Factors associated with late smoking initiation in Minnesota women

This case-control study investigated factors associated with late initiation (i.e, initiation after the age of 17 years) of smoking among young women. The most significantly elevated odds ratios for late initiation were having a significant other who smoked and having friends who found smoking acceptable at initiation. Peers, especially significant others, played an important role in smoking initiation among young women. Prevention efforts should focus on strategies that reduce the acceptability of smoking in the social environment. (Am J Public Health. 1993;183:1333-1335)
Women who start to smoke after age 17 tend to respond to the same types of influences as adolescents who begin smoking. In Minnesota, where 30% of women smokers between the ages of 18 and 30 start smoking after age 17, a study was conducted to investigate causes of smoking initiation among post-adolescent women. Having peers who smoke, especially spouses or significant others, and having the perception that smoking is socially acceptable tend to be highly associated with late onset of smoking among these women. Contrary to popular belief and anecdotal evidence, stressful life events were not significantly associated with late onset smoking. Other factors associated with late onset were poor high school grades, rare church attendance, and other 'problem' behaviors during high school. Prevention efforts should be directed at women with less education and focus on making smoking less socially acceptable.