Wyoming Survey & Analysis Center, University of Wyoming, Dept 3925, 1000 E University Ave, Laramie, WY 82071, USA.
Prev Chronic Dis. 2012;9:E05. Epub 2011 Dec 15.
Young adults have the highest smoking rate of any age group in the United States and Canada, and recent data indicate that they often initiate smoking as young adults. The objective of this study was to systematically review peer-reviewed articles on cigarette smoking initiation and effective prevention efforts among young adults.
We searched 5 databases for research articles published in English between 1998 and 2010 on smoking initiation among young adults (aged 18-25) living in the United States or Canada. We extracted the following data from each study selected: the measure of initiation used, age range of initiation, age range of study population, data source, target population, sampling method, and sample size. We summarized the primary findings of each study according to 3 research questions and categories of data (eg, sociodemographic) that emerged during the data extraction process.
Of 1,072 identified studies, we found 27 articles that met our search criteria, but several included a larger age range of initiation (eg, 18-30, 18-36) than we initially intended to include. Disparities in young adult smoking initiation existed according to sex, race, and educational attainment. The use of alcohol and illegal drugs was associated with smoking initiation. The risk of smoking initiation among young adults increased under the following circumstances: exposure to smoking, boredom or stress while serving in the military, attending tobacco-sponsored social events while in college, and exposure to social norms and perceptions that encourage smoking. Effective prevention efforts include exposure to counter-marketing, denormalization campaigns, taxation, and the presence of smoke-free policies.
Much remains to be learned about young adult smoking initiation, particularly among young adults in the straight-to-work population. Dissimilar measures of smoking initiation limit our knowledge about smoking initiation among young adults. We recommend developing a standardized measure of initiation that indicates progression to regular established smoking.
在美国和加拿大，年轻人的吸烟率是所有年龄段中最高的，最近的数据表明，他们通常在成年早期开始吸烟。本研究的目的是系统地回顾美国和加拿大的年轻成年人吸烟起始和有效预防措施方面的同行评议文献。
我们在 5 个数据库中搜索了 1998 年至 2010 年间发表的关于居住在美国或加拿大的年轻成年人（年龄在 18-25 岁之间）吸烟起始的英文研究文章。我们从每个选定的研究中提取了以下数据：使用的起始措施、起始年龄范围、研究人群年龄范围、数据来源、目标人群、抽样方法和样本量。我们根据 3 个研究问题和数据类别（例如，社会人口统计学）对每项研究的主要发现进行了总结，这些类别是在数据提取过程中出现的。
在确定的 1072 项研究中，我们发现了符合我们搜索标准的 27 篇文章，但其中一些研究的起始年龄范围较大（例如，18-30 岁，18-36 岁），超出了我们最初的预期。年轻成年人吸烟起始存在性别、种族和教育程度的差异。使用酒精和非法药物与吸烟起始有关。在以下情况下，年轻成年人吸烟起始的风险增加：接触吸烟、在军队服役时感到无聊或压力、在大学期间参加烟草赞助的社交活动、以及接触鼓励吸烟的社会规范和观念。有效的预防措施包括接触反营销、去正常化运动、税收和实施无烟政策。
在年轻成年人的吸烟起始方面，我们还有很多需要了解的地方，尤其是在直接进入工作岗位的年轻成年人中。不同的吸烟起始衡量标准限制了我们对年轻成年人吸烟起始的了解。我们建议制定一个标准化的起始衡量标准，以表明向定期固定吸烟的转变。
