Trends in young adult smoking uptake

Purpose While smoking initiation among adolescents has declined since 1977, the decline in young adult (YA) smoking uptake is not as encouraging. To examine trends in YA smoking initiation, we examined seven years of data from the National Health Information Survey (NHIS). Methods Study subjects were participants in the 1997–2003 NHIS surveys between the ages of 25 and 34 who gave an answer to the question about ever having smoked ≥100 cigarettes (n = 44,137). Age of YA smoking uptake was defined as 18–24 years. Smoking initiation was defined according to CDC guidelines (lifetime use >100 cigarettes). Trends in the proportion of YA initiatiors were examined by sex, race, highest level of educational attainment, and number of cigarettes smoked per day over seven years of data. Analyses were weighted to take into account the complex sampling design of the NHIS. Results The proportion of adolsecent initiators (<18 years) showed a significant decline (22.7–20.9%, p for trend = 0.048) while YA smoking uptake remained relatively flat (18.2–17.9%, p for trend = 0.993). No significant trends by sex were observed for YA, though there was a significant increase in Black YA males (16.1–24.0%, p for trend = 0.032). Significant trends were also found for YA smoking uptake among those with a college education (10.6–13.8%, p for trend <0.001)—in particular for college educated Whites (11.1–14.9, p for trend <0.001) and for college educated non-Black ethnic minorities (11.1–13.2%, p for trend 0.036). Furthermore, a significant decline in the number of cigarettes smoked per day was also observed among YA initiators (15.6–13.9/day, p for trend = 0.05). Conclusion There are significant trends in YA smoking by race and educational attainment. These results suggest that targeted antismoking campaigns have the potential for success if aimed at those who are most susceptible – the college educated and the ethnic minorities. Furthermore, because YA initiators have demonstrated a decreasing trend in the number of cigarettes they smoke per day, it is also possible that they may be more responsive to antismoking programs.