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Arch Pediatr Adolesc Med. 2007 Jul;161(7):704-10.

Symptoms of tobacco dependence after brief intermittent use: the Development and Assessment of Nicotine Dependence in Youth-2 study.

Author information

  • 1Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA 01655, USA. difranzj@ummhc.org

Abstract

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.

PMID:
17606835
[PubMed - indexed for MEDLINE]
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