Identifying mechanisms of adoption of tobacco and alcohol use among youth: The Bogalusa heart study☆

Network procedures revealed social influence mechanisms on alcohol and tobacco adoption. Children who smoke have best friends who smoke. Children who drink additionally develop drinking cliques. Smokeless tobacco is less social. Tobacco and alcohol adoption also spreads indirectly by imitation of an admired other's friends. Children's healthful programs must develop techniques which consider the sociability, visibility, social norms and public acceptance of the behavior, indirect nature of role models, and social support for non- or alternate use.