Smoking in Cape Town: Community Influences on Adolescent Tobacco Use

Background. This paper examines the effect of pro- and antisocial opinions about communities on cigarette use by Black, Colored, and White 8th- and 11th-grade students in Cape Town, South Africa. Methods. This analysis consists of 1,328 students who completed a questionnaire in 1997 on sociodemographic characteristics, substance abuse, adolescent behaviors, and opinions about their communities. Structural equation modeling (SEM) was used to assess hypotheses related to the social development model positing direct and indirect associations between community constructs and smoking within the previous 31 days. Results. White students had the highest proportion (36.3%, P < 0.01) of past-31-days smokers compared to Colored (29.7%) and Black (9.7%) students. SEM analysis showed that among all groups the strongest association (β = 0.29, Whites, P < 0.01; β = .14, Coloreds, P < 0.01; β = 0.05, Blacks, P < 0.05) with recent cigarette smoking was the personal knowledge of adults who engaged in antisocial behavior. Conclusions. Youth smoking behavior may be affected by antisocial adult behavior, subjective adult norms, and community affirmation. Thus, in addition to other factors, social norms and community influence should be considered in preventing adolescent smoking.