Global Public Health, Monash University, Sunway Campus, Selangor, Malaysia.
Nicotine Tob Res. 2013 Mar;15(3):729-33. doi: 10.1093/ntr/nts177. Epub 2012 Sep 18.
It is held that younger smoking initiates are more likely to become regular smokers. The definitions of smoking initiation (a puff, part of a cigarette, a whole cigarette) are inconsistent and raise questions about the robustness of the view. We sought to re-examine the relationship using adolescent smoking data from 3 European countries.
A stratified secondary, logistic regression analysis of Global Youth Tobacco Survey data was conducted using a design-based analysis. Subgroup analyses were conducted of 13- to 15-year olds from Latvia (high smoking prevalence), Slovenia (moderate prevalence), and Montenegro (low prevalence) who had initiated smoking. The outcome was current smoking--smoking everyday for the past 30 days, or smoking 10 or more days in the past 30 days. Smoking initiation was operationalized as a single puff of a cigarette, and age of smoking initiation was a derived continuous measure.
In Latvia, there was a significant association between age of smoking initiation and current smoking for males (p < .05) and females (p < .001) when smoking was operationalized as smoking every day. It was only significant in female adolescents (p < .001) for smoking 10 or more days. In Slovenia and Montenegro, there was no significant relationship between age of smoking initiation and current smoking for either males or females.
The evidence about the relationship between age of smoking initiation and current smoking is not clear. Explanations for the findings may relate to a lack of power, the specificity of the measure, or problems with the theory.
人们认为，较年轻的吸烟初始者更有可能成为常规吸烟者。吸烟初始的定义（一口烟、半支烟、一支烟）不一致，这引发了对该观点可靠性的质疑。我们试图使用来自 3 个欧洲国家的青少年吸烟数据重新检验这种关系。
我们对全球青少年烟草调查数据进行了基于设计的分层二级逻辑回归分析。在拉脱维亚（吸烟率较高）、斯洛文尼亚（中等流行率）和黑山（低流行率）进行了 13 至 15 岁吸烟初始者的亚组分析。结局是当前吸烟——过去 30 天每天吸烟，或过去 30 天中吸烟 10 天或以上。吸烟初始被定义为吸一口香烟，吸烟初始年龄是一个连续的衍生指标。
在拉脱维亚，当将吸烟定义为每天吸烟时，吸烟初始年龄与男性（p<0.05）和女性（p<0.001）当前吸烟之间存在显著关联；而当吸烟定义为吸烟 10 天或以上时，这种关联仅在女性青少年中显著（p<0.001）。在斯洛文尼亚和黑山，吸烟初始年龄与男性或女性当前吸烟之间均无显著关系。
吸烟初始年龄与当前吸烟之间的关系证据并不明确。对这些发现的解释可能与缺乏统计效能、测量的特异性或理论问题有关。
