The first smoking experiences of Asian American adolescents parallel that of smoking cessation when individuals lapse in a highly tempting situation and when the environment is permissive to smoking. This study is the first to use reversal theory pairs as a framework for smoking initiation. Smoking prevention and intervention programs should consider the importance of the physical, social environment, and the psychological states of adolescents when they smoke the first time.

Asian American adolescents initiate smoking later than other groups. Depressive symptoms were at high levels in the sample and were correlated with smoking. Thus, for Asian American adolescents, smoking prevention programs should be extended to later grades, with particular attention to low-performing students and those who are more acculturated. Likewise, programs that identify and assist adolescents with depressive symptoms may be useful in smoking prevention.

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