Transitions to regular smoking and nicotine dependence in the Adolescent National Comorbidity Survey (NCS-A).
ABSTRACT 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.
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ABSTRACT: AimsTo examine the interrelationships between cigarette consumption and DSM-IV nicotine dependence (ND) criteria from smoking onset in adolescence up to seven years later, adjusting for alcohol consumption and DSM-IV alcohol dependence (AD) criteria.DesignA cohort drawn from grades 6-10 in an urban school system was interviewed five times at 6-month intervals (Waves 1-5) and 4.5 years later (Wave 6). A parent was interviewed three times.SettingChicago, Illinois.ParticipantsRecent smokers (n=409).MeasurementsStructured household interviews ascertained number of cigarettes smoked, DSM-IV ND symptoms, drinks consumed, DSM-IV AD symptoms, and selected covariates.AnalysisReciprocal prospective associations between number of cigarettes smoked and ND criteria, controlling for time-varying alcohol consumption and dependence criteria, were examined with cross-lagged models.FindingsReciprocal associations between number of cigarettes smoked and ND criteria were both significant. Cigarette consumption had stronger associations with later ND (β=0.25, 95% CI=0.17-0.32) than dependence had with later cigarette consumption (β=0.09, 95% CI=0.01-0.16). Alcohol and cigarette consumption influenced each other; AD scores were associated with later ND scores but not the reverse. Reports of pleasant initial experiences from smoking were positively associated with cigarette consumption and ND the first year after smoking onset; later smoking onset was negatively associated with cigarette consumption the seventh year after onset; parental ND predicted cigarette consumption and ND throughout.Conclusions In adolescent smokers, higher cigarette consumption predicts later severity of DSM-IV nicotine dependence more than the reverse. Smoking and drinking also influence each other mutually over time.Addiction 05/2014; 109(9). DOI:10.1111/add.12619 · 4.60 Impact Factor
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ABSTRACT: To better inform the development of smoking cessation programs for adolescents and young adults, a prospective study was employed to systematically examine behavioral, demographic, health, and psychosocial determinants of smoking cessation. Data from the 2003-2005 National Youth Smoking Cessation Survey were used. Of 2,582 smokers (16-24 years) sampled, 1,354 provided complete baseline telephone interview data on the study variables, and their self-reported smoking status at 2-year follow-up was known (currently smoking vs. not smoking). Multivariable logistic regression analysis was employed to examine independent predictors of smoking status (outcome variable) at the 2-year follow-up period. Four of 5 participants remained smokers after 2 years. Of high nicotine dependence smokers, 90% remained smokers at follow-up; of low nicotine dependence smokers, 77% remained smokers at follow-up. Higher nicotine dependence smokers started smoking earlier in life (13.2 vs. 14.3 years; p < .05). Similarly, those not smoking at the 2-year follow-up period started smoking later in life than those still smoking (14.5 vs. 13.7 years). Along with nicotine dependence, various psychosocial and demographic variables at baseline predicted smoking status at the 2-year follow-up period. Identifiable demographic and psychosocial factors influence smoking behavior among U.S. adolescents and young adults. Even low nicotine dependence is a strong predictor of follow-up smoking behavior. This, coupled with the early smoking age of high nicotine dependence smokers, underscores the importance of early nicotine avoidance among youth.Nicotine & Tobacco Research 02/2014; 16(6). DOI:10.1093/ntr/ntu005 · 2.81 Impact Factor
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ABSTRACT: Smoking is a leading cause of mortality and morbidity worldwide. Smoking initiation often occurs during adolescence. This paper reviews and synthesizes adolescent development and nicotine dependence literatures to provide an account of adolescent smoking from onset to compulsive use. We extend neurobiological models of adolescent risk-taking, that focus on the interplay between incentive processing and cognitive control brain systems, through incorporating psychosocial and contextual factors specific to smoking, to suggest that adolescents are more vulnerable than adults to cigarette use generally, but that individual differences exist placing some adolescents at increased risk for smoking. Upon smoking, adolescents are more likely to continue smoking due to the increased positive effects induced by nicotine during this period. Continued use during adolescence, may be best understood as reflecting drug-related changes to neural systems underlying incentive processing and cognitive control, resulting in decision-making that is biased towards continued smoking. Persistent changes following nicotine exposure that may underlie continued dependence are described. We highlight ways that interventions may benefit from a consideration of cognitive-neuroscience findings.Neuroscience & Biobehavioral Reviews 09/2014; 45. DOI:10.1016/j.neubiorev.2014.07.003 · 10.28 Impact Factor