Reducing Early Smokers' Risk for Future Smoking and Other Problem Behavior: Insights from a Five-Year Longitudinal Study

Purpose: To identify risk and protective factors during early and later adolescence that predict future regular smoking and multiple problem behavior among at-risk youth, defined as those who tried smoking by grade 7. Methods: At grades 7, 10, and 12, data were collected from 2,000 early Smokers drawn from California and Oregon. Multivariate regression analyses tested predictors of the two grade 12 outcomes in separate models using data from grades, 7 and 10. Gender interactions and buffering of risk factors by protective factors were assessed. Results: For at-risk youth, consistent protective factors against future smoking and problem behavior included living in an intact nuclear family (all four models) plus getting good grades and parental disapproval of smoking/drug use (three of four models). Consistent risk factors included exposure to substance-using peers (four models) and problems in school (three of four models). Adult Substance use was a predictor during early, but not later, adolescence pro-smoking/drug use beliefs were significant predictors during later adolescence. There were few differences across gender and no significant buffers against risk. Conclusions: At-risk youth would likely benefit from peer resistance training, parental involvement in prevention efforts, and efforts to improve educational performance during both middle school and high school. Changing pro-drug beliefs may be more effective among older adolescents. (C) 2008 Society for Adolescent Medicine. All rights reserved.