Published online August 10, 2009
PEDIATRICS Vol. 124 No. 3 September 2009, pp. 895-902 (doi:10.1542/peds.2008-2015)
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ARTICLE

Individual and Social Influences on Progression to Daily Smoking During Adolescence

Min Jung Kim, PhD, Charles B. Fleming, MA and Richard F. Catalano, PhD

Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington

OBJECTIVES: The goal was to identify individual and social predictors of progression to daily smoking by the end of high school among youths who initiated smoking by grade 8.

METHODS: The analysis sample of 270 adolescent smokers was taken from the Raising Healthy Children project. Data were taken from annual interviews in grades 7 and 12. Daily smoking was defined as having smoked ≥1 cigarette per day in the past 30 days at the time of each interview. Discrete-time survival analysis was used to assess associations with individual, family, peer, and school predictors.

RESULTS: A total of 58% (n = 156) of the analysis sample made the transition to daily smoking by grade 12. The likelihood of onset of daily smoking among those who had not yet demonstrated onset was smallest in grade 9 (probability: 0.12) and greatest in grade 12 (probability: 0.25). Youth depression, prosocial beliefs, and antisocial behavior had overall associations with risk of smoking escalation. In addition, parents' and peers' smoking, family management, academic grades, and school commitment had significant univariate associations with smoking progression. After adjustment for gender, low-income status, and other potential predictors, youths' antisocial behavior and parents' and peers' smoking predicted greater likelihood of escalation to daily smoking, whereas parental use of positive family management predicted lower likelihood of escalation.

CONCLUSIONS: This study supports preventing escalation in adolescent smoking by targeting parents' and peers' smoking and involvement in other forms of antisocial behavior and working with parents to improve their use of positive family management practices.

Key Words: progression • daily smoking • smoking prevention • smoking predictors • family management

Abbreviations: RHC—Raising Healthy Children

Accepted May 5, 2009.


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