Objective

To estimate initiation rates among individuals aged 10-24 for the calendar years 1907-81.

Design

Birth cohort analyses using a data set combining all of the National Health Interview Surveys asking questions about smoking.

Subjects

Multiple cross-sectional samples of the US population.

Results

Initiation of cigarette smoking was essentially a male behaviour at the start of the century, and a steep rise in incidence of smoking in white male adolescents occurred during the second decade of this century when mass marketing techniques were applied to cigarette sales and the US mobilised for World War I. A rapid rise in incidence of smoking in white female adolescents is noted in the late 1920s and 1930s, coinciding with the early efforts to target women with tobacco advertising. A dramatic increase in incidence of smoking for white male adolescents occurred during World War II. The incidence declined precipitously among white male adolescents, beginning in the late 1940s, and continuing through to 1980. In contrast, the incidence of smoking among white females remained constant through the 1950s and early 1960s, and increased at the very end of the 1960s and early 1970s. This increase in female incidence coincided with targeting of young women by advertising campaigns linking smoking with a slender female figure and the women’s liberation movement. The increased incidence seen during the early 1970s and in the 1955-59 birth cohort was limited to those female adolescents aged 17 years and younger.

Conclusion

The historical changes in the initiation of cigarette smoking presented in this paper, and their temporal association with gender-specific marketing and promotional activities, lend support to a link between cigarette advertising and promotional activities and initiation of cigarette smoking by adolescents and young adults.

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