Objective: To assess the association between adolescent smoking and volume of exposure to various forms of media after controlling for multiple relevant covariates.
Methods: A survey of all adolescents at a large suburban high school assessed: (1) current smoking and susceptibility to future smoking; (2) volume of exposure to various media; and (3) covariates related to smoking. Multivariate logistic regression models assessed relationships between each of the independent variables (media exposures) and the two smoking outcomes after controlling for covariates.
Results: Of the 1138 respondents, 19% (n=216) reported current smoking. Forty percent (n=342) of the non-smokers (n=922) were susceptible to future smoking. Students reported exposure to an average of 8.6 (standard deviation 5.1)h of media daily, including 2.6h of music. Those with high exposure to films and music were more likely to be smokers (P(trend)=0.036 and P(trend)<0.001, respectively), and those with high exposure to books were less likely to be smokers (P(trend)<0.001). After controlling for all relevant covariates, those with high exposure to music had greater odds of being smokers than those with low exposure [odds ratio (OR) 1.90, 95% confidence intervals (CI) 1.10-3.30], and those with high exposure to books had lower odds of being current smokers (OR 0.55, 95% CI 0.33-0.94).
Conclusion: Exposure to films and music are associated with smoking, but only the relationship between music exposure and smoking persists after rigorous covariate control. Exposure to books is associated with lower odds of smoking.