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Patient Educ Couns. 2004 Dec;55(3):345-52.

Unplanned smoking initiation: new insights and implications for interventions.

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  • 1Department of Health Education and Health Promotion, Universiteit Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands.


Despite intensive efforts, most smoking prevention interventions have had disappointing results. In the present paper, the assumption underlying these efforts that smoking initiation is the result of a rational decision or plan, is questioned. The process of adolescent smoking initiation is described, based on a recently conducted series of studies. It is argued that smoking initiation among adolescents is unplanned behaviour. Therefore, interventions regarding smoking initiation should not only include a focus on smoking-specific cognitions. Models that incorporate both conscious and unconscious processes need to be used in mapping smoking prevention efforts. Further, programmes that help adolescents to quit smoking need more attention. Finally, it is argued that smoking prevention interventions should aim at influencing the image of nonsmoking by using mass media interventions and restrictive policies.

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