. The maintenance of smoking, on the other hand, shows a degree of independence from prevalence 103…”

Instability in smoking patterns among school leavers in Victoria, Australia

“…For example, Jarvis20 argues that the onset of addiction occurs in the initiation phase during adolescence, and from there tobacco use just escalates. In their research fitting “epidemic” models to the uptake of cigarette smoking, Rowe and colleagues21 22assumed a sequential progression from non-smoker to trier to regular smoker. In this work, there was little consideration of decreases in smoking involvement once initiation to smoking (or “infection”) had occurred.…”