Table 2 Matrix of types and levels of influence on smoking

Ultimate

Definitions: Personality traits and intrapersonal characteristics that although beyond the easy control of adolescents, might promote some internal motivation to smoke cigarettes or make them susceptible to the physiological effects of tobacco.

Constructs: Genetic susceptibility to nicotine; lack of impulse control; external locus of control: aggressiveness; extraversion; sociability; risk-taking; sensation seeking; neuroticism or emotional instability.

Definitions: Characteristics of the people who make up adolescents’ most intimate social support system. These characteristics are not specific to smoking and are beyond the personal control of adolescents but nonetheless put them at risk for succumbing to social pressure to smoke.

Constructs: Infrequent opportunities for rewards from family members; lack of parental warmth, support, or supervision; negative evaluations from parents; home strain; parental divorce or separation; unconventional 'values of parents; unconventional values among peers.

Definitions: Aspects of adolescents’ surroundings, neighbourhoods, social institutions, and culture that, although beyond the personal control of adolescents, put them at risk for developing positive attitudes towards tobacco use.

Constructs: Local crime and employment rates; inadequate schools; poor career and academic options; infrequent opportunities for rewards at school; negative evaluations from teachers; media and advertising depictions of smoking; weak public smoking ordinances; low tobacco taxes; cigarette availability; weak school-level policies on smoking.

Distal

Definitions: Affective states and general behavioural skills of adolescents that promote some internal motivation to smoke and that undermine their refusal skills.

Constructs: Low self-esteem; temporary anxiety, stress, or depressed mood; poor coping skills; inadequate social skills; weak academic skills.

Definitions: Emotional attachments of adolescents and the tobacco-specific attitudes and behaviours of influential role models who encourage smoking.

Constructs: Weak attachments to and weak desire to please family members; strong attachment to and strong desire to please peers; greater influence by peers than parents; smoking-specific attitudes and behaviours of role models.

Definitions: General values and behaviours of adolescents that contribute to their attitudes toward tobacco use.

Constructs: Weak commitment to conventional values, school, and religion; social alienation and criticism; weak desire for success and achievement; hedonic values and short-term gratification; rebelliousness; desire for independence from parents; tolerance of deviance.

Proximal

Definitions: Beliefs about one’s ability to smoke cigarettes and to avoid smoking.

Constructs: Refusal skills; determination to smoke; use self-efficacy; refuse self-efficacy.

Definitions: Beliefs about the normative nature of smoking and pressures to smoke.

Constructs: Prevalence estimates; motivation to comply with other smokers; beliefs that important others (friends, parents and other role models) encourage smoking.

Definitions: Beliefs and evaluations about the costs and benefits of smoking.

Constructs: Expected costs and benefits of not smoking; evaluation of costs and benefits of not smoking; expected costs and benefits of smoking; attitudes towards smoking by others; attitudes toward smoking by self.

Immediate predictors

Decision/intentions

Trial behaviour

Related behaviours