Objective: The purpose of this dissertation was to examine which student- and school-level factors differentiated (1) susceptible never smokers from non-susceptible never smokers, (2) experimental smokers from never smokers, and (3) current smokers from experimental smokers among a nationally representative sample of Canadian students in grade 9-12. Methods: Student-level data from Canada???s nationally representative 2008-2009 Youth Smoking Survey (2008 YSS) were linked with school-level data from the 2006 Census, and one built environment characteristic, and examined using multi-level logistic regression analyses. Results: Overall as hypothesized in these three studies, student-level and school-level characteristics were associated with smoking susceptibility among never smokers, experimental smoking and current smoking. The likelihood of susceptibility among never smokers (P=0.0002), experimental smoking (P<0.0001) and current smoking (P<0.001) significantly varied across schools. This study identified that attending a school in an urban (AOR=0.62; 95% CI 0.46-0.82) setting or in a high socioeconomic status (SES) neighbourhood (AOR=0.88; 95% CI 0.79-0.98) was inversely associated with odds of a student being an experimental smoker (versus a never smoker) when adjusting for student-level characteristics. The number of tobacco retailers located within a 1-km radius of each school was associated with the odds of a student being a current smoker (versus an experimental smoker) (AOR 1.03; 95% CI 1.01-1.05) and also associated with a student being a susceptible never smoker (versus a non-susceptible never smoker) (AOR 1.01; 95% CI 1.00-1.02) when adjusting for student-level characteristics. Additionally, several student-level intrapersonal and social context characteristics were associated with smoking susceptibility, experimental smoking and current smoking. Conclusions: This study showed that the characteristics of the school a student attends may increase their likelihood of a student being in any of the smoking stages that were examined. Additionally, several student-level factors were also associated with the three smoking stages. Understanding these factors will provide more insight to guide stakeholders interested in developing anti-tobacco strategies that are responsive to the risk and protective factors of adolescents in different smoking stages.

Most adult smokers begin smoking during adolescence; nicotine dependence can develop relatively quickly and, once established, most smokers smoke for approximately 40 years. For adolescents dependent upon nicotine, cessation interventions are not well established. It is, therefore, essential that public health interventions focus on preventing initiation and maintenance and decreasing the prevalence of youth smoking. In spite of legislation to protect New Zealand adolescents, a large proportion continues to use tobacco at least weekly. Recent surveys have shown a slight decrease in cigarette smoking prevalence, overall, but, no reduction and marked increases have been reported within some subgroups. The overall aim of this research was to identify school and personal factors associated with secondary school students smoking. The specific research objectives included: a) identifying factors at the personal, family, peer, school and 'tobacco-genic' environment levels which were associated with regular and established cigarette smoking; b) describing the extent of smoke-free policy and health education programmes in secondary schools; and, c) evaluating the relations between cigarette smoking among students and potential protective factors, smoke-free policies and practices and health education programmes. The research was based on data from 3,434 secondary school students from 82 schools. The multi-stage sampling procedures and data analyses ensured that the results were able to be generalised to the New Zealand secondary school student population. Smoking was more prevalent amongst girls for all measures of smoking frequency and significant differences were found for smoking prevalence between ethnic groups and school decile. In terms of family influences, the smoking behaviours of parents were not associated with increased odds of smoking nor were perceived relationships between students and their parents, or exposure to SHS. In contrast, the smoking behaviour of siblings was associated with increased odds of smoking but it is likely that both student and sibling smoking are both influenced by the same processes within the family. Similarly, low levels of self-concept were not associated with increased odds for daily smoking. The smoking behaviour of a best friend was a pervasive risk factor as was a high level of disposable income, frequent episodes of unsupervised activities, and 'pro-smoking' knowledge. Being male, visiting a place of worship, and the intention to stay at school until after Year 13 reduced the odds of daily smoking among students. Multilevel models were used to identify school level effects. After adjusting for student, family and school characteristics significant between-school variance in smoking prevalence remained and this suggests that there are factors, arguably beyond the immediate control of the student or family that may influence a student�s smoking behaviour. The presence of a school effect also supports the WHO concept of 'health promoting schools' in that schools can make a difference to health outcomes. Understanding how the health promoting schools model has been interpreted and implemented in NZ schools, along with critique of the implementation of the amended legislation making all schools smoke-free, would be a pertinent 'next-step' in identifying characteristics of schools which are associated with decreased tobacco use.

This thesis explored whether individual differences in taste perception (as measured by the rated intensity of 6-n-propylthiouracil (PROP)) were associated with tobacco use, alcohol use and misuse and obesity in the Dunedin Multidisciplinary Health and Development Study birth cohort at age 32. This cohort of 1037 participants was assessed at ages 3, 5, 7, 9, 11, 13, 15, 18, 21, 26 and, most recently, at 32 years, when 96% of the living study members were interviewed. At age 32, participants rated the intensity of a 0.0032mol/L solution of PROP using the general labelled magnitude scale (gLMS). PROP is almost tasteless to some but tastes bitter to others. As bitter tastes are aversive, due to their association with toxicity, it has been suggested that responses to PROP may reflect individual differences in taste perception that, in turn, have a protective effect on health. Study One sought to establish correlates of rated PROP intensity in this sample. A model controlling for sex, childhood socio-economic status (SES), childhood IQ and gLMS use predicted approximately 12% of the variability in PROP ratings. This finding highlighted the importance of using appropriate covariates in research attempting to link PROP perception with health risk behaviours, as these factors have also been associated with tobacco use, alcohol use and adiposity. Study Two did not find that greater perceived intensity from PROP was protective against smoking, as pack years smoked was not associated with PROP rating and ratings between groups of smokers were not significantly different. Differences in PROP perception were not protective against the lifetime smoking in this sample. Similarly, Study Three found no evidence to suggest that greater intensity from PROP was associated with reduced alcohol misuse. Furthermore, the previously observed association between PROP and yearly alcohol consumption may be better explained by the fact that SES accounts for some of the variance in both measures. In Study Four, rated PROP intensity was associated with Body Mass Index (BMI), waist circumference and body fat percentage, in women, but not in men. These associations were weakened after the inclusion of covariates in the models, but remained significant for both BMI and body fat percentage. Findings from Study Four indicate that taste perception may be associated with measures of adiposity in women. Taken together, these results highlight the importance of using appropriate control variables in research and indicate that a single measure of PROP perception may not adequately reflect the full effect of individual differences in taste perception on tobacco use or alcohol use and misuse. Since PROP perception was associated with differences in adiposity in women, however, individual differences in taste perception may be of public health importance. Future research should use continuous measures of a wider range of taste stimuli, to establish how taste perception (rather than just bitterness perception) affects health. Research should also ensure that covariates associated with tobacco use, alcohol use and misuse and adiposity (such as sex, SES and IQ) are included in analyses.

Thesis (Ph.D.)--Virginia Commonwealth University, 2008. / Prepared for: School of Social Work. Title from title-page of electronic thesis. Advisors : Melissa Abell, Faye Z. Belgrave. Bibliography: leaves 272-319.

Thesis (M.S.)--Missouri State University, 2008. / "May 2008." Includes bibliographical references (leaves 67-70). Also available online.

Thesis (M.P.H.M. (Primary Health Care Management))--Mahidol University, 2008. / LICL has E-Thesis 0038 ; please contact computer services.

Thesis (M.P.H.)--Georgia State University, 2008. / Title from file title page. Michael Eriksen, committee chair; Francis McCarty, Melissa Taylor, committee members. Description based on contents viewed July 24, 2009. Includes bibliographical references (p. 85-89).

Thesis (Ph. D.)--University of Missouri-Columbia, 2008. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on August 3, 2009) Vita. Includes bibliographical references.

Issued also as Thesis (Ph. D.--Columbia University). / Tobacco's influence on "Society: manners and customs": p. 75-89. Tobacco trade: p. 105. "Famous pipe-makers": p. 143. Includes bibliographical references (p. 352-367).

Thesis (Ph.D.)--Virginia Commonwealth University, 2008. / Prepared for: School of Social Work. Advisors : Melissa Abell, Faye Z. Belgrave. Bibliography: leaves 272-319. Also available online via the Internet.