This is the conclusion of the team of Dr. Jennifer O’Loughlin, who published the results of their study in American Journal of Epidemiology.

O’Loughlin, of the University of Montreal, Quebec, suggests that efforts to prevent smoking should take into account “the individual factors such as age, self-esteem, alcohol use and school performance.”

They should also be considered “contextual factors such as parental smoking and friends, and school smoking policies,” the expert told Reuters Health.

The team investigated how these factors modify the onset smoking in 877 students (half male) who had 13 years at baseline.

Over the next five years, the team interviewed every three months to students on the consumption of snuff and other factors potentially associated with smoking initiation. During this period, 421 (48 percent) began smoking, 87 of them (21 percent), daily.

Living in a single parent and poor school performance has increased the risk of starting to smoke. Drinking alcohol tripled the risk.

Having brothers and friends who smoke increased two to three times the risk of teens smoking. If the parent, teachers and school staff smoked, the risk of starting smoking was multiplied by 50 percent or more.

Feeling the urge to smoke a cigarette rose six times the risk. Adolescents who felt stressed, acting impulsively and were susceptible to snuff advertising were also more likely to start smoking.

In contrast, gender, parental education, the feeling of depression, concerns about weight or overweight, the pursuit of new sensations, exercise and sports, and watching TV were among the factors that were not associated with increased risk of starting to smoke.

Prevention programs and smoking cessation-oriented social snuff consumption in the home and school, as well as advertising on snuff would have a positive effect on adolescent cigarette smoking, summarizes O’Loughlin.

The authors suggest that more research is needed on factors associated with alcohol consumption and smoking, and genetic variables associated with the risk of starting to smoke.