Special Feature: Adolescents With Jobs Are More Likely to Begin Smoking
Despite decreasing rates of cigarette use in the U.S., ensuring that adolescents do not start smoking remains a vital goal of any national tobacco control program. Therefore, research that seeks to understand when and why youth begin smoking is critical to developing effective antismoking strategies.
Evidence is mounting that something happens when youth start working that compels them to smoke. For instance, in South Korea, when adolescents start working at part-time jobs, their risk of starting to smoke increases by four percent. RAND's Rajeev Ramchand found similar results in Baltimore, where youth who began working had a nine-fold increased risk of starting to smoke relative to their unemployed peers.
With these trends in mind, it's worth exploring potential strategies to prevent smoking among youth who enter the workforce.
Would restricting employment opportunities for youth be a feasible response?
No. Youth work to make money, and industries that employ youth, like fast food restaurants, rely on an adolescent workforce. For example, in both the U.S. and South Korea, approximately one-quarter of all school-attending youth work in part-time jobs during the school year.
What about prevention strategies?
A comprehensive prevention initiative that targets youth entering the workforce could be a viable option. Specific strategies used to target young workers will need to be based on research that examines the reasons why youth start smoking when they start working. Possible strategies include:
- increasing the price of cigarettes
- ensuring smoke-free work environments for youth
- restricting marketing of tobacco products and promoting antismoking messages
- implementing educational curricula
What about increasing the price of cigarettes?
If researchers find evidence to support the “income hypothesis” that youth who work have the means to purchase cigarettes, aggressive strategies to increase the price of cigarettes may be recommended. However, researchers have found that having a job—not necessarily making money from that job—is associated with increased smoking, meaning there is little evidence to support the income hypothesis or this particular strategy.
If it's not the additional income that causes youth with jobs to start smoking, what are some other possible explanations?
There are many factors that might increase smoking initiation among young workers. First, youth more likely to take up part-time jobs might be independently more likely to start smoking. Other possible explanations are that these youth have increased opportunities to use cigarettes provided by older coworkers, or may turn to smoking to cope with the increased stress brought on by having a job, or managing responsibilities at home, school, and work.
What if youth worked in smoke-free environments?
There is significant evidence that ensuring that young people are working in smoke-free environments may be effective. Although such regulations are designed to limit nonsmokers' exposure to second-hand smoke, studies have found that such policies are correlated with increased rates of smoking cessation and reduced cigarette use among adult employees. If enacted in workplaces that employ youth, these policies might similarly prevent young people from starting to smoke.
What about educational programming?
It is important to provide youth with the information and tools they need to choose not to smoke when the opportunity presents itself. Research demonstrates that providing youth with education about the harms associated with smoking, strategies to increase their ability to resist opportunities to use tobacco, and correcting their beliefs about social norms can decrease smoking initiation.
It may also be effective to engage their reasons for working in the first place; for example, by teaching them ways to use or save their earnings for delayed gratification, rather than attaining the immediate rewards offered by smoking. Workplaces that hire youth may be an appropriate setting for such interventions.
What challenges remain?
Although smoking cessation programs for adults delivered in workplace settings are effective, the first study of similar efforts targeting young American workers showed that irregular schedules and high turnover resulted in low levels of participation. An additional challenge will be gaining the cooperation of employers, who are unlikely to experience large direct consequences to their business resulting from the smoking behaviors of their young employees. Finally, it is important to both test the strategies we know to be effective and to develop innovative approaches for this specific setting. These challenges are surmountable and are critical to overcome if we are to continue to curb tobacco use among young populations.