The loss of autonomy over smoking in relation to lifetime cigarette consumption

Department of Family Medicine and Community Health, University of Massachusetts Medical School, United States
Addictive behaviors (Impact Factor: 2.44). 01/2010; DOI: 10.1016/j.addbeh.2009.08.001

ABSTRACT New Zealand youth who had smoked only one cigarette had diminished autonomy over smoking. We sought to examine this issue in a US sample and examine the early onset of DSM-IV nicotine dependence. A self-administered survey was completed by 367 adolescent smokers in Massachusetts. Diminished autonomy was measured with the Hooked on Nicotine Checklist. Diminished autonomy was present in 5.7% of youth after one cigarette, in 9% after 2, in 26% after 3–4, in 44% after 5–9, in 43% after 10–19, in 67% after 20–99, and in 96% after 100 or more. DSM-IV nicotine dependence was absent in youth who had not smoked 10 cigarettes but was present in 9% after 10–19 cigarettes, in 17% after 20–99, and in 58% after 100 or more. Our data confirm the New Zealand study by showing diminished autonomy among subjects who had smoked only 1 or 2 cigarettes. Diminished autonomy after one or two cigarettes, and DSM-IV nicotine dependence after 10–19, support the sensitization-homeostasis theory of nicotine addiction that the addiction process is initiated by the first few cigarettes.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study was to measure the correlates, including normative beliefs, associated with waterpipe (WP) and cigarette smoking prevalence and dependence. A cross-sectional study was carried out using a proportionate cluster sample of Lebanese students in 17 public and private universities. Of the 4900 distributed questionnaires, 3384 (69.1%) were returned to the field worker. All available students during break times were approached, with no exclusion criteria. sociodemographic variables, detailed active and passive smoking, in addition to items of the tobacco dependence scales were all evaluated. Correlates to WP smoking were studying in a private university (adjusted OR, aOR=1.50 (1.26 to 1.79); p<0.001) and ever smoking cigarettes (aOR=1.80(1.44 to 2.26); p<0.001); friends' and societal influence were found on smoking behaviour and dependence. Although the role of parents was not visible in decreasing the risk of smoking WP, their protective influence seemed more important on WP dependence (β=-1.09(-1.79 to -0.28); p<0.001), a behaviour that is considered more deleterious for health. Parents' and friends' disagreement with smoking had a protective effect on cigarette smoking and dependence (aOR<1; p<0.01), while thinking that idols and successful people smoke increased the risk of both cigarette smoking and dependence (aOR>1; p<0.01). In conclusion, WP smoking and dependence are influenced by parents' and friends' opinions, and idols' smoking status. Future research is necessary to further improve our understanding of motives for WP smoking and dependence.
    BMJ Open 01/2014; 4(2):e004378. DOI:10.1136/bmjopen-2013-004378 · 2.06 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Given the increased rates of nondaily smoking and the lack of validated measures to assess factors related to nondaily smoking, we aimed to develop a measure of reasons for nondaily smoking among young adults. Specifically, we developed a scale assessing reasons or triggers for nondaily smoking and examined its reliability, factor structure, and concurrent validity.
    The Journal of Smoking Cessation 06/2014; 9(1):17-25. DOI:10.1017/jsc.2013.8
  • [Show abstract] [Hide abstract]
    ABSTRACT: Tobacco use and exposure are preventable causes of morbidity and mortality. Whereas the impact of this public health issue is well described in adults with kidney disease, its role in the pediatric chronic kidney disease (CKD) population is largely unknown. This review discusses the prevalence of tobacco use and exposure in children with CKD, updates the reader on how tobacco affects the kidney, and presents intervention strategies relevant to this patient population.
    Pediatric Nephrology 06/2014; 30(2). DOI:10.1007/s00467-014-2804-9 · 2.88 Impact Factor