Most people who smoke as adults first tried cigarettes in their teenage years. 1 Smoking uptake and prevalence escalates rapidly during adolescence, with 2% of Australians aged 12 years reporting smoking in the past month during 2017, increasing to 16% among those aged 17 years in the same year. 2 Once started, many young people will continue to smoke beyond their school years; while 21% of 12-17-year-old current smokers in 2017 were ‘certain’ they would not be smoking in 12 months’ time and 32% said they were ‘unlikely’ to be smoking, one-quarter were undecided, and 23% were ‘likely’ or ‘certain’ to be smoking in a year’s time. 2
An estimated 14,503 Australian school children progressed from experimental to established smoking behaviour i in 2017, 2 a decline from 16,586 in 2014 3 and 17,900 in 2011. 4 Young people show signs of dependence on tobacco-delivered nicotine at very low consumption levels, and after smoking only a few cigarettes. 5 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. 6
By far the majority of Australian teenagers who become smokers obtain their first cigarette from a friend or an acquaintance. 7
The first 18 sections of this chapter ( 5.1 through to 5.18 ) describe a range of factors that influence smoking experimentation and transition to more regular and established smoking. While the various threads are discussed separately, it is important to remember that 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 the factors that occur or can be influenced to help prevent the uptake of smoking.
1. US Department of Health and Human Services. Preventing tobacco use among young people: A report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2012. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/2012/
2. Guerin NW, V. ASSAD 2017 statistics & trends: Australian secondary students’ use of tobacco, alcohol, over-the-counter drugs, and illicit substances. Melbourne: Cancer Council Victoria, 2018. Available from: https://www.health.gov.au/resources/collections/australian-secondary-school-students-alcohol-and-drug-assad-survey-2017
3. White V and Williams T. Australian secondary school students' use of tobacco in 2014. Canberra: Australian Department of Health, Tobacco Control Taskforce, 2015. Available from: http://www.cancervic.org.au/downloads/cbrc/ASSAD_2014_Report.pdf .
4. White V and Bariola E. 3. Tobacco use among Australian secondary students in 2011, in Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substances in 2011. Canberra: Drug Strategy Branch Australian Government Department of Health and Ageing; 2012. Available from: http://www.nationaldrugstrategy.gov.au .
5. Sargent J and DiFranza J. Tobacco control for clinicians who treat adolescents. CA A Cancer Journal for Clinicians, 2003; 53(2):102–23. Available from: https://onlinelibrary.wiley.com/doi/full/10.3322/canjclin.53.2.102
6. Fidler JA, Wardle J, Henning Brodersen N, Jarvis MJ, and West R. Vulnerability to smoking after trying a single cigarette can lie dormant for three years or more. Tobacco Control, 2006; 15(3):205–9. Available from: http://tc.bmjjournals.com/cgi/content/abstract/15/3/205
7. Australian Institute of Health and Welfare. 2010 National Drug Strategy Household Survey: Survey report. Drug statistics series no. 25, AIHW cat. no. PHE 145.Canberra: AIHW, 2011. Available from: http://www.aihw.gov.au/publication-detail/?id=32212254712&libID=32212254712&tab=2 .