Predictors of smoking development in a population-based sample of adolescents: a prospective study.
OBJECTIVE
To study the development of smoking behavior in adolescents using a longitudinal, multivariate design.


METHODS
Adolescents (n = 14,133, age range 12 to 18 years) took part in the longitudinal Add Health study (two waves, separated by 1 year, 56% smokers and 44% nonsmokers at Wave 1). Eight risk factor domains were established at Wave 1 (daily activities, psychological health, personality, school situation, family functioning, rough living, religion, and neighborhood status), which were further separated into subdomains by factor analysis. Subdomains were used to predict risk at Wave 2 of smoking initiation, progression, or failure to discontinue, using logistic regression analysis. Analyses were performed for boys and girls separately and results corrected for age, race, urbanicity, and socioeconomic status.


RESULTS
Use/abuse of other substances by self and peers influenced most stages of smoking, whereas trouble in school was associated with initiation and progression of smoking. Poor family relations predicted initiation of experimental smoking for girls, whereas low involvement in active pastimes predicted failure to discontinue experimental smoking. For boys, low religiosity predicted progression to regular smoking and failure to quit regular smoking, whereas delinquency also reduced success of regular smoking discontinuation.


CONCLUSIONS
These findings may direct efforts for prevention and intervention of adolescent smoking behavior and may also provide guidance for future studies.
van den Bree
Marianne B M
MB
University of Wales, College of Medicine, Division of Psychological Medicine, Heath Park, Cardiff CF14 4XN, Wales, United Kingdom.
Whitmer
Michelle D
MD
Pickworth
Wallace B
WB
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology