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Media exposure, interactive health literacy, and adolescents’ susceptibility to future smoking

Abstract Background: Few studies have investigated interactive health literacy (IHL)’s relationship with adolescents’ smoking-related behavior. This study investigated IHL’s association with adolescents’ susceptibility to future smoking. Materials and methods: We conducted a school-based cross-sectional study of Japanese students enrolled in public junior high school, grades 7–9 (n=1937), who completed a self-report questionnaire. Variables were grade, gender, media exposure [television (TV), internet, and magazines], IHL (interest in learning about health, understanding what they hear about health, trying to follow what is taught about health), and susceptibility to future smoking. Results: Significant findings were: [1] media exposure was positively associated with adolescents’ susceptibility to future smoking (TV: p<0.01, internet: p<0.01, magazines: p<0.01); [2] IHL was negatively associated with adolescents’ susceptibility to future smoking (interest in learning about health: p<0.001; understanding what they hear about health: p<0.05; trying to follow what is taught about health: p<0.001). IHL’s influence on susceptibility to future smoking was found to be marginally stronger than that of media exposure. Conclusion: School health-education programs that promote adolescents’ IHL may effectively reduce adolescents’ susceptibility to future smoking.