A cross-sectional assessment of the influence of information sources about substance use in adolescents' tobacco prevalence.

Background: Tobacco consumption is a relevant public health problem, with adolescence being a common period of initiation. One factor that has rarely been investigated is the information available to adolescents regarding the consequences of substance use. Therefore, the primary objective of this study was to assess the correlation between teenagers' self-reported information level about substance consumption and its sources and smoking prevalence. The study differentiates between sources monitored by state or supranational organizations (schools, parents, and mass media) and those that are not (peers, siblings, and the Internet). Three modes of tobacco consumption were examined: cigarette, e-cigarette, and hookah. Methods: This study used a survey conducted in 2023 with teenagers residing in Tarragona (Spain). The survey received 1307 responses from a target demographic comprising approximately 8000 individuals. Hierarchical ordered logistic regression was employed to evaluate the significance of the variables pertaining to each modality of tobacco consumption. The assessed variables encompassed the perceived level of information concerning substance use and the quantity of monitored and unmonitored resources that provide that information. These variables were controlled for four individual and four environmental factors. Results: Logistic regressions indicated that although the extent of information regarding substance consumption consequences does not correlate with smoking in any form, the amount of monitored and unmonitored information resources was significantly associated with all consumption modalities. Information derived from monitored sources consistently exerts a protective effect. In the case of cigarette consumption, the 95 % confidence interval of the odds ratio (95%CI) was 0.43-0.91; for e-cigarrette, 95%CI = 0.45-0.86, and for hookah usage 95%CI = 0.42-0.86. The use of unmonitored resources appears to encourage consumption. In the case of cigarette, 95%CI = 1.08-2.34; for e-cigarette, 95%CI = 1.39-2.69; and for hookah use 95%CI = 1.39-2.68. Conclusions: The results in this paper have significant implications for health literacy dissemination, underscoring the need for public authorities to consider both monitored and unmonitored information sources in relation to smoking prevalence in adolescents. These results imply that information emanating from monitored sources of information in the design and implementation of measures against adolescents' tobacco use.