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Description
The process of becoming a smoker has been an underinvestigated area and as a result, there is uncertainty regarding the specific influences that contribute to smoking onset. This study examines empirically the process and risk factors involved in adolescent smoking acquisition. The primary objective was to test the currently accepted integrative model of adolescent smoking uptake and to validate a measure to identify adolescents in the pre-smoking preparatory phase of the initiation process. Using the 1989 Teenage Attitudes and Practices Survey of a nationally representative population of 7,960 adolescents in the United States, and subsequent four-year follow-up, the effect of susceptibility to smoking was examined while controlling for sociodemographic, social learning, social bonding, intrapersonal, and other risk factors, by means of a multiple logistic regression analysis. Among adolescent never smokers at baseline, the susceptibility to smoking measure was an independent and stronger predictor of experimentation than was exposure to other smokers, commonly regarded as the strongest predictor of smoking uptake. This suggests that the positive move toward becoming a smoker appears to be the development of a cognitive susceptibility to smoking. For experimenters at baseline, the single most important predictor of current established smoking at followup was smoking experience. Although susceptibility to smoking was also a predictor in this latter transition, the magnitude of risk on progression to established smoking was not as great as its influence on progression from never smoking to experimentation. As a result of incorporating the susceptibility to smoking measure with smoking experience, a more detailed smoking uptake continuum was created. Moreover, using these two measures, we can classify adolescents on their probability of future smoking. Therefore, uniform interventions for adolescent smoking may not be appropriate since risk of future smoking varies according to susceptibility and smoking experience.
