Smoking cessation in young adults: age at initiation of cigarette smoking and other suspected influences.
Level 3 - non-randomized controlled study
Observational cohort analysis measuring hazard ratios for smoking cessation.
PubMed 8633738 · doi:10.2105/ajph.86.2.214
What was done
Researchers analyzed 414 individuals who had smoked daily for at least 1 month, sampled from a cohort of 1,007 young adults randomly selected from a southeast Michigan health maintenance organization. The study estimated hazard ratios of quitting associated with age at smoking initiation while adjusting for potential confounders including sex, race, education, and nicotine dependence.
What was found
Compared with smoking initiation at or before age 13, the likelihood of cessation was significantly higher with later initiation: - Initiation at ages 14 to 16: Hazard Ratio (HR) = 1.6 - Initiation at or after age 17: HR = 2.0 Nicotine dependence and low education were also reported to decrease the likelihood of cessation, though numerical estimates and confidence intervals were not provided in the abstract.
Why it matters
These findings suggest that interventions delaying smoking onset past early adolescence may increase the likelihood of eventual cessation in young adulthood.
Limits
The analysis relies on retrospective self-report from a single regional HMO sample, creating potential for recall bias. The effective sample size for daily smokers was 414, and the abstract omits confidence intervals, exact p-values, and effect estimates for other covariates.
Cited by
- partial Starting cigarette smoking at age 13 almost certainly results in addiction, whereas starting at an older age rarely leads to addiction.