Exposure of non-smoking U.S. adolescents to environmental tobacco smoke: Setting-specific subpopulation trends from 2000-2009, setting-specific correlates, and association of exposure with susceptibility to initiate smoking

Statement of the Problem: This dissertation identifies among non-smoking U.S. adolescents: (a) subpopulation trends from 2000-2009 in environmental tobacco smoke (ETS) exposure in cars (ETSC) and in rooms (ETSR); (b) correlates of ETSC and ETSR exposures, respectively, in 2009; and (c) an estimate of the association between ETS exposure and susceptibility to initiate smoking in 2009.;Methods: The study was a secondary analysis of National Youth Tobacco Survey (NYTS) data sets from 2000, 2002, 2004, 2006 and 2009. Subpopulation trends were identified through multivariate logistic regression models controlling for gender, grade level, and race/ethnicity using datasets from all measured years. Using the most recent---i.e., 2009---dataset, correlates of ETSC and ETSR exposures were identified through multivariate logistic regression models. Using the same dataset, associations between ETS exposure and susceptibility to initiate smoking were identified first through multivariate logistic regression models and then through propensity score matching statistical techniques.;Results: Significant downward linear trends in ETSC and ETSR exposures were identified for all measured subpopulations of adolescents from 2000-2009, except for ETSC exposure among Native Hawaiians/Pacific Islander students. Downward trends in both ETSC and ETSR exposures for male students were significantly steeper than the downward trend for female students. For ETSC, the downward trend for Black students was significantly steeper than the downward trend for White students. For ETSR, the downward trend for White students was significantly steeper than the downward trends for both Hispanic and Native Hawaiian/Pacific Islander students. Gender, race/ethnicity, personal income, number of friends who smoke, residing with a smoker, and having rules about smoking at home were identified as significant correlates for both ETSC and ETSR exposure. Analyses showed that ETS exposure was significantly associated with susceptibility to initiate smoking in both the full sample of non-smoking adolescents and a smaller sample of non-smoking adolescents who were matched on their propensity for exposure to ETS. Implications of results and practical advice for health professionals are addressed.