Changes in the patterns of initiation of cigarette smoking in the United States: 1950, 1965, and 1980.

We examined changes in the patterns of the rates of smoking initiation in the United States by gender for 1950, 1965, and 1980. Data from National Health Interview Surveys on the ages people started smoking (survey years 1970, 1978, 1979, 1980, 1987, and 1988) were used to construct age-specific rates of smoking initiation for males and females 10 to 24 years of age for 1950, 1965, and 1980. We used information from 87,483 white respondents who were between 20 and 50 years of age when surveyed. In 1950, initiation was higher for males of all ages than for females, and smoking initiation rates were higher among those age 18 years and older compared to those younger. Although still somewhat higher, the rates for males in 1965 had declined much more than those for females, and the tendency for higher rates in older youth was still evident. In 1980, no gender difference was seen and most initiation clearly took place in those younger than 18 years of age. We concluded that the public health campaign has been successful in convincing older youth not to smoke. However, smoking initiation rates in younger adolescents have changed little, indicating that new approaches to tobacco control are necessary if smoking prevalence in the United States is to be further reduced.