Tracking of Avoidance of Alcohol Use and Smoking Behavior in a Fifth Grade Cohort over Three Years


  • Gwen Felton Ph.D., RNCS, FAAN,

  • Mary Ann Parsons Ph.D., RNCS, FAAN,

  • Dianne S. Ward Ed.D.,

  • Russell R. Pate Ph.D.,

  • Ruth P. Saunders Ph.D.,

  • Marsha Dowda MSPH,

  • Stewart Trost M.S.,

  • Gwen Felton and Mary Ann Parsons are Professors at the College of Nursing, University of South Carolina, Columbia, South Carolina. Dianne S. Ward and Russell R. Pate are Professors, Ruth P. Saunders is an Assistant Professor, Marsha Dowda is a Statistician, and Stewart Trost is a Research Assistant at the School of Public Health, University of South Carolina, Columbia, South Carolina.

Address correspondence to Gwen M. Felton, Department of Family and Community Health, College of Nursing, University of South Carolina, Columbia, SC 29208. E-mail:


This study examined the maintenance of positive health behavior (avoidance of alcohol use and cigarette smoking) and factors associated with the maintenance of these behaviors from fifth through seventh grade by a cohort of rural students (N= 232). African American and White students showed similar patterns of high avoidance of alcohol until seventh grade. Although more girls avoided use than boys, avoidance decreased in both groups with progression in grade. Mothers', fathers', and best friends' drinking behaviors influenced avoidance behavior; drinking was less likely to occur among those whose parents and friends did not drink. Friends' drinking behavior influenced alcohol use as early as fifth grade. Smoking avoidance was maintained by 74% of the students over the 3 years. Although there were no racial differences in smoking, African Americans started smoking about 1 year earlier than Whites. During seventh grade, an increase in smoking occurred among boys and girls, but was particularly striking among girls. Avoidance of smoking was influenced by mothers' behavior but not fathers'. Best friends' smoking behavior exerted a major influence on avoidance between grades 6 and 7. In grades 5 and 6, those who avoided smoking were more physically active than smokers, but by seventh grade their physical activity declined to a similar level as smokers. Rural adolescent boys seemed to be at early risk for alcohol use and smoking, while rural girls delayed involvement by 1 to 2 years. Communities, schools, and families can help adolescents avoid alcohol use and smoking through early prevention efforts.