Association of age at onset of cigarette and alcohol use with subsequent smoking and drinking patterns among Japanese high school students.

This study examined relationships between age of smoking and drinking initiation, and subsequent patterns of smoking and drinking among Japanese high school students. Self-administered anonymous questionnaires were conducted using a sample of 1,466 students in grades 10 through 12 at seven public senior high schools in urban areas of Okinawa, Japan. After controlling for demographic variables, students who began smoking at age 12 or younger were more likely to become heavy smokers and heavy drinkers than those who began smoking at ages 15 or older. Age of smoking initiation was not related to risks for current smoking and current drinking. Students who started drinking at age 12 or younger, and at 13 or 14 years, were significantly associated with current smoking, current drinking, heavy smoking, and heavy drinking, compared to students who began drinking at ages 15 or older. Early onset smoking and drinking represent significant predictors for subsequent use of cigarettes and alcohol. These findings suggest that smoking and drinking prevention programs should begin during elementary school.