Cognitive Susceptibility to Smoking and Initiation of Smoking during Childhood: A Longitudinal Study

Abstract

Background.The earlier the onset of cigarette smoking the greater the risk of addictive smoking. Because smoking initiation is occurring at ever younger ages, early onset of smoking is primarily a childhood phenomenon. In this study cognitive susceptibility to smoking was examined as a risk factor for childhood onset of cigarette smoking. This was the first prospective investigation of cognitive susceptibility to smoking as a predictor of smoking initiation by children.Methods.Three annual surveys were completed by 788 children who, at baseline, were in the third or fifth grade and had never puffed on a cigarette.Results.At baseline, 51% of children had either single or multiple indicators of susceptibility to smoking. Over 2 years, children with single indicators of susceptibility were 80% more likely to initiate smoking, and children with multiple indicators of susceptibility were four times as likely to initiate smoking as nonsusceptible peers. Susceptibility was a stronger predictor of initiation than all other predictors examined, including exposure to family members and friends who smoke cigarettes.Conclusion.Among abstinent children ages 8 to 10 years, cognitive susceptibility to smoking was a significant predictor of whether they initiated smoking prior to adolescence. Reducing children's susceptibility to smoking could strengthen efforts to prevent early onset of cigarette smoking.