Risk and protective factors: An integration of the epidemiological and psychological approaches to adolescent smoking

Epidemiological research has identified parental, sibling and peer group smoking as risk factors for adolescent smoking. In contrast, psychological research has emphasised the importance of smoking related beliefs. The present study aimed to integrate these literatures. Four hundred and twenty nine 16-19 year olds from educational, training and employment centres completed a questionnaire about their risk factors, smoking related beliefs and smoking behaviour and were categorised as either low, medium or high risk on the basis of their risk score. The results suggested that risk status was related not only to whether or not the individual currently smoked but also to characteristics of their smoking behaviour and smoking related beliefs such as whether they had ever tried smoking, the amount smoked, their identity as a smoker, smoking self efficacy, smoking related behavioural intentions and beliefs about the costs and benefits of smoking. However, the relationship between risk and beliefs was not always simply correlational The results suggested that psychological factors moderated the impact of risk with beliefs that smoking was not unsociable and that lung cancer was curable promoting smoking in low risk subjects. Further, the results indicated that some high risk individuals may be protected from smoking if they believe that smoking is unsociable and do not believe that smoking relaxes people. The results are discussed in terms of the integration of epidemiological and psychological approaches to smoking and the implications for health promotion interventions.