Greater smoking intensity may be linked to early smoking initiation among Filipinos: Evidence from the 2021 Global Adult Tobacco Survey Philippines.

Introduction: Understanding the relationship between age at smoking initiation and later smoking intensity is crucial for assessing future health consequences of smoking early and informing strategies to prevent and reduce tobacco use. This study explores the relationship between the two smoking-related behaviors among Filipino daily smokers.

Methods: Secondary data analyses from the 2021 Global Adult Tobacco Survey Philippines were performed. This study covers those who were reported to be daily smokers. The outcome of interest was smoking intensity, measured as the number of manufactured cigarettes consumed per day, while the main predictor was age at smoking initiation. Data from 2260 participants were analyzed. Negative binomial regression was used to test for the relationship between age at smoking initiation and smoking intensity while controlling for sociodemographic variables and other smoking-related behaviors.

Results: The average age at which daily smoking commenced was 20.93 (SD=6.35) years, while the average number of manufactured cigarettes consumed per day was 9.50 (SD=7.26). Age at smoking initiation was a significant predictor of smoking intensity, even after controlling for potential confounders. Each additional year in the age at which smoking was initiated was associated with a 1.55% decrease in smoking intensity in the adjusted model (β= -0.0155, p<0.0001). Other predictors of smoking intensity were current age (β=0.0072; 95% CI: 0.0050-0.0094, p<0.0001), sex (β= -0.1146; 95% CI: -0.2157 - -0.0136, p=0.0262), and smoking rules at home (β=0.1807; 95% CI: 0.1175-0.2439, p<0.0001).

Conclusions: Greater smoking intensity may be linked to early smoking initiation among Filipino adult daily smokers. The results may support interventions that target younger ages to curb heavy tobacco use at later ages.