Characteristics of recent cigarette use initiation among youth: Findings from a U.S. national survey

Objective. — To estimate to what extent triers (puffer) who never smoked a whole cigarette differ on non-biological factors from those smoking a whole cigarette in the first year of initiation.

Methods. — A 2004 and 2006 nationally representative sample of students enrolled in grades 6 through 12 in the U.S. Our analysis included students aged 12–18 years who started smoking <1 year since the date of the interview (n=1,884). Analyses were conducted using SUDAAN 9.0.1.

Results.— Most (72.3%) of the recent initiates tried a few puffs on a cigarette but did not smoke a whole cigarette. Adolescents aged 12 – 14 years, females, blacks and Other-Non-Hispanics had higher rates of puffers than adolescents aged 15 – 18 years, males, whites and Hispanics. In the fully adjusted model, whole cigarette smokers were more than twice as likely than puffers to think that smoking makes you look cool (OR=2.14) and to report that their friends smoke cigarettes (O.R.=1.91). Peer smoking was perhaps the most significant power discriminating factor between single and multiple cigarette smokers (O.R.=1.87). None of the demographic and parental smoking factors were correlated with differences between puffers and smokers of a whole cigarette or in smoking progression.

Conclusions. —The most important factors to distinguish adolescent puffers from smokers of a whole cigarette were age, gender, having peers who smoke and believing that people who smoke look cool. The need for a comprehensive approach is warranted to prevent smoking initiation and progression.