Why delaying smoking initiation is critical

Early initiation into smoking is a major concern in public health. It predicts a stronger dependence and a lower ability to quit smoking. People who started smoking before the age of 16 have a probability twice as high as those who started smoking after this age to remain a smoker at age 60.

En 2008, we carried out a secondary analysis Inserm (1993) and ESPAD (1999, 2003 and 2007) studies on young people aged 15-16. "Early smokers", whom we have defined as people who started smoking before the age of 12, tend to use other more important substances.


By simultaneously taking into account these different criteria, the addictive behaviors associated with smoking all remain significant in the analysis (logistic regression model). Thus, premature tobacco consumption is associated with:

  • consumption of more than 10 cigarettes per day (risk increased by 55%)
  • early cannabis use (risk multiplied by 4)
  • experimenting with illicit drugs other than cannabis (risk increased by 31%)
  • early alcohol consumption (risk multiplied by 3)
  • early intoxication (risk increased by 43%).

Increased mortality, increased risk of disease

The early initiation is also synonymous with increased damage to the health of these smokers ... A study published in 2017 analyzed data from the National Health Interview Survey (from 1997 to 2005) which covered more than 90 subjects aged 000 or over, smokers or former smokers. Of these, 30% had started smoking regularly before the age of 7,3.

This study shows that, for those who currently smoke, the precocity of tobacco consumption (here, before 13 years) increases the risk of developing:

  • cardiovascular or metabolic disease (risk increased by 67%)
  • lung disease (risk increased by 79%)
  • cancer related to smoking (risk multiplied by 2)

In addition, all-cause mortality is increased by 18% among these “early” smokers.

This study also shows - which is important - that, for those who no longer smoke, the precocity of tobacco consumption (here, before the age of 13) increases the risk of developing:

  • cardiovascular or metabolic disease (risk increased by 38%)
  • lung disease (risk increased by 89%)
  • cancer related to smoking (risk increased by 44%)

In addition, all-cause mortality is increased by 19% among these former “early” smokers.

It is therefore important to delay initiation to smoking, just like initiation to alcohol or cannabis.

The data visualizations of this article were carried out by Marie Simon.

Philippe arvers, Addictologist and tobacco specialist, Grenoble Alpes University

La original version of this article was posted on The Conversation.

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