How do impulsivity and education relate to smoking initiation and cessation among young adults?

This study examined the predictive value of impulsivity for starting and quitting smoking and whether education had an independent effect on smoking careers or moderated the impulsivity-smoking association.

Two waves of the cohort study Young in Norway were used in the present study (third wave: 1999, age range: 19-32 years; fourth wave: 2005, age range: 25-38 years). Postal questionnaires were used for data collection. Subjects participating in 1999 and 2005 were eligible (N = 2,562). Stable smokers (daily smokers in 1999 and 2005) and nonsmokers (never smokers in 1999 and 2005), quitters (daily smokers in 1999, nonsmokers in 2005), and starters (never smokers in 1999, daily smokers in 2005) constituted the analytical sample (1,776 men and women). The associations between self-reported impulsivity and education and smoking were investigated using logistic regression analyses.

The odds ratio (OR) for a 1-unit increase in the impulsivity score was 2.16 (95% CI [1.09, 4.30]) for smoking initiation, whereas the OR [95% CI] for low compared with high education was 2.55 (95% CI [1.36, 4.77]). Education, but not impulsivity, emerged as a significant determinant for smoking cessation compared with continued smoking. The OR for quitting smoking by low compared with high education was 0.61 (95% CI [0.42, 0.90]). Mutual adjustment for education and impulsivity did not change any of the results. The interaction term between impulsivity and education was not significantly related to smoking.

Because impulsivity emerged as important for smoking initiation regardless of educational level, it should be considered when planning and implementing smoking prevention programs for both low and high socioeconomic groups.