Introduction: Research links normative infl uence to youth
smoking in Egypt. This analysis assesses the association of
descriptive norms at the household and neighborhood levels
with the smoking behavior of 1,366 men aged 15 – 24 in rural
Minya governorate, Egypt.
Methods: Data come from the 2004 Minya Village Health Survey
of 6,096 people from 2,093 households. A two-level, random
effects multivariate logistic regression model with individual
data clustered at the neighborhood level was fi t to the data. The
strengths of normative infl uence at the household and neighborhood
levels on male youths ’ smoking behavior were assessed,
controlling for age, education, employment, outcome beliefs
about smoking, and household wealth.
Results: Male youths who lived in a household with an adult
male who smoked were much more likely to smoke than
were youth who lived in a household with adult male(s) who
did not smoke (odds ratio [ OR ] = 2.73, 95% CI = 1.84 – 4.07,
p < .001). Living with one or more male youth who smoked
was also strongly associated with male youth smoking ( OR =
1.91, 95% CI = 1.29 – 2.84, p = .001). Living in a neighborhood
with an SD greater than the population mean proportion
of males who smoked (both adult and youth) was
associated with a 24% greater likelihood of youth smoking
( OR = 1.24, 95% CI = 1.04 – 1.48, p = .017). Unmeasured factors
at the neighborhood level accounted for 3.1% of the
variability.
Conclusions: Young men in Minya who live with smokers or in
neighborhoods with smokers are more likely to smoke. Policies
and interventions enacted at the household and neighborhood
levels may prevent youth smoking.