Resistance to peer influence, smoking friends, cigarette and betel nut use, and gender among Pacific Islander youth

Abstract

The present study examined the relationships between resistance to peer influence and cigarette and betel nut use, as well as the potential mediating role of friends who use cigarettes and betel nut, among boys and girls in Guam. This study included 673 ethnically diverse students (49% female; M age = 12.7, SD = 0.89) from eight public middle schools. The mediation analysis demonstrated that higher resistance to peer influence for both cigarette and betel nut use was associated with lower cigarette and betel nut use directly and that this association was mediated by friends who used cigarette and betel nut products. That is, low resistance to peer influence for both cigarette and betel nut use was associated with a greater number of friends who smoke and use betel nut, which was linked with more cigarette and betel nut use. The moderated mediation analysis revealed no gender difference in the indirect effect (i.e., the mediation of friends who used cigarettes and betel nut). These findings can be used to inform the design and implementation of intervention and prevention programs for at-risk youth, regardless of gender, who are vulnerable to substance use in the Pacific.

Keywords: Pacific Islander youth; Resistance to peer influence; cigarette and betel nut use; friends who use cigarettes and betel nut.

Figure 1.

A proposed moderated mediation model for cigarette and betel nut use and gender.

Figure 2.

A mediation model of resistance to peer cigarette smoking influence as a predictor to cigarette smoking friends as a mediator to cigarette smoking as an outcome variable. **p<.01, ***p<.001 Note: Standardized regression coefficients are presented in this figure. Total effect (C) = −.74*** (SE = .18) and direct effect (C’) = C’ = −.56** (SE = .17). Indirect effect for resistance to peer cigarette smoking to cigarette smoking friends as a mediator to last 30 days cigarette smoking was significant (β = −.04, SE = 02, 95% CI [−.084, −.004]). Age and gender were controlled for in this model. Ethnicities (Chamorros, Filipinos, and Micronesians) were not significant predictors and thus removed from the model.

Figure 3.

A mediation model of resistance to peer betel nut use influence as a predictor to betel nut friends as a mediator to betel nut use as an outcome variable. *p<.05, **p<.01, ***p<.001 Note: Standardized regression coefficients are presented in this figure. Total effect (C) = −.45*** (SE = .12) and direct effect (C’) = C’ = −.33** (SE = .11). Indirect effect for resistance to peer betel nut use to betel nut friends as a mediator to last 30 days betel nut use was significant (β = −.04, SE = 02, 95% CI [−.085, −.007]). Age and gender were controlled for in this model. Ethnicities (Chamorros, Filipinos, and Micronesians) slightly changed the significance of indirect effect… were not significant predictors and thus removed from the model.