Smoking Initiation Rates in Adults and Minors: United States, 1944–1988

To the authors' knowledge, calendar year trends in cigarette smoking initiation rates have not been examined on a population basis. National Health Interview Survey data (1970, 1978, 1979, 1980, 1987, and 1988) on age of starting to smoke fairly regularly were used to compute smoking initiation rates for males and females aged 10-24 years from 1944 through the mid-1980s. Information from 102,626 respondents was included. The authors examined trends in these rates and looked for associations with milestones in the antismoking public health campaign. Smoking initiation in 21- to 24-year-old (adult) males declined sharply beginning around 1950 when evidence regarding the health consequences of smoking was first made public. The decline in adult females began in the mid-1960s when the Surgeon General's report was released, intensifying the public health campaign. The initiation rate for adult males and females dropped below 1% by the end of the study period. Initiation rates in 15- to 20-year-old males also began to decrease in the mid-1960s, but rates for 10- to 14-year-old males did not decrease over the study period. Initiation rates for females both in the 15-20 and 10-14 year age groups actually increased, at least through the mid-1970s. These trends in smoking initiation suggest that knowing the health consequences of smoking has kept adults from starting to smoke. Such knowledge either may be lacking or may not be salient among the youngest age groups.