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Trends and timing of cigarette smoking uptake among US young adults: survival analysis using annual national cohorts from 1976 to 2005

Authors

Abstract

Aims

To measure changes over time in cigarette smoking uptake prevalence and timing during young adulthood (ages 19–26 years), and associations between time-invariant/-varying characteristics and uptake prevalence/timing.

Design

Discrete-time survival modeling of data collected from United States high school seniors (modal age 17/18) enrolled in successive graduating classes from 1976 to 2005 and participating in four follow-up surveys (to modal age 25/26).

Setting

The longitudinal component of the Monitoring the Future study.

Participants

A total of 10 758 individuals reporting no life-time smoking when first surveyed as high school seniors.

Measurements

Smoking uptake (any, experimental, occasional and regular); socio-demographic variables; marital, college and work status; time spent socializing.

Findings

The percentage of young adults moving from non-smoker to experimental smoking [slope estimate 0.11, standard error (SE) = 0.04, P = 0.005] or occasional smoking (slope estimate 0.17, SE = 0.03, P < 0.001) increased significantly across graduating classes; the percentage moving from non-smoker to regular smoker remained stable. All forms of smoking uptake were most likely to occur at age 19/20, but uptake prevalence at older ages increased over time [e.g. cohort year predicting occasional uptake at modal age 25/26 adjusted hazard odds ratio (AHOR) = 1.05, P = 0.002]. Time-invariant/-varying characteristics had unique associations with the timing of various forms of smoking uptake (e.g. at modal age 21/22, currently attending college increased occasional uptake risk (AHOR = 2.11, P < 0.001) but decreased regular uptake risk (AHOR = 0.69, P = 0.026).

Conclusions

Young adult occasional and experimental smoking uptake increased in the United States for non-smoking high school seniors graduating from 1976 to 2005. Smoking uptake for these cohorts remained most likely to occur at age 19/20, but prevalence of uptake at older ages increased.

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Article Information

DOI

10.1111/add.12926

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© 2015 Society for the Study of Addiction

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Keywords

  • Cigarette smoking;
  • delayed smoking uptake;
  • discrete-time survival analysis;
  • late smoking uptake;
  • tobacco;
  • young adults

Publication History

  • Issue online:
  • Version of record online:
  • Accepted manuscript online:
  • Manuscript Accepted:
  • Manuscript Revised:
  • Manuscript Received:

Funded by

  • National Institute on Drug Abuse. Grant Numbers: grants DA001411, DA016575

Supporting Information

Appendix S1 STROBE Statement Checklist of Items That Should be Included in Reports of Cohort Studies.

Appendix S2 Sample Flow Diagram.

Table S1 Weighted Descriptives of Time-Invariant Covariates Measured at Modal Age 18 (Total Sample N=10,758).

Table S2 Weighted Descriptives of Time-Varying Covariates (Total Sample N=10,758).

Table S3 Multivariate Discrete-Time Survival Models Examining the Timing of Any Young Adult Smoking Uptake among High School Seniors Graduating from 1976–2005.

Table S4 Multivariate Discrete-Time Survival Models Examining the Timing of Uptake to Experimental Smoking Only among High School Seniors Graduating from 1976–2005.

Table S5 Multivariate Discrete-Time Survival Models Examining the Timing of Uptake to Occasional but Not Regular Smoking among High School Seniors Graduating from 1976–2005.

Table S6 Multivariate Discrete-Time Survival Models Examining the Timing of Uptake to Regular Smoking among High School Seniors Graduating from 1976–2005.

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  1. 1Stephanie A. Stern, Yvonne M. Terry-McElrath, Megan E. Patrick, Beverage-specific patterns of 5+ alcoholic drink consumption by young adults in the U.S., Addictive Behaviors, 2017, 65, 19CrossRef
  2. 2Yvonne M. Terry-McElrath, Patrick M. O’Malley, Lloyd D. Johnston, Discontinuous Patterns of Cigarette Smoking From Ages 18 to 50 in the United States: A Repeated-Measures Latent Class Analysis, Nicotine & Tobacco Research, 2017CrossRef
  3. 3Megan E. Patrick, Yvonne M. Terry-McElrath, High-intensity drinking by underage young adults in the United States, Addiction, 2017, 112, 1, 82Wiley Online Library
  4. 4Azure B. Thompson, Paul D. Mowery, Jacob Kraemer Tebes, Sherry A. McKee, Time Trends in Smoking Onset by Sex and Race/Ethnicity Among Adolescents and Young Adults: Findings From the 2006–2013 National Survey on Drug Use and Health, Nicotine & Tobacco Research, 2017CrossRef
  5. 5Isaac M. Lipkus, Darren Mays, Kenneth P. Tercyak, Characterizing Young Adults’ Susceptibility to Waterpipe Tobacco Use and Their Reactions to Messages About Product Harms and Addictiveness, Nicotine & Tobacco Research, 2016, ntw251CrossRef