On Monday, Aug. 6, 2012, the Archives of General Psychiatry published a study showing two things: early-onset of smoking among ever-smokers was significantly tied to heavy smoking later in life and that starting earlier was more likely to lead to heavy smoking later in life than late-onset smoking depending on the presence of a mutant gene.
In the latter case, there's a lot more science-y dialog than I care to toss around in a blog entry, andI wrote about the study in full on the main site. No, my real concern is the unadjusted finding: early onset smoking was associated with more than a two-and-a-half times odds ratio of heavy smoking in adulthood (unadjusted OR 2.63, 95% CI 2.49 to 2.78, P<0.001).
According to the researchers, the participants that qualified for "early-onset" designation started smoking at age 16 or younger. In New Jersey, the youngest someone can be to legally purchase cigarettes is 19 -- up from 18 the same year I became legally allowed to purchase cigarettes, roughly 7 years ago.
Heavy smoking status was identified as more than 20 cigarettes per day, roughly more than a pack-per-day, on average.
When you hear one of "Big Tobacco's target demographics is younger smokers, this is precisely why:
- Cigarettes are chemically addictive
- The earlier someone starts smoking, the longer they will have to be addicted for
- The earlier someone starts smoking, the more likely they are to smoke more when they get older
With these and the genetic factors associated with higher smoking risks in the study, the authors use those data to conclude that "these results provide further compelling evidence in support of public health interventions targeting adolescent smoking."
Another key note is that these data are from international ever-smokers from 43 different studies with 33,348 combined participants. While I would not advocate for a "Not even once"-style anti-smoking campaign, that may be what these numbers call for. The missing piece in all of these claims made in the public service announcements is that cigarettes are an incremental burden -- we've already started showing the end results heavy smoking has on health, but the journey starts young, with having ever smoked, and grows into a burden of more than a pack-a-day in adulthood.
Smoking rates are down. But the risks aren't there, according to this study, with late-onset smokers. It's with our youth. "Smoking: don't get sucked in," doesn't seem like such a bad message with some numbers behind it. To parrot the authors, interventions need to be significant and hit youth, preferably before they start smoking.