title: The relationship between age of smoking initiation and current smoking: an analysis of school surveys in three European countries.
abstract: BACKGROUND
  It is held that younger smoking initiates are more likely to become regular smokers. The definitions of smoking initiation (a puff, part of a cigarette, a whole cigarette) are inconsistent and raise questions about the robustness of the view. We sought to re-examine the relationship using adolescent smoking data from 3 European countries.
  
  
  METHODS
  A stratified secondary, logistic regression analysis of Global Youth Tobacco Survey data was conducted using a design-based analysis. Subgroup analyses were conducted of 13- to 15-year olds from Latvia (high smoking prevalence), Slovenia (moderate prevalence), and Montenegro (low prevalence) who had initiated smoking. The outcome was current smoking--smoking everyday for the past 30 days, or smoking 10 or more days in the past 30 days. Smoking initiation was operationalized as a single puff of a cigarette, and age of smoking initiation was a derived continuous measure.
  
  
  RESULTS
  In Latvia, there was a significant association between age of smoking initiation and current smoking for males (p < .05) and females (p < .001) when smoking was operationalized as smoking every day. It was only significant in female adolescents (p < .001) for smoking 10 or more days. In Slovenia and Montenegro, there was no significant relationship between age of smoking initiation and current smoking for either males or females.
  
  
  CONCLUSIONS
  The evidence about the relationship between age of smoking initiation and current smoking is not clear. Explanations for the findings may relate to a lack of power, the specificity of the measure, or problems with the theory.
authors.affiliation: Global Public Health, Monash University, Sunway Campus, Selangor, Malaysia. daniel.reidpath@monash.edu
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Reidpath
authors.forename: Mei-Lee
authors.initials: ML
authors.lastname: Ling
authors.forename: Edith
authors.initials: E
authors.lastname: Wellington
authors.forename: Nabilla
authors.initials: N
authors.lastname: Al-Sadat
authors.forename: Shahjahan
authors.initials: S
authors.lastname: Yasin
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000367:Age Factors; D003625:Data Collection; D005260:Female; D006801:Humans; D007844:Latvia / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D054548:Montenegro / Q000453:epidemiology; D015995:Prevalence; D012574:Schools; D017524:Slovenia / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology* / Q000639:trends