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Luis G. Escobedo, MD, MPH; Stephen E. Marcus, PhD; Deborah Holtzman, PhD; Gary A. Giovino, PhD

JAMA. 1993;269(11):1391-1395.

Abstract
Objective.
—To examine smoking patterns, smoking initiation, and the relationship of sports participation and age at smoking initiation to regular and heavy smoking among adolescents.

Design.
—Survey.

Participants.
—A nationally representative sample of US high school students.

Outcome Measures.
—Prevalences of smoking patterns, prevalence and incidence of smoking initiation, and prevalences and odds of regular and heavy smoking in relation to sports participation and age at smoking initiation.

Results.
—Seventy-two percent of students reported experimenting with, formerly, or ever smoking cigarettes, and 32% reported smoking in the past 30 days. Students who had participated in interscholastic sports were less likely to be regular and heavy smokers than were others who had not participated. Smoking initiation rates increased rapidly after age 10 years and peaked at age 13 to 14 years. Students who began smoking at age 12 years or younger were more likely to be regular and heavy smokers than were students who began smoking at older ages.

Conclusions.
—These data suggest that smoking initiation at a young age can increase the risk of nicotine addiction during adolescence and that sports participation may influence smoking behavior. Interventions to prevent smoking should be available before age 12 years to help combat the smoking epidemic among youth.

(JAMA. 1993;269:1391-1395)

Author Affiliations
From the Division of Adolescent and School Health (Drs Escobedo and Holtzman) and the Office on Smoking and Health (Drs Marcus and Giovino), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga.

Footnotes
Reprint requests to Division of Chronic Disease Control and Community Intervention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop K-47, Atlanta, GA 30333 (Dr Escobedo).

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