Smoking initiation among Israeli adolescents: a 24-year time-to-event analysis

Area of Science:

• Public Health
• Epidemiology
• Sociology

Background:

• Preventing smoking initiation is vital for reducing future smoking-related mortality and morbidity.
• Understanding the factors influencing smoking uptake in adolescents is key to developing effective prevention strategies.

Purpose of the Study:

• To examine the correlates and patterns of smoking initiation among Israeli youth.
• To identify specific ages and associated factors for smoking initiation using time-to-event analysis.

Main Methods:

• Analysis of 24 representative samples of new military recruits (N=50,254) from 1986-2009.
• Application of Cox regression and Kaplan-Meier analysis to determine factors associated with smoking initiation.
• Utilized logistic regression to identify predictors of smoking status.

Main Results:

• The peak age for smoking initiation was 17, with mean initiation ages of 15.7 for males and 16.0 for females.
• A decline in the age of initiation and peak hazard age was observed between 1986 and 2009.
• Earlier smoking initiation in both genders was significantly associated with lower education levels (<12 years), low paternal education, Russian birthplace, and religion. Specific associations were found for boys (high fitness, low/medium SES) and girls (Western-born, prior contraception use).

Conclusions:

• Individual and family characteristics, especially low educational attainment, are significant correlates of smoking initiation among Israeli military recruits.
• Time-to-event analysis provides valuable insights into identifying high-risk periods for smoking initiation, complementing traditional epidemiological methods.