Health Education Research Advance Access originally published online on May 17, 2004
Health Education Research 2004 19(5):561-569; doi:10.1093/her/cyg071
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Health Education Research Vol.19 no.5, © Oxford University Press 2004; All rights reserved
The protective effect of parental expectations against early adolescent smoking initiation
Prevention Research Branch, Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20852-7510, USA
E-mail: MORTONB{at}exchange.nih.gov
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Abstract |
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Substantial research and theory suggests that smoking initiation is socially mediated, with both peers and parents playing important roles. To learn more about how parenting behaviors influence smoking initiation, students (n = 1002) from four middle schools were surveyed at the beginning of the sixth grade (T1), and the end of the sixth (T2) and seventh (T3) grades. T1 and T2 – T1 predictors were regressed on smoking initiation at the end of seventh grade. In bivariate logistic regression analyses, association with friends who smoke, attitudes toward deviance, outcome expectations for smoking, perceived school climate, parental expectations, parental involvement at T1 and increases in these variables (T2 – T1) were associated with smoking initiation at T3, but only the T1 measures of social competence, academic engagement, school adjustment, perceived prevalence, parental monitoring and parental involvement were associated with smoking initiation at T3. In multivariate logistic regression analyses, parental expectations were negatively associated, and increases in attitudes accepting of deviance and affiliation with friends who smoke were positively associated with smoking initiation. Analysis of interactions indicated that parental expectations and monitoring did not mediate the effect on smoking initiation of attitudes toward deviance or the number of friends who smoke. These findings provide evidence that parental expectations may protect early adolescents against smoking even in the context of increases in favorable attitudes and friends who smoking.
Substantial research and theory suggests that smoking initiation is socially mediated, with both peers and parents playing important roles. To learn more about how parenting behaviors influence smoking initiation, students (n = 1002) from four middle schools were surveyed at the beginning of the sixth grade (T1), and the end of the sixth (T2) and seventh (T3) grades. T1 and T2 – T1 predictors were regressed on smoking initiation at the end of seventh grade. In bivariate logistic regression analyses, association with friends who smoke, attitudes toward deviance, outcome expectations for smoking, perceived school climate, parental expectations, parental involvement at T1 and increases in these variables (T2 – T1) were associated with smoking initiation at T3, but only the T1 measures of social competence, academic engagement, school adjustment, perceived prevalence, parental monitoring and parental involvement were associated with smoking initiation at T3. In multivariate logistic regression analyses, parental expectations were negatively associated, and increases in attitudes accepting of deviance and affiliation with friends who smoke were positively associated with smoking initiation. Analysis of interactions indicated that parental expectations and monitoring did not mediate the effect on smoking initiation of attitudes toward deviance or the number of friends who smoke. These findings provide evidence that parental expectations may protect early adolescents against smoking even in the context of increases in favorable attitudes and friends who smoking.
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Introduction |
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Early initiation of smoking increases the likelihood of adult smoking dependence (Chassin et al., 1996
). Smoking rates have declined among adults, but the rate of smoking initiation among early adolescents remains high (Gilpin et al., 1999), more than doubling during middle school from less than 10% of sixth graders to nearly 20% of eighth graders (Simons-Morton et al., 1999). Because early experimentation increases the likelihood of eventual habitual smoking (Chassin et al., 1996; Everett et al., 1999), there is great interest in determining why adolescents start to smoke.
Substantial research and theory suggests that smoking initiation is socially mediated, with both peers and parents playing important roles (Chassin et al., 1990; Conrad et al., 1992). Peer influences appear to be pre-eminent (Conrad et al., 1992), but the nature of peer influences is complex. As the prevalence of smoking increases during adolescence, youth are exposed increasingly to other youth who smoke, which may alter their perceptions about the prevalence and normative nature of smoking (Ajzen and Fishbein, 1973), attitudes about the acceptability, attractiveness and availability of smoking (Jessor and Jessor, 1977), and personal expectations about the consequences of smoking during adolescence (Bandura, 1986). Accordingly, prevalence estimates (Hansen and Graham, 1991) and outcome expectancies (Smith and Goldman 1994) may also be influenced by or interact with peer affiliation. Moreover, youth interested in smoking may select friends who smoke or are accepting of those who do in what Dishion et al. (Dishion et al., 1995) have described as an induction of similarity. Youth who are less socially competent (Harter, 1982), depressed (Conrad et al., 1992) or disengaged from school (Simons-Morton et al., 1999a) may be more susceptible to peer influence and attracted to smoking.
Conceptually, smoking initiation during early adolescence is inconsistent with family management practices that are involved, demanding and responsive, practices sometimes referred to as authoritative (Baumrind, 1991; Simons-Morton et al., 2002). A few studies have shown that authoritative parenting practices are negatively associated with smoking (Dielman et al., 1993; Jackson et al., 1994; Steinberg et al., 1994; Dishion et al., 1995; Simons-Morton et al., 1999). Authoritative parenting behaviors may serve to socialize teens regarding appropriate behavior, and increase the effectiveness of specific expectations and messages discouraging smoking (Darling and Steinberg 1993). Parents who practice consistent and constructive family management practices are likely to develop teens who perceive smoking as deviant and unacceptable, have little motivation to smoke, and may be relatively less susceptible to peer influences to smoke. Dishion et al. (Dishion et al., 1995) have argued and Chassin et al. (Chassin et al., 1993) have shown in a high school population that parenting behavior may provide indirect effects on the selection of peers, and the amount of time and circumstances in which teens spend time with problem-behaving peers, thereby moderating negative peer influences. However, empirical evidence of direct and indirect protective effects of parenting behavior against smoking initiation among early adolescents is limited (Steinberg et al., 1994; Distefan et al., 1998).
The purpose of this study is to examine the effects of antecedent psychosocial factors selected from theory and assessed at the beginning of the sixth grade on smoking initiation assessed at the end of seventh grade. The research seeks to determine the extent to which parenting behaviors are directly protective against smoking initiation or modify the association with smoking initiation of psychosocial factors such as increases in negative peer influences.
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Procedure |
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Two successive cohorts of students in four middle schools in one suburban Maryland school district were surveyed at the beginning (Time 1; T1) and again at the end of the sixth (Time 2; T2) and seventh grades (Time 3; T3). School records indicate that 24% of students were enrolled in the national free or reduced school lunch program, indicating a substantial low-income population residing in this suburban area east of Washington, DC. Special education students with reading difficulties were excluded from data collection. At each measurement time students who had provided written parental consent completed a questionnaire during a 90-min class period. Two trained proctors administered the surveys in each class of 20–35 students. Make-up assessment periods were scheduled the following week for students who were absent on the assessment day. Teachers remained in the classroom during the survey and were responsible for student discipline, but were not involved in the conduct of the survey. Study investigators and project staff served as trainers and team leaders, each supervising several pairs of data collectors. To emphasize confidentiality, students first completed, detached and turned in a cover page that included their name, survey identification number, birth date and home room teacher's name, allowing the investigators to link the respondents across the several surveys. Students were encouraged to complete the questionnaire, but informed that they could skip any questions. The study protocol was approved by the Institutional Review Board of the NICHD and by authorized representatives of the school district.
Sample characteristics
Out of 1490 eligible students, a total of 1270 (85.2%) completed the survey at the beginning of sixth grade (T1). Of those not completing the survey, the parents of 118 refused permission to participate, 47 students did not return a completed consent form and 55 were absent both assessment days. Three surveys from eligible students were incomplete and deemed unusable, thus 1267 students were assessed at T1. Of these, 86% (1122) were also assessed at the end of the sixth grade (T2). Of the 145 not reassessed at T2, 18 were absent both days of the assessment at T2, seven transferred or could not be located, the parents of 41 refused participation and 60 failed to return a parent consent form. In addition, 19 students not identified as special education students with reading difficulties at T1 were identified as such by the school at T2, 30 provided unusable data, leaving an analyzable sample of 1092. At T3, 971 of the 1092 (88.9%), plus 31 assessed at T1, but not at T2, were reassessed. Of these, 47% were female, 53% male, 74.6% were white, 17.8% were black and 7.6% were of other race/ethnicity, 17.8% lived in a single family home, and 67.2% of mothers were educated beyond high school. Of the 121 lost to follow-up from T2 to T3, one was due to parental refusal, 24 were absent, three moved out of the district and could not be located, nine were classified as special education, nine failed and 75 provided unusable data. For regression analyses examining smoking initiation the sample of 971 was reduced to 924 by 47 records for which data were missing. Those assessed at T1, but not T3, were significantly more likely to be male, black, part of a one-parent family and have reported smoking at T1.
Measures
Background variables
Several items provided basic information concerning sex, race, study-school attended, mother's level of education and membership in a single- or two-parent family.
Dependent variable
Smoking was assessed by asking, ‘How many times have you smoked a cigarette, even a puff, in the last 30 days?’. This question is similar to those commonly asked in national substance use surveys (Johnston et al., 1996). Substantial evidence indicates that self-reports produce reliable and valid estimates of substance use when procedures to ensure confidentiality are employed, as in this study (Dolcini et al., 1996).
Independent variables
The primary independent variables of interest were peer and parent influences. Other independent variables were included to provide a more comprehensive assessment of possible determinants of smoking initiation. Measures developed for this study were carefully piloted test and factor analyzed (Simons-Morton et al., 1999b). Included in Table I for each variable is the number of items, coefficient 
and items, and response options. Peer influence was measured by asking the respondent to indicate how many of his or her five closest friends (0–5) smoke. Attitudes toward deviance was assessed by eight items that asked if it is okay (yes or no) for kids your age to smoke, drink, cheat in school, etc.? Outcome expectations were assessed with five items that asked, ‘If you were to smoke cigarettes, how likely would either positive or negative things occur as a result, for example, you would enjoy it or friends would not approve?’. We measured perceived prevalence/social norms with a single item that asked the respondents to indicate the percentage of eighth graders who smoke. We developed eight items measuring social competence based on the conceptualization of Harter (Harter, 1982), in which respondents rated their ability to resist dares, resolve conflicts, communicate and retain self control. Academic engagement was assessed with three items that asked about how hard they tried in school. School climate included five items asking students about their teachers and school. The school adjustment scale consisted of 11 items in which the study participants were asked how well they were able to keep up schoolwork, get schoolwork done on time, etc. Students completed the six-item Weinberger Adjustment Inventory depressive symptoms subscale (Weinberger, 1997).
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Four aspects of parenting behavior were measured. Parental involvement was assessed by a six-item index adapted from Hetherington et al. (Hetherington et al., 1992
) that included items on how much the respondent believed their parents know about their friends, activities and health habits. Parental expectations was assessed by six items in which the study participants reported how upset their parents would be if they found out the teen smoked cigarettes or engaged in other problem behavior. Adolescents were asked about parental monitoring with four questions about how closely their parents kept tabs on them. Parent–teen conflict was assessed with four items about conflict with parents. A single item asked youth to indicate if there was an adult at home who smokes.
Analyses
To focus the analyses on smoking initiation, those who reported smoking at T1 were eliminated from regression analyses. Among non-smokers at T1, study participants who reported at T3 smoking one or more cigarettes in the past 30 days were categorized as smokers. Analyses were conducted using SAS Proc Genmod. Each predictor variable was dichotomized and its relationship to smoking initiation was examined in relation to its value at T1 and also at T2 minus T1 (T2 – T1) to capture change in that variable over time. In preliminary, unadjusted analyses, smoking status was regressed on each predictor variable. The T1 or the T2 – T1 value of each variable with the larger unadjusted odds ratio (OR) was included in the analyses. In the multivariate analyses, sex, race and school were entered into the logistic regression model, along with friends who smoke, parent involvement and parental monitoring. Then each of the remaining independent variables at P 
0.10 in the bivariate analysis was entered into the model one at a time and retained if significant at P 0.05. Selected interactions with main effects were examined.
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Results |
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The overall prevalence of recent (30-day) smoking increased from 3.8% (39 of 1017) at T1 to 10.1% (98 of 966) at T2 to 18% (180 of 1002) at T3, as shown in Table II. Smoking prevalence was significantly higher among boys than girls at T1 (P < 0.05), but not different at T2 or T3. A significantly greater percentage of white than black students reported smoking at each time point.
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Shown in Table III are the means and SDs for each variable at T1 and T2 for T3 non-smokers and smokers. In every case the scores for the variables get worse over time for both groups, with increasing values for variables expected to increase risk, such as friends who smoke, attitudes toward deviance, outcome expectations, perceive prevalence, depression and parent–teen conflict, and deceasing values for the variables expected to decrease risk, such as social competence, academic engagement and parenting behaviors. Consistent differences between non-smokers and smokers can be noted at each time point, and in some cases the differences increased over time. For example, among non-smokers the average number of friends double from T1 to T2, but among smokers it nearly quadrupled. Mean parenting practices declined in both groups, but the decline was greater among smokers than non-smokers.
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In the bivariate logistic regression analyses shown in Table III, both T1 and T2 – T1 measures of friends who smoke, attitudes toward deviance, outcome expectations for smoking and the T1 measure of perceived prevalence were positively associated with smoking status. School climate, parental involvement and parental expectations measured at T1 and T2 – T1, and social competence, academic engagement and parental monitoring assessed at T1, were negatively associated with smoking initiation. School adjustment, depressive symptoms, parent–teen conflict and having an adult at home who smokes were not significantly associated with smoking initiation.
In the multiple logistic regression analyses, shown in Table IV, in which sex, race and school were also controlled, the increases from T1 to T2 in problem-behaving friends and attitudes were positively associated with smoking initiation, while parental expectations at T1 was negatively associated with smoking initiation. The negative association between parental monitoring assessed at T1 and smoking initiation at T3 was not significant. Main effects for sex, race and school were not significant. When the regression analyses were repeated with interaction terms included, no race or sex interactions were found, and parental expectations, parental monitoring and social competence did not interact or modify the associations between smoking initiation and increases in positive attitudes or friends who smoke.
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Discussion |
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The early adolescent transition is typified by dramatic changes in attitudes and behavior, including for many, experimentation with cigarette smoking. Early experimentation with smoking is of particular research interest because it is strongly associated with eventual addiction and related problems (Gilpin et al., 1994). Substantial literature has shown that affiliation with peers who smoke and deviance acceptance increase the likelihood of experimentation with smoking initiation (Conrad et al., 1992
). A much smaller, but growing, literature shows that parenting behaviors provide protective effects against smoking. Our research advances the literature by providing evidence that antecedent parental expectations provided independent protective effects against smoking initiation, even in the presence of increases in affiliation with peers who smoke and attitudes accepting of smoking.
Other research has shown that peer affiliation is associated with smoking initiation among teens (Conrad et al., 1992) and that these influences appear to be more important than parent influences (Dielman et al., 1993; Flay et al., 1994). Our data indicate that increases during the sixth grade in favorable attitudes and affiliation with friends who smoke were stronger predictors of smoking initiation than the initial values assessed at the beginning of sixth grade. Attitudes about smoking may become more positive over time for a number of reasons, including an increasing interest in smoking and perceptions that smoking is normative, as adolescents come in greater contact with young smokers. The association between increases in the number of friends who smoke may reflect peer influence, although recent research among high school students showing that actual offers of tobacco to other teens are infrequent suggests that peer pressure may be less a factor than peer selection (Sussman et al., 1993). Youth may select friends who smoke because they are interested in experimenting with cigarettes, and their peers who smoke provide access to cigarettes and are likely to be accepting of others who smoke.
The negative association between positive parenting behaviors and smoking initiation has been demonstrated in a number of cross-sectional (Conrad et al., 1992; Simons-Morton et al., 1999) and a few prospective papers (Dielman et al., 1993; Flay et al., 1994; Jackson et al., 1994; Steinberg et al., 1994). However, it remains unclear which parenting behaviors provide protective effects and how these effects may operate. The study findings provide evidence that parental expectations were significantly protective and parental monitoring was marginally protective against smoking initiation. The negative relationship between parenting behaviors and smoking initiation is consistent with other research on the effects of parenting behavior on substance use, with monitoring the variable most often identified as the key parenting behavior (Chilcoate and Anthony, 1990; Jackson et al., 1994; Steinberg et al., 1994; Dishion et al., 1995; DiClemente et al., 2001). Surprisingly, we found that expectations was the most important parenting behavior and that effects persisted from the beginning of the sixth grade to the end of the seventh grade. Of course, most parents expect their early adolescent children not to smoke and would be upset if they found out they were smoking, but how clearly these expectations are communicated to early adolescents may vary greatly (Simons-Morton and Haynie, 2003).
The data provided an unusually good opportunity to determine if the protective effect of parenting behaviors was due to indirect effects on changes in attitudes or friends who smoke. In previous analyses of these data through T2 (Simons-Morton, 2002), we found that parental involvement moderated the effects of peer influences on smoking initiation. This earlier finding is consistent with the finding of Dishion et al. (Dishion et al., 1995) who found that boys' substance use was consistent with the behavior of their best friends when parental monitoring and involvement were low. Parental monitoring and involvement may alter the influence of problem-behaving peers primarily by limiting the amount and context of exposure to problem-behaving peers (Dishion et al., 1995), including unsupervised opportunities for problem behavior. The analyses of interactions found no significant mediating effects of attitudes or peer affiliation. Therefore, we conclude that expectations provided an independent effect on smoking initiation, apart from attitudes and peer affiliation. Because most parents of middle school-aged children expect their early adolescent not to smoke, the difference may be how clearly parents transmit their expectations to their children.
The study was limited by inclusion of only four suburban study schools and a brief follow-up period of about 8 months. Study participation was very good, due to the cooperation of the administration and faculty of the study schools and extensive effort on the part of study staff. Those lost to follow-up or excluded from analysis because of baseline smoking behavior were in ways different from the population finally analyzed. Nevertheless, the main finding of the study that parent expectations protected youth from smoking initiation, despite increases in favorable attitudes and affiliation with friends who smoke, is new and important. These findings are consistent with the concept that parenting behaviors early in adolescence provide important protective effects against smoking initiation for several years, despite increases in other, negative psychosocial influences.
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Acknowledgments |
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This research was supported by NIH Contract N01-HD-4-3207. The authors wish to recognize Allen Belsheim for statistical programming.
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References |
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|---|
Ajzen, I. and Fishbein, M. (1973) Attitudinal and normative variables as predictors of specific behaviors. Personality and Social Psychology, 27, 41–57.
Bandura, A. (1986) Social Foundations of Thought and Action: A Social Cognitive Theory. Prentice-Hall, Englewood Cliffs, NJ.
Baumrind, D. (1991) Effective parenting during the early adolescent transition. In Cowan, P.A. and Hetherington, E.M. (eds), Family Transitions. Advances in Family Research Series. Erlbaum, Hillsdale, NJ, pp. 111–163.
Chassin, L., Presson, C.C. and Sherman, S.J. (1990) Social psychological contributions to the understanding and prevention of adolescent cigarette smoking. Personality and Social Psychology Bulletin, 16, 133–135.[Abstract]
Chassin, L., Pillow, D.R., Curran, P.J, Molina, B.S. and Barrera, M. (1993) Relation of parental alcoholism to early adolescent substance use: a test of three mediating mechanisms. Journal of Abnormal Psychology, 102, 3–19.[CrossRef][ISI][Medline]
Chassin, L., Presson, C.C., Rose, J.S. and Sherman, S.J. (1996) The natural history of cigarette smoking from adolescence to adulthood: demographic predictors of continuity and change. Health Psychology, 15, 478–484.[CrossRef][ISI][Medline]
Chilcoate, H.D. and Anthony, J.C. (1996) Impact of parent monitoring on initiation of drug use through late childhood. Journal of the American Academy Child and Adolescent Psychology, 35, 91–100.
Conrad, K.M., Flay, B.R. and Hill, D. (1992) Why children start smoking cigarettes: predictors of onset. British Journal of Addiction, 87, 1711–1724.[CrossRef][ISI][Medline]
Darling, N. and Steinberg, L. (1993) Parenting style as context: an integrative model. Psychological Bulletin, 113, 487–496.[CrossRef][ISI]
DiClemente, R.J., Wingood, G.M., Crosby, R., Sionean, C., Cobb, B.K., Harrington, K., Davies, S., Hook, E.W., III and Oh, M.K. (2001) Parental monitoring: association with adolescent risk behaviors. Pediatrics, 107, 1363–1368.
Dielman, T.E., Butchart, A.T. and Shope, J, T. (1993) Structural equation model tests of patterns of family interaction, peer alcohol use and intrapersonal predictors of adolescent alcohol use and misuse. Journal of Drug Education, 23, 273–316.[ISI][Medline]
Dishion, T.J, Capaldi, D., Spracklen, K.M. and Li, F. (1995) Peer ecology of male adolescent drug use. Development and Psychopathology, 7, 803–824.[ISI]
Dishion, T., Capaldi, D. and Yoerger, K. (1999) Middle childhood antecedents to progressions in male adolescent substance use: an ecological analysis of risk and protection. Journal of Adolescent Research, 14, 175–205.
Dolcini, M.M., Adler, N.E. and Ginsberg, D. (1996) Factors influencing agreement between self-reports and biological measures of smoking among adolescents. Journal of Research on Adolescence, 6, 515–542.
Everett, S.A., Warren, C.W., Sharp, D., Kann, L., Husten, C.G. and Crouter, A.C. (1999) Initiation of cigarette smoking and subsequent smoking behavior among US high school students. Preventive Medicine, 29, 327–333.[CrossRef][ISI][Medline]
Flay, B.R., Hu, F.B., Siddiqui, O., Day, L.E., Hedeker, D., Petraitis, J., Richardson, J. and Sussman, S. (1994) Differential influence of parental smoking and friends; smoking on adolescent initiation and escalation of smoking. Journal of Health and Social Behavior, 35, 248–265.[CrossRef][ISI][Medline]
Gilpin, E.A., Choi, W.S., Berry, C. and Pierce, J.P. (1999) How many adolescents start smoking each day in the United States? Journal of Adolescent Health, 25, 248–255.[CrossRef][ISI][Medline]
Hansen, W.B and Graham, J.W. (1991) Preventing alcohol, marijuana and cigarette use among adolescents: peer pressure resistance training versus establishing conservative norms. Preventive Medicine, 20, 414–430.[CrossRef][ISI][Medline]
Harter, S. (1982) The perceived competence scale for children. Child Development, 53, 87–97.[CrossRef][ISI]
Hetherington, E.M., Clingempeel, W.G., Anderson, E.R., Deal, J.E., Stanley-Hagan, M., Hollier, E.A. and Lindner, M.S. (1992) Coping with marital transition. Monographs of the Society for Research in Child Development, 57, 2–3.
Jackson, C., Bee-Gates, D.J. and Henriksen, L. (1994) Authoritative parenting, child competencies and initiation of cigarette smoking. Health Education Quarterly, 21, 103–116.[ISI][Medline]
Jessor, R. and Jessor, S. (1977) Problem Behavior and Psychological Development: A Longitudinal Study of Youth. Academic Press, New York.
Simons-Morton, B.G. (2002) Prospective analysis of peer and parent influences on smoking initiation among early adolescents. Prevention Science, 3, 275–283.
Simons-Morton, B.G. and Haynie, D. (2003) Growing up drug free: a developmental challenge. In Bornstein, M.H., Davidson, L., Keyes, C.L.M., Moore, K.A. and The Center for Child Well-being (eds), Well-being: Positive Development Across the Life Course. Erlbaum, Mahwah, NJ, pp. 109–122.
Simons-Morton, B.G., Crump, A.D., Saylor, K.E. and Yu, K. (1999a) Student–school bonding and adolescent problem behavior. Health Education Research, 14, 99–107.
Simons-Morton, B.G., Crump, A.D., Haynie, D.L., Saylor, K.E., Eitel, P. and Yu, K. (1999b) Psychosocial, school and parent factors associated with recent smoking among early adolescent boys and girls. Preventive Medicine, 28, 138–148.[CrossRef][ISI][Medline]
Simons-Morton, B.G., Hartos, J. and Haynie, D. (2002) Application of authoritative parenting to adolescent health behavior. In DiClemente, R., Crosby, R. and Kegler, M. (eds), Emerging Theories and Models in Health Promotion Research and Practice: Strategies for Improving Practice. Jossey-Bass, San Francisco, CA.
Smith, G.T. and Goldman, M.S. (1994) Alcohol expectancy theory and the identification of high-risk adolescents. Journal of Research on Adolescence, 4, 229–247.
Stacy, A.W., Sussman, S., Dent, C.W., Burton, D. and Flay, B.R. (1993) Moderators of peer social influence in adolescent smoking. Personality and Social Psychology, 8, 163–172.
Steinberg, L., Fletcher, A. and Darling, N. (1994) Parental monitoring and peer influences on adolescent substance use. Pediatrics, 93, 1060–1064.
Sussman, S., Hahn, G., Dent, C.W., Stacy, A.W., Burton, D. and Flay, B.R. (1993) Naturalistic observation of adolescent tobacco use. International Journal of Addiction, 28, 803–811.[ISI][Medline]
Weinberger, D.A. (1997) Distress and self-restraint as measures of adjustment across the life span: confirmatory factor analysis in clinical and non-clinical samples. Psychological Assessment, 9, 132–135.[CrossRef][ISI]
Received on March 22, 2003; accepted on September 29, 2003
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