Social Influences on Cigarette Initiation Among College Students Ruth R. Staten, PhD, ARNP-CS; Melody Noiand, PhD, CHES Mary Kay Rayens, PhD; Ellen Hahn, DSN, RN; Mark Dignan, PhD, FAAHB S. Lee Ridner, PhD, ARNP-NP Objectives: To examine the rela- tionship of demographic and social influence with initiation of ciga- rette use among undergraduates. Methods: Students were mailed anonymous surveys including 437 participants who indicated that they had not smoked cigarettes before age 18. Of those, 107 be- came late initiators (24%), and 330 remained never smokers (76%). Results: Those who drank alcohol in college and had at least 1 parent with a college education were more likely to initiate smoking than were those who did not drink and nei- ther parent had attended college. Conclusions: Strategies that focus on reducing alcohol and tobacco use need to be tested. Key words: cigarette initiation, college students, social influ- ences, prevention Am J Health Behav. 2007,31{'i):3S3-362 C igarette smoking is the leading cause of preventable morbidity and mortality in the United States.' In the United States, cigarette smoking has declined to 21.6% of all adults. Lifetime cigarette use for 18- to 25-year-olds is 65%, with 39.5% using cigarettes within the past 30 days.^ There was an increase Ruth R. Staten, Associate Professor, College of Nursing and University Health Service; Melody Noiand, George and Betty Blanda Endowed Pro- fessor in Education, College of Education De- partment of Kinesiology and Health Promotion; Mary Kay Rayens, Associate Professor, College of Nursing and College of Public Health; Ellen Hahn, Professor, College of Nursing and College of Public Health; Mark Dignan, Professor, College of Medicine Department of Internal Medicine, Pre- vention Research Center, University of Kentucky, Lexington, KY. S. Lee Ridner, Assistant Profes- sor, School of Nursing, University of Louisville, Louisville, KY. Address correspondence to Dr Staten, College of Nursing and University Health Service, Uni- versity of Kentucky, Lexington, KY. E-mail: rrstatOO@uky.edu in smoking among 18- to 24-year-olds from 1999 to 2002. However, smoking in this age-group decreased from 28.5% in 2002 to 23.9% in 2003.^ College students (30.5%) smoke less than their noncoUege peers (44.5%).= Smoking among college students increased from 22% in 1993 to 28% in 1997"sto 32.9% in 1999.* In 2003, current cigarette use among college stu- dents declined to 22.5%.'' Of those who smoked, more than half had attempted to quit within the last year, and 18% had tried to quit more than 5 times within the last year.5 Although those with higher educational levels are less likely to smoke cigarettes,^"' many young adults become regular smokers after the age of 18 or after entering college.^'°''' Although most smoking college students first smoked prior to college, more than one fourth of these smokers became regular smokers after the age of 19 years.^ Little is known about prevention of smoking with college students, but fac- tors influencing initiation among middle and high school students are well docu- mented, and most smoking prevention Am J Health Behav.™ 2007;31(4):353-362 353