Due to the addictive nature of nicotine, adolescents who experiment with smoking are at high risk to develop a regular smoking pattern and to continue smoking in adulthood. This thesis examined the factors contributing to smoking inititation among adolescents. The method employed in this study was a systematic literature review. The purpose of this study was to identify factors contributing to adolescent smoking initiation. The aim of the thesis is to produce an evidence based information that will published on Turku University of Applied Sciences’ Hoitonetti. Six articles were systematically selected to answer the research question. The study found the influence of smoking friends, smoking siblings and family influences, adolescents’ sense of wellbeing and poor ego development to be strong contributing factors to adolescent smoking initiation. The study also found that adolescents with psychological problems have a high chance of initiating smoking. Some risk groups were identified in the study. These include adolescents with low self esteem, those who performed badly in school, those with weight concerns, those who spend a lot of time on television, popular students in schools with high smoking rates, those with tattoos, and adolescents in their last grades in school. Smoking prevention programs should aim at identifying risk groups and finding measures to protect vulnerable groups from initiation. The study recommends counseling adolescents on the dangers of keeping bad company. Programs should aim at helping adolescents gain emotional control so as to enable them resist pressures from peers. Also since adolescents learn by imitation, older siblings and family members should be educated on the dangers of smoking in the presence of adolescents and also about leaving cigarettes at the disposal of adolescents. The study recommends supporting adolescents on ways of dealing with stress so that they don’t turn to cigarettes. Also preventive measures should also aim at ego development.