预防青少年吸烟对实现无烟一代至关重要。本研究旨在使用《千禧队列研究》的数据评估晚期青少年吸烟和从早期到晚期青少年吸烟增加的风险因素。我们还使用英国国家统计局2018-19年的人口数据提供了吸烟人数和吸烟增加的预估数据。分析对象为14-17岁的青少年。我们使用不同的逻辑回归模型，评估17岁时的年龄、性别、种族、家庭收入、居住国家、看护者吸烟、同伴吸烟和社交媒体使用情况与17岁时的定期吸烟(定义为每周至少吸一支香烟)以及14-17岁之间的吸烟增加(定义为14岁时从未吸烟，17岁时变成定期吸烟者)之间的关联。本研究包括了可获得吸烟数据的8944名14-17岁的青少年，其中948人(10.6%)在17岁时是定期烟草吸食者。在这948人中，有488人(51.5%)在14岁到17岁之间开始吸烟。在不吸烟的14岁青少年中，报告看护者吸烟的青少年(1188人中的162人[13.6%]与非吸烟看护者的6538人中的324人[5.0%];p<0.0001)、同伴吸烟的青少年(1764人中的223人[12.6%]与没有吸烟同伴的5350人中的229人[4.3%];p<0.0001)和报告社交媒体使用更高(每周至少5个小时)的青少年(1176人中的115人[9.8%]与社交媒体使用时间更少(每周不到1个小时)的2947人中的120人[4.1%];p=0.0059)中，吸烟增加更为普遍。我们估计有164313名(95%CI 146815-181811)青少年在17岁时为定期吸烟者，其中101715人(85994-117435)在14岁到17岁之间开始吸烟。我们的研究结果提醒人们吸烟流行病的传染性。虽然我们仅评估了社交媒体使用而非在线烟草广告的实际曝光，但我们的研究结果加强了对烟草广告不断变化的认识。该研究由英国癌症研究基金会(资助编号：PPRCTAGPJT\100005)和英国国家卫生与护理研究学院公共卫生研究学校支持。资助机构在撰写稿件和提交出版物的决定中没有任何角色。

Preventing smoking uptake among adolescents is essential to achieve a smoke-free generation. The aim of this study was to assess risk factors for smoking in late adolescence and smoking uptake between early and late adolescence, using data from the Millennium Cohort Study. We also present estimates of numbers of smokers and smoking uptake.Adolescents aged 14-17 years were included in the analysis. In separate logistic regression models, we assessed associations between age, sex, ethnicity, household income, country of residence, current smoking of a caregiver, current smoking of peers and use of social media, and regular smoking (defined as smoking at least one cigarette per week) at the age of 17 years and smoking uptake between the ages of 14 and 17 years (defined as being a never-smoker at the age of 14 years and a regular smoker at the age of 17 years). We also estimated numbers of regular smoking and smoking uptake using the Office for National Statistics 2018-19 population estimates.Data from 8944 adolescents aged 14-17 years with smoking data available were included, 948 (10·6%) of which were regular tobacco smokers at the age of 17 years. 488 (51·5%) of these 948 started smoking between the ages of 14 years and 17 years. Smoking uptake was more common among adolescents reporting caregiver smoking (162 [13·6%] of 1188 vs 324 [5·0%] of 6538 with non-smoking caregivers; p<0·0001); peers smoking (223 [12·6%] of 1764 vs 229 [4·3%] of 5350 without smoking peers; p<0·0001), and those reporting higher (at least 5 h/weekday) social media use (115 [9·8%] of 1176 vs 120 [4·1%] of 2947 with lower [less than 1 h/weekday] social media use; p=0·0059), among 7786 adolescents who did not smoke at age 14. We estimated that 164 313 (95% CI 146 815-181 811) adolescents were regular smokers by the age of 17 years, of whom 101 715 (85 994-117 435) took up the habit between the age of 14 years and 17 years.Our findings are a reminder of the transmissibility of the smoking epidemic. Although we only assessed social media use, not actual exposure to online tobacco advertising, our findings strengthen calls for awareness of the changing landscape of tobacco advertising.Cancer Research UK (grant reference PPRCTAGPJT\100005) and the UK National Institute for Health and Care Research School for Public Health Research. The funders had no role in the writing of the manuscript or the decision to submit for publication.Copyright © 2022 Elsevier Ltd. All rights reserved.