University of Massachusetts Medical School Faculty Publications


Gender differences in risk factors for cigarette smoking initiation in childhood

UMMS Affiliation

Department of Family Medicine and Community Health

Publication Date


Document Type



Gender and Sexuality | Substance Abuse and Addiction


INTRODUCTION: We investigated whether established risk factors for initiating cigarette smoking during adolescence (parents, siblings, friends smoke; home smoking rules, smokers at home, exposure to smoking in cars, academic performance, susceptibility to smoking, depressive symptoms, self-esteem, school connectedness, use of other tobacco products) are associated with initiation in preadolescents, and whether the effects of these factors differ by gender.

METHODS: In spring 2005, baseline data were collected in self-report questionnaires from 1801 5th grade students including 1553 never-smokers (mean age=10.7years), in the longitudinal AdoQuest I Study in Montreal, Canada. Follow-up data were collected in the fall and spring of 6th grade (2005-2006). Poisson regression analyses with robust variance estimated the effects of each risk factor on initiation and additive interactions with gender were computed to assess the excess risk of each risk factor in girls compared to boys.

RESULTS: 101 of 1399 participants in the analytic sample (6.7% of boys; 7.7% of girls) initiated smoking during follow-up. After adjustment for age, gender and maternal education, all risk factors except academic performance and school connectedness were statistically significantly associated with initiation. Paternal and sibling smoking were associated with initiation in girls only, and girls with lower self-esteem had a significant excess risk of initiating smoking in 6th grade.

CONCLUSIONS: Risk factors for smoking initiation in preadolescents mirror those in adolescents; their effects do not differ markedly by gender. Preventive programs targeting children should focus on reducing smoking in the social environment and the dangers of poly-tobacco use.


Children, Cigarette smoking, Gender, Risk factors, Smoking initiation

DOI of Published Version



Addict Behav. 2017 Apr 4;72:144-150. doi: 10.1016/j.addbeh.2017.04.004. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Addictive behaviors

PubMed ID