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      Youth tobacco access: trends and policy implications

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          We examined whether the supply routes via which New Zealand adolescents aged 14–15 years accessed tobacco had changed during a period of dynamic policy activity.


          We analysed data from seven consecutive years (2006–2012) of the New Zealand Action on Smoking and Health (ASH) Year 10 survey, a nationwide cross-sectional annual survey.


          All New Zealand schools teaching Year 10 students are invited to participate in the survey; school-level participation rates have ranged between 44% and 58% and more than 25 000 students have responded to the survey in each year. The results presented draw on the subsample who reported smoking when surveyed (N∼9200). The data were weighted by age, ethnicity and school socioeconomic status (SES) to remove effects of systematic over-response by New Zealand Europeans and under-response by those in lower SES groups from trend analyses.

          Primary and secondary outcome measures

          The survey measured adolescents’ main reported tobacco supply source.


          Smoking prevalence declined significantly (8.1%) over the period examined (linear tend coefficient: −0.74; 95% CI −1.03 to −0.45, significant p<0.01). Friends showed a significant decline in relative importance as a supply source while caregivers and other sources showed a significant increase over the period examined.


          The findings show that social supply, particularly via friends, caregivers and others, such as older siblings, is a key tobacco source for adolescents; commercial supply is much less important. The findings raise questions about the additional measures needed to reduce smoking among youth. Endgame policies that make tobacco more difficult to obtain and less appealing and convenient to gift merit further investigation.

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          Most cited references 36

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          Smoking cessation in young adults: age at initiation of cigarette smoking and other suspected influences.

          Previous research has suggested that early smoking initiation predicts longer duration of smoking, heavier daily consumption, and increased chances of nicotine dependence. This report set out to estimate the relationship between smoking cessation and age of initiation, as well as nicotine dependence, sex, race, and education. A sample of 1007 young adults was randomly selected from a large health maintenance organization in southeast Michigan. Hazard ratios of quitting associated with age at smoking initiation were estimated among 414 persons who smoked daily for 1 month or more. With potential confounders controlled for, the likelihood of cessation was significantly higher in smokers who initiated smoking after age 13. The hazard ratio for quitting associated with smoking initiation at ages 14 to 16 was 1.6 and with initiation at or after age 17 was 2.0, compared with initiation at or before 13 years of age. Factors that decreased the likelihood of cessation were nicotine dependence and low education. Public policy to discourage early smoking, if it succeeds in delaying the initiation of smoking, might contribute to the reduction of smoking-related mortality and morbidity by increasing the potential for quitting.
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            Tobacco industry youth smoking prevention programs: protecting the industry and hurting tobacco control.

            This report describes the history, true goals, and effects of tobacco industry-sponsored youth smoking prevention programs. We analyzed previously-secret tobacco industry documents. The industry started these programs in the 1980s to forestall legislation that would restrict industry activities. Industry programs portray smoking as an adult choice and fail to discuss how tobacco advertising promotes smoking or the health dangers of smoking. The industry has used these programs to fight taxes, clean-indoor-air laws, and marketing restrictions worldwide. There is no evidence that these programs decrease smoking among youths. Tobacco industry youth programs do more harm than good for tobacco control. The tobacco industry should not be allowed to run or directly fund youth smoking prevention programs.
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              Effect of the age at which smoking begins on frequency of smoking in adulthood.

               E Taioli,  E L WYNDER (1991)

                Author and article information

                [1 ]Department of Marketing, University of Otago , Dunedin, Otago, New Zealand
                [2 ]Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago , Dunedin, Otago, New Zealand
                [3 ]Department of Public Health, University of Otago , Wellington, New Zealand
                [4 ]Department of Marketing, University of Otago , WellingtonNew Zealand
                Author notes
                [Correspondence to ] Professor Janet Hoek; janet.hoek@

                All authors are members of the ASPIRE2025 collaboration (

                BMJ Open
                BMJ Open
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                17 April 2014
                : 4
                : 4
                24742976 3996823 bmjopen-2013-004631 10.1136/bmjopen-2013-004631
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

                Smoking and Tobacco


                preventive medicine, public health


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