Predictors of Cigarette Smoking Initiation in Early, Middle, and Late Adolescence.
OBJECTIVE
Little is known about age-related differences in risk factors for cigarette smoking initiation. We identified predictors of initiation in early, middle, and late adolescence from among sociodemographic factors, indicators of smoking in the social environment, psychological characteristics, lifestyle indicators, and perceived need for cigarettes.


METHODS
Data were drawn from a longitudinal study of 1,801 children recruited at age 10-11 years from 29 elementary schools in Montreal, Canada. Multivariable logistic regression within a generalized estimating equations framework was used to identify predictors among never smokers across three 2-year windows: age 11-13 years (n = 1,221); age 13-15 years (n = 737); and age 15-17 years (n = 690).


RESULTS
Among the 18 risk factors investigated, two differed across age. Friends' smoking, a strong risk factor in early adolescence (odds ratio [95% confidence interval] = 5.78 [3.90-8.58]), lost potency in late adolescence (1.83 [1.31-2.57]). Depressive symptoms, a risk factor in early and middle adolescence (1.60 [1.26-2.02] and 1.92 [1.45-2.54], respectively), were inversely associated in late adolescence (.76 [.58-1.00]). Sex, TV viewing, and weight-related goals were not associated with initiation at any age. All other factors were significant in two or three age groups.


CONCLUSIONS
Most risk factors for smoking initiation were stable across age. Tobacco control interventions may be robust for risk factors across age groups and may not need adjustment. At all ages, interventions should focus on eliminating smoking in the social environment and on reducing the availability of tobacco products.
Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Institut national de santé publique du Quebec, Montréal, Quebec, Canada. Electronic address: jennifer.oloughlin@umontreal.ca.
Jennifer
J
O'Loughlin
Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Department of Exercise Science, Concordia University, Montréal, Quebec, Canada.
Erin K
EK
O'Loughlin
Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts.
Robert J
RJ
Wellman
Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
Marie-Pierre
MP
Sylvestre
Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
Erika N
EN
Dugas
Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada.
Miguel
M
Chagnon
Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
Hartley
H
Dutczak
Institut national de santé publique du Quebec, Montréal, Quebec, Canada.
Johanne
J
Laguë
Department of Psychology, PERFORM Centre & Psychology Department, Concordia University, Montréal, Quebec, Canada.
Jennifer J
JJ
McGrath
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D017668:Age of Onset; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010379:Peer Group; D011792:Quebec; D012307:Risk Factors; D012574:Schools; D012907:Smoking / Q000523:psychology*; D012931:Social Environment
Adolescent; Children; Cigarette smoking initiation; Longitudinal; Nicotine; Tobacco