(HealthScoutNews) -- Teens start smoking for a lot of reasons, but one of the biggest influences on whether they become regular smokers is their friends, concludes a new study.

Kids who had at least three friends who were regular smokers were 24 times more likely to become regular smokers themselves, according to the study, which is published in the current issue of the Journal of Consulting and Clinical Psychology.

"This study confirms what most parents already knew -- if you're around kids who are a bad influence, you pick [their habits] up," says child psychologist Alan Hilfer from Maimonides Medical Center in New York City. "Smoking has always been an attempt to look cool and more sophisticated to your peers," he adds. Hilfer was not involved in the study.

Past research has indicated that almost 35 percent of high school students smoke at least one cigarette a month, and that nearly one quarter smoke every day, according to the study.

The researchers, from Brown University Medical School, interviewed almost 21,000 teen-agers in seventh through 12th grades two times. The teens were classified as "never smokers," "experimental smokers," "intermittent smokers" and "regular smokers." Experimental smokers said they hadn't had a cigarette in the past 30 days, but didn't disapprove of smoking. Intermittent smokers had smoked between one and 29 out of the previous 30 days, and regular smokers reported smoking on a daily basis.

Having friends who smoked was far and away the biggest risk factor for the progression of teen smoking from experimental to intermittent or regular smoking. Other important factors were alcohol use, parental smoking, depression and feeling alienated from school.

Teens who drank alcohol more than twice a month were nine times more likely to start smoking than abstinent kids. Teens with fathers who smoked had a 26 percent higher risk of becoming smokers themselves. Interestingly, maternal smoking only seemed to have an effect on daughters, increasing their risk of smoking by 36 percent.

Several factors emerged as protective against smoking. Kids from close families were 9 percent less likely to smoke. Another protective factor was being African-American, Hispanic or Asian.

The authors say that by knowing which kids are most at risk, prevention efforts can be better targeted to the kids who need it most.

"Parents have to know their kids and monitor this stuff," says Hilfer. He says parents need to know who their kids' friends are and they need to talk to the other parents as well.

If parents see any signs of their teen smoking, they need to "make an attempt to help kids stop smoking before it becomes too pernicious a habit," he adds.

What To Do

For more information on what makes teens more likely to smoke, go to Kid'sHealth.org. Or you might want to have your teen read this article, also from Kid's Health, that talks directly to teens about the realities of smoking. The U.S. Centers for Disease Control and Prevention also offers information for parents and kids on preventing smoking.

Reference Source 101

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