Television viewing and age at smoking initiation: does a relationship exist between higher levels of television viewing and earlier onset of smoking?

This cross-sectional study of children assessed the association between television viewing and age at smoking initiation, using self-reports administered by research assistants in schools. Participants were 909 students in their first and fourth years of secondary education in a random sample of 15 secondary schools in Flanders, Belgium, who had smoked at least one cigarette. The main outcome measure was age at smoking initiation. The independent variable was weekly television viewing volume. Gender, educational level, parental smoking, and peer smoking were the control variables. The relationship between television viewing and age at smoking initiation was significant. Higher levels of television viewing were related to earlier onset of smoking behavior in adolescents. The relationship of television viewing with age at smoking initiation was stronger than that of peer smoking, parental smoking, and gender. For each hour of television viewing per day, the average smoking initiation age decreased by 60 days. Heavier television viewers start smoking at an earlier age. Two possible explanations for this relationship are suggested. Social learning theory suggests that actors and actresses serve as behavioral role models for heavy viewers. Cultivation theory suggests that exposure to positive messages influences smoking attitudes. Further research should examine whether the relationship is causal and whether television acts as a provider of smoking role models or whether it influences smoking attitudes.