Factors explaining tobacco use

Smoking initiation
In the United States, smoking initiation typically
occurs during adolescence. About 90% of adult
smokers have tried their first cigarette by 18 years
of age and 70% of daily smokers have become
regular smokers by that age [67,68]. Because most
adolescents who smoke at least monthly continue
to smoke into adulthood, youth-oriented tobacco
preventions and cessation strategies are warranted
[67,68]. Since the mid-1990s, by 2004, the past-
month prevalence had decreased by 56% in 8th
graders, 47% in 10th graders, and 32% in 12th
graders [69]. In recent years, however, this down-
ward trend has decelerated [69]. The downward
trend is unlikely to be sustained without steady and
systematic efforts by health care providers in pre-
venting initiation of tobacco use and assisting young
smokers in quitting.
A wide range of sociodemographic, behavioral,
personal, and environmental factors have been ex-
amined as potential predictors of tobacco exper-
imentation and initiation of regular tobacco use
among adolescents. For example, it has been sug-
gested that the prevalence of adolescent smok-
ing is related inversely to parental socioeconomic
status and adolescent academic performance [68].
Other identified predictors of adolescent smoking
include social influence and normative beliefs, neg-
ative affect, outcome expectations associated with
smoking, resistance skills (self-efficacy), engaging in
other risk-taking behaviors, exposure to smoking in
movies, and having friends who smoke [70–75].
Although numerous studies have been successful
in identifying predictors of smoking initiation, few
studies have identified successful methods for pro-
moting cessation among youth, despite the finding
that in 2005,more than half of high school cigarette
smokers have tried to quit smoking in the past year
and failed [52]. These results confirm the highly
addictive nature of tobacco emphasizing the need
for more effective methods for facilitating cessation
among the young.