Who is starting smoking? An investigation of smoking initiation - PowerPoint PPT Presentation

Who is starting smoking? An investigation of smoking initiation among all ages using prospectively collected data Richard Edwards, Kristie Carter, Jo Peace,

Background • Tobacco industry argues that decision to smoke is an informed choice by adult smokers • Previous investigations of prevalence of uptake have focused on the experience of children and youth • Mostly use cross-sectional data • Data from TUS and NZ census suggest uptake occurs between 15-19 years and between 20-24 years • Identifying uptake using cross-sectional data may not be valid, especially among older age groups

Informed Choice “The risks associated with smoking are universally known, and … smoking is, and should continue to be, a matter of informed adult choice ” Imperial Tobacco NZ Ltd 2010: Submission to the Māori Affairs Select Committee Enquiry into the tobacco industry in Aotearoa and the consequences of tobacco use for Māori

Background • Tobacco industry argues that decision to smoke is an informed choice by adult smokers • Previous investigations of prevalence of uptake have focused on the experience of children and youth • Mostly use cross-sectional data • Data from TUS and NZ census suggest uptake occurs between 15-19 years and between 20-24 years • Identifying uptake using cross-sectional data may not be valid, especially among older age groups

Smoking prevalence by age, 15-24 years, 2006 Census 35% 30% 25% Male 20% Female 15% 10% 5% 0%

Aims To assess smoking initiation and quitting rates prospectively across all age ranges using a population- based study

Methods SoFIE study • Nationally representative longitudinal survey of the usually resident population living in private households in NZ. • Detailed health module asked in waves 3 (2004/5), 5 (2006/7) and 7 (2008/9) • 15,095 adults responded in all waves (3,5 and 7) (68% response rate from wave 1) • Attrition rate highest in youngest, Maori, or “other” respondents, low income respondents or those with poorer health status.

Smoking Status • Never smoker, ex-smoker or current smoker status determined at each wave • “Current smoker’ if he/she reported to “regularly smoke one or more tobacco cigarettes per day” • Classified as initiating smoking if they changed from a never smoker to a current smoker • Classified as quitting smoking if they changed from a current smoker to an ex-smoker

Results - Smoking prevalence by age group, SOFIE Wave 3 data (2004/5) 25 20 15 Prevalence 10 5 0 15-17 18-19 20-24 25-34 35-44 45-54 55-64 65+

Results - Smoking Initiation Smoking Initiation 16 14 12 Percentage 10 W 5-7 8 W 3-5 6 4 2 0 15-17 18-19 20-24 25-34 35-44 45-54 55-64 65+ Age at Wave 3 Initiation rates between waves 3 and 5 and waves 5 and 7 by age group

Results - Quitting Quitting Smoking 35 30 25 Percentage 20 15 W 5-7 W 3-5 10 5 0 15-17 18-19 20-24 25-34 35-44 45-54 55-64 65+ Age at Wave 3 Percentage of smokers quitting between waves 3 and 5 and waves 5 and 7.

Discussion • Initiation is rare after age 24 years, but common • Suggests that industry arguments that decision to smoke is an “informed choice” may be false – Mature adults rarely start to smoke – Initaition of smoking by young adults may not represent exercise of informed choice (further research) • No clear pattern in quitting across age groups • Efforts to prevent initiation of smoking should focus on smoking uptake among young adults as well as children