Rapid progression to regular cigarette smoking among nonsmoking adolescents: interactions with gender and ethnicity

Prev Med. 2003 Apr;36(4):455-63. doi: 10.1016/s0091-7435(02)00041-5.


Background: While the correlates and predictors associated with transition through the stages of smoking acquisition have received substantial attention, the identification of factors associated with the time course of progression remain generally unexplored.

Methods: We identified adolescents escalating from nonsmoking to regular smoking in 1 year as rapid progressors (n = 98) and those escalating from nonsmoking to experimental smoking in 1 year as slow progressors (n = 555). We entered demographic and psychosocial variables, initial reactions to smoking variables, and their interactions with gender and ethnicity into a logistic regression analysis comparing rapid progressors to slow progressors.

Results: At baseline, rapid progressors reported more friends who smoked regularly. Girls who reported more concern with dieting and less social success were more likely to progress to regular smoking within 1 year; these variables did not influence progression in boys. Those who associated positive feelings with their initial smoking experience were more likely to progress to regular smoking. Differences between white and African American youth emphasize the importance of physiological interpretations of initial smoking experiences.

Conclusions: Our findings suggest that even as nonsmokers, adolescents likely to progress quickly to regular smoking can be identified. Researchers designing prevention programs should take these factors into account.

MeSH terms

  • Adolescent
  • Adolescent Behavior* / ethnology
  • African Americans / statistics & numerical data
  • Age Distribution
  • Child
  • European Continental Ancestry Group / statistics & numerical data
  • Feeding Behavior / psychology
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Sex Factors
  • Smoking / epidemiology*
  • Smoking / psychology
  • Social Environment
  • Tennessee / epidemiology
  • Weight Loss