Approximately 90% of adult smokers first tried cigarettes before the age of 18, and practically all began using cigarettes before the age of 26 (81). In addition to being at higher risk for nicotine dependence (82), individuals who have an earlier onset of cigarette use are at increased risk for heavy smoking (22) and worse tobacco-related health outcomes in adulthood (83). Added to this, one study conducted on students in grades 9–12 in Canada found that a delay of one year in the age of smoking onset was associated with lower odds of being a current smoker (adjusted OR = 0.76, 95% CI= 0.73–0.79). Increasing the age of onset also seems to increase the likelihood of successful smoking cessation, as results from another study found that the likelihood of smoking cessation was greater in smokers who had begun cigarette smoking after age 13, relative to individuals who had begun earlier (84). These findings suggest that early prevention and intervention are needed to avoid early-onset cigarette use to reduce negative consequences associated with cigarette use, such as nicotine dependence and tobacco-related health outcomes in adulthood (83).
