Objective: Smoking among young people is declining in many European countries, although in some (particularly Central and Eastern Europe), the rates among young females are increasing. We compared the risk factors and variables for smoking in early- versus mid-adolescence with a view to helping policy makers identify age-specific prevention strategies.
Methods: An anonymous questionnaire on smoking habits was administered to 1383 underage students in the Veneto Region (northeast Italy) in 2010, consisting of multiple-choice questions using words, numbers, and graphical illustrations designed to make it appeal to the adolescent age group.
Results: Among 611 sixth-grade students, 93.5% of the boys and 95.3% of the girls had never smoked, although this was true of 53.2% of the boys and only 38.8% of the girls among 772 ninth-grade students. The first cigarette was smoked in different social settings and places, depending on the adolescents' age group. Age also influenced how much adolescents approved of smoking and their perception of how much their parents approved of them smoking. Adherence to the rules of their group of friends was the only variable found associated with smoking in both the age groups considered.
Conclusion: We found experimental or habitual cigarette smoking rare among sixth graders, but much more common among ninth graders. Focused preventive measures are therefore needed in the intervening years. The transition from middle school to higher education coincides with a sharp drop in the perceived regulation of smoking at school, emphasizing the need for action to establish high schools as smoke-free environments.