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Introduction: 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., Methods: 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., Results: 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)., Conclusion: Our study demonstrates that, as adolescence advances, factors related to smoking behavior can vary.

Background: Most cigarette smokers take up their habit during adolescence. The aim of this study was to compare the age at which the students of a metropolitan high school and those of a non-metropolitan high school start smoking., Methods: Nine hundred and seventy-eight students (55.6% males, mean age 15.8 +/- 1.5 years) in a big city (Naples) and 467 (50.3% males, mean age 16 +/- 1.5 years) in a small town (Capua-CE) filled in a questionnaire on cigarette smoking. Two hundred and nine (21.4%) students (99 males, 110 females, mean age 16.5 +/- 1.3 years) in Naples and 99 (21.2%) students (59 males, 40 females, mean age 16.8 +/- 1.3 years) in Capua stated that they had smoked at least one cigarette in the last week and were considered as smokers., Results: The age at which adolescents start smoking did not differ between the big and the small city (Naples 14.9 +/- 1.5 years; Capua 14.9 +/- 1.6 years; p = 0.849) nor between sexes, both in Naples (males 14.9 +/- 1.5 years, females 14.8 +/- 1.4 years; p = 0.576) and in Capua (males 14.8 +/- 1.6 years, females 15 +/- 1.5 years; p = 0.379). Both in Naples and in Capua, no relation was found between the age at which the adolescent starts smoking and the smoking habits of the father, mother, siblings, best friend of the same sex, best friend of the opposite sex and friends. In Naples, the age at which the adolescent started smoking was related to the number of cigarettes he or she smoked in the last week (p = 0.004) and to the number of cigarettes smoked per day by the father (p = 0.001)., Conclusions: In adolescents, the age at which the habit of smoking is taken up does not differ both between a big and a small city and between sexes; in the big city, the age at which the adolescent started smoking was related to the number of cigarettes he or she smoked in the last week and to the number of cigarettes smoked per day by the father.

Smoking is a major health hazard. Most cigarette smokers start by the age of 18 years. The purpose of this study was to assess the prevalence of the intention to smoke among the students of a metropolitan compared to a non-metropolitan high school. The influence of age, sex, demographic and socio-economic variables, and the role of smoking models of family members and friends, were examined. Nine hundred forty-five students (529 males and 416 females; mean age 15.8 +/- 1.5 years) attending a high school in Naples and 442 students (223 males and 219 females; mean age 16.1 +/- 1.6 years) in Capua, a small town 40 Km distant from Naples, filled in an extensive questionnaire on smoking. The prevalence of intention to smoke was 10.4% in Naples and 9.3% in Capua. It was related to age (p < 0.01) in Naples, but not in Capua. The prevalence of smokers was 24.2% in Naples (males 21.6%, females 27.6%; p = 0.038) and 24.1% in Capua (males 29.2%, females 19%; p = 0.017). As expected, in both cities intention to smoke was associated (p < 0.001) with the strength of existing smoking habit. Students smoking over 21 cigarettes/week were more likely to continue than students smoking less 21 cigarettes/week, both in Naples and in Capua. More than half of smoking students, in both cities, were irresolute about their habit in the subsequent year. In Naples, intention to smoke of male students was associated with mother's (p = 0.02) and siblings' (p < 0.0001) smoking habit; in female students intention to smoke was associated with father's (p = 0.02), mother's (p < 0.001), parents' (p < 0.01) and siblings' smoking habit (p = 0.0002). In Capua an association was evident, in male students, between intention to smoke and paternal smoking habit (p = 0.04); in female students, intention to smoke was associated with siblings' smoking habit (p = 0.03). In Naples and in Capua, for both sexes, intention to smoke was related to smoking habits of the best friend of the same sex (p < 0.0005), the best friend of the opposite sex (p < 0.00005) and friends (p < 0.00001). Multivariate analysis showed, in Naples, an independent relation between adolescent intention to smoke and age (p = 0.01), smoking status of student (p < 0.0001) and friends' smoking habit (p = 0.01). In male students intention to smoke was associated with age (p = 0.003), smoking habit of student (p < 0.0001), mother's (p = 0.02) and friends' (p = 0.02), whereas in females it was associated with smoking behavior of student (p < 0.0001). In Capua student intention to smoke was related to the smoking status of the student (p < 0.0001) and of the best friend of the opposite sex (p < 0.04); in male as in female students, intention to smoke was associated with smoking habit of the student (p < 0.0001). In conclusion, prevalence of adolescents' intention to smoke is similar in two distinct populations of high school students of a city and a small town. Smoking is at higher prevalence among females in the city and among males in the small town. Intention to smoke increases with age, in the great city, and is related to student's existing habit and peer models. More than half of smoking students, in both cities, were irresolute about their habit in the subsequent year. This study has identified some variables associated with adolescents' intention to smoke; we feel that these findings may contribute to a better understanding of smoking behavior among adolescents and may have preventive implications.

Background: Smoking is the leading preventable cause of death. Most cigarette smokers take up the habit during adolescence. The purpose of this study was to assess the prevalence of cigarette smoking behavior among the students of a metropolitan high school as compared to those attending a non-metropolitan high school, examining age, sex and demographic and socioeconomic differences, as well as the influence of smoking models (family members and friends) on smoking behavior among adolescents., Methods and Results: Nine hundred seventy-eight students (544 males, 434 females; mean age 15.8 +/- 1.5 years) attending a high school in the city of Naples and 467 students (235 males, 232 females; mean age 16 +/- 1.5 years) from a high school of Capua, a small town 40 kilometers away from Naples, filled out an extensive questionnaire on smoking. The prevalence of smokers was 24.2% (males 21.8%, females 28.2%; p = 0.02) in Naples and 23.8% in Capua (males 29.8%, females 19.2%; p < 0.001) and was related to age (p < 0.001) both in Naples and in Capua. In Naples, smoking behavior among male students was associated with smoking by sibling (p = 0.00005), whereas an association with father (p = 0.0003), mother (p = 0.00005), parental (p = 0.0002) and sibling (p = 0.00002) smoking was observed among females. In Capua, an association was evident only between smoking in female students and sibling smoking habits (p = 0.02). In both Naples and Capua, smoking status of the students was related to smoking habits of best friends of the same sex, best friends of the opposite sex and friends. Multivariate analysis showed an independent relationship in Naples between adolescent smoking behavior and smoking status of siblings (p = 0.01), best friends of the same sex (p < 0.001) and best friends of the opposite sex (p < 0.001). In males, smoking behavior was associated with the smoking behavior of best friends of the same (p < 0.001) and of the opposite sex (p = 0.01), whereas in females, it was linked with the smoking behavior of siblings (p = 0.05), mother (p < 0.05) and best friends of the same sex (p < 0.001). In Capua, student smoking was related to smoking among friends (p < 0.001) and this held true for both males (p = 0.05) and females (p < 0.0001)., Conclusions: The prevalence of smoking habits among teenagers is similar in two distinct populations of high school students from a city and from a small town. Smoking showed a higher prevalence among females in the city and among males in the small town. It increases with age and is related to peer and family smoking models. This study has identified several variables associated with smoking status among adolescents. We thus feel that these findings may contribute to a better understanding of smoking behavior among teenagers and may have prevention implications.