Smoking initiation among Israeli adolescents: A 24-year time-to-event analysis

L. Rosen; V. Rozhavski; H. Levine; T. Sela; Y. Bar-Ze'ev; V. Molina-Hazan; S. Zarka

doi:10.1016/j.ypmed.2014.05.020

Smoking initiation among Israeli adolescents: A 24-year time-to-event analysis

L. Rosen^*, V. Rozhavski, H. Levine, T. Sela, Y. Bar-Ze'ev, V. Molina-Hazan, S. Zarka

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Introduction: Preventing smoking initiation will protect future generations from smoking-attributable death and disease. This study examines the correlates and patterns of initiation among Israeli youth using time-to-event analysis and other methods. Methods: Twenty-four consecutive representative samples (1986-2009) of new military recruits (N. = 50,254) were analyzed. Cox regression and Kaplan-Meier analysis were used to identify factors associated with smoking initiation, and logistic regression was used to identify factors associated with smoking status. Results: The most hazardous age for smoking initiation was seventeen, subsequent to the mean age of smoking initiation (males: 15.7, females: 16.0). Age of initiation and age of greatest hazard for initiation declined among recruits between the years 1986 and 2009. Earlier smoking initiation among boys and girls was significantly associated with low education levels (<. 12. years) (males: HR. = 2.98, CI: [2.79, 3.18]; females: HR. = 3.35, CI: [2.96, 3.80]), low paternal education levels, Russian birthplace, and religion. Earlier initiation in boys was associated with high fitness levels and low/medium socio-economic status. Earlier initiation in girls was associated with being Western-born and ever-use of contraception. Conclusions: Smoking initiation among Israeli youth recruited to the armed forces is associated with individual and family characteristics, particularly low education levels. Time-to-event analysis complements traditional means of understanding smoking initiation by identifying ages at which initiation hazard is high.

Original language	English
Pages (from-to)	141-147
Number of pages	7
Journal	Preventive Medicine
Volume	65
DOIs	https://doi.org/10.1016/j.ypmed.2014.05.020
State	Published - Aug 2014
Externally published	Yes

Bibliographical note

Funding Information:
The study was supported by the Israel National Institute for Health Policy Research (Grant number 2007/12/R ). We thank the health surveillance personnel of the Israel Defense Forces for patiently collecting the data throughout the years. We thank Jonathan Harris for assistance with the graphs. No other authors contributed substantively to this work.

Keywords

Cox proportional hazards model
Hazard
Smoking initiation
Survival analysis
Time-to-event analysis
Tobacco control
Youth smoking prevention

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ypmed.2014.05.020

Cite this

@article{2703cff014e449ecbca1a56689a00ff4,

title = "Smoking initiation among Israeli adolescents: A 24-year time-to-event analysis",

abstract = "Introduction: Preventing smoking initiation will protect future generations from smoking-attributable death and disease. This study examines the correlates and patterns of initiation among Israeli youth using time-to-event analysis and other methods. Methods: Twenty-four consecutive representative samples (1986-2009) of new military recruits (N. = 50,254) were analyzed. Cox regression and Kaplan-Meier analysis were used to identify factors associated with smoking initiation, and logistic regression was used to identify factors associated with smoking status. Results: The most hazardous age for smoking initiation was seventeen, subsequent to the mean age of smoking initiation (males: 15.7, females: 16.0). Age of initiation and age of greatest hazard for initiation declined among recruits between the years 1986 and 2009. Earlier smoking initiation among boys and girls was significantly associated with low education levels (<. 12. years) (males: HR. = 2.98, CI: [2.79, 3.18]; females: HR. = 3.35, CI: [2.96, 3.80]), low paternal education levels, Russian birthplace, and religion. Earlier initiation in boys was associated with high fitness levels and low/medium socio-economic status. Earlier initiation in girls was associated with being Western-born and ever-use of contraception. Conclusions: Smoking initiation among Israeli youth recruited to the armed forces is associated with individual and family characteristics, particularly low education levels. Time-to-event analysis complements traditional means of understanding smoking initiation by identifying ages at which initiation hazard is high.",

keywords = "Cox proportional hazards model, Hazard, Smoking initiation, Survival analysis, Time-to-event analysis, Tobacco control, Youth smoking prevention",

author = "L. Rosen and V. Rozhavski and H. Levine and T. Sela and Y. Bar-Ze'ev and V. Molina-Hazan and S. Zarka",

note = "Funding Information: The study was supported by the Israel National Institute for Health Policy Research (Grant number 2007/12/R ). We thank the health surveillance personnel of the Israel Defense Forces for patiently collecting the data throughout the years. We thank Jonathan Harris for assistance with the graphs. No other authors contributed substantively to this work.",

year = "2014",

month = aug,

doi = "10.1016/j.ypmed.2014.05.020",

language = "אנגלית",

volume = "65",

pages = "141--147",

journal = "Preventive Medicine",

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T1 - Smoking initiation among Israeli adolescents

T2 - A 24-year time-to-event analysis

AU - Rosen, L.

AU - Rozhavski, V.

AU - Levine, H.

AU - Sela, T.

AU - Bar-Ze'ev, Y.

AU - Molina-Hazan, V.

AU - Zarka, S.

N1 - Funding Information: The study was supported by the Israel National Institute for Health Policy Research (Grant number 2007/12/R ). We thank the health surveillance personnel of the Israel Defense Forces for patiently collecting the data throughout the years. We thank Jonathan Harris for assistance with the graphs. No other authors contributed substantively to this work.

PY - 2014/8

Y1 - 2014/8

N2 - Introduction: Preventing smoking initiation will protect future generations from smoking-attributable death and disease. This study examines the correlates and patterns of initiation among Israeli youth using time-to-event analysis and other methods. Methods: Twenty-four consecutive representative samples (1986-2009) of new military recruits (N. = 50,254) were analyzed. Cox regression and Kaplan-Meier analysis were used to identify factors associated with smoking initiation, and logistic regression was used to identify factors associated with smoking status. Results: The most hazardous age for smoking initiation was seventeen, subsequent to the mean age of smoking initiation (males: 15.7, females: 16.0). Age of initiation and age of greatest hazard for initiation declined among recruits between the years 1986 and 2009. Earlier smoking initiation among boys and girls was significantly associated with low education levels (<. 12. years) (males: HR. = 2.98, CI: [2.79, 3.18]; females: HR. = 3.35, CI: [2.96, 3.80]), low paternal education levels, Russian birthplace, and religion. Earlier initiation in boys was associated with high fitness levels and low/medium socio-economic status. Earlier initiation in girls was associated with being Western-born and ever-use of contraception. Conclusions: Smoking initiation among Israeli youth recruited to the armed forces is associated with individual and family characteristics, particularly low education levels. Time-to-event analysis complements traditional means of understanding smoking initiation by identifying ages at which initiation hazard is high.

AB - Introduction: Preventing smoking initiation will protect future generations from smoking-attributable death and disease. This study examines the correlates and patterns of initiation among Israeli youth using time-to-event analysis and other methods. Methods: Twenty-four consecutive representative samples (1986-2009) of new military recruits (N. = 50,254) were analyzed. Cox regression and Kaplan-Meier analysis were used to identify factors associated with smoking initiation, and logistic regression was used to identify factors associated with smoking status. Results: The most hazardous age for smoking initiation was seventeen, subsequent to the mean age of smoking initiation (males: 15.7, females: 16.0). Age of initiation and age of greatest hazard for initiation declined among recruits between the years 1986 and 2009. Earlier smoking initiation among boys and girls was significantly associated with low education levels (<. 12. years) (males: HR. = 2.98, CI: [2.79, 3.18]; females: HR. = 3.35, CI: [2.96, 3.80]), low paternal education levels, Russian birthplace, and religion. Earlier initiation in boys was associated with high fitness levels and low/medium socio-economic status. Earlier initiation in girls was associated with being Western-born and ever-use of contraception. Conclusions: Smoking initiation among Israeli youth recruited to the armed forces is associated with individual and family characteristics, particularly low education levels. Time-to-event analysis complements traditional means of understanding smoking initiation by identifying ages at which initiation hazard is high.

KW - Cox proportional hazards model

KW - Hazard

KW - Smoking initiation

KW - Survival analysis

KW - Time-to-event analysis

KW - Tobacco control

KW - Youth smoking prevention

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AN - SCOPUS:84904127986

SN - 0091-7435

VL - 65

SP - 141

EP - 147

JO - Preventive Medicine

JF - Preventive Medicine

ER -

Smoking initiation among Israeli adolescents: A 24-year time-to-event analysis

Abstract

Bibliographical note

Keywords

UN SDGs

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