Most smokers pick up the habit as
adolescents, drawn to cigarettes, in part, by advertisements featuring
attractive models in playful poses, or cool movie characters whose
mystique is enhanced by the fact that they smoke.
Teens would be less likely to smoke by learning to view ads and other
types of media more analytically, the results of a study in the current
issue of
Archives of Pediatric and Adolescent Medicine suggest.
The study provides some of the first quantitative evidence that
training teens about the messages and motivations behind various types
of media has the potential to reduce teen smoking. Researchers from the
University of Pittsburgh School of Medicine developed a scale to
measure smoking media literacy (SML), or the ability to analyze and
evaluate the messages, motivations and tactics behind advertisements and
other mass media portrayals of tobacco, and found that the results
correlated with teens' current smoking patterns, intentions to smoke and
attitudes about smoking.
Surprisingly, association between SML and smoking behaviors was
stronger, in some cases, than other known predictors, such as
socioeconomic status, parental smoking and stress.
"Many of the other factors that influence smoking behaviors are
things that we cannot control," said Brian Primack, M.D., Ed.M.,
assistant professor in the school's division of general internal
medicine, and lead author of the study. "Media literacy is one of the
few areas in which we can actively affect change."
More than 1,200 suburban Pittsburgh high school students who
participated in the study were assigned scores ranging from 0-10 based
on their responses to an 18-item survey. Students responded to
statements such as, "When people make movies and TV shows, every camera
shot is very carefully planned," "Most movies and TV shows that show
people smoking make it look more attractive than it really is," and
"Advertisements usually leave out a lot of important information," by
indicating whether they strongly agreed, agreed, disagreed or strongly
disagreed. Higher scores represented increased SML. After controlling
for 17 variables such as peer smoking, self-esteem and rebelliousness,
SML still had a statistically significant association with current
smoking (defined as smoking within the last 30 days), intention to smoke
and general attitudes about smoking.
According to the results, a variance as small as one point on the
10-point scale corresponded with a noteworthy divergence in smoking
behaviors. For instance, a student who scored a 7 was 22 percent less
likely to currently be a smoker than his classmate whose SML score came
in at 6, just one point lower, even after controlling for all other
factors. That same student would be 31 percent less likely to be
susceptible to future smoking, according to the study's results.
These findings could be particularly valuable for traditional
school-based intervention programs, which tend to rely heavily on
negative messages and reprimands and frequently fail in their objective
to prevent teen smoking. The study suggests that such tobacco control
programs could be far more effective if they incorporated SML training.
Schools could also better evaluate SML educational program effectiveness
by quantifying outcomes through pre- and post-training measurements.
"It's encouraging that media literacy, which is so eminently
teachable, shows such promise as a component of a comprehensive tobacco
intervention program," Dr. Primack said. "Our ability to measure that
awareness, using the scale we developed as a tool, can provide hard
evidence about which programs are effective as well."
Despite the study's promising findings, the researchers have
identified several areas that warrant further examination. For example,
norms - students' expressed perception of how acceptable or unacceptable
smoking is among their family and friends - was the one area that showed
no significant independent association with SML after controlling for
all variables. The researchers plan to explore that relationship to
determine if there truly is no link, or if the norm measurement tool
that they used was not representative of the true nature of smoking
norms. Also, the student population surveyed was homogeneous in terms of
race, ethnicity and geography, so the results will need to be confirmed
in more diverse populations. Finally, a longitudinal study that tracks
the relationship between higher SML scores and future decisions to begin
smoking could provide valuable insight.
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