The Application of Problem Behavior Theory to the Understanding of Tobacco Use Among African American Youth Living in Urban Public Housing

Background and Purpose: Each year, approximately 45,000 African Americans die from smoking-related disease such as cardiovascular disease and lung cancer (National Vital Statistics Report, 2005). An estimated 500,000 African Americans who are under the age of 18 will die prematurely from a tobacco-related disease (CDC, 1998). Although previous studies contribute to establish smoking cessation and prevention programs for African American youth, there are gaps in the literature regarding identifying predictors of tobacco use among African American youth living in urban public housing. Using Jessor and Jessor's Problem Behavior Theory (PBT, 1977), this study examines the prevalence and relative impact of multiple variables on tobacco use among African American youth living in urban public housing.

Methods: A purposive sample of 518 African American youth who were living in public housing developments at the time of the interview in three large U.S. cities was collected. The youths averaged 15.3 years of age (SD=2.5) with a range of 11-20 and 51% were male. Using Problem Behavior Theory (1977), we measured personality system (intention to use a tobacco, self-efficacy, attitudes towards delinquent behavior, and depressive symptoms), perceived environment system (family relationships, parent support, and parent supervision), and behavior system (delinquent peers, alcohol use, and marijuana use).

Results: Findings revealed nearly half (46.1%) of the study sample youth used tobacco in their life; one-fifth (20.1%) used in the past 12 months. Of those who ever used a tobacco, the average onset age was 14.2 years old (SD=2.6). Of those who smoked in the past 12 months, they smoked more than 9 times on average. Multivariate regression analyses showed that age (b=0.07), intention to use a tobacco (b=0.18), depressive correlates (b=0.02), delinquent behavior (b=0.02), and marijuana use (b=0.59) positively predicted the extent of tobacco use during the past 12 months. In addition, age positively moderated the impact of intention to tobacco and marijuana use on tobacco use.

Conclusions and Implications: Our findings extend PBT by testing the three system variables in a sample of African American youth living in urban public housing. Our study emphasizes that practices and policies aimed at reducing the significant predictors of tobacco use including smoking intention, depressive symptoms, delinquent behavior, and marijuana use may ameliorate the detrimental consequences of adolescent smoking. Further, programs may be more effective and efficacious among younger youth than older youth.