Factors associated with smoking refusal self-efficacy among Finnish and Portuguese early adolescents

Background Research indicates that refusal self-efficacy predicts adolescent smoking behavior and needs to be addressed in health education programs. Developing such programs requires examining the factors associated with smoking refusal self-efficacy in the target group. Thus, our study examined factors associated with smoking refusal self-efficacy among early adolescents in Finland and Portugal. Methods Self-reported data on smoking refusal self-efficacy, smoking outcome expectations, smoking-related attitudes, motives, and motivations were obtained from 295 early adolescents, and analyzed using a logistic regression and correlation calculations. Results Experiences with tobacco, smoking-related attitudes and motives, the motivation to refrain from smoking in the future, and smoking outcome expectations were associated with smoking refusal self-efficacy. Gender, and the smoking behavior of relatives and friends were independent predictors of smoking refusal self-efficacy. The findings were similar in both countries. Conclusions Our results strengthen the notion that parental smoking is not associated with smoking refusal self-efficacy of early adolescents but smoking by friends and relatives and gender favoring girls are. Thus, health education programs aiming to support early adolescent smoking refusal self-efficacy need to consider the role of peer influence and the social acceptance of smoking and place more emphasis on effectively supporting boys' smoking refusal self-efficacy.