Warning: Popularity may be hazardous to pre-teens' health

Warning: Popularity may be hazardous to pre-teens' health. According to a study in the October issue of the Journal of Adolescent Health, popular students in 16 Southern California middle schools were more likely to become smokers than their less popular peers.

Researchers at the Keck School of Medicine of the University of Southern California surveyed 1,486 students in the sixth grade and then again the following year, in seventh grade. Students were defined as smokers if they had ever smoked-whether just a puff or a whole cigarette-and they were classified as susceptible to smoking if they refused to rule out any smoking in their future. Popularity was measured by the number of times a young person was named as a friend by other students in his or her class.

"In the year between the two surveys, we found that the popular students became more susceptible to smoking than their peers and were more likely to actually smoke than their peers," says study lead author Thomas W. Valente, Ph.D., associate professor of preventive medicine and member of the Institute for Health Promotion & Disease Prevention Research (IPR) at the Keck School. "The association existed across ethnicities and genders but was strongest for non-white boys."

Researchers theorize that popular sixth-graders may believe that being among the first to experiment with smoking will help them stay popular. Popular students try to set trends without deviating very far from the norms of the community, according to the study.

Because popular students model behaviors that others imitate -that is, because they are trendsetters-researchers expect smoking to spread more rapidly among young people when popular boys and girls choose to smoke.

The study also showed that isolated students-those who named no friends in the classroom-also were more likely to become smokers. The authors surmise that teen-agers who are isolated in the classroom may be connected to older friends who are more likely to smoke. These friends provide role models for smoking.

Most of the students in the study did not smoke (10 percent smoked as sixth-graders and 16 percent smoked as seventh-graders) but as they age, they will increasingly face peer influence to smoke by popular students in the classroom and older friends outside it, researchers say.

The link between smoking and popularity has implications for smoking and other substance-abuse prevention programs in schools. Prevention programs that use peer leaders have been found to be more effective than ones led by teachers, but if popular students embrace smoking, these programs will have limited success. Programs may therefore need to recruit and work with popular students if they hope to succeed, researchers note.

Researchers cautioned that students in the schools under study were primarily Latino and Asian American. Further research is needed to see whether the study conclusions apply to the general population.