Smoking and youth

Epidemiology of smoking

Smoking remains the single most preventable cause of disease morbidity and
mortality worldwide1 and young adolescence is the age at which young people
start to experiment with tobacco products.


Studies show a dramatic increase in smoking between puberty and young
adulthood.2 The early onset of smoking is one of the most important
predictors for later smoking and correlates with heavier smoking.3,4 There
is also positive correlation between daily smoking and the experimentation
with other psychoactive substances.5 Recent research shows that first symptoms
of tobacco dependence can occur within a few weeks of occasional smoking.6
Many young smokers believe it is possible to stop smoking without help and
overestimate the percentage of adolescents who succeed in quitting.7,8 Studies
show that young smokers often fail to stop smoking.9-11

Conclusions for the approach of the Smokefree Class Competition

  1. primary prevention measures related to smoking should begin before the
    majority of young people start to experiment with smoking,
  2. a first goal should be the delay or prevention of smoking
  3. a second goal should be the prevention of the transmission from
    experimental to regular smoking.


  1. Ezzati M, Lopez AD. Estimates of global mortality attributable to smoking in 2000. Lancet 2003; 362(9387):847-852.
  2. Langness A, Richter M, Hurrelmann K. Health Behaviour in school-aged children–results of the international study “Health Behavior in School-aged Children”. Gesundheitswesen 2005; 67(6):422-431 [German].
  3. Conrad KM, Flay BR, Hill D. Why children start smoking cigarettes: predictors of onset. Br J Addict 1992; 87(12):1711-1724.
  4. Paavola M, Vartiainen E, Puska P. Smoking cessation between teenage years and adulthood. Health Educ Res 2001; 16(1):49-57.
  5. Bailey SL. Adolescents’ multisubstance use patterns: the role of heavy alcohol and cigarette use. Am J Public Health 1992; 82(9):1220-1224.
  6. DiFranza JR, Savageau JA, Rigotti NA, Fletcher K, Ockene JK, McNeill AD et al. Development of symptoms of tobacco dependence in youths: 30 month follow up data from the DANDY study. Tob Control 2002; 11(3):228-235.
  7. Stanton WR, Lowe JB, Gillespie AM. Adolescents’ experiences of smoking cessation. Drug Alcohol Depend 1996; 43(1-2):63-70.
  8. Sussman S, Dent CW, Severson H, Burton D, Flay BR. Self-initiated quitting among adolescent smokers. Prev Med 1998; 27(5 Pt 3):A19-A28.
  9. Mermelstein R. Teen smoking cessation. Tob Control 2003; 12 Suppl 1:i25-i34.
  10. Hanewinkel R, Wiborg G. Initial evaluation of a real-world self-help smoking cessation programme for adolescents and young adults. Addict Behav 2006; 31(10):1939-1945.
  11. Sussman S, Dent CW. Five-year prospective prediction of self-initiated quitting of cigarette smoking of high-risk youth. Addict Behav 2007; 32(5):1094-1098.

return to top of page