Cigarette consumption during childhood and persistence of smoking through adolescence.
BACKGROUND
The childhood cause of adolescent smoking requires prospective study.


OBJECTIVE
To compare prospective with retrospective estimates of childhood smoking and to test cigarette consumption and susceptibility to smoking during childhood as predictors of smoking behavior at late adolescence.


METHODS
Eight-year prospective study.


METHODS
From February through April of 1994, 1995, and 1996, surveys were completed in elementary schools in central North Carolina; from February through May 2002, telephone interviews were completed wherever participants resided.


METHODS
Of 868 age-eligible children, 737 (84.9%) provided survey data between the ages of 8 and 10 years; of these subjects, 594 (80.6%) were interviewed at the age of 17 years.


METHODS
Current, established, and daily smoking.


RESULTS
Current smoking was reported by 23.0% of those having never puffed on a cigarette (abstinent) in childhood vs 42.7% (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.58-3.82), 50.0% (OR, 3.36; 95% CI, 1.41-8.01), 58.3% (OR, 4.41; 95% CI, 1.46-14.18), and 56.5% (OR, 4.37; 95% CI, 1.86-10.29) of those who smoked 1 or fewer, 2 to 4, 5 to 20, and more than 20 cigarettes, respectively, during childhood. Established smoking was reported by 15.0% of those abstinent in childhood vs 21.3% (OR, 1.52; 95% CI, 0.89-2.58), 40.6% (OR, 3.93; 95% CI, 1.61-9.59), 50.0% (OR, 4.96; 95% CI, 1.77-16.18), and 47.8% (OR, 5.21; 95% CI, 2.20-12.32) of those who smoked 1 or fewer, 2 to 4, 5 to 20, and more than 20 cigarettes, respectively, during childhood. Daily smoking was reported by 10.1% of those abstinent in childhood vs 11.2% (OR, 1.10; 95% CI, 0.56-2.18), 28.1% (OR, 3.45; 95% CI, 1.24-9.03), 33.3% (OR, 4.47; 95% CI, 1.29-15.84), and 39.1% (OR, 5.75; 95% CI, 2.35-14.08) of those who smoked 1 or fewer, 2 to 4, 5 to 20, and more than 20 cigarettes, respectively, during childhood. Among abstinent children, high vs low susceptibility to smoking predicted greater likelihood of current (37.5% vs 16.7%; OR, 2.98; 95% CI, 1.55-5.74), established (32.1% vs 9.3%; OR, 4.81; 95% CI, 2.29-10.07), and daily (21.4% vs 7.0%; OR, 4.02; 95% CI, 1.71-9.44) smoking at follow-up.


CONCLUSIONS
Relatively small increases in the number of cigarettes consumed during childhood are associated with significantly higher odds of current, established, and daily smoking in adolescence.
Jackson
Christine
C
Pacific Institute for Research and Evaluation, Chapel Hill Center, Chapel Hill, NC, USA. cjackson@pire.org
Dickinson
Denise
D
D000293:Adolescent; D000294:Adolescent Behavior; D017677:Age Distribution; D002648:Child; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology* / Q000639:trends