Adolescent nondaily smokers: Favorable views of tobacco yet receptive to cessation

Favorable views of cigarette use may be a potentiating factor that influences the progression of nicotine dependence among adolescents. Using data from the South Carolina Youth Tobacco Survey (2005-2007), a statewide two-stage cluster sample of students in Grades 6-12 (N = 7,385), we examined attitudes toward smoking and quit behaviors among adolescent smokers across a range of smoking frequencies. Compared with past-30-day nonsmokers, adolescents who smoked 1-2 days in the past month were more likely to believe that (a) smokers have more friends, (b) smoking looks cool, and (c) it is safe to smoke in the short term and then quit, but less likely to think that (d) tobacco is as addictive as other drugs and (e) smoking few cigarettes per day is harmful. Those who smoked 1-2 days in the past month were similar to more frequent smokers, including those who smoked daily. Similar findings were found for lifetime exposure to smoking. Among those who smoked 1-2 days in the previous month, motivation to quit (54%) and incidence of quit attempts (52% in past year) were slightly higher compared with heavier smokers. Even minimal levels of cigarette use are associated with favorable views of smoking, and adolescents with minimal levels of cigarette use resemble chronic smokers in several key ways. Adolescents at very early stages of cigarette use are at significant risk for chronic use. Tobacco control efforts should capitalize on motivation to quit with focused prevention strategies that arrest the progression from nondaily to daily smoking.