A longitudinal study of smoking transitions in youth
Initial Award Abstract
We propose a second follow-up in 1999 of young adults (18-23 years) who were first followed (funded by Robert Wood Johnson Foundation) in 1996 as 15- to 20-year-olds, and first interviewed (baseline) in 1993 as 12- to 17-year olds as part of the California Tobacco Surveys. The main goal of the proposed research is to improve our understanding of what might help prevent people from becoming addicted smokers. Although daily or regular smoking is very unusual before age 15, most eventual regular smokers had their first cigarette before then. Since many adolescents who experiment do not become addicted smokers, it is important to identify what might inhibit or interrupt the smoking uptake process in its later phases, which last into the young adult period.
We hypothesize that cigarette price and smoking restrictions in the workplace and at home might impede the smoking uptake process. These barriers may prevent experimenters from becoming addicted, delay the development of a significant level of cigarette consumption, or even encourage early smoking cessation. In California an additional $0.50/pack excise tax became effective January 1, 1999, and it appears that the tobacco industry will raise the price of cigarettes another $0.45/pack to pay for the recent settlement. This unprecedented rise in cigarette prices after a period of price stagnation provides a unique experimental context; we can compare transition rates in similarly aged cohorts of adolescents who did and did not experience the steep increase in the price of cigarettes. Additionally, as the adolescents from the earlier surveys enter the workforce, they will likely encounter situations when they cannot smoke. Since 1996, nearly all indoor workplaces in California have been smokefree. We will compare transition rates, and cigarette consumption, among those who work in smokefree workplaces, those who attend college and those who work primarily outdoors or who are unemployed. The analyses will adjust for socioeconomic and other known predictors of smoking uptake. Similarly, it will be important to discover whether young adults who lived under home smoking restrictions in their parents’ homes, adopt similar home smoking rules when the have a place of their own. We plan to determine whether the smoking behavior of young adults who live in smokefree homes is different from those without such restrictions, again adjusting for other factors, this time including the smoking status of others in the household.
Another goal is to quantify exposure to cigars among young adults, who have shown the greatest proportionate increase in cigar use in recent years. We expect that most cigar use is very occasional and therefore itself not a threat to health, but there is currently no population data that can prove this assertion. What may be of more concern is the role of cigars in fostering cigarette use. Young adult cigar smokers who never became addicted cigarette smokers may turn to cigarettes as a more convenient way to maintain a nicotine addiction they acquired from cigars. Also, former cigarette smokers who smoke cigars may relapse to cigarette smoking for the same reasons. Finally, we will investigate the influence of tobacco advertising and promotions on transition to established smoking, as an extension or our earlier work demonstrating its importance in the transition toward smoking from the earliest stage of being a confirmed never smoker. |