Smoking behaviour among young adults: beyond youth prevention

OBJECTIVE: There is a widespread assumption that smoking behaviour is largely established by the age of 18 years. As a result, smoking prevention has focused almost exclusively upon youth. However, recent trends suggest that young adulthood may be an important--and largely overlooked--period in the development of regular smoking behaviour. The current study sought to examine patterns of tobacco use among young adults (aged 18-29 years) and to address the implications for tobacco control policy. DESIGN: Data are presented from the 2003 Canadian Tobacco Use Monitoring Survey, a national survey of smoking behaviour (n = 10,559, response rate 89%). MAIN OUTCOME MEASURES: Measures of smoking behaviour, smoking initiation, susceptibility to smoking, and occupational status. RESULTS: A total of 1.4 million or 28% of young adults in Canada currently smoke, the highest proportion among all age groups. The prevalence of daily smoking rose from 8% among youth to 22% among young adults, and approximately one fifth of smokers tried their first cigarette after the age of 18 years. Smoking behaviour among young adults was also distinct from older smokers: young adults were more likely to be occasional smokers and reported lower daily consumption. Finally, smoking prevalence and cessation rates varied substantially within subgroups of young adults, as characterised by occupational setting. CONCLUSIONS: Dramatic increases in the proportion and intensity of smoking occurs after the age of 18 years. Smoking behaviour among young adults is distinct from both youth and older adults, and warrants immediate attention from the public health community.