The Mediating Role of Parental Factors in the Social Patterning of Smoking among Adolescents in Urban Indonesia.

INTRODUCTION: Parental factors may explain part of the social patterning of smoking among adolescents. This study aims at assessing the association between adolescent smoking and family characteristics (parental education, family wealth, and religion) and the mediating role of parental factors (smoking, control, and permissiveness towards smoking). METHODS: In 2017, a cross-sectional survey was conducted in eight Indonesian cities among 2,393 students aged 13-18 years. Multilevel logistic regression analysis estimated the associations between family characteristics and adolescent smoking. Generalized Structural Equation Models (GSEM) quantified mediation of these associations by parental factors. Analyses were stratified by gender. RESULTS: Smoking prevalence was 35.8% among boys and 2.6% among girls. Odds of smoking were higher among those with lower parental education among boys (low vs. high: OR:1.57, 95%CI:1.01-2.43), but not girls (OR:0.91, 95%CI:0.24-3.43). The association among boys was partially mediated by father's smoking status, parental control, and parental permissiveness towards smoking. High family wealth was associated with higher odds of smoking among girls (poorer vs. wealthier: OR:0.39, 95%CI:0.15-0.99), but not boys (OR:0.76, 95%CI:0.52-1.10). This association among girls was not clearly mediated by parental factors. Religion was not associated with smoking among boys or girls. CONCLUSIONS: In Indonesia's urban settings, inequalities in boys' smoking by educational background may be addressed by measures aimed at supporting lower educated parents to improve parental control and to reduce permissiveness towards smoking.

Meanings about participation in a formation of restorative practices / Sentidos sobre a participação em uma capacitação em práticas restaurativas / Sentidos sobre la participación en una formación de prácticas restaurativas

Restorative Justice (JR) involves ethical, philosophical and political principles in understanding human conflicts in different contexts. Considering the importance and scarcity of studies related to the training processes of facilitators in restorative practices, the objective of this study was to understand the meanings produced about participation in these formations. Representatives of each social group enrolled in a training in restorative practices were interviewed. From the thematic analysis of the interviews, the analytical axes "for what," "who" and "how" were created. The results showed that the participants had changes in the quality of listening, communication, and understanding of conflict and punishment. However, the participants were unsure of facilitating restorative circles, which demonstrates the need for more practical exercises. Building the group's conversational context can help align expectations and decrease anxiety levels and dropout rates during the training process.

A Justiça Restaurativa (JR) envolve princípios éticos, filosóficos e políticos na compreensão dos conflitos humanos em diferentes contextos. Considerando a importância e escassez de estudos referentes a processos formativos de facilitadores em práticas restaurativas, o objetivo deste estudo foi compreender os sentidos produzidos sobre a participação nessas formações. Entrevistaram-se representantes de cada grupo social inscrito em uma capacitação de práticas restaurativas. A partir da análise temática das entrevistas, foram criados os eixos analíticos "para que", "quem" e "como". Os resultados mostraram que os participantes tiveram mudanças na qualidade da escuta, da comunicação e do entendimento de conflito e punição. Entretanto, os participantes se mostraram inseguros para facilitar os círculos restaurativos, o que demonstra a necessidade de mais exercícios práticos. Realizar a construção do contexto conversacional do grupo pode colaborar para alinhar expectativas e diminuir os níveis de ansiedade e taxa de abandono no decorrer do processo formativo.

La Justicia Restaurativa (JR) involucra principios éticos, filosóficos y políticos en la comprensión de los conflictos humanos en diferentes contextos. Teniendo en cuenta la importancia y la escasez de los estudios relacionados con los procesos de capacitación de los facilitadores en las prácticas restaurativas, el objetivo de este estudio fue comprender los sentidos producidos sobre la participación en estas formaciones. Se entrevistó a representantes de cada grupo social inscrito en una capacitación en prácticas restaurativas. A partir del análisis temático de las entrevistas, se crearon los ejes analíticos "para qué", "quién" y "cómo". Los resultados mostraron que los participantes tuvieron cambios en la calidad de la escucha, la comunicación y la comprensión del conflicto y el castigo. Sin embargo, los participantes no estaban seguros de facilitar los círculos restaurativos, lo que demuestra la necesidad de ejercicios más prácticos. Construir el contexto conversacional del grupo puede ayudar a alinear las expectativas y disminuir los niveles de ansiedad y las tasas de abandono durante el proceso de capacitación.

Snowball Effect of User Participation in Online Environmental Communities: Elaboration Likelihood under Social Influence.

Ecological preservation and sustainable development depend on active public involvement. The emergence of online environmental communities greatly facilitates people's participation in green endeavors. The population penetration of such platforms accelerates as existing users persuade people around them and media coverage further attracts public attention. This snowball effect plays an important role in the user base expansion, but the specific mechanism of social influence involved is yet to be examined. Based on the social influence theory, cognitive response theory, and elaboration likelihood model, this study establishes a research model depicting the relationship between persuasion in terms of social influence and outcomes in terms of behavioral intention and actual participation through the mediation of cognitive responses in terms of perceived value and perceived risk. Empirical results from survey observations show that social influence has both moderated (by education) and mediated (through perceived risk) effects on behavioral intention, which leads to actual participation. Meanwhile, social influence shapes the perceived value, which has a direct and strong impact on actual participation. These central and peripheral routes through which social influence affects individual participation yield useful theoretical and practical implications on human behavior with online environmental communities.

Defining Barriers and Facilitators to Advancement for Women in Academic Surgery.

Importance: Sex equity is elusive in academic surgery departments across the United States. Persistent inequities remain a considerable problem and inhibit professional advancement for female surgeons. Identifying the factors that promulgate sex discrepancies may provide a framework for institutional growth and personal progress for women. Objective: To identify barriers and facilitators to success at the individual and organizational level to develop evidence-based interventions designed to close the sex gap in surgery. Design, Setting, and Participants: This qualitative study included 26 female participants who were current and former surgical faculty employed by Michigan Medicine, the health system of the University of Michigan, between 2000 and 2017. Semistructured personal interviews were conducted from June 28 to September 29, 2017, via telephone. Each interview lasted 45 minutes to 1 hour. Interviews were recorded and then transcribed for analysis. Main Outcomes and Measures: The interview included 7 questions referring to the surgeon's experience with the Michigan Medicine Department of Surgery and 7 questions referring to nonspecific areas of interest. Results: The 26 participants in this study ranged in age from 32 to 64 years, with faculty experience ranging from 3 to 22 years. Thematic analysis was used to locate, analyze, and report patterns within the data related to barriers and facilitators for women in academic medicine. Three major themes were identified by researchers. Participants reported that (1) organizational culture and institutional policies affect opportunities for advancement; (2) relational interactions with leadership, mentors, colleagues, and staff affect promotion and attrition; and (3) individual characteristics mediate the perception of professional and personal success. Conclusions and Relevance: In this qualitative study of 26 female academic surgeons, a complex matrix of organizational and individual factors were found to contribute to sex inequities in academic surgery. This research may provide insight into the sex biases that inhibit advancement, may inform strategies that facilitate progress, and may inspire interventions that could help eliminate institutional and individual barriers to the academic success of women.

Implementing physical activity programs for patients with cancer in current practice: patients' experienced barriers and facilitators.

PURPOSE: The present study aimed to identify patients' experienced barriers and facilitators in implementing physical activity programs for patients with cancer. METHODS: We interviewed 34 patients in focus-group-interviews from three different hospital-types. We included patients with cancer who were either receiving curative treatment or had recently completed it. Barriers and facilitators were explored in six domains: (1) physical activity programs, (2) patients, (3) healthcare professionals (HCPs), (4) social setting, (5) organization, and (6) law and governance. RESULTS: We found 12 barriers and 1 facilitator that affect the implementation of physical activity programs. In the domain of physical activity programs, the barrier was physical activity programs not being tailored to the patient's needs. In the domain of patients, lacking responsibility for one's own health was a barrier. Knowledge and skills for physical activity programs and non-commitment of HCPs impeded implementation in the domain of HCPs. Barriers in the domain of organization included inconvenient place, time of day, and point in the health treatment schedule for offering the physical activity programs, inadequate capacity, inaccessibility of contact persons, lack of information about physical activity programs, non-involvement of the general practitioner in the cancer care process, and poor communication between secondary and primary HCPs. Insufficient insurance-coverage of physical activity programs was a barrier in the domain of law and governance. In the domain of physical activity programs, contact with peers facilitated implementation. We found no barriers or facilitators at the social setting. CONCLUSIONS: Factors affecting the implementation of physical activity programs occurred in various domains. Most of the barriers occurred in the domain of organization. IMPLICATIONS FOR CANCER SURVIVORS: An implementation strategy that deals with the barriers might improve the implementation of physical activity programs and quality of life of cancer survivors.

Scars of disengagement: perspectives on community leadership and youth engagement in rural South Africa.

Given the emerging global youth disengagement epidemic, anticipated population growth, and the threat of continued rural-urban migration among young adults, recent research has focused on community leadership practice and the factors that influence youth engagement at the local level. Studying these practices and factors can elicit interventions that can improve youth engagement and youth health. This study engaged South African rural community leaders in interviews to collect perceptions and experiences on community leadership and factors that influence youth engagement and their health behaviors. Content analysis was used to analyze the data. Emergent themes are categorized into four domains: conceptualizations of leadership, current youth behaviors, barriers to youth engagement, and youth leadership opportunities and potential solutions. Findings demonstrate a clear grasp of the concept of community leadership among community leaders, and an awareness of the complex interplay of social, economic and environmental factors on youth disengagement and the potential interventions to promote more youth participation.

Sowing social inclusion for marginalised residents of a social housing development through a community garden.

ISSUE ADDRESSED: In addition to food, physical activity, mental health and environmental benefits, community gardens (CGs) provide opportunities for social inclusion and increased social capital. These are particularly important to the socially isolated residents of social housing developments (SHDs). This scoping study explored the feasibility of a CG program for tenants of SHD in inner eastern Melbourne by assessing their interest in, and requirements for, inclusively designed CGs. METHODS: In this phenomenological enquiry, focus group discussions, supported by photo-elicitation, were employed. Three focus groups (N = 19) were conducted with self-selected participants who consented to participate. Two focus groups were conducted with English-speaking tenants while a third focus group was conducted with Mandarin-speaking tenants. RESULTS: There was a demand for CGs by the English-speaking participants driven by desire for networking, social connectedness and inclusion; for improved access to fresh produce, connection with nature, physical activity and mental well-being. Participants expressed interest in a garden located near their SHD with supportive physical and social environments including disability access, plot autonomy, fencing, socio-cultural events, training programs and management opportunities. However, the Mandarin-speaking tenants maintained that age, language difficulty and neighbourhood insecurity posed significant barriers to their participation. CONCLUSION: Guided by the Ottawa Charter for Health Promotion, social inclusion and community development theories, the study recommends that to establish socially inclusive CGs, a dynamic relationship of the design principles of a CG and the socio-ecological determinants of health should be established to address any barriers and successfully facilitate engagement. In addition, CG programs need to be guided by community development principles. Future research could employ community-based participatory research models in the implementation and evaluation of a CG program for socially isolated population groups.

The development of children's preferences for equality and equity across 13 individualistic and collectivist cultures.

A concern for fairness is a fundamental and universal element of morality. To examine the extent to which cultural norms are integrated into fairness cognitions and influence social preferences regarding equality and equity, a large sample of children (N 2,163) aged 4-11 were tested in 13 diverse countries. Children participated in three versions of a third-party, contextualized distributive justice game between two hypothetical recipients differing in terms of wealth, merit, and empathy. Social decision-making in these games revealed universal age-related shifts from equality-based to equity-based distribution motivations across cultures. However, differences in levels of individualism and collectivism between the 13 countries predicted the age and extent to which children favor equity in each condition. Children from the most individualistic cultures endorsed equitable distributions to a greater degree than children from more collectivist cultures when recipients differed in regards to wealth and merit. However, in an empathy context where recipients differed in injury, children from the most collectivist cultures exhibited greater preferences to distribute resource equitably compared to children from more individualistic cultures. Children from the more individualistic cultures also favored equitable distributions at an earlier age than children from more collectivist cultures overall. These results demonstrate aspects of both cross-cultural similarity and divergence in the development of fairness preferences.

Facilitating successful implementation of a person-centred intervention to support family carers within palliative care: a qualitative study of the Carer Support Needs Assessment Tool (CSNAT) intervention.

BACKGROUND: An understanding of how to implement person-centred interventions in palliative and end of life care is lacking, particularly for supporting family carers. To address this gap, we investigated components related to successful implementation of the Carer Support Needs Assessment Tool (CSNAT) intervention, a person-centred process of carer assessment and support, using Promoting Action on Research Implementation in Health Services (PARIHS) as a theoretical framework. This study identifies how the PARIHS component of 'facilitation' and its interplay with the components of 'context' and 'evidence' affect implementation success. METHODS: MRC Framework Phase IV study to evaluate implementation of the CSNAT intervention at scale, over six months, in 36 UK palliative care services. 38 practitioners acting as internal facilitators in 35/36 services were interviewed. Field notes were collected during teleconference support sessions between the external and internal facilitators. RESULTS: Successful implementation was associated with internal facilitators' 'leverage' including their positioning within services, authority to change practice, and having a team of supportive co-facilitators. Effective facilitation processes included a collaborative approach, ongoing communication, and proactive problem solving to address implementation barriers. Facilitators needed to communicate the evidence and provide legitimacy for changing practice. Contextual constraints on facilitation included having to adjust recording systems to support implementation, organisational changes, a patient-focused culture and lack of managerial support. CONCLUSIONS: The CSNAT intervention requires attention to both facilitation processes and conducive organisational structures for successful implementation. These findings are likely to be applicable to any person-centred process of assessment and support within palliative care.

A Randomized Trial of High-Value Change Using Practice Facilitation.

PURPOSE: To understand how focused versus general practice facilitation can impact goal setting, action planning, and team performance in primary care transformation. BACKGROUND: Practice transformation in primary care is a crucial part of health reform, but can fatigue teams, leading to variable results. Practice facilitation may reduce primary care fatigue to help teams reach challenging transformation goals, but may require a more focused approach than previous studies suggest. METHODS: We performed a 12-month cluster randomized trial, during which 8 primary care clinics received practice facilitation. Four practices in the intervention arm received targeted facilitation to focus quality improvement (QI) goals on high-value elements (HVEs) intended to reduce cost and utilization, whereas 4 control practices received generalized QI facilitation. We investigated the impact of the targeted versus generalized approach on goal selection, action item selection and achievement, HVE attainment, and collaborative practice, using quantitative and qualitative methods. RESULTS: Intervention clinics selected an average of 7 goals and 29 action items, compared with 8 goals and 40 action items among controls. Eighty-three percent of intervention goals were related to HVEs, compared with 27% of goals among controls. Intervention clinics selected 101 HVE goals and met 68%, while controls selected 41 and met 61%. Analysis of pre-post practice surveys indicated greater improvement among intervention across 4 of 8 domains of collaborative practice. CONCLUSION: Targeted facilitation may be more effective than a generalized approach to support practices in reaching high-value change goals, as well as fostering improvement of team focus on goals, roles and responsibilities.

Do unto others: How cognitive fusion shapes the transmission of moral behavior.

Moral transmission is the concept that moral behaviors can be contagious, spreading from person to person like a pathogen of social influence. We investigated how cognitive fusion-a transdiagnostic vulnerability to diverse mental health problems-influences moral transmission across 3 studies (N = 891) using real behavioral outcomes, including economic game decisions and donations to charity. The findings suggest that cognitively fused individuals are more susceptible to moral transmission because (a) they are more likely to pay forward or pay back moral behavior, and (b) they are more likely to engage in compensatory moral behavior. In fact, (c) our analyses revealed a more direct association between these 2 psychological processes, supporting our argument that moral transmission can integrate a variety of seemingly discrete social phenomena. As predicted, participants with more depression and anxiety symptoms revealed patterns of behavior similar to those high in cognitive fusion. Implications for research in both social and clinical psychology are discussed. (PsycINFO Database Record

Alcohol Expectancy, Drinking Behavior, and Sexual Victimization Among Female and Male College Students.

College students have high rates of heavy drinking, and this dangerous behavior is strongly linked to sexual victimization. Although research has examined risk factors for sexual assault, few studies have simultaneously studied the various pathways through which risks may affect sexual assault and how these pathways may be uniquely different among females and males. As such, the current study uses path analyses to examine whether alcohol expectancies mediate the relationship between social factors (e.g., hooking up, amount friends drink) and drinking behavior and experiencing sexual victimization, and whether drinking behavior mediates the relationship between alcohol expectancies and sexual victimization among a college sample of 704 males and females from a large Midwestern university. For both females and males, sexual victimization was positively associated with child sexual abuse, hooking up more often, and heavier drinking, whereas greater alcohol expectancies were associated with sexual victimization only for females. Several mediating pathways were found for both females and males. Gender comparisons revealed that some of the pathways to sexual victimization such as hooking up, amount friends drink, and housing type operated differently for females and males.

Do organizational and political-legal arrangements explain financial wrongdoing?

The 2008 financial crisis was a systemic problem with deep-rooted structural causes that created opportunities to engage in financial malfeasance, a form of corporate wrongdoing. However, few quantitative studies exist on the effects of organizational and political-legal arrangements on financial malfeasance. In this paper, we examine the effects of organizational and political-legal arrangements that emerged in the 1990s in the FIRE sector (i.e., financial, insurance, and real estate) on financial malfeasance. Our historical contextualization demonstrates how changes in the political-legal arrangements facilitate the emergence of new corporate structures and opportunities for financial malfeasance. Our longitudinal quantitative analysis demonstrates that US FIRE sector corporations with a more complex organizational structure, larger size, lower dividend payment, and higher executive compensation are more prone to commit financial malfeasance.

Leading the Way on Diversity: Community Psychology's Evolution from Invisible to Individual to Contextual.

To take up the AJCP editor's call to think forward in this article, I offer up three challenges that revolve around further contextualizing our understandings of diversity, i.e., reconsidering the notion of "difference" between discrete categories; more fully emphasizing diversity as socially situated; and further delving into local, setting-specific practices that shape the meanings of diversity. Enhanced attention to these three challenges can transform theory, research, and action about diversity as we move into community psychology's next 50 years.

Faster but Less Careful Prehension in Presence of High, Rather than Low, Social Status Attendees.

Ample evidence attests that social intention, elicited through gestures explicitly signaling a request of communicative intention, affects the patterning of hand movement kinematics. The current study goes beyond the effect of social intention and addresses whether the same action of reaching to grasp an object for placing it in an end target position within or without a monitoring attendee's peripersonal space, can be moulded by pure social factors in general, and by social facilitation in particular. A motion tracking system (Optotrak Certus) was used to record motor acts. We carefully avoided the usage of communicative intention by keeping constant both the visual information and the positional uncertainty of the end target position, while we systematically varied the social status of the attendee (a high, or a low social status) in separated blocks. Only thirty acts performed in the presence of a different social status attendee, revealed a significant change of kinematic parameterization of hand movement, independently of the attendee's distance. The amplitude of peak velocity reached by the hand during the reach-to-grasp and the lift-to-place phase of the movement was larger in the high rather than in the low social status condition. By contrast, the deceleration time of the reach-to-grasp phase and the maximum grasp aperture was smaller in the high rather than in the low social status condition. These results indicated that the hand movement was faster but less carefully shaped in presence of a high, but not of a low social status attendee. This kinematic patterning suggests that being monitored by a high rather than a low social status attendee might lead participants to experience evaluation apprehension that informs the control of motor execution. Motor execution would rely more on feedforward motor control in the presence of a high social status human attendee, vs. feedback motor control, in the presence of a low social status attendee.

Scaling-Up Youth-Led Social Justice Efforts through an Online School-Based Social Network.

The exploration of social networking sites (SNS) in promoting social change efforts offers great potential within the field of community psychology. Online communities on SNS provide opportunities for bridging across groups, thus fostering the exchange of novel ideas and practices. Currently, there have only been limited efforts to examine SNS within the context of youth-led efforts. To explore the potential of SNS to facilitate the diffusion of social justice efforts between distinct youth groups, we linked three school-based youth-led participatory action research projects involving 54 high school students through a SNS. This study offers an innovative methodological approach and framework, utilizing social network analysis and strategic sampling of key student informants to investigate what individual behaviors and online network features predict student adoption of social change efforts. Findings highlight prospective facilitators and barriers to diffusion processes within a youth-led online network, as well as key constructs that may inform future research. We conclude by providing suggestions for scholars and practitioners interested in examining how SNS can be used to enhance the diffusion of social justice strategies, youth-led engagement efforts, and large-scale civic organizing.

Perceived Benefits, Facilitators, Disadvantages, and Barriers for Physical Activity Amongst South Asian Adolescents in India and Canada.

OBJECTIVES: The purpose of this study was to understand perceived benefits, facilitators, disadvantages, and barriers for physical activity among South Asian adolescents in India and Canada. METHODS: Thirteen focus group discussions with South Asian (origin) adolescent boys and girls of different nutritional status and socioeconomic status in rural and urban India and urban Canada. RESULTS: Across the groups, fitness and 'energy' were perceived to be major benefits of physical activity. In India, better academic performance was highlighted, while health benefits were well detailed in Canadian groups. In all settings, friends, family, and teachers were perceived as facilitators of as well as barriers to physical activity. Lack of a safe space to play was a major concern for urban adolescents, while academic pressures and preference for other sedentary recreational activities were common barriers across all groups. Girls were less likely than boys to be interested in physical activity, with girls' participation in India further limited by societal restrictions. CONCLUSION: The study suggests key areas for promotion of physical activity among South Asian adolescents: balance between academic pressure and opportunities for physical activity, especially in India; urban planning for a built environment conducive to physical activity; and gender-sensitive programming to promote girls' activity which also addresses culture-specific barriers.

Social patterning in grip strength, chair rise, and walk speed in an aging population: the Czech HAPIEE Study.

BACKGROUND: The aim was to examine the association of objective measures of physical functioning (PF) with education and material circumstances and the decline in PF with age by socioeconomic position (SEP). METHODS: In 3,205 subjects (60-75 years) from the Czech Republic, we assessed relationship between PF, SEP, and age. Linear regression was used to assess PF measures and SEP measures. RESULTS: Cross-sectional decline in PF by age was similar in all individuals. Differences between SEP groups were similar across age groups, except for the difference in walk speed by material circumstances in men-bigger at older ages (p = .004). Men and women with the highest education were about 2 s faster at the chair rise test than those with the lowest education. DISCUSSION: Findings suggest strong educational gradient in PF, an inconsistent role of self-assessed material circumstances, and virtually no interaction of SEP with the cross-sectional decline in PF by age.

Correlates of prescription drug market involvement among young adults.

BACKGROUND: While a significant minority of prescription drug misusers report purchasing prescription drugs, little is known about prescription drug selling. We build upon past research on illicit drug markets, which increasingly recognizes networks and nightlife as influential, by examining prescription drug market involvement. METHODS: We use data from 404 young adult prescription drug misusers sampled from nightlife scenes. Using logistic regression, we examine recent selling of and being approached to sell prescription drugs, predicted using demographics, misuse, prescription access, and nightlife scene involvement. RESULTS: Those from the wealthiest parental class and heterosexuals had higher odds (OR=6.8) of selling. Higher sedative and stimulant misuse (OR=1.03), having a stimulant prescription (OR=4.14), and having sold other illegal drugs (OR=6.73) increased the odds of selling. College bar scene involvement increased the odds of selling (OR=2.73) and being approached to sell (OR=2.09). Males (OR=1.93), stimulant users (OR=1.03), and sedative prescription holders (OR=2.11) had higher odds of being approached. DISCUSSION: College bar scene involvement was the only site associated with selling and being approached; such participation may provide a network for prescription drug markets. There were also differences between actual selling and being approached. Males were more likely to be approached, but not more likely to sell than females, while the opposite held for those in the wealthiest parental class relative to lower socioeconomic statuses. Given that misuse and prescriptions of sedatives and stimulants were associated with prescription drug market involvement, painkiller misusers may be less likely to sell their drugs given the associated physiological dependence.

Socioeconomic status and smokers' number of smoking friends: findings from the International Tobacco Control (ITC) Four Country Survey.

BACKGROUND: Smoking rates are higher among low socioeconomic (SES) groups, and there is evidence that inequalities in smoking are widening over time in many countries. Low SES smokers may be more likely to smoke and less likely to quit because smoking is heavily concentrated in their social contexts. This study investigated whether low SES smokers (1) have more smoking friends, and (2) are more likely to gain and less likely to lose smoking friends over time. Correlates of having more smoking friends and gaining or losing smoking friends were also considered. METHOD: Respondents included 6321 adult current smokers (at recruitment) from Wave 1 (2002) and Wave 2 (2003) of the International Tobacco Control Project (ITC) Four Country Survey, a nationally representative longitudinal cohort survey of smokers in Australia, Canada, UK, and US. RESULTS: Low SES smokers reported more smoking friends than moderate and high SES smokers. Low SES smokers were also more likely to gain smoking friends over time compared with high SES smokers. Smokers who were male, younger, and lived with other smokers reported more smoking friends, and were also more likely to gain and less likely to lose smoking friends. Smoking behaviours, such as higher nicotine dependence were related to reporting more smoking friends, but not to losing or gain smoking friends. CONCLUSIONS: Smoking is highly concentrated in the social networks of lower SES smokers and this concentration may be increasing over time. Cessation interventions should consider how the structure of low SES smokers' social networks affects quitting.