Edwards Richard, Carter Kristie, Peace Jo, Blakely Tony
Aust N Z J Public Health. 2013 Dec;37(6):516-9. doi: 10.1111/1753-6405.12105.
Investigations of smoking initiation often focus on the experiences of children and youth. However, prevalence data from the Tobacco Use Surveys (TUS) and the New Zealand (NZ) census suggest substantial uptake of smoking occurs after 15 years of age, including among young adults aged 18-24 years. Identifying initiation rates is difficult using cross-sectional prevalence data, particularly among older age groups, which are subject to cohort effects and where quitting and premature mortality reduce prevalence. We aimed to identify initiation rates using a prospective study design.
The SoFIE-Health longitudinal survey included 15,095 subjects aged 15 years or older who responded in the three years that include the health module: 2004/05, 2006/07 and 2008/09. We calculated the proportion of 'never smokers' who became regular smokers (initiation) by age at baseline.
Initiation between 2004/05 and 2008/09 was 14.2% for 15-17 year olds, 7.0% for 18-19 years, 3.1% for 20-24 years and 1.4% for 25-34 years, with low levels of initiation (<1.0%) among older age groups.
There were strong age-related gradients in smoking initiation. Substantial initiation occurs among older youth and young adults, but is rare after age 24.
Efforts to prevent initiation of smoking should focus not only on adolescents but also on older youth and young adults.
吸烟起始的调查通常聚焦于儿童和青少年的经历。然而，烟草使用调查（TUS）和新西兰（NZ）人口普查的患病率数据表明，大量吸烟行为发生在15岁之后，包括18 - 24岁的年轻成年人。使用横断面患病率数据很难确定起始率，尤其是在老年人群体中，这一群体受队列效应影响，且戒烟和过早死亡会降低患病率。我们旨在通过前瞻性研究设计确定起始率。
SoFIE - Health纵向调查纳入了15,095名15岁及以上的受试者，他们在包含健康模块的三年（2004/05、2006/07和2008/09）中做出了回应。我们根据基线年龄计算了从不吸烟者成为经常吸烟者（起始）的比例。
2004/05至2008/09年间，15 - 17岁人群的起始率为14.2%，18 - 19岁为7.0%，20 - 24岁为3.1%，25 - 34岁为1.4%，老年人群体的起始率较低（<1.0%）。
吸烟起始存在明显的年龄相关梯度。大量起始发生在大龄青少年和年轻成年人中，但24岁之后很少见。
预防吸烟起始的努力不仅应关注青少年，还应关注大龄青少年和年轻成年人。
