International Journal of Public Health

, Volume 63, Issue 1, pp 125–136 | Cite as

Socioeconomic status is associated with the prevalence and co-occurrence of risk factors for cigarette smoking initiation during adolescence

  • Robert J. Wellman
  • Marie-Pierre Sylvestre
  • Erin K. O’Loughlin
  • Hartley Dutczak
  • Annie Montreuil
  • Geetanjali D. Datta
  • Jennifer O’LoughlinEmail author
Original Article



To investigate whether the prevalence or co-occurrence of risk factors for cigarette smoking initiation differ by socioeconomic status (SES) and whether SES interacts with risk factors to increase initiation.


In 2005, 1451 5th grade never smokers (mean age 10.7 years) in Montréal, Canada, provided baseline data, with follow-up in 6th and/or 7th grade (2005–2007). Poisson regression analyses estimated the association between 13 risk factors and initiation. Excess risk of each risk factor in low vs. moderate–high SES participants was assessed.


Cigarette smoking was initiated by 9.4% of participants (n = 137). Low SES was associated with a higher prevalence and co-occurrence of risk factors. The estimated association of most risk factors with initiation was similar across SES, although participants from low SES neighborhoods whose mothers had no university education had three times the risk of initiation [ARR = 3.10 (1.19, 8.08)] compared to more affluent peers.


Tobacco control efforts must address the higher prevalence and co-occurrence of risk factors in lower SES contexts since these may render initiation highly probable in many lower SES youth.


Socioeconomic status Adolescents Cigarette smoking Smoking initiation Risk factors 



This project was funded by the Canadian Tobacco Control Research Initiative (15689) and the Institut national de santé publique du Québec (INSPQ) through a financial contribution from the Québec Ministry of Health and Social Services to the INSPQ. Views expressed in this document do not necessarily reflect those of the Québec Ministry of Health and Social Services. Jennifer O’Loughlin holds a Canada Research Chair in the Early Determinants of Adult Chronic Disease. Erin O’Loughlin is supported by a doctoral fellowship from the Fonds de Recherche du Québec-Santé. The funders were not involved in the design or conduct of the study, data collection, management, analysis, or interpretation, or preparation, review or approval of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Supplementary material

38_2017_1051_MOESM1_ESM.pdf (747 kb)
Supplementary material 1 (PDF 746 kb)


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Copyright information

© Swiss School of Public Health (SSPH+) 2017

Authors and Affiliations

  • Robert J. Wellman
    • 1
  • Marie-Pierre Sylvestre
    • 2
    • 3
  • Erin K. O’Loughlin
    • 2
    • 4
  • Hartley Dutczak
    • 2
  • Annie Montreuil
    • 5
  • Geetanjali D. Datta
    • 2
    • 3
  • Jennifer O’Loughlin
    • 2
    • 3
    • 5
    Email author
  1. 1.Department of Family Medicine and Community HealthUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Centre de Recherche CRHUMUniversité de MontréalMontréalCanada
  3. 3.Department of Social and Preventive MedicineUniversity of MontrealMontréalCanada
  4. 4.Department of Exercise ScienceConcordia UniversityMontréalCanada
  5. 5.Institut National de Santé Publique du QuébecMontréalCanada

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