Public Release: 

Anti-Smoking Programs Should Start In Elementary School

Center for Advancing Health

Researchers Also Find Parents' Smoking As Important As Peer Pressure

Programs to keep children from starting to smoke should begin "at least as early as primary grades," not middle school, and they should target the influence of their parents' smoking as well as peer pressure, according to researchers who monitored smoking in a group of fifth-grade children for three years.

"The prevailing smoking prevention strategy, which concentrates resources on middle school prevention programs for adolescents, overlooks the needs of children who are at risk for habitual cigarette smoking," warns Christine Jackson, PhD, and colleagues at the University of North Carolina, Chapel Hill.

Moreover, "simply delaying the age at initiation of cigarette smoking is unlikely to reduce the proportion of children who eventually become habitual smokers," Jackson and her colleagues write in the August issue of Health Education and Behavior. Instead, they say, efforts should try to modify the important risk factors, such as low behavioral self-control and parental monitoring.

The research team surveyed 401 students while they were in the fifth, sixth, and seventh grades to determine why some of them tried smoking but did not continue, others tried it and did continue, and still others never smoked during the three-year period. Most of the children were white (84 percent) and about half (51 percent) were girls.

Although many studies have shown that the influence of friends is the single strongest factor in predicting whether children will try smoking, Jackson's study suggests that interventions "need to focus as much on countering the influence of parent smoking as on countering the influence of peer smoking."

More than half (54 percent) of the children had tried smoking by the seventh grade, Dr. Jackson and her colleagues found. Almost one quarter (22 percent) had tried smoking early in the study, 16 percent tried smoking late in the study, and 16 percent currently smoked regularly.

Compared with children who never smoked, those who currently smoked were more likely to be living in a single-parent household; have a parent who smoked; have best friends who smoked; believe their parents did not monitor their smoking and would not punish them for smoking; and believe cigarettes are easily available. These children were also more likely to be susceptible to peer pressure and have low grades in school and low behavioral self-control.

"The results also indicate, however, that early initiators do not necessarily continue to smoke," the researchers caution. "[They] are at greater risk for continued smoking if exposure to parental and peer modeling occurs in combination with susceptibility to peer influence, low parental monitoring, easy access to cigarettes, and other risk attributes."

The research was supported by a grant from the National Institute on Drug Abuse.


Health Education & Behavior, a bimonthly peer-reviewed journal of the Society for Public Health Education (SOPHE), publishes research on critical health issues for professionals in the implementation and administration of public health information programs. SOPHE is an international, non-profit professional organization that promotes the health of all people through education. For additional information about SOPHE, contact Elaine Auld: 202-408-9804.

Posted by the Center for the Advancement of Health, For information about the Center, contact Richard Hebert,, 202-387-2829.


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