Perceptions of smoking-related risks and benefits as predictors of adolescent smoking initiation.

OBJECTIVES: The predictive value of perceptions of smoking-related risks and benefits with regard to adolescent smoking initiation has not been adequately established. We used prospective, longitudinal data to directly test whether smoking-related perceptions predict smoking initiation among adolescents. METHODS: We administered surveys assessing perceptions of smoking-related risks and benefits to 395 high school students, beginning at the start of their ninth-grade year. We conducted follow-up assessments every 6 months until the end of 10th grade, obtaining 4 waves of data. RESULTS: Adolescents who held the lowest perceptions of long-term smoking-related risks were 3.64 times more likely to start smoking than were adolescents who held the highest perceptions of risk. Adolescents who held the lowest perceptions of short-term smoking-related risks were 2.68 times more likely to initiate. Adolescents who held the highest perceptions of smoking-related benefits were 3.31 times more likely to initiate. CONCLUSIONS: Findings from this study provide one of the first sets of empirical evidence to show that smoking initiation is directly related to smoking-related perceptions of risks and benefits. Thus, efforts to reduce adolescent smoking should continue to communicate the health risks of smoking and counteract perceptions of benefits associated with smoking.

Having sex and condom use: potential risks and benefits reported by young, sexually inexperienced adolescents.

PURPOSE: This study determines what young adolescents themselves identify as the potential positive and negative outcomes of having sex, using a condom and not using a condom. METHODS: Using written surveys, 418 ethnically diverse ninth graders, 86% of whom had never had sex, responded to a scenario describing two adolescents who had sex. One randomly selected group read a scenario in which a condom was used; the other group read a scenario in which no condom was used. All participants were asked to list the risks and benefits of having sex. Depending on the scenario read, participants were asked to list the risks and benefits of either using or not using a condom. Responses were coded thematically. Percentages of responses were compared with chi-square analysis in total and by gender. RESULTS: Participants spontaneously identified a broad range of health and psychosocial risks and benefits of having sex, using a condom and not using a condom. A strong aversion to pregnancy was evident, and the risks of sexually transmitted disease/human immunodeficiency virus (STD/HIV) and condom malfunction were commonly mentioned. Benefits of using a condom included pregnancy and STD prevention. Benefits of both having sex and of not using a condom included improving the relationship, fun, and pleasure. Gender differences emerged across questions. CONCLUSIONS: Communication with adolescents regarding safe sexual activity could benefit from widening the communication from a focus on health risks to include discussion of the psychosocial risks and benefits that adolescents themselves think about with respect to sex and condom use.

Adolescents tell us why teens have oral sex.

Adolescents' perceived reasons why teens have oral sex ranged from physical pleasure, improving intimate relationships, reducing risks associated with vaginal sex, the influence of substances, and social factors such as reputation concerns and peer experiences.

Oral versus vaginal sex among adolescents: perceptions, attitudes, and behavior.

OBJECTIVE: Despite studies indicating that a significant proportion of adolescents are having oral sex, the focus of most empirical studies and intervention efforts concerning adolescent sexuality have focused on vaginal intercourse. This narrow focus has created a void in our understanding of adolescents' perceptions of oral sex. This study is the first to investigate adolescents' perceptions of the health, social, and emotional consequences associated with having oral sex as compared with vaginal sex, as well as whether adolescents view oral sex as more acceptable and more prevalent than vaginal sex. METHODS: Participants were 580 ethnically diverse ninth-grade adolescents (mean age: 14.54; 58% female) who participated in a longitudinal study on the relationship between risk and benefit perceptions and sexual activity. Participants completed a self-administered questionnaire that inquired about their sexual experiences and percent chance of experiencing outcomes from, attitudes toward, and perceived prevalence of oral versus vaginal sex among adolescents. RESULTS: More study participants reported having had oral sex (19.6%) than vaginal sex (13.5%), and more participants intended to have oral sex in the next 6 months (31.5%) than vaginal sex (26.3%). Adolescents evaluated oral sex as significantly less risky than vaginal sex on health, social, and emotional consequences. Adolescents also believed that oral sex is more acceptable than vaginal sex for adolescents their own age in both dating and nondating situations, oral sex is less of a threat to their values and beliefs, and more of their peers will have oral sex than vaginal sex in the near future. CONCLUSIONS: Given that adolescents perceive oral sex as less risky, more prevalent, and more acceptable than vaginal sex, it stands to reason that adolescents are more likely to engage in oral sex. It is important that health care providers and others who work with youths recognize adolescents' views about oral sex and broaden their clinical preventive services to include screening, counseling, and education about oral sex.

Effective strategies for recruiting families ascertained through alcoholic probands.

BACKGROUND: Recruiting a large number of participants meeting strict inclusion criteria can be challenging, particularly when selecting for a condition associated with a social stigma such as alcoholism, when participation involves collection of medical specimens and sensitive information, and when the participation of family members or other collaterals is required. Developing and implementing a successful recruitment plan depends upon identifying the most effective recruitment strategies given the available resources. METHODS: Several strategies for recruiting subjects for a large family study on the genetics of alcoholism were evaluated over a two-year period with regard to participant yield, time and cost expenditure. RESULTS: Overall effectiveness of a recruitment strategy was determined based on a composite of yield, cost and time expenditure. The most effective recruitment strategies were direct mail, press release, the Internet and treatment center collaborations. CONCLUSION: Results provide insight into successful strategies for recruiting large numbers of participants and their family members selected for a condition associated with a social stigma.