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Cigarette Consumption During Childhood and Persistence of Smoking Through Adolescence

Christine Jackson, PhD; Denise Dickinson, MPH Arch Pediatr Adolesc Med. 2004;158:1050-1056.

Background  The childhood cause of adolescent smoking requires prospective study.

Objectives  To compare prospective with retrospective estimates of childhood smoking and to test cigarette consumption and susceptibility to smoking during childhood as predictors of smoking behavior at late adolescence.

Design  Eight-year prospective study.

Setting  From February through April of 1994, 1995, and 1996, surveys were completed in elementary schools in central North Carolina; from February through May 2002, telephone interviews were completed wherever participants resided.

Participants  Of 868 age-eligible children, 737 (84.9%) provided survey data between the ages of 8 and 10 years; of these subjects, 594 (80.6%) were interviewed at the age of 17 years.

Main Outcome Measures  Current, established, and daily smoking.

Results  Current smoking was reported by 23.0% of those having never puffed on a cigarette (abstinent) in childhood vs 42.7% (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.58-3.82), 50.0% (OR, 3.36; 95% CI, 1.41-8.01), 58.3% (OR, 4.41; 95% CI, 1.46-14.18), and 56.5% (OR, 4.37; 95% CI, 1.86-10.29) of those who smoked 1 or fewer, 2 to 4, 5 to 20, and more than 20 cigarettes, respectively, during childhood. Established smoking was reported by 15.0% of those abstinent in childhood vs 21.3% (OR, 1.52; 95% CI, 0.89-2.58), 40.6% (OR, 3.93; 95% CI, 1.61-9.59), 50.0% (OR, 4.96; 95% CI, 1.77-16.18), and 47.8% (OR, 5.21; 95% CI, 2.20-12.32) of those who smoked 1 or fewer, 2 to 4, 5 to 20, and more than 20 cigarettes, respectively, during childhood. Daily smoking was reported by 10.1% of those abstinent in childhood vs 11.2% (OR, 1.10; 95% CI, 0.56-2.18), 28.1% (OR, 3.45; 95% CI, 1.24-9.03), 33.3% (OR, 4.47; 95% CI, 1.29-15.84), and 39.1% (OR, 5.75; 95% CI, 2.35-14.08) of those who smoked 1 or fewer, 2 to 4, 5 to 20, and more than 20 cigarettes, respectively, during childhood. Among abstinent children, high vs low susceptibility to smoking predicted greater likelihood of current (37.5% vs 16.7%; OR, 2.98; 95% CI, 1.55-5.74), established (32.1% vs 9.3%; OR, 4.81; 95% CI, 2.29-10.07), and daily (21.4% vs 7.0%; OR, 4.02; 95% CI, 1.71-9.44) smoking at follow-up.

Conclusion  Relatively small increases in the number of cigarettes consumed during childhood are associated with significantly higher odds of current, established, and daily smoking in adolescence.