A large study of U.S. Air Force trainees suggests that starting to smoke at an early age may pave the way for heavier smoking in adulthood, as well as other unhealthy behaviors -- at least among European-Americans and Hispanics.
"These findings have important potential public health implications," said lead author Harry A. Lando of the School of Public Health at the University of Minnesota in Minneapolis.
"In the absence of successful prevention, even significant delay of smoking onset could be beneficial in terms of reduced tobacco dependence, greater likelihood of quitting and less severe health consequences," said Lando.
Lando and colleagues analyzed questionnaire results from nearly 5,000 smokers of European-American, African-American and Hispanic-American descent entering U.S. Air Force Basic Military Training from August 1995 to August 1996. The average age of the study participants was 19.
European-Americans started smoking at the youngest age, followed by Hispanic-Americans and African-Americans, the researchers found. European-Americans started smoking an average of more than a year before African-Americans.
Although starting to smoke at a younger age was generally associated with less healthy behaviors such as eating more high-fat foods and reduced motivation to quit, the researchers noted ethnic variations among early smokers.
Within each ethnic group, the youngest smoking initiators were the least motivated to quit. But among European-Americans and Hispanic-Americans, and not among African-Americans, starting to smoke at an early age predicted higher nicotine dependence -- and thus heavier smoking -- in adulthood.
European-American and Hispanic early smokers were also more likely to binge drink (eight or more alcoholic drinks daily) and less likely to wear seatbelts, but this behavior pattern was not observed among early African-American smokers.
For European-Americans only, earlier smoking was associated with lower levels of physical activity. European-American early smokers were also substantially less likely to have quit one year following basic military training.
The researchers report their findings in the current issue of the journal Nicotine and Tobacco Research.
Lando and colleagues were intrigued by the weaker association between early smoking and negative lifestyle behaviors in African-Americans and consider this worthy of additional research. "Perhaps because smoking onset was so late for African-Americans, there was less opportunity to observe consistent relationships in age of initiation in this young population of Air Force recruits," Lando speculated.
The researchers also pointed out that more than 75 percent of the Air Force trainee study participants began smoking before the legal age of cigarette sale. "The high rate of initiation prior to legal age of sale continues to be of considerable public health concern," said Lando. "It is critical that age of sale laws be enforced and that access of minors to tobacco products be reduced."
This study was supported by a grant from the National Heart, Lung, and Blood Institute.
Nicotine & Tobacco Research is the official peer-reviewed quarterly journal of the Society for Research on Nicotine and Tobacco. For information about the journal, contact Gary E. Swan, PhD, at (650) 859-5322.
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Journal
Nicotine & Tobacco Research