An improved surveillance measure for adolescent smoking?

Objective To assess the possible usefulness and validity of a new measure to identify adolescents at risk of smoking cigarettes. Design The new measure was compared with standard ones with respect to their ability to identify young adolescents at risk of later smoking cigarettes; and the correlation between known risk factors for smoking and both the new and the standard measure of current smoking was assessed. Setting and subjects Cross-sectional, population-based 1992 California Tobacco Survey of 1789 adolescents (12–17 years) and 1667 adults (18-28 years). Main outcome measures Susceptibility to smoke, defined as the absence of a firm resolve not to smoke; current smoking, defined as any smoking in the last month; and daily smoking. Results Less than 2% of 12 to 13 year olds reported current smoking, whereas 27 % were susceptible. None reported daily smoking. Susceptibility rates peaked at around 45% at age 19 years, and peak rates of young adult daily smoking approached 25%. Factors related to current smoking in logistic regression analysis were also related to susceptibility to smoke even among adolescents who had never smoked a whole cigarette, suggesting that susceptibility is indeed the first stage of smoking uptake. Conclusion Although it overestimates eventual adult smoking, the susceptibility measure should capture a greater percentage of young adolescents who eventually smoke than the current smoker measure. Subject to further validation in longitudinal studies, this measure may offer a means of focusing intervention resources on those adolescents at risk of starting to smoke. Also, this measure could be used for surveillance and as an outcome measure to assess the effectiveness of prevention programmes.