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Interventions to reduce smoking susceptibility among youth imperative

Persisting racial and ethnic disparities in smoking susceptibility were observed among young nonsmokers in the United States, prompting the need for prevention intervention programs that target youth when they are most susceptible to initiate smoking, according to recent findings published in Pediatrics.

“Youth is a critical developmental stage for cigarette smoking prevention efforts,” Sherine El-Toukhy, PhD, MA, of the division of intramural research at the National Institute of on Minority Health and Health Disparities, and colleagues wrote. “Roughly 5.6 million or 1 in every 13 individuals who are [age 17 years or younger] will prematurely die of smoking.”

“Little is known about smoking susceptibility, which precedes smoking behavior. Defined as lack of a firm commitment to not smoke, smoking susceptibility is a predictor of smoking experimentation among youth,” they added.

El-Toukhy and colleagues used data from the National Youth Tobacco Survey from 1999 to 2014 to determine racial and ethnic differences in smoking susceptibility over time and age among 143,917 participants from the United States between the ages of 9 and 21 years (mean age, 14.01 years) who have never smoked cigarettes. They evaluated nonlinear trends in susceptibility to smoking by using time-varying effect modeling. Analysis was adjusted for demographics, residence with smokers and exposure to tobacco advertising.  

Results indicated that from 2000 to 2009, those less susceptible to smoking than non-Hispanic whites included non-Hispanic blacks (lowest adjusted odds ratio [aOR], 0.80 in 2003-2005) and non-Hispanic Asian Americans (aOR, 0.83). There was no significant difference in susceptibility between non-Hispanic whites and non-Hispanic Asian Americans after 2009. Those more susceptible to smoking than non-Hispanic whites included Hispanics from 1999 to 2014 (highest aOR, 1.67 in 2012) and other non-Hispanics from 2012 to 2014 (highest aOR, 1.40 in 2014).

Non-Hispanic blacks at ages 11 to 13 (highest aOR, 1.22 at age 11.5) and other non-Hispanics at ages 12 to 14 years (highest aOR, 1.27 at age 12) were more susceptible to smoking in comparison to non-Hispanic whites. Hispanics had a higher smoking susceptibility rate during adolescence especially at age 12 (aOR, 1.60) and 16.5 (aOR, 1.46). Conversely, non-Hispanic Asian Americans had a lower smoking susceptibility rate compared to non-Hispanic whites at ages 11 to 15 years (lowest aOR, 0.76 at ages 11-13).

“Reducing racial and ethnic disparities in smoking is a goal of the U.S. Department of Health and Human Services in promoting health equity,” El-Toukhy and colleagues concluded. “A focus on youth susceptibility is fitting to reduce these disparities. Targeting youth when they are most susceptible to smoking with tailored prevention interventions could reduce smoking initiation, especially among racial/ethnic minorities.” – by Alaina Tedesco

Disclosure: This study was funded by the NIH. The researchers report support from the Intramural Research Program of the National Institutes of Health, National Institute on Minority Health and Health Disparities.