The implementation of tobacco control policies in the past decade has resulted in changed patterns of cigarette use among young adults. For many of these individuals, light or intermittent smoking has replaced smoking multiple packs per day. Little research exists on the age at which patterns of cigarette use stabilize. A new study attempted to fill this gap by examining data from the Truth Initiative Young Adult Cohort Study, a nationally representative sample of young adults aged 18-34 years. The researchers used survey data from baseline and 6 waves of follow-ups, which occurred every six months. The average completion rate was 60.3% and the cumulative average response rate across waves was 5.7%. Although this is a low response rate, the authors argue it is still representative. Participants were 9,791 survey respondents, 64.4% (n =6,305) of whom provided data at two or more time points. They were sorted into one of three categories: Daily smokers, non-daily smokers, and never-smokers/those who smoked, but not within the past 30 days (these two groups were combined into a single category). After analysis, three classes of smokers were identified: “Rapid escalators” (11.3%), “dabblers” (9.4%), and “never or ever triers” (79.3%). Rapid escalators had the greatest estimated probability of daily smoking (~80%), while the other two classes had low probabilities. Dabblers had the greatest estimated probability of non-daily smoking (~50%) and the other categories had low probabilities. The estimated probability of never smoking was nearly 100% among never-smokers, while this probability decreased over time among dabblers. Low socioeconomic status and parental smoking during childhood were identified as risk factors associated with cigarette use progression. Smoking patterns were found to be stable by age 21.
Take away: Intervening prior to age 21 may disrupt progression to established daily or occasional smoking. These findings offer support for the effectiveness of policies that raise the minimum age for purchasing tobacco products to age 21.