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September 26, 1990, Vol 264, No. 12 >
ARTICLE | September 26, 1990

Sociodemographic Characteristics of Cigarette Smoking Initiation in the United States: Title and subTitle BreakImplications for Smoking Prevention Policy FREE

Luis G. Escobedo, MD, MPH; Robert F. Anda, MD, MS; Perry F. Smith, MD; Patrick L. Remington, MD, MPH; Eric E. Mast, MD, MPH
[+] Author Affiliations

Reprint requests to Office of Surveillance and Analysis, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Mailstop F-05, 1600 Clifton Rd NE, Atlanta, GA 30333 (Dr Escobedo).


JAMA. 1990;264(12):1550-1555. doi:10.1001/jama.1990.03450120062030
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Article
References

Cigarette smoking initiation greatly influences smoking prevalence in the United States. To understand better the initiation of cigarette smoking, we estimated the age-specific incidence of cigarette smoking initiation in relation to race/ethnicity, sex, and educational attainment, using the reported age at smoking onset for 18- to 35-year-old respondents in the 1987 National Health Interview Survey (N = 14 764) and the Hispanic Health and Nutrition Examination Survey (N = 3123) conducted during 1982 to 1984. Among white, black, and Hispanic respondents the incidence of smoking initiation increased rapidly after 11 years of age, reaching a peak in groups 17 to 19 years of age, rapidly declining in groups through age 25 years, and gradually declining thereafter. Age-specific smoking initiation rates were generally lower among black than white respondents, similar between white and Hispanic respondents, and appreciably higher among black and Hispanic men than women. Compared with persons who graduated from high school, persons with less than high school education were consistently more likely to start smoking cigarettes during childhood and adolescence. These data indicate that age and educational attainment are the factors most consistently associated with cigarette smoking initiation among all race/ethnic groups in the United States. These data also emphasize the need for smoking-prevention education beginning at an early age, particularly among persons of low socioeconomic status.

(JAMA. 1990;264:1550-1555)

REFERENCES

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Fiore MC, Novotny TE, Pierce JP, Hatziandreu EJ, Patel KM, Davis RM.  Trends in cigarette smoking in the United States: the changing influence of gender and race . JAMA . 1989;;261:49-55.
2 +
Pierce JP, Fiore MC, Novotny TE, Hatziandreu EJ, Davis RM.  Trends in cigarette smoking in the United States: educational differences are increasing . JAMA . 1989;;261:56-60.
3 +
Pierce JP, Fiore MC, Novotny TE, Hatziandreu EJ, Davis RM.  Trends in cigarette smoking in the United States: projections to the year 2000 . JAMA . 1989;;261:61-65.
4 +
Carmody TP.  Affect regulation, nicotine addiction, and smoking cessation . Psychoactive Drugs . 1989;;21:331-342.
5 +
Reducing the Health Consequences of Smoking: 25 Years of Progress—A Report of the Surgeon General . Rockville, Md: Office on Smoking and Health; 1989;. US Dept of Health and Human Services publication (CDC) 89-8411.
6 +
Baugh JG, Hunter SM, Webber LS, Berenson GS.  Developmental trends of first cigarette smoking experience of children: the Bogalusa Heart Study . Am J Public Health . 1982;;72:1161-1164.
7 +
Kandel DB, Logan JA.  Patterns of drug use from adolescence to young adulthood, I: periods of risk for initiation, continued use, and discontinuation . Am J Public Health . 1984;;74:660-666.
8 +
O'Malley PM, Bachman JG, Johnston LD.  Period, age, and cohort effects on substance use among American youth, 1976-82 . Am J Public Health . 1984;;74:682-688.
9 +
Kovar MG, Poe GS.  The National Health Interview Survey design, 1973-84, and procedures, 1975-83 . Vital Health Stat 1 . 1985;;No. (18) :15-66.
10 +
 Plan and operation of the Hispanic Health and Nutrition Examination Survey, 1982-84 . Vital Health Stat 1. 1985;;No. 19:1-54.
11 +
Schoenborn CA, Marano M.  Current estimates from the National Health Interview Survey: United States, 1987 . Vital Health Stat 10 .1988;;No. (166) :133-139.
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Nutrition Monitoring in the United States: An Update Report on Nutrition Monitoring . Prepared for the US Dept of Agriculture and the US Dept of Health and Human Services. Washington, DC: Life Sciences Research Office, Federation of American Societies for Experimental Biology; 1989;. US Dept of Health and Human Services publication (PHS) 89-1255.
13 +
Forthofer RN.  Investigation of nonresponse bias in NHANES II . Am J Epidemiol. 1983;;117: 507-515.
14 +
O'Toole BI, Battistutta D, Long A, Crouch K.  A comparison of costs and data quality of three health survey methods: mail, telephone and personal home interview . Am J Epidemiol. 1986;;124: 317-328.
15 +
Brownson RC, Davis JR, Chang JC, DiLorenzo TM, Keefe TJ, Bagby JR.  A study of the accuracy of cancer risk factor information reported to a central registry compared with that obtained by interview . Am J Epidemiol. 1989;;129:616-624.
16 +
Slattery ML, Hunt SC, French TK, Ford MH, Williams RR.  Validity of cigarette smoking habits in three epidemiologic studies in Utah . Prev Med. 1989;;18:11-19.
17 +
Luepker RV, Pallonen UE, Murray DM, Pirie PL.  Validity of telephone surveys in assessing cigarette smoking in young adults . Am J Public Health. 1989;;79:202-204.
18 +
Shah BU. SESUDAAN: Standard Errors Program for Computing of Standardized Rates From Sample Survey Data . Research Triangle Park, NC: Research Triangle Institute; 1981;.
19 +
Ernster VL.  Trends in smoking, cancer risk, and cigarette promotion: current priorities for reducing tobacco exposure . Cancer. 1988;;62: 1702-1712.
20 +
Escobedo LG, Remington PL, Anda RF.  Long-term secular trends in initiation of cigarette smoking among Hispanics in the United States . Public Health Rep. 1989;;104:583-588.
21 +
Botvin GJ, Batson HW, Witts-Vitale S, Bess V, Baker E, Dusenbury L.  A psychosocial approach to smoking prevention for urban black youth . Public Health Rep. 1989;;104:573-582.
22 +
Pentz MA, Brannon BR, Charlin VL, Barret EJ, MacKinnon DP, Flay BR.  The power of policy: the relationship of smoking policy to adolescent smoking . Am J Public Health . 1989;;79:857-862.
23 +
Chavez EL, Edwards R, Oetting ER.  Mexican American and white American school dropouts' drug use, health status, and involvement in violence . Public Health Rep. 1989;;104:594-605.
24 +
Johnson JL, Delgado JL.  Reaching Hispanics with messages to prevent alcohol and other drug abuse . Public Health Rep. 1989;;104:588-594.
25 +
Glynn TJ.  Essential elements of school-based smoking prevention programs . J Sch Health . 1989;;59:181-188.
26 +
Centers for Disease Control.  School policies and programs on smoking and health—United States, 1988 . MMWR . 1989;;38:202-203.
27 +
Krohn MD, Naughton MJ, Lauer RL.  Adolescent cigarette use: the relationship between attitudes and behavior . MMWR . 1987;;36( (suppl 4S) ): 25S-33S.
28 +
Eckert P.  Beyond the statistics of adolescent smoking . Am J Public Health . 1983;;73:439-441.
29 +
Krohn MD, Massey JL, Skinner WF, Lauer RM.  Social bonding theory and adolescent cigarette smoking: a longitudinal analysis . J Health Soc Behav. 1983;;24:337-349.
30 +
Marcos AC, Johnson RE.  Cultural patterns and causal processes in adolescent drug use: the case of Greeks versus Americans . Int J Addict. 1988;;23: 545-572.
31 +
Centers for Disease Control.  Cigarette smoking—Behavioral Risk Factor Surveillance System, 1988 . MMWR . 1989;;38:845-848.
32 +
Pirie PL, Murray DM, Luepker RV.  Smoking prevalence in a cohort of adolescents including absentees, dropouts, and transfers . Am J Public Health . 1988;;78:176-179.
33 +
Last JM. Public Health and Human Ecology . East Norwalk, Conn: Appleton & Lange; 1987;: 212-217.
34 +
Novotny TE, Warner KE, Kendrick JS, Remington PL.  Smoking by blacks and whites: socioeconomic and demographic differences . Am J Public Health . 1988;;78:1187-1189.
35 +
Clay CM, Dyer AR, Liu K, Stamler J.  Education, smoking and non-cardiovascular mortality: findings in three Chicago epidemiological studies . Int J Epidemiol. 1988;;17:341-347.
36 +
Davies JM, Semenciw RM, Mao Y.  Cardiovascular disease mortality trends and related risk factors in Canada . Can J Cardiol. 1988;;4(suppl A):16A-20A.
37 +
Hover SJ, Gaffney LR.  Factors associated with smoking behavior in adolescent girls . Addict Behav. 1988;;13:139-145.
38 +
De Moor C, Elder JP, Young RL, Wildey MB, Molgaard CA.  Generic tobacco use among four ethnic groups in a school age population . J Drug Educ. 1989;;19:257-270.
39 +
Gliksman MD, Dwyer T, Wlodarczyk J, Pierce JP.  Cigarette smoking in Australian schoolchildren . Med J Aust. 1989;;150:81-84.
40 +
Mittelmark MB, Murray DM, Luepker RV, Pechacek TF, Pirie PL, Pallonen UE.  Predicting experimentation with cigarettes: the Childhood Antecedents of Smoking Study (CASS) . Am J Public Health . 1987;;77:206-208.
41 +
Semmer NK, Cleary PD, Dwyer JH, Fuchs R, Lippert P.  Psychosocial predictors of adolescent smoking in two German cities: the Berlin-Breman Study . MMWR . 1987;;36( (suppl 4S) ):3S-10S.
42 +
Davis RM.  Current trends in cigarette advertising and marketing . N Engl J Med. 1987;;316: 725-732.
43 +
Pekurinen M.  The demand for tobacco products in Finland . Br J Addict. 1989;;84:1183-1192.
44 +
Lewit EM.  U.S. tobacco taxes: behavioural effects and policy implications . Br J Addict. 1989;;84:1217-1234.
45 +
Frankel BG.  Reducing tobacco consumption: public policy alternatives for Canada . Can Med Assoc J. 1988;;138:419-423.
46 +
Centers for Disease Control.  Cigarette advertising—United States, 1988 . MMWR . 1990;;39: 261-265.
47 +
Kolbe LJ, Allensworth DD, Lovato CY, Hogan PE, Cooke BEM. School Health in America: An Assessment of State Policies to Protect and Improve the Health of Students . 4th ed. Kent, Ohio: American School Health Association; 1985;:5-6.

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Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Fiore MC, Novotny TE, Pierce JP, Hatziandreu EJ, Patel KM, Davis RM.  Trends in cigarette smoking in the United States: the changing influence of gender and race . JAMA . 1989;;261:49-55.
2 +
Pierce JP, Fiore MC, Novotny TE, Hatziandreu EJ, Davis RM.  Trends in cigarette smoking in the United States: educational differences are increasing . JAMA . 1989;;261:56-60.
3 +
Pierce JP, Fiore MC, Novotny TE, Hatziandreu EJ, Davis RM.  Trends in cigarette smoking in the United States: projections to the year 2000 . JAMA . 1989;;261:61-65.
4 +
Carmody TP.  Affect regulation, nicotine addiction, and smoking cessation . Psychoactive Drugs . 1989;;21:331-342.
5 +
Reducing the Health Consequences of Smoking: 25 Years of Progress—A Report of the Surgeon General . Rockville, Md: Office on Smoking and Health; 1989;. US Dept of Health and Human Services publication (CDC) 89-8411.
6 +
Baugh JG, Hunter SM, Webber LS, Berenson GS.  Developmental trends of first cigarette smoking experience of children: the Bogalusa Heart Study . Am J Public Health . 1982;;72:1161-1164.
7 +
Kandel DB, Logan JA.  Patterns of drug use from adolescence to young adulthood, I: periods of risk for initiation, continued use, and discontinuation . Am J Public Health . 1984;;74:660-666.
8 +
O'Malley PM, Bachman JG, Johnston LD.  Period, age, and cohort effects on substance use among American youth, 1976-82 . Am J Public Health . 1984;;74:682-688.
9 +
Kovar MG, Poe GS.  The National Health Interview Survey design, 1973-84, and procedures, 1975-83 . Vital Health Stat 1 . 1985;;No. (18) :15-66.
10 +
 Plan and operation of the Hispanic Health and Nutrition Examination Survey, 1982-84 . Vital Health Stat 1. 1985;;No. 19:1-54.
11 +
Schoenborn CA, Marano M.  Current estimates from the National Health Interview Survey: United States, 1987 . Vital Health Stat 10 .1988;;No. (166) :133-139.
12 +
Nutrition Monitoring in the United States: An Update Report on Nutrition Monitoring . Prepared for the US Dept of Agriculture and the US Dept of Health and Human Services. Washington, DC: Life Sciences Research Office, Federation of American Societies for Experimental Biology; 1989;. US Dept of Health and Human Services publication (PHS) 89-1255.
13 +
Forthofer RN.  Investigation of nonresponse bias in NHANES II . Am J Epidemiol. 1983;;117: 507-515.
14 +
O'Toole BI, Battistutta D, Long A, Crouch K.  A comparison of costs and data quality of three health survey methods: mail, telephone and personal home interview . Am J Epidemiol. 1986;;124: 317-328.
15 +
Brownson RC, Davis JR, Chang JC, DiLorenzo TM, Keefe TJ, Bagby JR.  A study of the accuracy of cancer risk factor information reported to a central registry compared with that obtained by interview . Am J Epidemiol. 1989;;129:616-624.
16 +
Slattery ML, Hunt SC, French TK, Ford MH, Williams RR.  Validity of cigarette smoking habits in three epidemiologic studies in Utah . Prev Med. 1989;;18:11-19.
17 +
Luepker RV, Pallonen UE, Murray DM, Pirie PL.  Validity of telephone surveys in assessing cigarette smoking in young adults . Am J Public Health. 1989;;79:202-204.
18 +
Shah BU. SESUDAAN: Standard Errors Program for Computing of Standardized Rates From Sample Survey Data . Research Triangle Park, NC: Research Triangle Institute; 1981;.
19 +
Ernster VL.  Trends in smoking, cancer risk, and cigarette promotion: current priorities for reducing tobacco exposure . Cancer. 1988;;62: 1702-1712.
20 +
Escobedo LG, Remington PL, Anda RF.  Long-term secular trends in initiation of cigarette smoking among Hispanics in the United States . Public Health Rep. 1989;;104:583-588.
21 +
Botvin GJ, Batson HW, Witts-Vitale S, Bess V, Baker E, Dusenbury L.  A psychosocial approach to smoking prevention for urban black youth . Public Health Rep. 1989;;104:573-582.
22 +
Pentz MA, Brannon BR, Charlin VL, Barret EJ, MacKinnon DP, Flay BR.  The power of policy: the relationship of smoking policy to adolescent smoking . Am J Public Health . 1989;;79:857-862.
23 +
Chavez EL, Edwards R, Oetting ER.  Mexican American and white American school dropouts' drug use, health status, and involvement in violence . Public Health Rep. 1989;;104:594-605.
24 +
Johnson JL, Delgado JL.  Reaching Hispanics with messages to prevent alcohol and other drug abuse . Public Health Rep. 1989;;104:588-594.
25 +
Glynn TJ.  Essential elements of school-based smoking prevention programs . J Sch Health . 1989;;59:181-188.
26 +
Centers for Disease Control.  School policies and programs on smoking and health—United States, 1988 . MMWR . 1989;;38:202-203.
27 +
Krohn MD, Naughton MJ, Lauer RL.  Adolescent cigarette use: the relationship between attitudes and behavior . MMWR . 1987;;36( (suppl 4S) ): 25S-33S.
28 +
Eckert P.  Beyond the statistics of adolescent smoking . Am J Public Health . 1983;;73:439-441.
29 +
Krohn MD, Massey JL, Skinner WF, Lauer RM.  Social bonding theory and adolescent cigarette smoking: a longitudinal analysis . J Health Soc Behav. 1983;;24:337-349.
30 +
Marcos AC, Johnson RE.  Cultural patterns and causal processes in adolescent drug use: the case of Greeks versus Americans . Int J Addict. 1988;;23: 545-572.
31 +
Centers for Disease Control.  Cigarette smoking—Behavioral Risk Factor Surveillance System, 1988 . MMWR . 1989;;38:845-848.
32 +
Pirie PL, Murray DM, Luepker RV.  Smoking prevalence in a cohort of adolescents including absentees, dropouts, and transfers . Am J Public Health . 1988;;78:176-179.
33 +
Last JM. Public Health and Human Ecology . East Norwalk, Conn: Appleton & Lange; 1987;: 212-217.
34 +
Novotny TE, Warner KE, Kendrick JS, Remington PL.  Smoking by blacks and whites: socioeconomic and demographic differences . Am J Public Health . 1988;;78:1187-1189.
35 +
Clay CM, Dyer AR, Liu K, Stamler J.  Education, smoking and non-cardiovascular mortality: findings in three Chicago epidemiological studies . Int J Epidemiol. 1988;;17:341-347.
36 +
Davies JM, Semenciw RM, Mao Y.  Cardiovascular disease mortality trends and related risk factors in Canada . Can J Cardiol. 1988;;4(suppl A):16A-20A.
37 +
Hover SJ, Gaffney LR.  Factors associated with smoking behavior in adolescent girls . Addict Behav. 1988;;13:139-145.
38 +
De Moor C, Elder JP, Young RL, Wildey MB, Molgaard CA.  Generic tobacco use among four ethnic groups in a school age population . J Drug Educ. 1989;;19:257-270.
39 +
Gliksman MD, Dwyer T, Wlodarczyk J, Pierce JP.  Cigarette smoking in Australian schoolchildren . Med J Aust. 1989;;150:81-84.
40 +
Mittelmark MB, Murray DM, Luepker RV, Pechacek TF, Pirie PL, Pallonen UE.  Predicting experimentation with cigarettes: the Childhood Antecedents of Smoking Study (CASS) . Am J Public Health . 1987;;77:206-208.
41 +
Semmer NK, Cleary PD, Dwyer JH, Fuchs R, Lippert P.  Psychosocial predictors of adolescent smoking in two German cities: the Berlin-Breman Study . MMWR . 1987;;36( (suppl 4S) ):3S-10S.
42 +
Davis RM.  Current trends in cigarette advertising and marketing . N Engl J Med. 1987;;316: 725-732.
43 +
Pekurinen M.  The demand for tobacco products in Finland . Br J Addict. 1989;;84:1183-1192.
44 +
Lewit EM.  U.S. tobacco taxes: behavioural effects and policy implications . Br J Addict. 1989;;84:1217-1234.
45 +
Frankel BG.  Reducing tobacco consumption: public policy alternatives for Canada . Can Med Assoc J. 1988;;138:419-423.
46 +
Centers for Disease Control.  Cigarette advertising—United States, 1988 . MMWR . 1990;;39: 261-265.
47 +
Kolbe LJ, Allensworth DD, Lovato CY, Hogan PE, Cooke BEM. School Health in America: An Assessment of State Policies to Protect and Improve the Health of Students . 4th ed. Kent, Ohio: American School Health Association; 1985;:5-6.

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