The context of smoking initiation and maintenance: findings from interviews with youths.

The characteristics of initial cigarette-smoking situations and subsequent situations in which adolescents received an offer to smoke were examined by means of interviews with 287 youths in grades 7 through 10. Initiation of smoking generally took place in a social context (89%), with small groups (2.7 people) of same-gender, older (2.1 years), peers (and siblings) who were smokers (60%). In one-third of these onset situations, another novice smoked for the first time. Most subjects (81%) reported that they smoked their first cigarette because they accepted an offer. The characteristics of the onset situation did not significantly differ between regular and experimental smokers. The situations for later offers to smoke were similar: small groups of same-gender, slightly older, cigarette-smoking peers (and siblings). Descriptive and comparative data also are presented on procurement, perceived prevalence, parental influence, cravings, quit attempts, beliefs about ease of quitting, and intention to smoke. These data suggest that school-based interventions may not be sufficient to address the broad social context surrounding adolescent tobacco use. Community-wide interventions are advocated.