Friends Moderate the Effects of Pro-Smoking Media on College Students' Intentions to Smoke

Exposure to pro-smoking media, such as tobacco industry sponsored cigarette advertising in magazines and exposure to smoking in movies, contributes to smoking initiation in adolescents (Wellman, Sugarman, DiFranza, & Winickoff, 2006) and young adults (Rigotti, Moran, & Wechsler, 2005). However, the extent to which the social context of those exposures (i.e., the social circumstances in which youth see or hear pro-smoking media) moderates the impact of pro-smoking media has not been investigated (Pechmann & Knight, 2002). Understanding how social context moderates pro-smoking media exposure effects has important implications for intervening to help young people resist its persuasive intent and for policy designed to limit exposure. This study examined the moderating role of specific social contexts on college students’ exposure to pro-smoking media. Family can influence whether or not an individual smokes. Indeed, both parent (Engels, Knibbe, DeVries, Drop, & Van Breukelen, 1999) and sibling (Rende, Slomkowski, Lloyd-Richardson, & Niaura, 2005) smoking can have an impact on youth smoking. However, the extent to which these parent and/or sibling effects directly moderate the impact of pro-smoking media on smoking is not known. The presence of a parent or sibling may also activate certain cognitions or beliefs that challenge or enhance media messages, making those messages less (or more) powerful than they would otherwise have been (McCool, Cameron & Robinson, 2011), and indeed research in other domains (e.g., nutrition) has shown that the presence of a parent can blunt the effect of media on young people (Dorey & McCool, 2009; Nathanson, 1999, 2001) while the presence of a sibling may have the opposite effect (Wilson & Weiss, 1993). During media exposure, for example, parents may make rules about what media can be viewed, model behaviors that confirm or disconfirm media messages, communicate norms that influence what information is sought from media, and actively discuss media content (Austin, 1993). Parents tend to discourage their children from engaging in risky behaviors, thus exposures to pro-smoking media in the presence of parents may reduce smoking intentions and improve smoking refusal self-efficacy. College students interact frequently and communicate often with their parents, particularly about health-related behaviors like smoking and drinking alcohol (Small, Morgan, Abar, & Maggs, 2011). As such, the presence of family members could influence the impact of exposure to pro-smoking media in college students. Similarly, the presence of peers or a romantic partner may moderate the effects of pro-smoking media exposure on youth smoking. Young adults spend the majority of their leisure time with peers (Larson & Verma, 1999) and romantic relationships gain prominence in young adulthood (Furman, 2002). The presence of smoking peers and romantic partners contributes to smoking (Kobus, 2003) and could moderate the effects of pro-smoking media on behavior. For example, peers or romantic partners might influence the absolute number of exposures to pro-smoking media and their impact by influencing the nature and location of shared leisure time activities. Peers might also make many common pro-smoking media messages more salient. For example, adolescents believe that smoking cigarettes can help them fit in socially (Lewis-Esquerre, Rodrigue & Kahler, 2005) and help with weight control (Baker, Brandon & Chassin, 2004; Myers, McCarthy, MacPherson & Brown, 2003), and the presence of peers or romantic partners during pro-smoking media exposures that evoke these themes could make smoking seem especially appealing. Finally, shared exposure to pro-smoking media could also signal implicit approval of the messages contained in pro-smoking media (Leventhal & Cupchick, 1975). In the present study, we assessed the impact of pro-smoking media exposures on college students across three key social contexts: family, romantic partners, and friends (versus being alone). College students participated in a 3-week Ecological Momentary Assessment (EMA) study (Martino, Scharf, Setodji & Shadel, 2012; Shadel, Martino, Setodji & Scharf, 2012), in which they carried handheld data collection devices (i.e., smart phones) that allowed them log their exposures to pro-smoking media and report the social context of those exposures (i.e., whether exposure happened when they were with family, with friends, with a romantic partner, or alone) as they occurred in the real world. After entering this information, they responded to questions about their smoking intentions and smoking refusal self-efficacy, each of which has been shown to predict smoking behavior (Choi, Gilpin, Farkas & Pierce, 2001; Wakefield et al., 2004). In addition, they responded to three random prompts per day during which they reported their current social context and responded to the same questions about smoking intentions and smoking refusal self-efficacy. We expected that pro-smoking media exposures would have a differential impact on smoking intentions and smoking refusal self-efficacy depending on whether those exposures occurred in the presence of others (whether friends, romantic partners, or family members) or while students were alone. Specifically, we expected that the presence of peers and romantic partners would be related to increases in intentions to smoke and decreases in smoking refusal self-efficacy. In contrast, we were uncertain about how the presence of family during pro-smoking media exposures would affect these outcomes, as the effects of parents (protective) were hypothesized to be opposite of the effects of siblings (risk-enhancing).