WHICH ADOLESCENT EXPERIMENTERS PROGRESS TO ESTABLISHED SMOKING IN THEUNITED-STATES

Introduction: This study examined the adolescent smoking uptake proces s, specifically, the progression from experimentation to established s moking. Although adolescent smoking uptake has been described as consi sting of five stages (preparation, initial trying, experimentation, re gular smoking, and addiction), there is no accepted method of identify ing which experimenters will proceed to become addicted. Methods: Usin g a nationally representative sample of adolescents between the ages o f 12 and 18 at baseline, we examined their transition from experimenta tion (had at least a puff but has not smoked 100 cigarettes) to establ ished smoking (smoked at least 100 cigarettes in lifetime) four years later. Results: At follow-up, 31% of the experimenters at baseline had progressed to established smoking. Baseline level of smoking experien ce was the strongest independent predictor of established smoking, wit h current experimenters (smoked in the past 30 days but less than 100 cigarettes in lifetime) having the greatest risk of progressing to est ablished smoking compared to puffers (puffed but have not smoked a who le cigarette). Furthermore, this effect was modified by age; older cur rent experimenters at baseline had more than double the risk of younge r current experimenters of progressing to established smoking at follo w-up. Absence of a firm commitment not to smoke was a significant pred ictor among older experimenters but not in younger experimenters. Othe r important predictors of the transition from experimentation to estab lished smoking were exposure to other smokers and perceived school per formance. Conclusions: We found that, even among experimenters, there is an identifiable group of adolescents who are at higher risk of prog ressing to established smoking that can be targeted for intervention.