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Am J Public Health. 2010 Jul;100(7):1218-28. doi: 10.2105/AJPH.2009.167973. Epub 2010 May 13.

The social context of adolescent smoking: a systems perspective.

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Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, Irvine, CA 92697-3957, USA.


We used a systems science perspective to examine adolescents' personal networks, school networks, and neighborhoods as a system through which emotional support and peer influence flow, and we sought to determine whether these flows affected past-month smoking at 2 time points, 1994-1995 and 1996. To test relationships, we employed structural equation modeling and used public-use data from the National Longitudinal Study of Adolescent Health (n = 6504). Personal network properties affected past-month smoking at both time points via the flow of emotional support. We observed a feedback loop from personal network properties to emotional support and then to past-month smoking. Past-month smoking at time 1 fed back to positively affect in-degree centrality (i.e., popularity). Findings suggest that networks and neighborhoods in this system positively affected past-month smoking via flows of emotional support.

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