Background : Smoking can have a lifelong negative effect on health. Lower rates of successful smoking cessation in adulthood are associated with smoking initiation in early adolescence. Therefore, it is of utmost importance that public health programs tackle the problem of smoking initiation, rather than only focusing on smoking cessation.

Aims and Objectives: To identify factors responsible for early initiation of smoking. To identify modalities to prevent smoking at a young age.

Methods: A cross-sectional study was done among 453 smokers by enrolling consecutive cases who met the inclusion criteria from among those attending the Respiratory Medicine OPD of Pushpagiri Medical College from January to June of 2021. 

Results: All 453 study participants were males. More than 80% of the study group were above 60 years of age. 42% had higher secondary education, 20% were post-graduates and 16% came under the professional category. 60% started before completing their higher secondary, 12% after completing their higher secondary, and 12% during graduation, 3.9% of the participants started during post-graduation and 2% after starting their professional careers. 80% started due to peer pressure and 6% due to stress. The study showed that methods to prevent smoking include health education, participating in extracurricular activities and hobbies, maintaining good relationships, and having family support.

Conclusion: Cigarette smoking is known to increase the risk of many chronic diseases. Improved understanding of factors that contribute to the initiation and cessation of smoking can be used to strengthen preventive interventions and treatment strategies.