Many studies have examined the risk factors that lead young people to try their first cigarette, according to background information in the article. However, fewer researchers have differentiated these factors from those that cause children and teens to progress to established smoking, or having smoked 100 or more cigarettes. "Yet understanding this difference is critical," the authors write. "It would allow us to determine the age and stage at which youths are most sensitive to various types of interventions, thus enabling the more specific tailoring and more effective delivery of smoking prevention interventions."

Michael Siegel, M.D., M.P.H., of Boston University School of Public Health, and colleagues studied 3,834 Massachusetts youths who were age 12 to 17 at the first interview, conducted between 2001 and 2002. Of those, 2,791 were interviewed again two years later and 2,217 were interviewed four years later.

Overall, 9.3 percent of the participants became established smokers over the study period, including 9.6 percent of those living in towns with weak restaurant smoking regulations (where smoking is restricted to designated areas or not restricted at all), 9.8 percent of those in towns with medium regulations (smoking is restricted to enclosed or ventilated areas, or no smoking is allowed but variations are permitted) and 7.9 percent of those in towns with strong regulations (complete smoking bans). The strength of local smoking regulations was not associated with the transition from non-smoking to experimentation, but was associated with the transition from experimentation to established smoking.

The researchers note that smoking bans may influence youth by reducing their exposure to smokers in public places and also altering the perceived social acceptability of smoking. "Both of these effects would be expected to influence the transition from experimentation to established smoking but not experimentation in the first place," they write.

The results "suggest that local smoke-free restaurant laws may decrease youth smoking initiation," the authors continue. "If it represents a true effect, the observed 40 percent reduction in the odds of progression to established smoking in towns with local restaurant smoking bans would suggest that smoke-free policies may be the most effective intervention available to reduce youth smoking."

Journal reference: Arch Pediatr Adolesc Med. 2008;162[5]:477-483.

This study was supported by grants from the National Cancer Institute, the State and Community Tobacco Control Interventions Research Grant Program and the Flight Attendant Medical Research Institute.

Note: If no author is given, the source is cited instead.

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