Testing a model of avoiding environmental tobacco smoke in young adults

To test an explanatory model of gender, self-efficacy, situational influences, and other health-promoting behaviors on the avoidance of environmental tobacco smoke (ETS) in young adults. ETS is a cause of lung cancer, pulmonary disease, and cardiovascular disease. Although young adults are at increased risk for ETS exposure, there are few behavioral studies of ETS exposure and no reported studies of ETS exposure in young adults. Although college students are often exposed to ETS, the college environment offers a setting in which the opportunities for change are substantial.

Model-testing. Data are reported on a convenience sample of 136 nonsmoking 18- to 25-year old students in one mid-atlantic U.S. university. This sample of nonsmokers was drawn from a larger sample of 241 smokers and nonsmokers in 1995. Model constructs were based on Pender's health promotion model (HPM).

The General Self-efficacy Scale, Health Promotion Lifestyle Profile, and ETS Avoidance Scale were used along with items measuring ETS-avoidance efficacy and Living with Smoke. Path analysis was used to test the model.

The trimmed explanatory model showed that 26% of the variance in avoiding ETS was accounted for by gender, having self-efficacy, and ETS-avoidance efficacy, not living with people who smoke, and performing other healthy behaviors. Being female and general self-efficacy indirectly influenced ETS avoidance through their effects on related health promoting behaviors.

The explanatory model of ETS avoidance can provide useful information for the development of interventions to prevent exposure to passive smoke. Given the occurrence of ETS exposure in young adults, longitudinal research using this explanatory model is yielding promising results. Enhancing the self-efficacy of young adults and encouraging healthy lifestyle behaviors may be an important factor in their avoidance of ETS.