By DAVID WILLIAMSON
UNC-CH News Services
CHAPEL HILL - As a group, white children and those from low-income families take up smoking earlier than black children and youngsters whose parents make more money, a new University of North Carolina at Chapel Hill study shows.
The study, conducted by UNC-CH schools of nursing and public health investigators, also found that periodic, or experimental, smoking increased from 4 percent among third- and fourth-graders to 42 percent by eighth and ninth grades. The research is the first large study to report smoking habits of children as young as third-graders.
"Once they started experimenting with cigarettes, white children also advanced more rapidly to become regular smokers than black kids did," said Dr. Joanne S. Harrell, professor of nursing and principal investigator. "Boys were more likely to smoke at all ages than girls were."
A report on the findings appears in the November issue of the Journal of Adolescent Health.
The study is part of the larger continuing Cardiovascular Health in Children (CHIC) study, a scientific effort based at the UNC-CH School of Nursing to learn about improving children's -- and later adults' -- heart and lung health.
"We believe our work shows a need for smoking prevention classes very early, in elementary and middle school, especially in areas with large numbers of white children and children from poorer backgrounds," Harrell said. "Also, smoking cessation programs as well as smoking prevention classes would be useful for middle school and high school students."
Other findings were:
• The mean age that smoking began was 12.3 years.
• Children from rural areas were slightly more likely than urban children to
start smoking.
• Those who were more physically developed than classmates tended to start
smoking earlier.
The 1,970 children in the six-year study were a subset of 2,059 subjects involved in CHIC. They were evenly represented by sex, and 80 percent were white. Students first attended 21 geographically diverse elementary schools and later 23 middle and high schools across North Carolina.
Information analyzed came from detailed health and education-related questionnaires subjects and their parents completed each year.
"The low age of trial smoking is of great concern for the health of the public, since smoking-related diseases are more common in those who start smoking at an early age," Harrell said. "It also has been suggested that people who started smoking earlier are more likely to develop cancer than others who smoked just as much but started later."
Besides Harrell, authors of the journal article were Dr. Shrikant Bangdiwala, research associate professor of biostatistics; Chyrise B. Bradley, research assistant professor of nursing; and biostatisticians Shibing Deng and Julie A. Webb, all at UNC-CH.
In 1996, a Centers for Disease Control and Prevention publication projected deaths among American youths then smoking, the authors said. If current smoking patterns persisted, an estimated 5 million people who were 17 or younger in 1995 would die prematurely from smoking-related illnesses at a health-care cost of $200 billion or $12,000 per smoker. Sixty-four million years of potential life would be lost.
"According to the U.S. Surgeon General, of adults who had tried a cigarette, 88 percent had done so by age 18, while 71 percent of daily smokers had become smokers before reaching 18," Harrell said. "That is despite the fact that selling tobacco products to anyone under 18 is against the law in all the states."
The National Institute for Nursing Research supports the UNC-CH heart and fitness studies.
Note: Harrell's work number is (919) 966-4284 or 966-3610. Her home number is 942-7978. Project director Bradley can be reached at 966-3610 (w) or 304-2728 (h).
School of Nursing Contact: Renee Kinzie, (919) 966-1412.
News Services Contact: David Williamson, (919) 962-8596.