title: Predictors of smoking among Swedish adolescents.
abstract: BACKGROUND
  Smoking most often starts in adolescence, implying that understanding of predicting factors for smoking initiation during this time period is essential for successful smoking prevention. The aim of this study was to examine predicting factors in early adolescence for smoking in late adolescence.
  
  
  METHODS
  Longitudinal cohort study, involving 649 Swedish adolescents from lower secondary school (12-13 years old) to upper secondary school (17-18 years old). Tobacco habits, behavioural, intra- and interpersonal factors and socio-demographic variables were assessed through questionnaires. Descriptive statistics, univariable and multivariable logistic regression were used to identify predicting factors.
  
  
  RESULTS
  Smoking prevalence increased from 3.3% among 12-13 year olds to 25.1% among 17-18 year olds. Possible predictors of smoking were: female sex, lower parental education, poorer family mood, poorer self-rated health, poorer self-esteem, less negative attitude towards smoking, binge drinking, snus use and smoking. In a multivariable logistic regression analysis, female sex (OR 1.64, CI 1.08-2.49), medium and low self-esteem (medium: OR 1.57, CI 1.03-2.38, low: 2.79, CI 1.46-5.33), less negative attitude towards smoking (OR 2.81, CI 1.70-4.66) and ever using snus (OR 3.43, CI 1.78-6.62) remained significant independent predicting factors.
  
  
  CONCLUSIONS
  The study stresses the importance of strengthening adolescents' self-esteem, promoting anti-smoking attitudes in early adolescence, as well as avoidance of early initiation of snus. Such measures should be joint efforts involving parents, schools, youth associations, and legislating authorities.
authors.affiliation: Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-901 87 Umeå, Sweden. junia.joffer@Ltdalarna.se.
authors.forename: Junia
authors.initials: J
authors.lastname: Joffer
authors.forename: Gunilla
authors.initials: G
authors.lastname: Burell
authors.forename: Erik
authors.initials: E
authors.lastname: Bergström
authors.forename: Hans
authors.initials: H
authors.lastname: Stenlund
authors.forename: Linda
authors.initials: L
authors.lastname: Sjörs
authors.forename: Lars
authors.initials: L
authors.lastname: Jerdén
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014029:Tobacco Use Disorder / Q000453:epidemiology