Tobacco use causes more than 5 million deaths worldwide annually. In Canada (2009), prevalence of smoking was 13% among those 15–19 years and 23% among those 20–24 years. Many young smokers desire to quit, but have difficulty doing so. Empirical reviews have concluded that smoking cessation programs in youth have limited efficacy. In order to provide a solid knowledge base for tobacco interventions, determinants of self-initiated cessation in youth need to be understood. We systematically searched PUBMED and EMBASE for longitudinal studies on determinants of self-initiated smoking cessation in youth. N=3807 titles and N=787 abstracts were reviewed independently by two and three reviewers, respectively. Inclusion criteria were: published between January 1984 and August 2010, youth 10–28 years, and smoking cessation of ≥6 months. Seven articles were retained for in-depth analysis. 3 of 7 studies retained defined smoking cessation as abstinence of ≥6 months and four studies as 12 months. Seven factors emerged related to quitting: few friends who smoke, no intention to smoke, higher parental education, intact nuclear family, parental disapproval of smoking, good grades, good health, high cigarette resistance self-efficacy, and older age at first use. Additional factors are significant only in some studies or only assessed once. The longitudinal literature on predictors of youth cessation is not well developed. The most consistent predictors of self-initiated cessation include few friends smoking and no intention to smoke in the future. Tobacco interventions should target youth as well their friends as soon as possible after smoking onset given the difficulty in quitting.
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