The impacts of media messaging and age and sex variance on adolescent smoking habits in Croatia.

OBJECTIVES: To analyze the effects of age, sex, and media messages that encourage or discourage smoking, in conjunction with having 1 or more parents, close friends, teachers, or family members who smoke, on differences in patterns of adolescent smoking. METHODS: This research is based on Croatian responses to the 2011 Global Youth Tobacco Survey. A total of 4245 Croatian youths responded to the Global Youth Tobacco Survey, of which individuals 3551 were aged 13 to 15 years. Of this cross section, 1644 individuals were male; 1856 were female; and 51 were of unknown sex. RESULTS: There were significant differences among responses in terms of age. Older adolescents were more likely to smoke (P < 0.001) and more likely to experience the following: (1) outdoor exposure to other smokers, including teachers (P < 0.001) and fellow students (P < 0.001); (2) smoking in the presence of parents or guardians (P < 0.001) and best friends (P < 0.001). The most prominent predictor of smoking among male adolescents was the existence of a best friend who smokes, with an odds ratio of 6.38 and a corresponding 95% confidence interval of 3.69 to 11.01. Likewise, the most prominent predictor among female adolescents was also the existence of a best friend who smokes, with an odds ratio of 10.21 and a corresponding 95% confidence interval of 4.94 to 21.13. The majority of nonsmokers, 65.5% (n = 1640), and smokers, 58.8% (n = 506), have never seen advertisements for cigarettes broadcast during televised concerts, and 58.5% of nonsmokers (n = 1469) and 58.6% of smokers (n = 505) have never seen advertisements for cigarettes while attending concerts. CONCLUSIONS: Our study shows that there is no sex difference between the number of nonsmokers and smokers. Older adolescents tend to smoke more, and students who smoke outside reported seeing other adolescents and their teachers smoking almost daily. A majority of youths who reported that they smoke have parents who smoke at home and have close friends who smoke; having a close or best friend who smokes is the highest prediction factor that both male and female youths will begin smoking. The majority of nonsmokers and smokers have never seen pro-smoking messages when going to concerts or during other community and social events. This lack of exposure to smoking-related advertising is the result of new legal restrictions imposed in 2008 on tobacco-product producers. There is no statistical significance among smokers' and nonsmokers' perceptions of antismoking media messaging. Peer pressure has been shown to be the second-most influential factor, after having a best friend who smokes, for the likelihood that an individual will become a smoker, among both male and female adolescents.