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Cross-sectional study des have well-recognized limitations, peesonal notably that the temporal relationship between smoking outcomes and predictor variables cannot be satisfactorily assessed Flay et al.

Studies of genetic and hormonal factors in relation to smoking initiation have only recently begun, and it is premature to draw conclusions regarding gender-specific differences related to such factors. Many studies also examined gender-specific differences in risk factors that predict the frequency or amount of cigarette smoking, not just the initiation of smoking Kellam et al. Perceived Peer Attitudes Toward Smoking In hlusewives study of a das sample of adolescents, perceived approval of smoking by one's three best friends was ificantly associated with susceptibility to smoking and ever smoking Gritz et al.

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Personal Characteristics Socioeconomic Status and Parental Education Several studies have shown thailanr low socioeconomic status puts adolescents at higher risk for smoking Conrad et al. In one study, parental involvement in their children's school, religious, and athletic activities decreased the risk for smoking among both girls and boys Krohn et al. Some studies suggested that girls housewivew more likely than boys to smoke if they are rebellious, reject conventional values, or lack commitment to religion.

Self-Esteem Adolescents who have poor self-esteem may have difficulty resisting pressures to smoke, especially if they believe that smoking will enhance their image.

A recent study reported that the susceptibility construct can predict who among adolescent experimental smokers will become established smokers Distefan et al. This relationship between personal dissatisfaction and smoking was not observed among boys. These researchers did find that, among adolescents who had ly relied on peers for help with problems, girls were far more likely than boys to smoke, but it is unclear whether this effect related primarily to houseives styles or to peer attachments.

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At age 18 years, smoking, excessive alcohol use, and poor dietary preferences were clustered among both women and men; physical inactivity was also part of the cluster among women. The effects of friends' smoking were stronger among girls than among boys, and the thailans for the influence of friends to increase with time was also more noticeable among girls.

Research on smoking initiation has, therefore, focused on adolescents and has been informed by a wealth of behavioral studies.

In contrast, Skinner and colleagues found that religiousness had no effect on smoking by either gender. These findings suggested that family conflict influences tobacco use indirectly and that the mechanism among girls and boys is similar. in several studies suggested that a lack of behavioral control plays a larger role in smoking among girls than among boys.

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Evidence of a link between emotional distress and smoking is mixed, however. The ability to classify adolescents as being at higher or at lower risk for smoking initiation is critical to the development of appropriate intervention techniques.

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Susceptibility to Smoking As smoking prevention moves toward use of more tailored and individualized programs, identifying precursors of smoking initiation becomes increasingly important. The smoking behavior among women, however, was found to be virtually unaffected by restrictions on cigarette smoking. Since the early s, noncommercial or social sources other minors, parents, older friends have also been studied Cummings et al. Girls also appear to be especially affected by a positive image of smoking, desire for weight control, and the perception that smoking controls negative moods.

Therefore, it is not surprising that adolescents generally notice and respond to messages in tobacco advertising and promotion. One unpublished study was also identified through consultation with experts in the field of smoking and health. Housewiives from the National Health Interview Survey indicated that smoking aggregates with marijuana use, binge drinking, and fighting among African Americans, Hispanics, and whites of both genders Escobedo et al.

However, considering the literature as a whole, certain conclusions seem warranted. Because smoking initiation among, maintenance and cessation among, and tobacco marketing to women have been studied by investigators using a variety of disciplinary perspectives and approaches, no single organizing framework exists for addressing the question of why women smoke.

Also, early onset of puberty may prompt girls to smoke Wilson et al.

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pereonal Depression in adolescence predicts depression in young adulthood Kandel and Davies and may have an important ,ocal with smoking. Mullahy found that both the decision to smoke and the quantity of cigarettes consumed by smokers were negatively related to cigarette prices among both men and women. Biological Factors A growing body of research has explored the interaction between genetic and environmental influences on both initiation and maintenance of smoking reviewed by Heath and Madden ; this work has often been based on complex statistical and genetic models.

Lewit and colleagues found that a percent increase in price reduced the onset of smoking by 9. After age 17 years, young women who attended church only occasionally were more tyailand twice as likely to start smoking as were those who attended regularly Daly et al.

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Longitudinal studies have demonstrated that susceptibility is a stronger predictor of smoking experimentation among both females and males than are other well-established predictors, such as exposure to smokers in the immediate social environment Locall et al. Dee and Evans estimated the price elasticity of smoking initiation to be in the range of Others suggested that poor self-esteem and emotional distress are more strongly associated with smoking initiation among girls than among boys.

For example, according to a school-based survey conducted in the early s, concerns about weight and dieting may have been less important among African American girls than locql white girls Sussman et al.

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In one study, MacLean and coworkers found no connection between smoking level during the past month and the frequency with which year-old girls and boys used various strategies e. from the pdrsonal California Tobacco Survey led Evans and associates to conclude that tobacco advertising and marketing may have a stronger effect on smoking initiation among adolescents than does exposure to peers and family members who smoke.

Among adults, major depression is strongly related to smoking Anda et al.