Original Articles
Smoking initiation in youth: The roles of gender, race, socioeconomics, and developmental status

https://doi.org/10.1016/S1054-139X(98)00078-0Get rights and content

Abstract

Purpose: To describe smoking initiation, and to investigate factors that predict the early initiation of smoking in schoolchildren using a longitudinal approach.

Methods: A prospective study of smoking habits of children from the third and fourth grades through the eighth and ninth grades. The initial study population was 1970; 79.8% were white and 20.2% were African-American. Children were classified as “nonsmokers,” “experimental smokers,” or “current smokers” at five time points over 6 years. Multivariate regression models examined relationships of demographic and developmental factors with smoking initiation.

Results: Experimental smoking increased from 4% at Grades 3–4 to 42% at Grades 8–9, and current smoking prevalence rose from 0.4% to 9% over the same period. The mean age of initiation of smoking was 12.3 years. Smoking initiation (experimental smoking) was significantly different by racial group, socioeconomic status (SES), and pubertal development. White children and those of low SES were more likely to be experimental smokers, and also started earlier than African-American children and children of high SES. Once they started, white children advanced more rapidly to become current smokers. Boys had a higher prevalence of experimental smoking than girls at all time points. Children in rural areas were more likely than urban children to start smoking after age 12 years. Children who were at a higher pubertal stage than their peers were also more likely to experiment with smoking.

Conclusions: Race, SES, and pubertal stage are important predictors of initiation of smoking in schoolchildren. This study indicates a need for smoking prevention classes in elementary and middle school, especially in areas with large numbers of white and low-SES youth. Also, smoking cessation programs, as well as smoking prevention classes, would be useful for middle school and high school students.

Section snippets

Subjects and setting

Subjects were youths participating in the CHIC I and CHIC II studies who were followed longitudinally for 6 years. At the time of first data collection, the children were in third and fourth grades and were age 8–11 years of age (mean 9.2 ± 0.8). The initial sample (n = 2059) included 89 subjects from various racial and ethnic groups: 17 Hispanics, 25 Asians, 16 American Indians, and 31 “other and mixed.” These groups are not included in this analysis owing to the small number of subjects,

Results

The number of subjects for whom smoking data were available at each of the five data collection periods is shown in Table 1. Subject attrition over four of the five study time points ranged from 7.3% to 11.3%; there was a large drop in the sample size (41.7% of subjects) between Time 2 and Time 3. There were 2 years between those time points, and subjects had to reenroll in the study during that time. There was only 1 year between each of the other data collection points. Demographic

Discussion

This analysis of smoking in CHIC children shows that race, pubertal level, and family SES were very important factors in the initiation of smoking during childhood and adolescence. White children were more likely to begin smoking than African-American children. Children at higher Tanner stage of development were more likely to smoke. Low SES significantly increased the chance of a child’s beginning to smoke, and low-SES children were likely to begin trial smoking earlier, as were boys and those

Acknowledgements

This study was funded by Grant NR01837 from the National Institutes of Health (National Institute for Nursing Research).

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