Article Text

Download PDFPDF
Youth smoking risk and community patterns of alcohol availability and control: a national multilevel study
  1. Elissa R Weitzman1,
  2. Ying-Yeh Chen1,2,
  3. S V Subramanian1
  1. 1Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, USA
  2. 2Taipei City Psychiatric Centre, Taipei, Taiwan
  1. Correspondence to:
 Dr E R Weitzman
 Department of Society, Human Development and Health, Harvard School of Public Health, Landmark Center, 401 Park Drive, Rm 441, Boston, MA 02215, USA; eweitzmahsph.harvard.edu

Abstract

Study objective: To test whether college youth smoking risks are independently associated with community patterns of alcohol availability and control.

Design: Hierarchical multilevel multivariable modelling of cross sectional survey data. Outcomes included self reported current (past 30 day) cigarette smoking and heavy episodic (binge) drinking.

Setting: 120 nationally representative US colleges.

Participants: 10 924 randomly selected students.

Main results: Individual risks for smoking and binge drinking are independently associated with community patterns of alcohol availability, policy enforcement and control over and above individual perceptions about these factors, student and college characteristics, and school binge drinking rates. Youth exposed to high levels of alcohol availability are at higher risk of smoking (OR 3.61, 95% CI 1.75, 7.44) and binge drinking (OR 4.22, 95% CI 2.25, 7.93) than youth not so exposed; youth exposed to strongly enforced alcohol policy environments are at lower risk for smoking (OR 0.30, 95% CI 0.16, 0.57) and binge drinking (OR 0.17, 95% CI 0.10, 0.31) than youth not so exposed; youth exposed to communities with strong parental controls are at lower risk for smoking (OR 0.05, 95% CI 0.01, 0.23) and binge drinking (OR 0.06, 95% CI 0.01, 0.21) than youth not so exposed. Individual risks related to environmental exposures differ for youth with varying perceptions about alcohol availability and policy control.

Conclusions: Drinking environments in US college communities comprise strong independent risks for smoking. Smoking prevention models should be tested that include environmental drinking prevention strategies tailored to underlying perceptions and experiences of college youth.

  • smoking
  • drinking
  • youth
  • multilevel
  • prevention

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Funding: this study was supported by a grant from the Robert Wood Johnson Foundation.

  • Competing interests: none declared.