Adapting the Stage of Change model to investigate adolescent behavior related to reducing second hand smoke exposure

Aims: Second hand smoke (SHS) exposure is increasingly recognized as a major public health concern. Assessing adolescents’ motivational level to avoid SHS is vital to promote and reinforce reductions in SHS exposure. Methods: A brief measure based on the Stage of Change model was developed to characterize adolescents’ behavior related to reducing SHS exposure and used to identify potential determinants of SHS stage of change. The sample consisted of 1172 adolescents aged 13 to 15 years who participated in an internet-based cohort study of youth in British Columbia, Canada. Results: Sixty-six percent of the adolescents reported they had consistently made efforts to reduce exposure to SHS for more than 6 months, while 19% did not intend to reduce their exposure to SHS in the next 6 months. Adolescents’ SHS stage of change significantly differed by ethnicity, whether they had tried cigarettes, amount of tobacco smoked in their lifetime, parental and peer smoking statuses, past months’ exposure to SHS, frequent smoking in the home, and home smoking restrictions (all p < 0.05). Active smoking and more frequent exposure to SHS were associated with an increased probability of being in the pre-contemplation stage of change with regard to behavior related to reducing SHS exposure. Conclusion: This brief measure based

on the Stage of Change model can be used in future studies to characterize adolescents’ behavior around SHS. Adolescents who smoke or have parents and/or friends who smoke appear to be a population that could benefit from stage-matched interventions designed to raise awareness of the risks associated with SHS for smokers and non-smokers, and ultimately reduce SHS exposure.