NEW YORK (Reuters Health) - Middle-school students who have a best friend, parent or sibling who smokes are more likely to have tried cigarettes, researchers report.

Their study of more than 3,600 students from four geographic regions in the US found that having a best friend who smoked was the strongest influence on whether an eighth-grade student reported smoking at any time. Students who had a smoking best friend were more than 6 times more likely than other students to have ever smoked and more than 12 times as likely to have smoked in the past week.

And eighth-grade students with a family member who smoked were more than twice as likely to smoke than their peers living in non-smoking homes, according to the report in a recent issue of the Journal of School Health.

The results show that an adolescent's social environment influences the likelihood of smoking cigarettes, a major risk factor for heart disease and several cancers, and suggest interventions that might prevent kids from initiating smoking, the authors note.

"Middle school represents a time and place of vulnerability for children: therefore, advocacy for no-tobacco policies for all children and adults on middle school property or attending school functions needs to be continued," according to Dr. Carolyn C. Johnson from Tulane University in New Orleans, Louisiana, and colleagues.

Additionally, "professionals need to reach parents with stronger education efforts focused on the probability of their children using tobacco when easily accessible in the home," they write.

Their study also found that 44% of all eighth-grade students had tried cigarettes and about 20% said they had smoked cigarettes in the past 30 days. About 7% reported smoking daily, and whites and Latino students were more likely to smoke than black students.

While previous research has shown that whites tend to have higher smoking rates than other groups, the current study suggests that anti-smoking programs should also target the Latino community.

In general, students who had decided not to smoke in the fifth grade were less likely to smoke by the eighth grade than children who said they were not sure whether they would try cigarettes. Therefore, anti-smoking programs should address younger children's intentions to smoke, Johnson and colleagues suggest.

SOURCE: Journal of School Health 2002;72:58-64.

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