Sensation-seeking predicts initiation of daily smoking behavior among American Indian high school students

PurposeAmerican Indian (AI) youth have a high risk of smoking initiation. Sensation-seeking, defined as the tendency to seek novel and thrilling experiences, has been associated with smoking initiation in other groups but has never been examined in AI youth.MethodsData were from the Voices of Indian Teens Project (VOICES), a longitudinal study of AI youth from seven high schools in four AI communities in the western United States. Participants completed annual surveys in school over a three-year period. Our sample comprised 764 students who were non-smokers at baseline. Smoking initiation was defined as endorsement of daily smoking after baseline. We used binary logistic regression to evaluate the association of baseline sensation-seeking with odds of daily smoking initiation, stratified by gender.ResultsParticipants were 353 males and 411 females aged 13 to 21 years at baseline. After adjusting for covariates, baseline sensation-seeking correlated with smoking initiation differently in males and females. Sensation-seeking did not predict daily smoking in males. Among females, however, higher sensation-seeking scores at baseline predicted daily smoking in both the unadjusted (odds ratio = 1.4; 95% CI = 1.1–1.8; p = 0.005) and covariate-adjusted (odds ratio = 1.3; 95% CI = 1.0–1.6; p = 0.04) models.ConclusionGender-specific prevention programs may be warranted in addressing different risk-factor profiles in this high-risk population.

► Cigarette smoking is a major public health concern for Native communities.
► Sensation-seeking is a risk factor for daily smoking initiation in females.
► Gender-specific prevention programs may be necessary.