Racial/ethnic differences in cigarette smoking initiation and progression to daily smoking: a multilevel analysis.

ABSTRACT

OBJECTIVES: We sought to identify individual and contextual predictors of adolescent smoking initiation and progression to daily smoking by race/ethnicity. METHODS: We used data from the National Longitudinal Study of Adolescent Health to estimate the effects of individual (adolescent, family, peer) and contextual (school and state) factors on smoking onset among nonsmokers (n = 5374) and progression to daily smoking among smokers (n = 4474) with multilevel regression models. RESULTS: Individual factors were more important predictors of smoking behaviors than were contextual factors. Predictors of smoking behaviors were mostly common across racial/ethnic groups. CONCLUSIONS: The few identified racial/ethnic differences in predictors of smoking behavior suggest that universal prevention and intervention efforts could reach most adolescents regardless of race/ethnicity. With 2 exceptions, important contextual factors remain to be identified.