Smoking Behavior, Information Sources, and Consumption Values of Teenagers: Implications for Public Policy and Other Intervention Failures

This paper uses a hierarchical decision process model, uses of information, and a theory of consumption values as a strategic framework for evaluating the general failure of intervention strategies for teenage smoking initiation. Extremely high smoking consideration-to-trial rates and rapid cessation by occasional smokers provide narrow but unused strategic opportunities for intervention. Use of information sources varies by stage of model with interpersonal sources dominating consideration, trial, and cessation stages and mass media showing only a slightly increasing use in cessation compared to the earlier stages. The decision process model and consumption values are necessary for planning strategic interventions. Existing intervention programs are not appropriately targeted in the decision process. Programs should be developed to reduce the smoking consideration to trial rates in younger children and to encourage rapid cessation in older teenagers. The use of either print or broadcast mass media interventi on programs is not supported. Continuing high levels of teenage tobacco use in the United States and elsewhere cast doubts on the success of public policy interventions and the efficacy of widely held teenage smoking beliefs. While levels of teenage smoking have recently shown a slight decrease, high-school smoking rates are more than one-fourth higher than in 1991, and the percentage of frequent high-school smokers has risen approximately 32% during the same time period (Brooks 2000). Surprisingly, little appears to have changed since 1988, when one group of researchers observed: In spite of the attention, smoking behavior among adolescents has not decreased appreciably over the past five years, and the most intensive intervention efforts have been judged to be only of modest success (Cleary et al. 1988, p. 137). In that time frame, teenage smoking prevention programs were described as "modest" and "fragile" and having unwarranted optimism about their potential impact (Cleary et al. 1988, p. 149). Other researchers then questioned government regulations and policies in terms of effectiveness in achieving desired objectives (McAuliffe 1988; Ringold and Calfee 1990; Calfee and Ringold 1992). Today there is evidence that even total advertising bans may have only a limited effect on teenage smoking behavior (Langreth 1997). and attempts to limit youth access to tobacco have had limited, though not statistically significant, results (Forster et al. 1998). Seigel and Beiner (1997) reviewed two "successful" statewide anti-tobacco campaigns and found neither program reduced smoking initiation among adolescents. Advertising and antismoking information were found to be less important in predicting adolescent smoking levels than peer pressure and prior beliefs. Others have questioned the value of health warning labels for adolescents (Cecil, Evans, and Stanley 1996) and exposure to antismoking messages and advertisements, (Murray, Prokhorov, and Hardy 1994; Pechmann and Tatneshwar 1994). Even the impact of tobacco advertising campaigns such as "Joe Camel" on youth smoking has been recently questioned (Calfee, 2000; Cohen 2000). The ongoing tobacco company legal settlements and recent smoking discouragemen t strategies proposed by the tobacco industry (Beck 1996; Hwang 1995; Freedman and Hwang 1997) seem to be ineffectual as the teenage smoking situation is not improving. Previous findings that adolescents were smoking at a higher rate led politicians to state that children were condemning themselves to a lifetime of pain and disease (Buckley 1995; Consumer Reports 1995; Hwang 1995), and were interpreted as a continuing and major public policy failure. Teenage tobacco use continues as a major source of preventable disease, a major social problem, and a major pediatric illness, as well as a major growth market for tobacco companies (Public Health Service 1990; Kessler 1995). …