Recruitment of young people to cigarette smoking

Uptake of smoking typically occurs in adolescence, with few people starting to smoke after the age of 20 years. (35,36) In the United Kingdom, about 25 per cent of teenagers smoke by the age of 15 years, with some evidence that at this age (although not among young adults of 16 years of age and above) girls are more likely to smoke than boys. Rates of smoking in young people have shown no decline over the past 15 years in the United Kingdom, and there is evidence that they are currently increasing in the United States.

Initiation of smoking is subject to a number of influences: environmental, behavioural, and personal factors all play a part. (24) Environmental influences include parental smoking (approximately doubling the likelihood of a child starting to smoke), and smoking by siblings and friends. Tobacco advertising and promotions effectively target young people with images of smoking as trendy, sporty, and successful. (39,4°,4 and 42) Young people from deprived backgrounds where smoking is the norm are more likely to become smokers, an association which becomes accentuated in adulthood, implying that smoking is a marker for social trajectory.

Cigarette smoking is linked with poor school performance, truancy, low aspirations for future success, and early school leaving or drop-out. (24) Smoking in adolescents is frequently associated with other problem behaviours including alcohol and other drug use and other risk taking or rebellious behaviours, as well as with low self-esteem, anxiety, and depression.(43)

School-based interventions to reduce the uptake of smoking by teenagers have shown some initial success, but longer term follow-up has found that these effects dissipate/44,45 leading researchers to advocate approaches involving the creation of a wider social environment supportive of non-smoking. (46)

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