SMOKING INITIATION IN YOUTH - THE ROLES OF GENDER, RACE, SOCIOECONOMICS, AND DEVELOPMENTAL STATUS

Purpose: To describe smoking initiation, and to investigate factors th at predict the early initiation of smoking in schoolchildren using a l ongitudinal approach. Methods: A prospective study of smoking habits o f children from the third and fourth grades through the eighth and nin th 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 poin ts over 6 years. Multivariate regression models examined relationships of demographic and developmental factors with smoking initiation. Res ults: Experimental smoking increased from 4% at Grades 3-4 to 42% at G rades 8-9, and current smoking prevalence rose from 0.4% to 9% over th e same period. The mean age of initiation of smoking was 12.3 years. S moking initiation (experimental smoking) was significantly different b y racial group, socioeconomic status (SES), and pubertal development. White children and those of low SES were more likely to be experimenta l 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 ex perimental smoking than girls at all time points. Children in rural ar eas 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, S ES, and pubertal stage are important predictors of initiation of smoki ng in schoolchildren. This study indicates a need for smoking preventi on classes in elementary and middle school, especially in areas with l arge numbers of white and low-SES youth. Also, smoking cessation progr ams, as well as smoking prevention classes, would be useful for middle school and high school students. (C) Society for Adolescent Medicine, 1998