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Brief report| Volume 36, ISSUE 3, P239-242, March 2009

Perceived Accessibility of Cigarettes Among Youth

A Prospective Cohort Study
  • Chyke A. Doubeni
    Correspondence
    Address correspondence and reprint requests to: Chyke A. Doubeni, MD, MPH, Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester MA 01655
    Affiliations
    Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts

    Department of Medicine, and the Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Wenjun Li
    Affiliations
    Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Hassan Fouayzi
    Affiliations
    Department of Medicine, and the Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts
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  • Joseph R. DiFranza
    Affiliations
    Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts

    Department of Medicine, and the Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, Massachusetts
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Published:January 22, 2009DOI:https://doi.org/10.1016/j.amepre.2008.11.006

      Background

      The accessibility of tobacco for youth is difficult to measure, partly because of the varied sources of cigarettes. Perceptions about the accessibility of cigarettes assesses availability from all potential sources and has been found to predict future smoking. This study examines the determinants of perceived accessibility from the perspective of a longitudinal study.

      Methods

      Data were derived from the second Development and Assessment of Nicotine Dependence in Youth study, a 4-year longitudinal study of 1246 sixth-grade students who underwent up to 11 in-person interviews from 2002 to 2006. Perceived accessibility was assessed prospectively by asking students whether they agreed or disagreed with the statement It would be easy for me to get a cigarette.

      Results

      At baseline, the average age was 12 years; 85% had never before smoked; more than 21% perceived that cigarettes were easy to obtain. Perceived accessibility increased over the 4 years among the cohort. Youth with friends who smoked or whose parents allowed the watching of R-rated movies were more likely to perceive easy accessibility of cigarettes. Among nonsmokers, there was a dose–response relationship between perceived accessibility and exposure to smoking in the family environment. Nonsmokers who knew commercial sources of cigarettes also had higher perceived accessibility.

      Conclusions

      Several potentially preventable exposures to tobacco in the family and social environment contribute to confidence among some youth that cigarettes are easy to obtain. Further studies are needed to determine if modifying these factors (e.g., through programs to reduce the exposure of youth to tobacco products in the home) might reduce perceived accessibility.
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