The smoking spectrum: review of the existing evidence and future directions

  • Garbis A. MeshefedjianEmail author



The health hazards of tobacco use are well documented in the literature. Harms caused by tobacco products are not only confined to smokers themselves; non-smokers exposed to smoking may suffer from the ill consequences of tobacco as well. There is a need for a fresh health promotion strategy to prevent smoking initiation.


This paper aims to: (1) describe the natural history of smoking through its different phases, (2) review the evidence and identify independent correlates of each transitory phase, and (3) suggest possible opportunities for future preventive measures to reduce smoking initiation and tobacco use.


We conducted a literature review to identify potential factors that influence cigarette smoking. The findings are summarized to give an understanding of the natural history of smoking.


Public health departments should explore and encourage health creation in addition to disease prevention to attain an optimum population health status. This paper advocates a comprehensive healthy lifestyle approach at schools, including education about behavioral risks and protective factors. A smoke-free health promotion should promote education on the locus of control and self-determination to inform not only about the harms of smoking and its social influences, but also to empower teenagers with the knowledge and tools to recognize the manipulative techniques of the tobacco industry and victimization of its clientele.


Smoke-free efforts of public health departments should focus on empowering consumers—at least as much as on tobacco legislation—in order to enable them not to be drawn into using tobacco products in the first place.


Smoking history Review Empowerment Salutogenesis Prevention 



The author thanks Dr. Ak’ingabe Guyon for her comments and suggestions with regard to the first draft of the manuscript.


This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The author declares that he has no conflict of interest.

Ethical approval

No human and/or animal experimentations were involved in this research.


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Authors and Affiliations

  1. 1.Service des Connaissances, Direction Régionale de Santé PubliqueCentre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Centre-Sud-de-l’Île-de-MontréalMontréalCanada

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