Factors influencing the age at which adolescents start smoking. A comparison between a big and a small city.

Background: Most cigarette smokers take up their habit during adolescence. The aim of this study was to compare the age at which the students of a metropolitan high school and those of a non-metropolitan high school start smoking.

Methods: Nine hundred and seventy-eight students (55.6% males, mean age 15.8 +/- 1.5 years) in a big city (Naples) and 467 (50.3% males, mean age 16 +/- 1.5 years) in a small town (Capua-CE) filled in a questionnaire on cigarette smoking. Two hundred and nine (21.4%) students (99 males, 110 females, mean age 16.5 +/- 1.3 years) in Naples and 99 (21.2%) students (59 males, 40 females, mean age 16.8 +/- 1.3 years) in Capua stated that they had smoked at least one cigarette in the last week and were considered as smokers.

Results: The age at which adolescents start smoking did not differ between the big and the small city (Naples 14.9 +/- 1.5 years; Capua 14.9 +/- 1.6 years; p = 0.849) nor between sexes, both in Naples (males 14.9 +/- 1.5 years, females 14.8 +/- 1.4 years; p = 0.576) and in Capua (males 14.8 +/- 1.6 years, females 15 +/- 1.5 years; p = 0.379). Both in Naples and in Capua, no relation was found between the age at which the adolescent starts smoking and the smoking habits of the father, mother, siblings, best friend of the same sex, best friend of the opposite sex and friends. In Naples, the age at which the adolescent started smoking was related to the number of cigarettes he or she smoked in the last week (p = 0.004) and to the number of cigarettes smoked per day by the father (p = 0.001).

Conclusions: In adolescents, the age at which the habit of smoking is taken up does not differ both between a big and a small city and between sexes; in the big city, the age at which the adolescent started smoking was related to the number of cigarettes he or she smoked in the last week and to the number of cigarettes smoked per day by the father.