Background/Objectives: The first objective of this study is to assess the relationship between cigarette access and smoking behavior in 15-17 year old students. The second objective of this study is to assess the relationship between media and smoking behavior in those students. The third objective of this study is to observe whether the smoking rate will increase if subjects have both access and exposure to the tobacco product. I propose to use the youth survey data to test the impact of exposure to smoking-related media messages and the difficulty of acquiring tobacco products. I hypothesize that there is positive relationship among youth access to tobacco products, exposure to tobacco ads/promotions on social networking sites and active smoking. Methods: I examined National Youth Tobacco Survey data from 2014 and a total number of 1293 subjects as a secondary analysis. Results: The students with one or more than one method of accessing tobacco had higher odds compared to students with no access (OR = 70.12; 95% CI: 47.71–103.07; p < 0.0001 for only one method; OR = 240.22; 95% CI: 160.25–360.09; p < 0.0001 for more than one method). Moreover, the association between exposure to tobacco ads via internet, newspaper, point stores and movies/TV and smoking behavior was significant at both moderate and heavy exposure levels (OR = 1.44; 95% CI: 1.08–1.92; p = 0.014 for moderate exposure group; OR = 1.82; 95% CI: 1.26–2.62; p = 0.002 for heavy exposure group). The multivariable model, which shows the effect of the combination of these two factors, it states access to tobacco products was significantly positively associated with an increased smoking rate (OR = 69.06; 95% CI: 47.03-101.40; p < 0.001 for only one access group; OR = 241.78; 95% CI: 160.49–364.22; p < 0.001 for more than 1 access group). However, the severity of media exposure was not significantly associated with the increased odds of cigarette smoking among adolescents (OR = 1.14; 95% CI: 0.80-1.62; p = 0.470 for moderate exposure group; OR = 1.39; 95% CI: 0.81–2.40; p = 0.227 for heavy exposure group). Conclusion: I provided further evidence that exposure to tobacco messages and have access to tobacco products can increase the smoking rates among youth. These findings could be a result of better diagnosis and reporting, but the increase may also be due to other risk factors in the population. These findings may have implications for further and more aggressive counseling for teenagers. These effects should be further explored in a larger population of adolescents. Intervention methods should be designed to help the public understand the benefits of reducing adolescent’s exposures to tobacco smoke. / Epidemiology

<p><strong><p>Abstrakt</p><p>Titel: Hur får ungdomar tillgång till tobak? – En kvantitativstudie bland ungdomar i Halland<strong> </strong></p><p>Författare: Sandra Mellberg & Linda Vigren<strong> </strong></p><p>Sektion: Sektionen för Hälsa och Samhälle<strong> </strong></p><p>Handledare: Solgun Folke & Eja Pedersen<strong> </strong></p><p>Högskola: Högskolan i Halmstad<strong> </strong></p><p>Tid: 2009-12-17<strong> </strong></p><p>Sidantal: 13<strong> </strong></p><p>Nyckelord: Röka vattenpipa, rökning, snusning, tillgång till <strong>tobak, ungdomar.</strong></p></strong></p><p>Sammanfattning:  Syftet med studien var att beskriva hur ungdomar i åldrarna 14- 16 år får tillgång till tobak. Metoden var kvantitativ med enkät som datainsamlingsinstrument. Studien var en tvärsnittsstudie. Över hälften av de undersökta ungdomarna visste hur de skulle kunna få tag i tobak på ett enkelt sätt. Vanligast var det att ungdomar fick tobak från äldre eller jämnåriga kompisar. Studien visade dessutom att en tredjedel av de undersökta eleverna hade provat att röka vattenpipa. Studien bidrar till att ge en bild över hur lätt eller svårt ungdomar själva upplever att det är att få tag på tobak. Fortsatt forskning kan inrikta sig på att studera attityder hos de personer som köper ut eller säljer tobak till minderåriga. Tobaksanvändning bland ungdomar är fortfarande ett problem i Sverige.</p> / <p><strong><p>Abstract</p></strong></p><p>Titel: How do adolescents get access to tobacco? – A<strong> </strong>quantitative study among adolescents in Halland</p><p><strong><p>Author: Sandra Mellberg & Linda Vigren<strong> </strong></p><p>Section: Sektionen för Hälsa och Samhälle<strong> </strong></p><p>Instructor: Solgun Folke & Eja Pedersen<strong> </strong></p><p>University: Högskolan i Halmstad<strong> </strong></p><p>Time: 2009-12-17<strong> </strong></p><p>Pages: 13<strong> </strong></p><p>Keywords: Access to tobacco, adolescents, smoking hookah, snusing, tobacco.<strong> </strong></p></strong></p><p>Summarize:  The aim is to find out how adolescents age 14-16 years get tobacco. The method was quantitative with questionnaire. The study was a cross-sectional study. More than half of the studied pupils knew how to get tobacco in an easy way. It was most common that the adolescents got tobacco from older friends or from friends in the same age. The study showed that one third of the students had tried smoking hookah. The study contribute to give a wider perspective over how easy or hard adolescents feels it is to get hold of tobacco. Continued research can concentrate on studying people who buy or sell tobacco to minors. Tobacco use among adolescents is still a problem in Sweden.</p>

Abstrakt Titel: Hur får ungdomar tillgång till tobak? – En kvantitativstudie bland ungdomar i Halland Författare: Sandra Mellberg &amp; Linda Vigren Sektion: Sektionen för Hälsa och Samhälle Handledare: Solgun Folke &amp; Eja Pedersen Högskola: Högskolan i Halmstad Tid: 2009-12-17 Sidantal: 13 Nyckelord: Röka vattenpipa, rökning, snusning, tillgång till tobak, ungdomar. Sammanfattning:  Syftet med studien var att beskriva hur ungdomar i åldrarna 14- 16 år får tillgång till tobak. Metoden var kvantitativ med enkät som datainsamlingsinstrument. Studien var en tvärsnittsstudie. Över hälften av de undersökta ungdomarna visste hur de skulle kunna få tag i tobak på ett enkelt sätt. Vanligast var det att ungdomar fick tobak från äldre eller jämnåriga kompisar. Studien visade dessutom att en tredjedel av de undersökta eleverna hade provat att röka vattenpipa. Studien bidrar till att ge en bild över hur lätt eller svårt ungdomar själva upplever att det är att få tag på tobak. Fortsatt forskning kan inrikta sig på att studera attityder hos de personer som köper ut eller säljer tobak till minderåriga. Tobaksanvändning bland ungdomar är fortfarande ett problem i Sverige. / Abstract Titel: How do adolescents get access to tobacco? – A quantitative study among adolescents in Halland Author: Sandra Mellberg &amp; Linda Vigren Section: Sektionen för Hälsa och Samhälle Instructor: Solgun Folke &amp; Eja Pedersen University: Högskolan i Halmstad Time: 2009-12-17 Pages: 13 Keywords: Access to tobacco, adolescents, smoking hookah, snusing, tobacco.  Summarize:  The aim is to find out how adolescents age 14-16 years get tobacco. The method was quantitative with questionnaire. The study was a cross-sectional study. More than half of the studied pupils knew how to get tobacco in an easy way. It was most common that the adolescents got tobacco from older friends or from friends in the same age. The study showed that one third of the students had tried smoking hookah. The study contribute to give a wider perspective over how easy or hard adolescents feels it is to get hold of tobacco. Continued research can concentrate on studying people who buy or sell tobacco to minors. Tobacco use among adolescents is still a problem in Sweden.