Age at smoking initiation and subsequent smoking among Korean adolescent smokers

Demographics, clinical characteristics and cognitive symptoms of heavy smokers and non-heavy smokers in Chinese male patients with chronic schizophrenia

Many studies have shown a high smoking rate and cognitive impairment in patients with schizophrenia. The effects of smoking and nicotine intake on cognitive function in schizophrenia are still controversial. In this study, we divided patients into heavy smoking and non-heavy smoking groups and compared the clinical characteristics and cognitive symptoms between the two groups in Chinese male patients with schizophrenia. A total of 154 heavy smoking patients and 372 non-heavy smoking patients were recruited. They completed a detailed questionnaire including general and socio-demographic data. Positive and Negative Syndrome Scale (PANSS) was rated for psychopathology. The Fagerstrom Test for Nicotine Dependence (FTND) was used to assess the degree of nicotine dependence. Heavy smokers were younger, started smoking earlier and had a higher FTND total score than non-heavy smoking patients. Moreover, we found that heavy smokers had significantly lower negative symptom scores and cognitive factor scores than non-heavy smokers. Logistic regression analysis showed that cognitive factor score and age of initial smoking were significantly associated with heavy smoking. Linear regression analysis showed that cognitive factor score, age of initial smoking and dose of antipsychotics were significant predictors of the amount of smoking. Our findings suggest that there are significant differences in some demographic and clinical variables between heavy and non-heavy smokers in Chinese male patients with chronic schizophrenia. Moreover, heavy smokers have less cognitive symptoms, suggesting that heavy smoking may be beneficial for cognition of patients with schizophrenia.

Assessing the Evidence on the Differential Impact of Menthol versus Non-menthol Cigarette Use on Initiation and Progression to Regular Smoking: A Systematic Review and Meta-analysis

Background: Despite numerous assessments of the public health impact of menthol cigarettes, a rigorous synthesis related to menthol cigarettes and behavioral outcomes is lacking. This systematic review and meta-analysis examined the question: Does menthol cigarette use have a differential impact on initiation and progression to regular smoking compared to non-menthol cigarette use? Methods: We consulted 6 databases from their inception to October 15, 2021. We included articles comparing menthol versus non-menthol smokers among 4 predefined smoking initiation and progression outcomes. We assessed risk of bias was using the Agency for Healthcare Research and Quality Evidence-Based Practice Center approach. We applied a random-effects model to pool adjusted odds ratios. Results: We qualitatively synthesized 16 adjusted studies across the outcomes. Results from one meta-analysis suggested no difference between menthol and non-menthol smokers in likelihood to report daily versus non-daily smoking. Conclusion: This systematic review and meta-analysis did not identify a consistent, statistically significant, or differential association between menthol use and progression to regular smoking. Varying definitions of outcome measures and lack of longitudinal evidence limited the confident conclusions that could be drawn from this evidence base.

Relationships of Child-, Parents-, and Environment-Associated Determinants with Diet Quality, Physical Activity, and Smoking Habits among Indonesian Urban Adolescents

BACKGROUND

The trend of unhealthy lifestyles is increasing among adolescents and has been associated with the rising burden of noncommunicable diseases (NCDs). However, specific determinants of unhealthy lifestyles among adolescents in low- and middle-income countries remain limited.

OBJECTIVE

To investigate the relationships of child-, parents-, and environment-associated determinants with diet quality, physical activity, and smoking habits among low-socioeconomic urban adolescents.

METHODS

A cross-sectional study involving 238 adolescents aged 11 to 17 years was conducted in Jakarta, Indonesia. Adolescents and their parents were interviewed to assess the determinants of healthy lifestyles that included diet quality, physical activity, and smoking habits. Diet and physical activity were quantified using the Diet Quality Index for Adolescents (DQI-A) and Physical Activity Questionnaire for Older Children (PAQ-C), respectively. Multiple regression was used to determine the β coefficients and odds ratios predictive of healthy lifestyles.

RESULTS

Mean scores of DQI-A and PAQ-C were considered low (33.5% ± 8.9% and 2.1 ± 0.5, respectively). Overall, 17.6% of adolescents were smokers, with 88% of these being males. Predictors of diet quality were child- (age, gender) and environment-associated (house size, access to a computer) determinants with β coefficients of -6.52 to 3.26. The PAQ-C score was associated with child- (female) and environment-associated (living area) determinants with β coefficients of -0.45 and 0.14, respectively. Younger adolescents and females were protective factors for smoking. Parents-associated determinants were not associated with any lifestyle indicators.

CONCLUSIONS

Child- and environment-associated determinants were predictors of healthy lifestyles among adolescents. Thus, personal empowerment and environment transformation are needed to facilitate a healthy lifestyle and reduce the burden of NCDs among adolescents.

Transition in Smoking Stages and Its Relationship with Family Psychological Function and Perceived Social Support in Adolescents of Tabriz, Iran

BACKGROUND

There is limited information on the relationship between family psychological functions and perceived social support with progress in cigarette smoking stages in adolescents. This study was aimed to determine the relationship between family psychological function and perceived social support through a transition in different stages of cigarette smoking in adolescents of Tabriz, Iran.

METHODS

In this study, 4,216 students (14-19 years old) from high schools were selected by multistage cluster sampling method. Initially, we used valid and reliable questionnaires for demographic characteristics, risk factors, Iranian family psychological function, and perceived social support. The smoking status questionnaire was administered twice, with an interval of 6 months. Data were analyzed using univariate and multivariate logistic regression analysis.

RESULTS

Overall, 3,968 students with the mean (standard deviation) age of 15.96 (0.75) years completed the questionnaire in the first phase of the study. The results showed that lower levels of family psychosocial function (P < 0.001) and perceived social support (P < 0.001) in the univariate state were significantly associated with progress in cigarette smoking stages. By controlling the potential confounding factors, the weak and moderate family psychological function compared to the strong function increased the chance of progress in the cigarette smoking stages by almost 11 and 4 times, respectively (P < 0.001). The low and moderate level of perceived social support compared to the high level increased the chance of progress in cigarette smoking stages by almost 7 and 2 times, respectively (P < 0.001).

CONCLUSIONS

It is suggested to perform an organized, precise, and operational planning for strengthening the family psychological functions and providing an appropriate social support condition among adolescents to prevent the tendency toward cigarette smoking and its more advanced phases.

Factors Associated With Quitting Smoking in Indonesia

Objectives:

The aim of this study was to identify factors associated with quitting smoking in Indonesia

Methods:

Data on 11 115 individuals from the fifth wave of the Indonesia Family Life Survey were analyzed. Quitting smoking was the main outcome, defined as smoking status based on the answer to the question “do you still habitually (smoke cigarettes/smoke a pipe/use chewing tobacco) or have you totally quit?” Logistic regression was performed to identify factors associated with successful attempts to quit smoking.

Results:

The prevalence of quitting smoking was 12.3%. The odds of successfully quitting smoking were higher among smokers who were female (adjusted odds ratio [aOR], 2.69; 95% confidence interval [CI], 2.08 to 3.33), were divorced (aOR, 2.45; 95% CI, 1.82 to 3.29), did not chew tobacco (aOR, 3.01; 95% CI, 1.79 to 5.08), found it difficult to sacrifice smoking at other times than in the morning (aOR, 1.29; 95% CI, 1.14 to 1.46), and not smoke when sick (aOR, 1.32; 95% CI, 1.14 to 1.54). About 59% of variance in successful attempts to quit smoking could be explained using a model consisting of those variables.

Conclusions:

Female sex, being divorced, not chewing tobacco, and nicotine dependence increased the odds of quitting smoking and were associated with quitting smoking successfully. Regular and integrated attempts to quit smoking based on individuals’ internal characteristics, tobacco use activity, and smoking behavior are needed to quit smoking.

Application of Mixture Cure with the Doubly Censoring Model in Estimation of Initiation Age and Prevalence of Water-Pipe Smoking in Iran: a New Approach in Population-Based Studies

BACKGROUND

The initiation age and prevalence of smoking water-pipe are two important parameters for establishing preventive policies. Thus, the present study was conducted to introduce a new approach for estimating and evaluating the effect of demographic variables on the initiation age and prevalence of smoking water-pipe.

MATERIALS AND METHODS

The STEPwise approach for non-communicable disease risk factors surveillance (STEPS) 2011 data were used and daily smokers and non-smokers with the age range of 16 to 70 years were included in the study. A survival mixture cure rate model with doubly censoring was used.

RESULTS

Totally, 9764 individuals were enrolled in the study. No significant association was observed between the initiation age and gender (HR=1.07, 95% CI: 0.76, 1.58), whereas there was a significant difference between initiation age and area of residence (HR=0.62, 95% CI: 0.44, 0.88). The mean age of starting smoking was 25.82 years (95% CI: 24.13, 27.63). The odds of smoking in men were higher than in women (OR=2.34, 95% CI: 1.79, 3.7). The prevalence of smoking had a significant association with socioeconomic status (OR=0.84, 95% CI: 0.72, 0.97), but no association with the level of education (OR=1.06, 95% CI: 0.97, 1.15) and place of residence (OR=1.2, 95% CI: 0.93, 1.57) was found. The estimated prevalence of smoking water-pipe in total, men, and women was 4.8% (95% CI: 4.19%, 5.51%), 7.77% (95% CI: 6.76%, 8.86%), and 3.47% (95% CI: 2.8%, 4.25%).

CONCLUSION

A new statistical methodology was applied to estimate and evaluate the effect of demographic variables on the initiation age and prevalence of water-pipe smoking.

Smoking susceptibility among non-smoking school-going adolescents in Malaysia: findings from a national school-based survey

OBJECTIVE

The identification of susceptible non-smoking adolescents is an essential step in reducing smoking initiation among adolescents. The aim of this study was to examine the prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia.

DESIGN

Cross-sectional study.

SETTING

Primary and secondary schools in Malaysia.

PARTICIPANTS

11 246 non-smoking school-going adolescents.

OUTCOME MEASURES

The prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia.

RESULTS

Approximately 14% of non-smokers were susceptible to smoking, and the prevalence of susceptibility was significantly higher among males, ever-smokers and e-cigarette users. The odds of susceptibility to smoking were higher among males, e-cigarette users, those aged 12 years and under and those who had ever smoked or tried cigarettes. Students from schools with educational programmes on the health effects of second-hand smoke (SHS) and who perceived smoking to be harmful were less likely to be susceptible to smoking.

CONCLUSION

Smoking susceptibility is prevalent among school-going adolescents. A comprehensive approach that enhances or reinforces health education programmes on the adverse health effects of smoking and SHS among school children, that considers multiple factors and that involves all stakeholders is urgently needed to reduce the prevalence of smoking susceptibility among vulnerable subgroups, as identified from the present findings.

School Smoking Policies and Health Science Students' Use of Cigarettes, Shisha, and Dipping Tombak in Sudan

The relationship between school smoking policies and students' tobacco use is ambiguous, and little is known about the effect of these policies in low- and middle-income countries. This study was designed to assess the effects of schools' smoking policies and the exposure to residential smoking on cigarette smoking and the use of different kinds of tobacco products by Health Science students. Self-reports of cigarette smoking, use of shisha (smoking of fruits-mixed tobacco using a bowl and a connected hose); dipping tombak (local smokeless tobacco that users usually place inside oral cavity in the groove behind the lower lip), and tobacco use on school premises are analyzed. A cross-sectional survey was carried out using a modified self-report questionnaire, originally developed by WHO, among a representative sample of 1,590 third-year HSS from 25 schools drawn from 13 universities, using a multi-stages sampling technique. The response rate was 100% for schools and 68% for students. A multilevel analysis was performed by nesting student-level in school-level variables. Results from the adjusted models revealed that, when students reported awareness of smoking restriction, they were more likely to be current smokers (OR = 2.91; 95% CI: 1.68–5.02; p = 0.021) and shisha users (OR = 2.17; 95% CI: 1.54–3.06; p = 0.021). Results from additional analysis performed among tobacco users only, showed increased risk of smokers and tombak dippers who smoked or dipped on school premises (OR = 2.38; 95% CI: 1.34–4.25; p = 0.003, OR = 2.60; 95% CI: 1.22–5.56; p = 0.013, respectively). Current smokers (OR = 3.12; 95% CI: 1.98–4.92; p = ≤ 0.001), ever smokers (OR = 1.66; 95% CI: 1.31–2.10; p = ≤ 0.001) and shisha users (OR = 1.73; 95% CI: 1.36–2.21; p = ≤ 0.001) were exposed to residential smoking on one or more days during the previous 7 days. High percentages of those who used any kind of tobacco products reported being aware of school smoking policies, indicating no clear evidence that school smoking policies had an effect on use of any of the mentioned tobacco products. The lack of compliance with school policies shows the need for further policy enforcement and sustainability, taking into account the effect of residential smoking and social influences.

Youth tobacco use in Latin America: What is the real extent of the problem?

INTRODUCTION

Cigarette consumption among teenagers is one of the most critical health-related risk behaviors.

METHOD

Prospective study carried out in seven sites of five Latin American countries (Argentina [Cordoba, N=958, Corrientes, N=1013], Brazil [Curitiba, N=650; Uruguaiana, N=997], Cuba [Havana, N=1004], Mexico [Veracruz, N=991] and Paraguay [Ciudad del Este, N=868]) with public-school adolescents (aged 12-19 years). Respondents were asked to answer the California Student Tobacco Survey.

RESULTS

6550 adolescents took part in the survey (average age: 14 years). 38.5% (N=2517) "tried smoking" and 37.5% started smoking before the age of 12. Sixty-one percent of adolescents think that cigarettes are easily accessible; 41.7% considered that smokers have more friends; 88% indicated knowledge of the harms of smoking one to five cigarettes per day; 58.9% would smoke new cigarette types with less harmful substances; 27.8% have already used e-cigarettes; 28% have smoked hookah. Fifty-seven point five percent have been, in the past seven days, in the same room with someone who was smoking a cigarette; and 30.5% indicated that there were not any no-smoking rules inside their homes. Identifiable risk factors were (logistic regression analysis): smoking cigarettes offered by friends, smoking cigarettes with less harmful substances, knowing what a hookah is, being in the same room with a smoker in the past week. Identifiable protective factors against tobacco use were: knowing the health risks caused by smoking hookah and to have their own room.

CONCLUSION

Youth tobacco use in Latin America is a major public health concern, and tobacco control measures are highly needed.

Cigarette Smoking in South Korea: A Narrative Review

Although the prevalence of cigarette smoking has declined in Western countries over the past few decades, a comparable decline among males has not been observed in Asian countries, especially in South Korea, where approximately 40%–50% of men and 4%–8% of women have been identified as smokers, and there is a pressing need to understand the background of cigarette smoking in these populations. The present study is a narrative review of the research literature on cigarette smoking in South Korea. First, we describe the social, economic, and cultural factors that impact cigarette smoking in South Korea. The paper also reviews the available peer-reviewed literature comprising observational studies and interventional studies, including randomized controlled trials. The extant literature on smoking in Korean Americans is also reviewed. Cigarette smoking in South Korea has been relatively understudied, and this review identifies priority areas for future research, including the use of mobile interventions.

Sex Differences in Multilevel Factors of Smoking Experimentation and Age of Initiation in Korean Adolescents

This study purpose was to investigate sex differences in multilevel factors associated with smoking experimentation and age of initiation among Korean adolescents. Based on the ecological model, this cross-sectional study used data from the 2016 Korea Youth Risk Behavior Web-Based Survey (N = 65,528). Among 33,803 males (51.6%) and 31,725 females (48.4%), a greater proportion of males (21.9%) than females (7.1%) engaged in smoking experimentation. Males started smoking earlier than females (males: 12.7 years, females: 12.9 years, respectively, p < .05). In both sex groups, common factors associated with smoking were age, depression, suicidal ideation, academic achievement, household economic status, and having friends smoking and a specific person to talk with about their personal concern (all p values <.05). There were significant sex differences in psychological, family, and school factors of smoking initiation and experimentation. It is necessary to develop smoking interventions considering both individual and environmental factors with sex-specific strategies.

Knowledge, attitude and practice of cigarette smoking among senior secondary school students in Depok, Indonesia

BACKGROUND

Smoking behavior is primarily initiated and established during adolescence. Understanding the social context of smoking behavior among young people is required for developing strategies in preventing first tobacco use.

OBJECTIVE

This study aimed at exploring the determinants of smoking behavior among senior secondary school students in Depok, Indonesia by identifying knowledge regarding smoking-related adverse outcomes, perception and attitude toward smoking behavior and tobacco control policy.

METHODS

This study employed a cross-sectional design method. A total of 587 students from six senior secondary schools in Depok, Indonesia participated in this study. Univariate and multivariate statistical analyses were conducted to determine associations between cigarette smoking and independent variables.

RESULTS

Respondents ranged from 14 to 19 years old students. The proportion of current cigarette smokers were 99 students (17.0%) where the majority of the smokers were male (35.5%). The majority of the students, both smokers and non-smokers, were aware that cigarette smoking causes health problems. The present study found that attitudes that may lead to smoking behavior, in most cases, have been found to be significantly different between smokers and non-smokers. The perception of smoking behavior of smokers and non-smokers, such as smoking makes one more confident, cool, makes it easier to make friends, can relieve stress, symbolizes adulthood and masculinity, was statistically significant to smoking behavior.

CONCLUSION

The study highlights the importance of changing youths' image of cigarette smoking than merely educating students regarding the health hazards of smoking when they already possessed a good knowledge about those issues.

Source of cigarettes among youth smokers in Malaysia: Findings from the tobacco and e-cigarette survey among Malaysian school adolescents (TECMA)

INTRODUCTION

Understanding how and where youth obtain tobacco products are major factors in the development of suitable intervention programs to reduce youth smoking. This study aimed to determine the source of cigarettes and the associated factors among Malaysian school adolescent smokers.

METHODS

Our sample consisted of 1348 youth aged 10-17 years who were current smokers (having smoked at least once in the last 30 days). The source of cigarettes (commercial, over-the-counter purchases; or social, borrowing or obtaining from someone else) was the dependent variable, and multivariable logistic regression was employed to determine its association with independent variables (i.e. sociodemographics, smoking behavior, and knowledge of laws prohibiting sales of cigarettes to youth).

RESULTS

Over half (54.3%) of current smokers obtained cigarettes from commercial sources, with a proportion nearly two times higher (84.2% vs 43.7%) among frequent smokers (i.e. those smoking more than 20 days per month) compared to less-frequent smokers, and among young males (56.5% vs 32.0%) compared young females. Multivariable logistic regression indicated that in urban areas, young females (AOR=12.5, 95% CI: 1.38-99.8) frequent smokers (AOR=4.41, 95% CI: 2.05-9.46), and those studying in lower (AOR=3.76, 95% CI: 1.41-10.02) and upper secondary (AOR=4.74, 95% CI: 1.72-13.06) school students were more likely to obtain cigarettes from a commercial source. On the other hand, in rural areas, only frequent smokers were more likely to get their cigarettes from commercial sources, whilst other variables were not significant.

CONCLUSIONS

The proportion of youth smokers who obtained cigarettes from commercial sources appeared to be high, suggesting that law enforcement and health promotion activities should be enhanced to reduce the rate of smoking among Malaysian youth.

A Tool to Identify Adolescents at Risk of Cigarette Smoking Initiation

: media-1vid110.1542/5828318368001PEDS-VA_2017-3701Video Abstract OBJECTIVES: To describe the development of a prognostic tool to identify adolescents at risk for transitioning from never to ever smoking in the next year.

METHODS

Data were drawn from the Nicotine Dependence in Teens study, a longitudinal investigation of adolescents (1999 to present). A total of 1294 students initially age 12 to 13 years were recruited from seventh-grade classes in 10 high schools in Montreal. Self-report questionnaire data were collected every 3 months during the 10-month school year over 5 years (1999-2005) until participants completed high school (n = 20 cycles). Prognostic variables for inclusion in the multivariable analyses were selected from 58 candidate predictors describing sociodemographic characteristics, smoking habits of family and friends, lifestyle factors, personality traits, and mental health. Cigarette smoking initiation was defined as taking even 1 puff on a cigarette for the first time, as measured in a 3-month recall of cigarette use completed in each cycle.

RESULTS

The cumulative incidence of cigarette smoking initiation was 16.3%. Data were partitioned into a training set for model-building and a testing set to evaluate the performance of the model. The final model included 12 variables (age, 4 worry or stress-related items, 1 depression-related item, 2 self-esteem items, and 4 alcohol- or tobacco-related variables). The model yielded a c-statistic of 0.77 and had good calibration.

CONCLUSIONS

This short prognostic tool, which can be incorporated into busy clinical practice, was used to accurately identify adolescents at risk for cigarette smoking initiation.

Electronic cigarettes: an aid in smoking cessation, or a new health hazard?

The issue of electronic cigarettes is one of the most controversial topics in public health. There is intense debate and dividing opinions about their use patterns, health effects and association with smoking. This is expected since they were only recently introduced to the market and they refer to a harm-reduction approach and strategy that is not universally accepted for smoking and tobacco use in the public health community. Three main factors determine the public health impact of electronic cigarettes: (1) their safety/risk profile, both relative to smoking and in absolute terms; (2) their effectiveness for smoking reduction and cessation; (3) the patterns of use by different population subgroups, especially never-smokers, and adoption of use by youth. This analysis presents a brief overview of currently available evidence and gaps in research covering these three factors.

Age at diagnosis, obesity, smoking, and molecular subtypes in muscle-invasive bladder cancer

BACKGROUND

Heterogeneity of muscle-invasive bladder cancer (MIBC) has been characterized using whole-genome mRNA expression data, showing distinct molecular and clinicopathological characteristics by subtypes. However, associations between risk factors and molecular subtypes have not been reported.

METHODS

Four previously published schemes were used to categorize molecular subtypes in 372 MIBC patients from the Cancer Genome Atlas (TCGA). Data on gene expression (RNA-seq), demographic, and clinicopathological characteristics were retrieved through TCGA data portal. Polytomous logistic regression was used to estimate the associations of subtypes by different schemes with age at diagnosis, obesity, and smoking.

RESULTS

While some quantitative variation was evident, distinct molecular subtype schemes showed considerable consistency in the association with the risk factors. Generally, compared to patients with luminal-like tumors, patients with basal-like subtypes were more likely to be older (OR_{75 + yrs vs. <60 years} range = 1.32-2.89), obese (OR_{obese vs. normal} range = 1.30-3.05), and to start smoking at early age (OR_{<18 years vs. 25+ years} range = 1.11-4.57).

CONCLUSIONS

Different molecular subtypes of MIBC may have distinct risk profiles. Large population-based studies with detailed information on bladder cancer risk factors are needed to further define etiologic heterogeneity for bladder cancer.

How do Indonesian youth perceive cigarette advertising? A cross-sectional study among Indonesian high school students

Background

Previous studies have reported an association between cigarette advertising and smoking behavior. Although this has been reported extensively in the West, it has been reported less in Southeast Asian countries that have not completely banned tobacco advertising promotion and sponsorship (TAPS). Indonesia is the only ASEAN country that has not ratified the Framework Convention on Tobacco Control, so TAPS regulation is limited. This study aimed to assess the association between youths’ perceptions of cigarette ads and smoking initiation.

Design

We conducted a cross-sectional survey among 2,115 high school students aged 13–18 years in Yogyakarta, Indonesia. A self-administered questionnaire was distributed to gauge the perception of cigarette ads and initiation to smoking. We calculated the odds ratio (OR) between the perception of cigarette ads and smoking initiation, adjusting for sociodemographic and psychosocial variables. The sociodemographic variables included in the final model were age and sex.

Results

The final multivariate model showed an association between perception of tobacco ads encouraging youths to smoke and smoking initiation (OR 2.70) and current smoking (OR 7.63). Attitude toward TAPS was associated with smoking initiation (OR 1.51) and current smoking (OR 3.32). Exposure to cigarette ads had an association with smoking initiation only (OR 1.27) and did not have an association with current smoking. Having friends and family who smoked was associated with smoking initiation and current smoking in the final multivariate model. Smoking initiation and current smoking were also related to the susceptibility to smoke.

Conclusions

This study revealed that cigarette ads were perceived as encouraging youths to smoke and that smoking status was consistently associated with perception of cigarette ads targeted at youths, attitude toward TAPS, and susceptibility as well as smoking friends and family. Regulations to ban TAPS, particularly cigarette ads for preventing youths from smoking, should be adopted rapidly in Indonesia, where tobacco control remains limited.

A comparison of adolescent smoking initiation measures on predicting future smoking behavior

Objectives

Evidence suggests that age at smoking initiation has implications for tobacco use, nicotine dependence, and resulting long-term health and chronic disease outcomes. The objective of the current study was to examine two different measures of smoking onset and to compare their validity in predicting future adolescent smoking survey.

Methods

Data from grades 9–12 students who participated in the 2012/2013 Youth Smoking Survey, a nationally-generalizable Canadian survey, and who had ever tried a cigarette, even a few puffs (n = 8126) were used in a multivariable logistic regression analysis to examine the association between age at smoking onset and current smoking behavior.

Results

Both “age at first puff” and “age at first whole cigarette” were significantly associated with current smoking status. Specifically, a delay of one year in the age at first puff was associated with lower odds of being a current smoker by 24% (AOR = 0.76, 95% CI = 0.73–0.79). Similarly, high school students who smoked their first whole cigarette at old age were less likely to report being a current smoker (AOR = 0.66, 95% CI = 0.62–0.71).

Conclusion

Efforts to prevent smoking uptake among youth, especially younger youth, are especially important in tobacco control efforts.