Age-related differences in factors associated with cigarette smoking among Italian high school students

Adolescents' cigarette smoking is related to several factors. The aim of this study among high school students was to test the hypothesis that factors related to smoking behavior could differ in early (14-16-year-old students, younger age group) vs. late (17-21-year-old students, older age group) adolescence.

The smoking behavior of 910 students was evaluated by a questionnaire. Students were categorized on the basis of their lifetime smoking behavior as never, former, occasional and regular smoker. Data were analyzed using Student's t-test, chi-square test and multinomial logistic regression analysis.

In multinomial logistic regression analysis, variables related to adolescents' smoking behavior for both age groups were: positive attitude toward smoking (P < 0.001), illicit drug use (younger age group, P < 0.001; older age group, P = 0.003), smoking at home with parents (younger age group, P = 0.038; older age group, P < 0.001) and get drunk at least once (younger age group, P = 0.002; older age group, P = 0.026). In the younger age group, a significant association was also found between students' smoking behavior and having smoked a cigar at least once (P = 0.006) and smoking behavior of the best friend of the same sex (P = 0.001), whereas the relationship with the hours spent with friends of the opposite sex was of borderline significance (P = 0.058). In the older age group, other factors related to adolescent's smoking behavior were minimizing health consequences of smoking (P = 0.002) and the hours spent with friends of the same sex (P = 0.026).

Our study demonstrates that, as adolescence advances, factors related to smoking behavior can vary.