Adolescents who have tried cigarettes by seventh grade are much more likely to become regular smokers and have behavior problems as teens, a new study finds.

“We were struck by the degree to which early smoking appeared to indicate that kids were on the fast track toward a troubled adolescence,” said Phyllis Ellickson, Ph.D., who led the team of researchers at the RAND Corporation in Santa Monica, Calif. “We wanted to find out what factors in early and later adolescence might help these high-risk kids avoid negative consequences.”

The study appears in the October issue of the Journal of Adolescent Health.

The researchers collected data at seventh, 10th and 12th grade from 2,000 students in California and Oregon who were early smokers in middle school. They tested the students’ saliva samples for tobacco and marijuana to ensure accuracy.

At the beginning of middle school, 30 percent of the early smokers had recently used cigarettes, 14 percent were smoking regularly and 21 percent had multiple school problems, the authors wrote.

Ellickson and her colleagues found that having peers who smoke was a strong risk factor for becoming a regular smoker. At-risk teens were two or more times likely than low-risk teens — those who hadn’t tried smoking by seventh grade — to have peers who smoke and five times more likely to have had two or more problems in school.

“At grade seven, problems in school included being sent out of the classroom more than once, skipping school multiple times and absenteeism,” Ellickson said.

By the end of high school, 36 percent of early smokers were smoking regularly and 58 percent had engaged in two or more problem behaviors, including binge drinking, abusing and selling drugs and dropping out of school, according to the study.

The researchers found that teens who had not tried smoking by seventh grade were 1.5 times more likely to be those who had good grades and lived in an intact family. In other words, good grades — B or higher — and living in an intact nuclear family helped protect early smokers against these negative outcomes.
The RAND researchers concluded that teens whose parents disapproved of smoking and drug use had lower risks of problem behavior. They suggested that universal prevention programs that target peer resistance and parental involvement could help reverse the trends found in the study.

Jeanie Alter, program manager and lead evaluator of the Indiana Prevention Resource Center at Indiana University’s School or Health, Physical Education and Recreation, agreed that prevention programs can benefit teens at risk and stressed that the parents’ role is key.

“Clearly, peers are an influential factor in the lives of young people, particularly as they progress through adolescence,” she said. “However, it is critical to acknowledge the significant and sustained influence of parents. Though difficult to implement, program planners simply must involve parents and increase their disapproval of drug use.”

Journal of Adolescent Health: Contact Tor Berg at 415-502-1373 or .(JavaScript must be enabled to view this email address)

Ellickson PL, Tucker JS, Klein DJ. Reducing early smokers’ risk for future smoking and other problem behavior: insights from a five-year longitudinal study. J Adolesc Health 43(2), 2008.

Source: Health Behavior News Service