Transitions to Regular Smoking and Nicotine Dependence in the Adolescent National Comorbidity Survey (NCS-A)
Psychology Department, Wesleyan University, Middletown, CT 06459, USA. Annals of Behavioral Medicine
(Impact Factor: 4.2).
12/2011; 43(3):394-401. DOI: 10.1007/s12160-011-9330-9
This study aims to investigate the occurrence of nicotine dependence following the achievement of previous smoking milestones (initiation, weekly, and daily smoking).
Analyses are based on data from The National Comorbidity Survey-Adolescent, a nationally representative face-to-face survey of 10,123 adolescents (age 13-17) conducted between 2001 and 2004.
Among adolescents who had ever smoked (36.0%), 40.7% reached weekly smoking levels and 32.8% had reached daily smoking. Approximately one in five adolescents who had ever smoked (19.6%) met criteria for nicotine dependence. An earlier age of smoking initiation, a shorter time since the onset of smoking and faster transitions among smoking milestones were independently associated with the onset of daily smoking and nicotine dependence.
These findings shed new light on the course of smoking and nicotine dependence during adolescence by demonstrating a rapid transition across smoking stages for those most at risk for the development of chronic and dependent use.
Available from: Pramil Singh
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ABSTRACT: Identifying determinants of intent to quit may aid the design of antitobacco programs and promote effective tobacco control policies. In a nationwide survey in Cambodia, two thirds of tobacco smokers and 45% of female smokeless tobacco users planned to stop in the future. Multivariate determinants of intent in 2279 male smokers were age <37 years, age at initiation ≥18 years, Cham versus Khmer ethnicity (odds ratio [OR] = 6.93; 95% confidence interval [CI] = 1.38-34.89), longer education, and professional occupation. In 1188 female smokeless tobacco users, age <25 years, age at initiation ≥18 years, and tuberculosis (OR = 3.26; 95% CI = 1.61-6.61) were associated with intent. In female smokers (n = 321), age 18 to 25 years at initiation was associated with intent. In male smokers and female smokeless tobacco users, perceived physical advantages of tobacco were inversely associated with intent. These findings underscore the importance of policies and interventions to delay initiation and promote cessation in young people and counteract perceived physical benefits.
Asia-Pacific Journal of Public Health 08/2012; 25(S5). DOI:10.1177/1010539512454164 · 1.46 Impact Factor
Available from: Chuan-Yu Chen
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Prior studies examining the connection between disposable income and adolescent smoking often yielded mixed results, partly due to the lack of consideration for contextual variables. In the present study, we sought to broaden understanding of disposable income on adolescent smoking behaviors via both absolute and relative perspectives in the school context.
We obtained data from the 2010 Global Youth Tobacco Survey (GYTS) in Taiwan. Information concerning sociodemographics, disposable income, smoking history, and contextual smoking exposure (e.g., school) were assessed via self-report. Recent-onset smokers were defined as those who had their first cigarette within two years of the survey. Complex survey and multilevel analyses were carried out to estimate association.
Adolescents with higher monthly disposable income were 2∼5 times more likely to start smoking and become regular smokers. Having the least disposable income in a class appeared linked with increased risk of tobacco initiation by 40% (95% confidence interval [CI]: 2%-91%). Pupils' odds to start smoking were lowered to .70 when the majority of schoolmates had low disposable income (95% CI: .51-.99).
Adolescent risk of smoking initiation may be differentially affected by individual- and contextual-level absolute and relative disposable income. Future research is needed to delineate possible mechanisms underlying unfavorable health behaviors associated with disposable incomes in early adolescence.
Journal of Adolescent Health 03/2013; 52(6). DOI:10.1016/j.jadohealth.2012.12.009 · 3.61 Impact Factor
Available from: Daniel W Belsky
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ABSTRACT: IMPORTANCE Genome-wide hypothesis-free discovery methods have identified loci that are associated with heavy smoking in adulthood. Research is needed to understand developmental processes that link newly discovered genetic risks with adult heavy smoking. OBJECTIVE To test how genetic risks discovered in genome-wide association studies of adult smoking influence the developmental progression of smoking behavior from initiation through conversion to daily smoking, progression to heavy smoking, nicotine dependence, and struggles with cessation. DESIGN A 38-year, prospective, longitudinal study of a representative birth cohort. SETTING The Dunedin Multidisciplinary Health and Development Study of New Zealand. PARTICIPANTS The study included 1037 male and female participants. EXPOSURE We assessed genetic risk with a multilocus genetic risk score. The genetic risk score was composed of single-nucleotide polymorphisms identified in 3 meta-analyses of genome-wide association studies of smoking quantity phenotypes. MAIN OUTCOMES AND MEASURES Smoking initiation, conversion to daily smoking, progression to heavy smoking, nicotine dependence (Fagerström Test of Nicotine Dependence), and cessation difficulties were evaluated at 8 assessments spanning the ages of 11 to 38 years. RESULTS Genetic risk score was unrelated to smoking initiation. However, individuals at higher genetic risk were more likely to convert to daily smoking as teenagers, progressed more rapidly from smoking initiation to heavy smoking, persisted longer in smoking heavily, developed nicotine dependence more frequently, were more reliant on smoking to cope with stress, and were more likely to fail in their cessation attempts. Further analysis revealed that 2 adolescent developmental phenotypes-early conversion to daily smoking and rapid progression to heavy smoking-mediated associations between the genetic risk score and mature phenotypes of persistent heavy smoking, nicotine dependence, and cessation failure. The genetic risk score predicted smoking risk over and above family history. CONCLUSIONS AND RELEVANCE Initiatives that disrupt the developmental progression of smoking behavior among adolescents may mitigate genetic risks for developing adult smoking problems. Future genetic research may maximize discovery potential by focusing on smoking behavior soon after smoking initiation and by studying young smokers.
JAMA Psychiatry 03/2013; DOI:10.1001/jamapsychiatry.2013.736 · 12.01 Impact Factor
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