Translation and psychometric validation of the Persian version of the Questionnaire on Smoking Urges for assessment of craving to smoke among university students

Background Even though tobacco is one of the most preventable causes of death worldwide, it endangers more than 8 million people yearly. In this context, meta-analyses suggest that a significant part of the general Iranian population over 15 years of age smoke and that there is a need for good screening tools for smoking cravings and urges in Iran. The present study reported the translation and investigated the psychometric properties (i.e., factor structure, validity, and reliability) of the Persian version of the Questionnaire on Smoking Urges (QSU) with 12 items in the Iranian context. Method The translation process and content validity of the items were examined entirely in an expert panel using the Content Validity Index. The total sample of participants in which the translated version was tested consisted of 392 (172 female, 220 male, Mage = 22.31 years, SD = 2.90) university students who answered the QSU 12-item at the start of their participation in smoking cessation interventions. The QSU 12-item was firstly translated, then piloted using a subsample of 150 university students and finally validity and reliability of the instrument were investigated using a subsample of 242 participants. We tested the proposed models in the literature, that is, a 1-factor solution and a 2-factor solution with six items on each factor (Factor 1: desire/intention to smoke; Factor 2: relief of negative affect or withdrawal symptoms and anticipation of positive outcome). At last, we tested differences across differences in QSU-scores across different subgroups of individuals based on their demographics. Results The results suggested that, in contrast to past studies, a modified 2-factor model, using five items for Factor 1 and 7 items for Factor 2, was the best fitting model (CFI = .95, RMSEA = .09, CI = 90%). Additionally, the QSU 12-item Persian version showed good convergent and divergent validity, internal consistency (Factor 1 = .94, Factor 2 = .97), ICC (average measure ICC = .95, CI = 95%, F(391, 4301) = 20.54, p < .001), concurrent validity (r = .71, p < .01), and discriminant validity (r = −.04, p > .05). Finally, subgroups based on gender, marital status, (un)employment, and educational level did not differed in their responses to the QSU 12-item. Conclusion The Persian version of the QSU 12-item has satisfactory psychometric properties and, with a slight modification, it can be considered as a reliable and valid method to estimate smoking urges in the Iranian population. Moreover, the QSU 12-item seems appropriate to measure urge for smoking among groups of individuals with different sociodemographic backgrounds. Importantly, the QSU 12-item differentiates individuals’ desire and intention to smoke from their anticipated relief of negative affect or withdrawal symptoms, which can be important for personalizing interventions targeting individuals who want to quit smoking.

USING THE THEORY OF REASONED ACTION TO PREDICT SMOKING INTENTION AMONG NON-SMOKING SECONDARY SCHOOL GOING ADOLESCENTS IN PENINSULAR MALAYSIA

The study aims to determine the relationship of attitude and social-norm with the intention to smoke in the future among non-smoking youth. Data were derived from a study on smoking among form four students in a selected secondary school in Peninsular Malaysia, which utilised a pre-validated questionnaire to obtain data from the selected respondents. Descriptive statistics and structural equation modelling (SEM) were used in data analysis. The study revealed independent variables accounted for 22.6% of the variance in intention to initiate smoking and the model had a good fit. A significant relationship was observed between subjective norm and intention to initiate smoking (R=0.46). The study revealed that attitude and social norm substantially explained intention to smoke among non-smoking adolescents. Future measures should concentrate on correcting the subjective norms to reduce the intention to initiate smoking among non-smoking youth.

The Effects of Cigarette Advertisement and Peer Influence on Adolescent’s Smoking Intention in Indonesia

BACKGROUND: The occurrence of smoking among adolescents keeps increasing. Based on data from the Regional Health Research 2013, the prevalence of child smokers aged 10–18 years old was 7.2–9.1% in 2018. In fact, it exceeds the government’s target to reduce the number of child smokers in 2019 to 5.4%. Cigarette advertising is one of the reasons children are attracted to smoking, and Indonesia ranks first in ASEAN for youth exposure to tobacco advertisement and promotion. AIM: The aim of the study is to determine the factors that affect the urge to smoke in adolescents, specifically the influence of friends who smoke and exposure to cigarette advertisements in Sleman, Indonesia. METHODOLOGY: A non-experimental study with a correlation study and a cross-sectional approach. The sample was 318 respondents with a total sampling technique on first-grade junior high school students from three schools. The research instruments used were a questionnaire on exposure to cigarette advertisements, smoker friends, and the intention to smoke. The bivariate analysis used was the chi-square correlation test. RESULTS: Most of the respondents were exposed to cigarette advertisements in the medium category (56.6%), most of the respondents had smoking friends (57.2%), 11% of respondents had the desire to smoke shortly, and 15.1% of respondents had a desire to smoke for an extended period. The correlation test results between exposure to cigarette advertisements and smoking friends and the desire to smoke in the near and long term showed a p-value of <0.001. CONCLUSION: There was a significant relationship between exposure to cigarette advertisements and friends who smoke and the intention to smoke in the near and long term among adolescents in Sleman Regency, Indonesia.

School policies and smoking intention in a Swiss sample of adolescents

The majority of today’s adult smokers took up the habit during adolescence. The school community and the rules it imposes are important factors that can influence adolescents’ smoking intention and behaviour. Research on the effect of school tobacco policies on adolescents’ smoking concludes with mixed results. Our study aims to look at the influence of these policies on the intention to smoke and to know if this relation is mediated by individual and environmental factors. The study includes information on social norms, attitude towards smoking and smoking intention from 4515 students of 32 Ticino middle schools and on the tobacco policy implemented in this school. Linear regression indicates a marginal impact of school policy on intention to smoke. Schools that strongly enforce tobacco policy obtain an increase in their students’ intention to smoke, while schools that implement assistance programmes to overcome tobacco use decrease intention to smoke. Mediation models show that the influence of some of tobacco policy dimensions on the intention to smoke is mediated by personal attitudes towards smoking, beliefs about health consequences of smoking and perceived peers smoking. Increasing visibility of tobacco policies and having tobacco prevention programmes have stronger positive effects on smoking intention than other policy dimensions, but only through the mediation of individual and environmental factors.

Predicting Tobacco Smoking among Adolescents Using Social Capital and Media Exposure with Theory of Planned Behavior:

Tobacco smoking remains an ongoing and dire public health threat globally. Identifying factors that influence individuals&rsquo; smoking behavior is critical especially among adolescents. This study aimed to determine the effects of media exposure to tobacco advertisement, social capital, and other factors, on tobacco smoking among adolescents using Theory of Planned Behavior (TPB). This cross-sectional study was conducted in KulonProgo District, Yogyakarta Province, Indonesia, in April 2018. The dependent variable was smoking behavior. The independent variables were intention to smoke, attitude toward smoking, knowledge about tobacco use, subjective norm toward smoking, perceived behavior control not to smoke, media exposure to cigarette advertisement, and social capital among peer adolescents. The data were collected by questionnaire and analyzed by path analysis run on Stata 13. The TPB constructs including attitude toward smoking (b = 0.90; 95% CI = 0.29 to 1.51; p = 0.004), subjective norm toward smoking (b = 1.59; 95% CI = 0.99 to 2.19; p &lt; 0.001), and perceived behavior control not to smoke (b = -2.07; 95% CI = -2.68 to -1.45; p &lt; 0.001), had impact on intention to smoke and smoking behavior. Exposure to tobacco advertisement had indirect impact on smoking behavior through attitude toward smoking and intention to smoke. Weak social capital had indirect impact on smoking behavior through subjective norm toward smoking and intention to smoke. It concludes thatTPB can be used to explain smoking behavior among adolescents.

“Decide Now, Buy Marlboro”: Examining the influence and appeal of Marlboro’s new brand architecture among Filipino adolescents

In recent years, Philip Morris International (PMI) launched a global rebranding strategy to expand the reach of Marlboro. Using a mixed-methods design, this study evaluated the appeal and influence of Marlboro advertising among Filipino youth. Six hundred and twenty-three adolescents aged 13–17 years old in Metro Manila participated in a survey, including three advertising conditions: two for Marlboro and one for Mighty, a local cigarette brand. One-way repeated measures analysis of variance (ANOVA) and paired t-tests evaluated differences between the three conditions on participants’ attitudes toward advertisements [measured as identification, likeability, and perceived effectiveness (PE)]. Compared to Mighty, never-smokers rated Marlboro advertisements as more identifiable and likeable. Comparing by smoking status (never vs. ever), multivariable logistic regression assessed the influence of these attitudes on intention to smoke. Increased likeability was associated with greater intention to smoke among never-smokers, and greater PE increased odds of intention to smoke for both never- and ever-smokers. Additionally, six focus group discussions (FGD) explored responses to campaign messaging. Themes were compared within and across groups. Marlboro was also appealing to FGD participants, who described the ads as attractive to youth and promoting “adventure” and “freedom”, whereas the Mighty brand was seen as being for adults and current smokers. Our findings illustrate that Marlboro advertisements are distinctly appealing to youth. Marlboro rhetoric – where consumers are urged to “decide” to “Be Marlboro” – was particularly powerful. These findings support the need for addressing gaps in policies regulating the marketing and promotion of tobacco in the Philippines.