The relationship between secondhand smoke exposure, pro-tobacco social influences, and smoking susceptibility among nonsmoking zambian adolescents

Background: We tested the hypothesis that the extent of secondhand smoke (SHS) exposure among nonsmoking adolescents would be associated with their overall exposure to pro-tobacco social influences. Methods: Data were analyzed using descriptive and multivariate methods from the 2011 Zambia Global Youth Tobacco Survey. Results: The odds of SHS exposure increased with increasing exposure to pro-tobacco advertisements. About 39.5% of the gap in SHS exposure between nonsmokers with low versus high smoking susceptibility was attributable to differences in parental or peer smoking. Conclusions: Sustained efforts are needed to denormalize tobacco use in order to reduce youth susceptibility to tobacco use.