• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (85)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Pediatrics  • Adolescent Medicine  • Public Health  • Tobacco  • Alert me on articles by topic  Social Bookmarking   What's this?

The Development and Assessment of Nicotine Dependence in Youth–2 Study

Joseph R. DiFranza, MD; Judith A. Savageau, MPH; Kenneth Fletcher, PhD; Jennifer O’Loughlin, PhD; Lori Pbert, PhD; Judith K. Ockene, PhD; Ann D. McNeill, PhD; Jennifer Hazelton, BA; Karen Friedman, BA; Gretchen Dussault, BA; Connie Wood, MSW; Robert J. Wellman, PhD

Arch Pediatr Adolesc Med. 2007;161(7):704-710.

Objective  To extend the findings of the first Development and Assessment of Nicotine Dependence in Youth study by using diagnostic criteria for tobacco dependence and a biochemical measure of nicotine intake. The first study found that symptoms of dependence commonly appeared soon after the onset of intermittent smoking.

Design  A 4-year prospective study.

Setting  Public schools in 6 Massachusetts communities.

Participants  A cohort of 1246 sixth-grade students.

Interventions  Eleven interviews.

Main Outcome Measures  Loss of autonomy over tobacco as measured by the Hooked on Nicotine Checklist, and tobacco dependence as defined in International Classification of Diseases, 10th Revision (ICD-10).

Results  Among the 217 inhalers, 127 lost autonomy over their tobacco use, 10% having done so within 2 days and 25% having done so within 30 days of first inhaling from a cigarette; half had lost autonomy by the time they were smoking 7 cigarettes per month. Among the 83 inhalers who developed ICD-10–defined dependence, half had done so by the time they were smoking 46 cigarettes per month. At the interview following the onset of ICD-10–defined dependence, the median salivary cotinine concentration of current smokers was 5.35 ng/mL, a level that falls well below the cutoff used to distinguish active from passive smokers.

Conclusions  The most susceptible youths lose autonomy over tobacco within a day or 2 of first inhaling from a cigarette. The appearance of tobacco withdrawal symptoms and failed attempts at cessation can precede daily smoking; ICD-10–defined dependence can precede daily smoking and typically appears before consumption reaches 2 cigarettes per day.

Author Affiliations: University of Massachusetts Medical School, Worcester (Drs DiFranza, Fletcher, Pbert, Ockene, and Wellman, and Mss Hazelton, Savageau, Friedman, Dussault, and Wood); McGill University, Montreal, Montreal, Canada (Dr O’Loughlin); St George's Hospital Medical School, University of London, London, England (Dr McNeill); and Fitchburg State College, Fitchburg, Massachusetts (Dr Wellman).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Examining Hookah Smoking Among a Cohort of Adolescent Ever Smokers
Sterling and Mermelstein
Nicotine Tob Res 2011;13:1202-1209.
ABSTRACT | FULL TEXT  

Suicidal Behavior, Smoking, and Familial Vulnerability
Scherrer et al.
Nicotine Tob Res 2011;0:ntr230v1-ntr230.
ABSTRACT | FULL TEXT  

Exposure to smoking in films and own smoking among Scottish adolescents: a cross-sectional study
Hunt et al.
Thorax 2011;66:866-874.
ABSTRACT | FULL TEXT  

Colloquium Paper: Markov model of smoking cessation
Killeen
Proc. Natl. Acad. Sci. USA 2011;108:15549-15556.
ABSTRACT | FULL TEXT  

A systematic review of longitudinal population-based studies on the predictors of smoking cessation in adolescent and young adult smokers
Cengelli et al.
Tobacco Control 2011;0:tc.2011.044149v1-tc.2011.044149.
ABSTRACT | FULL TEXT  

Affecting Perceptions of Harm and Addiction among College Waterpipe Tobacco Smokers
Lipkus et al.
Nicotine Tob Res 2011;13:599-610.
ABSTRACT | FULL TEXT  

Children's loss of autonomy over smoking: the global youth tobacco survey
Soteriades et al.
Tobacco Control 2011;20:201-206.
ABSTRACT | FULL TEXT  

Sexual Objectification and Substance Abuse in Young Adult Women
Carr and Szymanski
The Counseling Psychologist 2011;39:39-66.
ABSTRACT  

Are Occasional Smokers a Heterogeneous Group? An Exploratory Study
Edwards et al.
Nicotine Tob Res 2010;12:1195-1202.
ABSTRACT | FULL TEXT  

Nicotine reduction revisited: science and future directions
Hatsukami et al.
Tobacco Control 2010;19:e1-e1.
ABSTRACT | FULL TEXT  

Early Course of Nicotine Dependence in Adolescent Smokers
Doubeni et al.
Pediatrics 2010;125:1127-1133.
ABSTRACT | FULL TEXT  

Health Effects of Light and Intermittent Smoking: A Review
Schane et al.
Circulation 2010;121:1518-1522.
FULL TEXT  

The behavioral ecology of secondhand smoke exposure: A pathway to complete tobacco control
Hovell and Hughes
Nicotine Tob Res 2009;11:1254-1264.
ABSTRACT | FULL TEXT  

Tobacco Use: A Pediatric Disease
Committee on Environmental Health, Committee on Su
Pediatrics 2009;124:1474-1487.
ABSTRACT | FULL TEXT  

Tobacco as a Substance of Abuse
Sims and the Committee on Substance Abuse
Pediatrics 2009;124:e1045-e1053.
ABSTRACT | FULL TEXT  

Determinants of First Puff and Daily Cigarette Smoking in Adolescents
O'Loughlin et al.
Am J Epidemiol 2009;170:585-597.
ABSTRACT | FULL TEXT  

Origin and use of the 100 cigarette criterion in tobacco surveys
Bondy et al.
Tobacco Control 2009;18:317-323.
ABSTRACT | FULL TEXT  

Adolescent nondaily smokers: Favorable views of tobacco yet receptive to cessation
Carpenter et al.
Nicotine Tob Res 2009;0:ntp023v1-ntp023.
ABSTRACT | FULL TEXT  

How should we define light or intermittent smoking? Does it matter?
Husten
Nicotine Tob Res 2009;0:ntp010v1-ntp010.
FULL TEXT  

Linking quantity and frequency profiles of cigarette smoking to the presence of nicotine dependence symptoms among adolescent smokers: findings from the 2004 National Youth Tobacco Survey
Caraballo et al.
Nicotine Tob Res 2009;0:ntn008v1-ntn008.
ABSTRACT | FULL TEXT  

Perceived Accessibility as a Predictor of Youth Smoking
Doubeni et al.
Ann Fam Med 2008;6:323-330.
ABSTRACT | FULL TEXT  

Effects of Inattention and Hyperactivity/Impulsivity Symptoms on Development of Nicotine Dependence from Mid Adolescence to Young Adulthood
Rodriguez et al.
J Pediatr Psychol 2008;33:563-575.
ABSTRACT | FULL TEXT  

Let the Children Be Heard: Lessons From Studies of the Early Onset of Tobacco Addiction
DiFranza and Richmond
Pediatrics 2008;121:623-624.
FULL TEXT