The study led by Phyllis Ellickson, Ph.D., at the RAND Corporation in Santa Monica, Calif found that having peers who smoke was a strong risk factor for becoming a regular smoker.
"We were struck by the degree to which early smoking appeared to indicate that kids were on the fast track toward a troubled adolescence," said Ellickson.
"We wanted to find out what factors in early and later adolescence might help these high-risk kids avoid negative consequences," he added.
At-risk teens were two or more times likely than low-risk teens - those who hadn't tried smoking by seventh grade - to have peers who smoke and five times more likely to have had two or more problems in school.
"At grade seven, problems in school included being sent out of the classroom more than once, skipping school multiple times and absenteeism," Ellickson said.
The study found that by the end of high school, 36 percent of early smokers were smoking regularly and 58 percent had engaged in two or more problem behaviours, including binge drinking, abusing and selling drugs and dropping out of school, according to the study.
It also showed that teens who had not tried smoking by seventh grade were 1.5 times more likely to be those who had good grades and lived in an intact family.
In other words, good grades and living in an intact nuclear family helped protect early smokers against these negative outcomes.
Jeanie Alter, program manager and lead evaluator of the Indiana Prevention Resource Centre at Indiana University's School or Health, Physical Education and Recreation, agreed that prevention programs can benefit teens at risk and stressed that the parents' role is key.
"Clearly, peers are an influential factor in the lives of young people, particularly as they progress through adolescence," she said.
"However, it is critical to acknowledge the significant and sustained influence of parents. Though difficult to implement, program planners simply must involve parents and increase their disapproval of drug use," she added.
The study appears in the October issue of the Journal of Adolescent Health.