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Subst Use Misuse. 2004 Jan;39(2):225-52.

Development and longitudinal test of an instrument to measure behavioral stages of smoking initiation.

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  • 1Department of Health Education and Health Promotion, Universiteit Maastricht, Maastricht, The Netherlands.


A dearth of longitudinal research has been observed regarding the measurement of the behavioral process of adolescent smoking initiation. The present study operationalizes the leading model on the process of smoking initiation, including two stages of nonpersistent smoking behavior that were previously unlabelled. An instrument was developed that distinguished six distinct stages of smoking initiation (i.e., never smoker, trier, experimenter, regular smoker, nonsmoking decider, and quitter). Data were gathered longitudinally in 1998 and 1999. The results indicated the applicability of the instrument in a large cross-cultural population of early European adolescents from Finland, Denmark, the United Kingdom, The Netherlands, Spain, and Portugal (n = 7899). Stage transitions had taken place in the expected sequence and progression to daily smoking at 12 months follow-up was successfully predicted. The theory-driven assessment of the process of adolescent smoking initiation may contribute to the development of a generally accepted measure of adolescent smoking initiation.

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