[Smoking among children and adolescents: a challenge for primary prevention]

The best way to prevent the deleterious health effects of cigarette smoking is helping children to refrain from starting the habit. As a part of a survey of the prevalence of asthma symptoms in children and adolescents, we investigated the smoking habits of grade seven and eight school children in Bochum, a city of approximately 400,000 people in northwestern Germany. A random sample of 2050 children (93%) answered a confidential questionnaire. Fifty-three percent of the children responded that they had ever smoked cigarettes and 26% indicated that they had smoked during the previous month. 10% of the teenagers smoked daily, and 5% smoked more than 10 cigarettes per day. The prevalence of active smoking during the previous month was more frequent among girls (28%) than among boys (23%), but slightly more boys (5%) than girls (4%) smoked more than 10 cigarettes per day. The prevalence of active smoking was increased among children living in families of lower socio-economic status or in households with smokers. The high prevalence of cigarette smoking among the school children in Bochum, Germany, emphasizes the need to develop and implement effective intervention programs for children and adolescents and to contribute to a social environment which is conductive to refraining from smoking.