5.1 Introduction

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5.1 Introduction

5.2 Stages in the uptake of smoking

5.3 Factors influencing uptake by young people—overview

5.4 Physiological aspects

5.5 Individual personality traits and psychiatric influences

5.6 Intentions, attitudes and beliefs

5.7 The home environment

5.8 The smoking behaviour of peers, and peer attitudes and norms

5.9 The educational environment: achievements, aspirations and 'school connectedness'

5.10 Other drug use

5.11 Accessibility of tobacco products to young smokers

5.12 Affordability of tobacco products

5.13 Opportunity to smoke

5.14 Cultural background

5.15 Tobacco advertising and promotion targeted at young people

5.16 Products and packaging created to appeal to new users

5.17 Factors influencing uptake of smoking later in life

5.18 Uptake—a concluding note

5.19 What is meant by prevention?

5.20 Approaches to youth smoking prevention

5.21 Mass media strategies/campaigns

5.22 Interactive technology and multimedia

5.23 School-based interventions

5.24 Peer influence and education

5.25 Parent/family/home targeted interventions

5.26 Reducing tobacco access and supply

5.27 Reducing product appeal

5.28 Promotion and visibility of tobacco

5.29 Denormalising smoking

5.30 Taxation and pricing of tobacco products

5.31 Harnessing predictors of uptake to prevent smoking

5.32 Preventing smoking in more 'at risk' groups

Acknowledgments

References

Most smokers become addicted in their teenage years1 and most Australian teenagers who become smokers obtain their first cigarette from a friend or an acquaintance.2, 3 Smoking prevalence escalates rapidly during adolescence, from 2% of 12-year-olds to 18% of 17-year-olds among Australian teenagers in 2005. Fewer than 10% of 17-year-old current[1] and daily smokers say that they definitely intend to quit smoking in the future. This strongly suggests that most Australian students who smoked in their final year of school in 2005 will continue smoking beyond their school years.2

Young people can become addicted to cigarettes at very low consumption levels, and after smoking only a few cigarettes.4 British research has found that smoking just a single cigarette at the age of 11 can leave a child susceptible to later uptake of regular smoking, even after a period of three or more years. This could be due to neurobiological factors, or social or personal traits.5

The first 18 sections of this chapter provide discussion about stages in the uptake of smoking, and the range of factors that influence an individual's decision whether or not to start smoking. While the various threads are discussed separately, it is important to remember that in reality many of these factors are interconnected and should not be considered in isolation. The second part of this chapter, commencing with Section 5.19, examines ways of countering these influences to help prevent the uptake of smoking.