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.