The Mediating Roles of Smoking-related Perception: Smoking, Education and Awareness

A sharp increase in the prevalence of smoking among adolescents is a significant public health concern. This study is among the first in the literature to explore the mediating effect of perceptions of smoking-related risks on the relationships between smoking and educational and awareness factors among adolescents. Data from the Global Youth Tobacco Survey Timor-Leste were analysed. Probit regression models were utilised to evaluate the impacts of demographic, educational and awareness factors on the likelihood of smoking. The mediating role of smoking risk perception was examined using structural equation modeling. Contrary to common findings, the perception of smoking-related risks was positively linked to the likelihood of smoking. Adolescents who were aware of tobacco control messages in mass media, received education on the risks of smoking and engaged in family discussions about tobacco use had higher perception of smoking-related risks than others, which in turn could impact adolescents’ smoking behaviour. However, the relationships between smoking and exposure to graphic or text warnings on cigarette packs, as well as reading school texts that included topics about smoking were not influenced by smoking-related perceptions. In summary, the perception of smoking-related risks mediates the associations between smoking and particular educational and awareness factors among adolescents.