Adolescent Nonsmokers: What Happens to Them in Young Adulthood?

It is well-documented that the majority of smokers begin smoking before age 18. Evidence suggests, however, that young adult smoking is not simply an extension of high school smoking. Many smokers initiate and progress to regular smoking after high school. This study examines patterns of smoking among a cohort of adolescents who remained nonsmokers to age 18. Participants who reported not smoking at all or smoked less than one cigarette before age 18 were included in the analysis (n=1,766). Semiparametric, group-based methods were used to identify trajectories of smoking from age 18 to 22. Based on the Bayesian Information Criteria, the 5-trajectory group model fit these data best. The largest trajectories, the “nonsmokers” (55.5%) and the “puffers” (24.7%), include youth who never smoked or smoked less than one cigarette, respectively, in their lifetime. The “occasional user” trajectory (11.6%) shows a stable pattern of less than monthly smoking from 18 to 22. The final two trajectory groups include adolescents who became regular smokers between 18 and 22. The “escalator” group (5.0%) shows a gradual progression of smoking from 18 to 21, at which time participants became regular smokers (smoking in the past week). The “high stable” group (3.3%) increased from less than monthly smoking at age 18 to regular smoking by age 19, and remained regular smokers until age 22. We will examine predictors of membership in the various trajectory groups, including demographic characteristics, college attendance, intentions to smoke, and engagement in social activities. Implications for prevention will be discussed.