Validation of susceptibility as a predictor of which adolescents take up smoking in the United States.

TLDR

Smoking onset has four levels, with a “susceptibility” level preceding early experimentation. The study evaluated whether smoking susceptibility predicts later smoking behavior among adolescents. A longitudinal analysis of 4,500 nationally representative adolescents who had never smoked at baseline was conducted. Four years later, 40% had experimented and 8% had become established smokers; baseline susceptibility was a stronger predictor of experimentation than family or friend smoking, yet it was less influential than exposure to smokers in determining progression to established smoking.

Abstract

Smoking onset has 4 levels, with a "susceptibility" level preceding early experimentation. This study assessed the predictive validity of smoking susceptibility in a longitudinal study of a nationally representative sample of 4,500 adolescents who at baseline reported never having puffed on a cigarette. At follow-up 4 years later, 40% of the sample had experimented with smoking, and 8% had established a smoking habit. Baseline susceptibility to smoking, defined as the absence of a firm decision not to smoke, was a stronger independent predictor of experimentation than the presence of smokers among either family or the best friend network. However, susceptibility to smoking was not as important as exposure to smokers in distinguishing adolescents who progressed to established smoking from those who remained experimenters at follow-up.