Smoking among American adolescents: A risk and protective factor analysis

Peter Scal, Marjorie Ireland, Iris Wagman Borowsky

Research output: Contribution to journalArticlepeer-review

91 Scopus citations


Cigarette smoking remains a substantial threat to the current and future health of America's youth. The purpose of this study was to identify the risk and protective factors for cigarette smoking among US adolescents. Data from the National Longitudinal Study of Adolescent Health was used, comparing the responses of all non-smokers at Time 1 for their ability to predict the likelihood of smoking at Time 2, one year later. Data was stratified into four gender by grade group cohorts. Cross-cutting risk factors for smoking among all four cohorts were: using alcohol, marijuana, and other illicit drugs; violence involvement; having had sex; having friends who smoke and learning problems. Having a higher grade point average and family connectedness were protective across all cohorts. Other gender and grade group specific risk and protective factors were identified. The estimated probability of initiating smoking decreased by 19.2% to 54.1% both in situations of high and low risk as the number of protective factors present increased. Of the factors that predict or protect against smoking some are influential across all gender and grade group cohorts studied, while others are specific to gender and developmental stage. Prevention efforts that target both the reduction of risk factors and enhancement of protective factors at the individual, family, peer group and community are likely to reduce the likelihood of smoking initiation.

Original languageEnglish (US)
Pages (from-to)79-97
Number of pages19
JournalJournal of Community Health
Issue number2
StatePublished - Apr 2003

Bibliographical note

Funding Information:
This research is based on data from the Add Health project, a program project designed by Richard Udry (PI) and Peter Bearman, and funded by grant P01-HD31921 from the National Institute of Child Health and Human Development to the Carolina Population Center, University of North Carolina at Chapel Hill, with cooperative funding participation by the National Cancer Institute; the National Institute of Alcohol Abuse and Alcoholism; the National Institute on Deafness and Other Communication Disorders; the National Institute of Drug Abuse; the National Institute of General Medical Sciences; the National Institute of Mental Health; the National Institute of Nursing Research; the Office of AIDS Research, NIH; the Office of Behavior and Social Science Research, NIH; the Office of the Director, NIH; the Office of Research on Womens Health, NIH; the Office of Population Affairs, DHHS; the National Center for Health Statistics, Centers for Disease Control and Prevention, DHHS; the Office of Minority Health, Centers for Disease Control and Prevention, DHHS; the Office of Minority Health, Office of Public Health and Science, DHHS; the Office of the Assistant Secretary for Planning and Evaluation, DHHS; and the National Science Foundation. Persons interested in obtaining data files from The National Longitudinal Study of Adolescent Health should contact Jo Jones, Carolina Population Center, 123 West Franklin Street, Chapel Hill, NC 27516-3997 (e-mail:

Funding Information:
This work was supported in part by grant #5-T71-MC00006-22, Adolescent Health Training Program (Maternal and Child Health Bureau, HRSA) and grant number CCU/448 513331, Centers for Disease Control and Prevention.


  • Adolescent tobacco use
  • Prevention
  • Smoking


Dive into the research topics of 'Smoking among American adolescents: A risk and protective factor analysis'. Together they form a unique fingerprint.

Cite this