Purpose. We examine early-onset cigarette smoking and how, if at all, it is related to subsequent smoking practices. Methods. From 2004 to 2007, face-to-face interviews were conducted with 485 adult cigarette smokers residing in the Atlanta metropolitan area. Data analysis involved a multivariate analysis to determine whether age of smoking onset was related to current smoking practices when the effects of gender, age, race, marital/relationship status, income, and educational attainment were taken into account. Results. The mean age for smoking onset was 14.8, and more than one-half of all smokers had their first cigarette between the ages of 12 and 16. Most people reported an interval of less than one month between their first and second time using tobacco. Earlier onset cigarette smoking was related to more cigarette use and worse tobacco-related health outcomes in adulthood. Conclusions. Early prevention and intervention are needed to avoid early-onset smoking behaviors. Intervening after initial experimentation but before patterned smoking practices are established will be challenging, as the interval between initial and subsequent use tends to be short. 1. Introduction Research focusing on the age of initiation for various types of legal and illegal substances has shown that “average” Americans begin experimenting with substances, typically alcohol and/or tobacco, during their teenage years [1]. Increasingly, early-onset use appears to be occurring. By the time they are nine or ten years old, approximately 10% of the American children have begun drinking alcohol [2] and nearly one-third of all youths begin drinking prior to the age of thirteen [3]. By 10th grade (approximately aged 15 or 16), more than one-half (58.2%) of all American youths have used alcohol [1]; and by 12th grade (approximately aged 17 or 18), more than one-half (54.1%) of American adolescents have been drunk at least once [1]. Study findings have revealed that early-onset alcohol use oftentimes is associated with a greater likelihood of subsequent illegal drug use [4]. When it occurs, experimentation with illegal drugs typically begins, on average, a few years after initial alcohol consumption. Recent data suggest that 28.6% of 13 and 14 year olds, 40.6% of 15 and 16 year olds, and 49.9% of 17 and 18 year olds have used at least one illegal drug during their lifetime [1]. By far, the most commonly used of these drugs is marijuana. The median age of first marijuana use is 15.5 years [5]. Nearly two-thirds (62.6%) of all marijuana users first try the substance between the ages of
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