title: Patterns of smoking among inner-city teenagers: smoking has a pediatric age of onset.
abstract: OBJECTIVE
  (1) To test the hypothesis that the prevalence of smoking among African-American teenagers is lower than among whites and Hispanic inner-city senior high school students; (2) to assess the patterns of smoking among inner-city teenagers; and (3) to ascertain the relationship between smoking status and their knowledge, attitudes, beliefs, and behaviors.
  
  
  METHODS
  All students attending inner-city senior high schools in two cities in New Jersey were included in the survey (n = 8,900). Response Rate was 85%; 89% of respondents were minority teenagers.
  
  
  RESULTS
  The overall point prevalence rate of cigarette smoking was 9%. Almost all smoking began before the age of 16 years. The factors that significantly (p < .001) contributed to the initiation of cigarette smoking were: peer influence, self-initiation, and the influence of relatives' cigarette smoking. The factors that were stated to play a major role in progression to regular smoking were: perceptions that smoking relieves stress and feelings of induced pleasure while smoking. In addition, smokers were significantly (p < .0005) less knowledgeable about smoke-related diseases than exsmokers or nonsmokers. Over two-thirds of smokers and exsmokers believed that it is the physician's responsibility to advise patients to quit smoking and the majority of the current smokers contemplated quitting smoking. The data support the hypothesis that smoking prevalence among African-American teenagers is significantly lower than among white and Hispanic teenagers who attended the senior high school and resided in the inner city.
  
  
  CONCLUSIONS
  These data suggest that multidimensional antismoking strategies are needed to address the smoking among predominately minority teenagers. This includes supportive messages from physicians, relatives, friends along with public policy to act as motivating factors to discourage early smoking.
authors.affiliation: Department of Preventive Medicine, and Community Health, University of Medicine and Dentistry, of New Jersey-New Jersey Medical School, Newark 07103-2714, USA.
authors.forename: G R
authors.initials: GR
authors.lastname: Najem
authors.forename: F
authors.initials: F
authors.lastname: Batuman
authors.forename: A M
authors.initials: AM
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Feuerman
mesh_terms: D000328:Adult; D001741:Black or African American; D017668:Age of Onset; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008297:Male; D009515:New Jersey / Q000453:epidemiology; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology* / Q000208:ethnology; D011795:Surveys and Questionnaires; D014505:Urban Population; D044465:White People