This study investigates the connectedness of adolescents’ smoking status, history of alcohol and cannabis use, and parental and peers’ smoking, dimensions only rarely explored concurrently. Multinomial regression models that compared the smoking status of adolescents were estimated based on a representative sample of 3,560 adolescents aged 14–15 from Switzerland. While 49.0% of respondents had never smoked, 9.0% smoked on a daily basis and 12.0% occasionally; 32.6% had never drank alcohol and 74.7% had never used cannabis. Overall, parental and peers’ smoking and other substance use factors are significantly associated with smoking status. Yet, history of substance use revealed less consistent associations with smoking status among current smokers (daily versus occasional smoking). The findings highlight the connectedness of adolescents’ and other substance use behaviors and support the relevance of concurrent prevention initiatives targeting adolescents with specific substance use profiles and/or growing up in prosmoking social milieus. 1. Introduction Adolescents’ smoking behavior is well documented in Switzerland [1–3]. The prevalence of smoking tobacco is comparable to the European average [4], although the age at consumption onset showed signs of decline over the last decade [3, 5]. While this observation might be in line with a slight decline of tobacco use among youth [2], it is significant as during adolescence nicotine dependence develops soon after smoking initiation and even from low levels of nicotine exposure [6–8]. Epidemiological studies have further highlighted that a consequent number of adolescents and young adults report using multiple psychoactive substances in Switzerland [9, 10]. For example, it was reported that smoking is strongly associated with alcohol consumption and to a lesser extent with cannabis use already among 15 years old [9]. Yet, the results from this latter Swiss study cover only few possible combinations of substance use patterns and do not consider factors related to adolescent smoking, such as social influences. Along with individual (e.g., other health-related behaviors, personality) and structural (e.g., purchase age restrictions, advertisement) factors, social factors, such as family and peer environment and particularly parental and peers’ smoking, appear to have a considerable influence on adolescents’ smoking behavior [11, 12]. Various theories, for example, social learning theory, primary socialization theory, social identity theory, and social network theory, provide a framework for understanding the
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