Table 4.
Studies Addressing Research Question on Circumstances Under Which Initiation Among Young Adults Takes Place, Systematic Review of Studies on Smoking Initiation Among Young Adults in the United States and Canada, 1998-2010
| Study | Primary Result |
|---|---|
| Exposure to smokers | |
| Ling et al (27) | Exposure to smokers (eg, family members, friends, coworkers, and other social contacts who smoke) doubled the susceptibility of never smokers and experimenters (ie, those who smoked fewer than 100 cigarettes) to future smoking.a |
| Green et al (21) | Among trainees who did not smoke before basic training, those who lived with a roommate who smoked were 1.7 times as likely to initiate cigarette use as those who lived with a roommate who did not smoke. |
| Exposure to tobacco marketing and social events sponsored by the tobacco industry | |
| Rigotti et al (28) | Compared to college students who did not attend tobacco promotional events, exposure to a tobacco promotional event increased the odds of becoming a current smoker 1.7 times among college students who had not smoked regularly before age 19. |
| Peer influence and social networks | |
| Sepe et al (29) | Tobacco industry documents showed that peer influence was a major factor in promoting smoking initiation among young adults. (Peer influence was not defined by the authors.) |
| Stockdale et al (22) | College students who reported trying or increasing their smoking since coming to college had significantly more prosmoking social influences (ie, riding in a car with other smokers, allowing someone to smoke in one's home, and having friends who smoke) than students who maintained, decreased, or quit smoking. |
| Costa et al (26) | Compared to never-smokers who did not initiate smoking during the 3-year study period, students who did initiate smoking reported greater vulnerability to peer pressure to smoke and drink. College students who initiated smoking after their first semester also reported having more friends or acquaintances that engaged in substance use such as marijuana or heavy drinking, compared to college students who never smoked. |
| Staten et al (23) | Among college students who report initiating smoking, 27% belonged to a fraternity or sorority; among never-initiators, 16% belonged to a fraternity or sorority. Compared to college students who did not participate in service organizations, college students who participated in service organizations were one-fourth as likely (odds ratio = 0.29) to initiate smoking while in college. |
| Attitudes and perceptions | |
| Stockdale et al (22) | College students who reported trying or increasing their smoking since coming to college had significantly lower antismoking attitudes (ie, having "relationships with smokers," not supporting smoking restrictions in public places, and not supporting college antitobacco policies) than did those who maintained, decreased, or quit smoking. |
| Choi et al (19) | Among college students who experimented with smoking in high school, those who believed their best friends would approve of their smoking 1 or more packs of cigarettes a day were 2.0 times as likely to progress in their smoking behavior, compared to those who believed their best friends would disapprove of their smoking 1 or more packs of cigarettes a day. Also among college students who experimented with smoking in high school, those who believed experimentation with smoking was either "moderately safe" or "safe" were 1.7 and 1.9 times, respectively, as likely to progress in their smoking behavior than were students who believed smoking was "not safe." |
| Costa et al (26) | College students who initiated smoking after their first semester reported being less responsive to "social regulation" (eg, having parents or friends who did not disapprove of problem behavior like underage drinking or using marijuana, having friends who would prevent transgressions like academic dishonesty), compared to college students who never smoked. Similarly, college students who initiated smoking after their first semester reported being less concerned with "personal regulation" (eg, personal health was less important, the consequences of health-compromising behavior were downplayed, personal achievement was less important), compared to college students who never smoked. |
| Green et al (21) | Among trainees who did not smoke before basic training, those who reported that some of their military training leaders and/or classroom instructors used tobacco were 1.7 times as likely to initiate smoking after basic training as trainees who did not report that their training leaders and instructors used tobacco. Among trainees who did not smoke before basic training, those who perceived that most (more than 50%) of their classmates smoked during technical training were 1.7 times as likely to initiate smoking compared with those who perceived that 50% or fewer of their classmates smoked during training. |
| Bray et al (12) | When asked why they started smoking regularly after joining the military, the top 3 responses given by military personnel across all service divisions were 1) "to help me relax or calm down," 2) "to help relieve stress," and 3) "to relieve boredom." |
a
This study defined susceptibility to future smoking as never smokers and experimenters (those who reported smoking fewer than 100 cigarettes in their lifetime) who answered anything but "definitely not" to "Do you think you will smoke a cigarette in the next year?"