Background:
Mizoram have the highest tobacco prevalence in India with half of the population using some forms of tobacco. GATS 2009-2010 report 67.2% of people in Mizoram use tobacco. In this century, nations have experienced an epidemic of diseases that are caused, either primarily or partly, by tobacco use. The success of tobacco control lies in prevention and cessation of tobacco use and identifying predictors have continued to prove most essential in countering initiation or maintenance. Socio-economic status have been found to play a major role in tobacco use. The aim of the study is to identify and compare predictors of adolescent smoking initiation and persistence among High, Middle and Low socio-economic status adolescents.

Methods:
300 adolescents were randomly sampled from Aizawl. Family, youth, peer and sociodemographic risk and protective factors were analyzed using SPSS package.

Results:
Low SES adolescents reported the highest rates of smoking initiation and persistence; Middle SES adolescents scored the lowest. Multivariate analyses revealed mostly common and few SES-specific predictors of smoking initiation and persistence. For initiation, maternal current smoking, child age, child problem behavior, and perceived peer pressure to smoke have greatest prediction in low SES groups followed by middle and high SES group; ineffective parenting were predictive among all SES groups. For persistence, child age, child problem behavior and perceived scholastic competence were predictive across all SES groups as well.

Conclusions:
More common than unique factors predict smoking initiation and persistence among adolescents of different socio-economic status. Social factors are more important for smoking initiation, whereas individual factors are more important for persistence, although child problem behaviors are common determinants both of initiation and persistence. With few exceptions, universal anti-smoking interventions should be targeted to youths of different socio-economic backgrounds. Intervention programs should target the social environment of the youth in order to have the most profound effect.