E-cigarette use among women of reproductive age: Impulsivity,cigarette smoking status,and other risk factors

IntroductionThe study aim was to examine impulsivity and other risk factors for e-cigarette use among women of reproductive age comparing current daily cigarette smokers to never cigarette smokers. Women of reproductive age are of special interest because of the additional risk that tobacco and nicotine use represents should they become pregnant.MethodSurvey data were collected anonymously online using Amazon Mechanical Turk in 2014. Participants were 800 women ages 24–44 years from the US. Half (n = 400) reported current, daily smoking and half (n = 400) reported smoking < 100 cigarettes lifetime. Participants completed questionnaires regarding sociodemographics, tobacco/nicotine use, and impulsivity (i.e., delay discounting & Barratt Impulsiveness Scale). Predictors of smoking and e-cigarette use were examined using logistic regression.ResultsDaily cigarette smoking was associated with greater impulsivity, lower education, past illegal drug use, and White race/ethnicity. E-cigarette use in the overall sample was associated with being a cigarette smoker and greater education. E-cigarette use among current smokers was associated with increased nicotine dependence and quitting smoking; among never smokers it was associated with greater impulsivity and illegal drug use. E-cigarette use was associated with hookah use, and for never smokers only with use of cigars and other nicotine products.ConclusionsE-cigarette use among women of reproductive age varies by smoking status, with use among current smokers reflecting attempts to quit smoking whereas among non-smokers use may be a marker of a more impulsive repertoire that includes greater use of alternative tobacco products and illegal drugs.     

Tobacco use characteristics among apprentices in Vocational Centers

BackgroundMost smokers start smoking during adolescence and become dependent before 20 years old. In France, vocational trainees are a population not much explored. The objective of our study is to present tobacco use characteristics among apprentices in Vocational Centers (VC).MethodsThis cross-sectional exhaustive study covered 1814 students (among whose 943 smokers) entering in a 1st year of the eight participating Vocational Centers in the Lorraine region (Eastern France, 2.3 million inhabitants, 16,500 vocational trainees), during the school years 2007–2008 and 2008–2009. Data collection concerned the sociocultural environment, tobacco use habits, degree of dependency to tobacco and co-addictions.ResultsAmong the study population, 52.0% declared they were smokers among whom 89.4% daily smokers, and 5.7% were ex-smokers. The average age of tobacco use initiation was 12.1 years (standard deviation [SD] = 2.1) and the average age at inception of regular cigarette smoking was 13.8 years (SD = 1.6). Current consumption of the smokers was 12.8 cigarettes per day (SD = 7.8). The average score of smoking addiction was 6.1 (SD = 2.8), according to the Hooked On Nicotine checklist test (score from 0 to 10 = strongly dependent). Finally, 37.1% of students (58.9% among smokers) smoked or have smoked cannabis.ConclusionThe high prevalence of smoking in Vocational Centers, the early start of tobacco use and the high tobacco consumption among apprentices show that they are overexposed compared to the general population of adolescents. In addition, these young people are already dependant to tobacco use. This underlines the need of specific measures dedicated to this population that amounts to 361,500 individuals in France.     

Prevalencia y perfil de uso del cigarrillo electrónico en España (2014)

ObjectiveTo describe the prevalence and user profile of electronic cigarettes among Spanish adults and evaluate the potential dual use of these devices with combustible or conventional tobacco in 2014 in Spain.MethodsCross-sectional study of a representative sample of the Spanish adult (16-75 years old) population (n = 1,016). A computer-assisted telephone survey was conducted in 2014. The prevalence and 95% confidence intervals (95% CI) for the use of electronic cigarettes stratified by gender, age, tobacco consumption and social status were calculated. The sample was weighted and a logistic regression model adjusted to obtain the crude odds ratios (OR) adjusted by gender, age and social status.Results10.3% (95% CI: 8.6-12.4) of the Spanish adult population stated being ever users of electronic cigarettes (2% current users, 3.2% past users and 5.1% experimental users). Among current electronic cigarette users, 57.2% also smoked combustible or conventional tobacco, 28% had never smoked and 14.8% were former smokers. The prevalence of electronic cigarette use was higher in the younger population (adjusted OR = 23.8; 95% CI: 2.5-227.7) and smokers of combustible tobacco (adjusted OR = 10.1; 95% CI: 5.8-17.5).ConclusionsThe use of electronic cigarettes in Spain is scarce and is most prevalent among young people and tobacco smokers. Nevertheless, one out of four current electronic cigarette users have never smoked. Hence, the regulation of these devices should be reinforced to avoid a possible gateway to nicotine products among never smokers.     

The association between cigarette rod length,slim design,and blood cadmium levels among U.S. smokers: NHANES 1999–2010

BackgroundPrevious research has shown that long or slim cigarette design can mitigate perception of harmfulness. Cadmium (Cd) is a toxicant in cigarettes and is associated with adverse outcomes. We assessed the relationship between cigarette rod length/circumference and blood Cd levels among U.S. smokers using data from the 1999–2010 National Health and Nutrition Examination Survey.MethodsThe analyses were performed on 4486 current cigarette smokers aged ≥ 20 years old. Cigarette rod length included regular (68–72 mm), king (79–88 mm), long (94–101 mm), and ultra-long (110–121 mm) cigarettes currently smoked. Overall and gender stratified multivariate linear regression analyses were performed, adjusting for other influential covariates.ResultsGender stratified analysis indicated that female smokers of long and ultra-long cigarette had 20% and 27% higher mean Cd levels compared to smokers of regular sized cigarettes respectively, despite the fact that all the ultra-long cigarettes were slim cigarettes. Furthermore, among females, slim cigarette users did not reduce blood cadmium levels compared to non-slim users.ConclusionsFemale smokers of long or ultra-long cigarettes had higher mean blood Cd levels compared to smokers of regular cigarettes independent of slim design. Further research into this association is warranted.     

Effect of nicotine patch on energy intake and weight gain in postmenopausal women during smoking cessation

IntroductionPost-cessation weight gain is a commonly cited barrier to smoking cessation. Some evidence suggests that nicotine replacement therapy may limit post-cessation weight gain by reducing energy intake. This project aims to assess differential changes in energy intake and body weight during smoking cessation in a sample of postmenopausal women randomized to receive 21 mg nicotine or placebo patch for 12 weeks.MethodsPostmenopausal women who smoked ≥ 10 cigarettes/day were enrolled in this double-blind randomized placebo-controlled study. Total energy intake (via four-day food diaries), body mass index (BMI; kg/m²), cigarettes/day and smoking status (self-report verified by exhaled carbon monoxide) were assessed at three time points: 2 weeks prior to quit date,12 weeks after quit date, and 12 months after smoking cessation treatment.ResultsParticipants (n = 119) were, on average, 55.8 ± 6.7 years old with a baseline BMI of 27.0 ± 5.2 and average cigarette/day was 21.1 ± 8.6. At Week 12, participants randomized to nicotine patch increased their mean caloric intake by 146.4 ± 547.7 kcal/day whereas those on placebo patch decreased their caloric intake by 175.3 ± 463.2 (f-value = 10.1, p-value = 0.002). Despite the differences in caloric intake, body weight remained similar between groups.ConclusionsThe results of this study indicate that nicotine patch may increase energy intake during treatment, and does not prevent post-cessation weight gain in postmenopausal smokers. Additional research is needed to replicate these findings and assess whether different forms of nicotine replacement therapy influence caloric intake and post-cessation weight gain in postmenopausal smokers.     

Spontaneous cigarette brand switching: consequences for nicotine and carbon monoxide exposure.

A group of smokers who had participated in smoking-related studies three to six years earlier were re-studied to assess changes in their smoking practices. Individuals who smoked the same brands of cigarettes showed no change in plasma cotinine (reflecting exposure to nicotine) or expired carbon monoxide (CO) concentration. Those who switched to cigarettes of lower nicotine yield (average decrease 38 per cent) showed reduced plasma cotinine concentrations, due primarily to smoking fewer cigarettes per day. The intake of nicotine per cigarette was not different. Subjects who smoked cigarettes of higher yield (102 per cent increase) had higher cotinine and CO levels, due to greater intake per cigarette.     

Trends in smoking prevalence and attributable mortality in China, 1991–2011

ObjectiveChina is the largest producer of tobacco worldwide. We assessed secular trends in prevalence of smoking, average cigarettes per day, mean age of initiation, and mortality attributable to smoking among the Chinese population between 1991 and 2011.DesignData came from the China Health and Nutrition Survey, conducted eight times between 1991 and 2011. A total of 83,447 participants aged 15 years or older were included in this study. Trends in smoking were stratified by sex, age, and region (urban vs. rural).ResultsIn 2011, 311 millions individuals were current smokers in China, with 295 million men and 16 million women, respectively. Between 1991 and 2011, the prevalence of current smoking decreased from 60.6% to 51.6% in men, and from 4.0% to 2.9% in women. However, during this period, the average number of cigarettes smoked per day per smoker increased from 15.0 to 16.5 in males, and from 8.5 to 12.4 in females. Further, age of smoking initiation decreased from 21.9 to 21.4 years in men and from 31.4 to 28.4 years in women. In 2011, 16.5% of all deaths in men and 1.7% in women were due to smoking. Between 1991 and 2011, the total number of deaths caused by smoking increased from 800,000 to 900,000.ConclusionsDuring the past 20 years, a slight decrease in smoking prevalence was observed in the Chinese population. However, cigarette smoking remains a major cause of death in China, especially in men.     

Tobacco control environment in the United States and individual consumer characteristics in relation to continued smoking: Differential responses among menthol smokers?

ObjectiveWe used a consumer panel augmented with state-specific measures of tobacco control activities to examine the main effects and interactions among consumer behaviors, particularly menthol cigarette smoking, and tobacco control environment on cessation over a six-year period.MethodsWe used the Nielson Homescan Panel, which tracks consumer purchasing behaviors, and tobacco control information matched to panelist zip code. We focused on 1582 households purchasing ≥ 20 packs from 2004 to 2009. Our analysis included demographics; purchasing behavior including menthol versus nonmenthol use (≥ 80% of cigarettes purchased being menthol), quality preferences (average price/pack), purchase recency, and nicotine intake (nicotine levels of cigarettes purchased); and tobacco control metrics (taxation, anti-tobacco advertising, smoke-free policies).ResultsMenthol smoking (Hazard Ratio [HR] = 0.79, 95% Confidence Interval [CI] 0.64, 0.99), being African American (HR = 0.67, CI 0.46, 0.98), being male (HR = 0.46, CI 0.28, 0.74), higher quality premium preferences (HR = 0.80, CI 0.77, 0.91), lower recency (HR = 1.04, CI 1.02, 1.05), and higher nicotine intake rates (HR = 0.99, CI 0.99, 0.99) were related to continued smoking. No significant interactions were found.ConclusionWhile there were no interactions between menthol use and effects of tobacco control activities, we did find additional support for the decreased cessation rates among menthol cigarette smokers, particularly in the African American population.     

Behavioral factors predicting serum cotinine concentrations of male smokers in a Japanese community.

Cigarette-derived toxic substances are inhaled along with the nicotine that is absorbed to satisfy the smoker's physical demand. Therefore, serum cotinine, a metabolite of nicotine, may be considered to be an indirect marker of absorption of the other toxic substances from smoking. However, few studies have examined factors related to serum cotinine concentrations in natural settings. The authors, therefore, have studied relations among patterns of smoking behavior and serum cotinine concentrations of community residents. Subjects were 60 smoking men living in the town of Yamasaki, Hyogo Prefecture, Japan. Number of daily cigarettes, depth of inhalation, hours from the last cigarette smoked and the total nicotine tolerance score were significantly, while neither nicotine-yields nor butt length of a discarded cigarette was correlated with serum cotinine concentrations. Multiple regression analysis confirmed that depth of inhalation and hours from the last cigarette smoked were independently significant. This finding suggests that attention only to self-reported daily number of cigarettes smoked may not be sufficient to detect smokers who are actually at high risk. Healthcare workers should also pay attention to smokers' patterns of smoking, particularly depth of inhalation.     

Smoking topography and biomarkers of exposure among Japanese smokers: associations with cigarette emissions obtained using machine smoking protocols

Objectives

Although the relative risk of lung cancer due to smoking is reported to be lower in Japan than in other countries, few studies have examined the characteristics of Japanese cigarettes or potential differences in smoking patterns among Japanese smokers.

Methods

To examine tar, nicotine and carbon monoxide (TNCO) emissions from ten leading cigarettes in Japan, machine smoking tests were conducted using the International Organization for Standardization (ISO) protocol and the Health Canada Intense (HCI) protocol. Smoking topography and tobacco-related biomarkers were collected from 101 Japanese smokers to examine measures of exposure.

Results

The findings indicate considerable variability in the smoking behavior of Japanese smokers. On average, puffing behaviors observed among smokers were more similar to the parameters of the HCI protocol, and brands with greater ventilation that yielded lower machine values using the ISO protocol were smoked more intensely than brands with lower levels of ventilation. The smokers of “ultra-low/low” nicotine-yield cigarettes smoked 2.7-fold more intensively than those of “medium/high” nicotine-yield cigarette smokers to achieve the same level of salivary cotinine (p = 0.024). CO levels in expiratory breath samples were associated with puff volume and self-reported smoking intensity, but not with nominal values of nicotine-yield reported on cigarette packages.

Conclusions

Japanese smokers engaged in “compensatory smoking” to achieve their desired nicotine intake, and levels of exposure were greater than those suggested by the nominal value of nicotine and tar yields reported on cigarette packages.     

The tobacco cessation consultation of the Salah-Azeiz Tunis cancer center: one year results

BackgroundTo reduce tobacco smoking is, in Tunisia, a public health priority. The tobacco cessation consultation is one of the interventions to fight against the tobacco epidemic; it is a new activity developed in the Salah-Azeiz Tunis cancer centre. The objective of this work is to evaluate the impact of the consultation on the smokers after one year of activities and to analyse the prognostic factors of tobacco cessation in order to improve the efficacy of such an activity in the future, in Tunisia.MethodsThe cessation methods were based on cognitive and behavioral therapies associated with nicotine patch, delivered free of charge. During one year (July 2003 to June 2004), 340 smokers were attended. Data on their smoking status and psychological characteristics were collected using a standardized questionnaire.ResultsThe patients were mostly men (79%), these smokers did not present important anxiodepressive troubles, 68% thought that they were able to quit easily. The majority (57%) smoked more than 20 cigarettes a day and was nicotinodependant (Fagenström > 7). Half of this population had already intended to stop, they declared to smoke mostly because of stress. The global cessation rate after a median follow-up of 32 weeks is 27%. The cessation rate lasting six months for 83 patients followed regularly was 23%. The good prognostic factors of cessation, after multivariate analysis, were (when taking out from the model the regular follow-up), to be confidant on the possibility to stop (OR = 0.87 [0.78–0.97]). On the contrary, a high score (>7) for Fagerström test (OR = 1.9 [1.1–3.4), the use of smoking to fight against stress (OR = 1.08 [1.0–1.2) and a smoking environment at home (OR = 4.5 [1.1–18.9]) were prognostic of a failure in quitting smoking.ConclusionThese results show that the cessation rate, which is still too low as compared with the literature, could be increased by a better follow-up of smokers associated with an information campaign on the existing possibilities to quit smoking in Tunisia.     

Cigarette smoking and 9/11-related posttraumatic stress disorder among World Trade Center Health Registry enrollees, 2003–12

ObjectiveNumerous studies have observed higher rates of smoking among adults with mental health conditions. We examined posttraumatic stress disorder (PTSD) and smoking over a 7–9 year period among adults with firsthand exposure to the 9/11 attacks enrolled in the World Trade Center Health Registry.MethodData were collected at three waves: W1 (2003–04), W2 (2006–07), and W3 (2011–12). Enrollees aged ≥ 25 at W1 and who completed all three waves (n = 34,458) were categorized by smoker-type: non-smoker, non-daily (smoked some days in last 30 days), light (1–10 cigarettes per day (CPD)), or heavy (11 + CPD). Enrollees who smoked at W1 but not W3 were considered to have quit. PTSD was defined as a score of ≥ 44 on the PTSD Checklist—Civilian Version.ResultsSmoking declined significantly from W1 (12.6%) to W3 (9.2%). Smoking prevalence was higher among enrollees with PTSD. In multivariable models, odds of quitting were 25–39% lower among heavy, light, and non-daily smokers with PTSD compared to those without.ConclusionPTSD was associated with reduced odds of quitting regardless of smoker-type. Disaster-exposed smokers with PTSD are likely in need of more supportive services in order to abstain from smoking.     

Risk factors for e-cigarette,conventional cigarette,and dual use in German adolescents: A cohort study

ObjectiveLittle is known about risk factors that are associated with e-cigarette use in adolescents.MethodsMultilevel mixed-effects regressions were performed to assess the relationship between factors that might be associated with e-cigarette, conventional cigarette and dual use in a cohort of 2693 German adolescents (mean age = 12.5 years; SD = 0.6). Risk factors were assessed in October 2010 and life time e-cigarette and conventional cigarette use were assessed 26 months later.ResultsUse of e-cigarettes as well as use of conventional cigarette and dual use were associated with higher sensation seeking scores, and higher odds of having friends and parents who smoke conventional cigarettes, with conventional cigarette use additionally with male gender, being older, having higher odds of siblings who smoke conventional cigarettes, and less likely for adolescents who attend a Gymnasium, secondary school with a strong emphasis on academic learning. The use of conventional cigarettes at baseline did not predict e-cigarette use at follow-up. Lifetime prevalence of e-cigarette use was 4.7%, of conventional cigarette use 18.4%. A quarter of e-cigarette users (23.8%) never smoked a conventional cigarette.DiscussionData indicate that e-cigarette and conventional cigarette use share many but not all risk factors. E-cigarettes could counteract the process of denormalization of smoking.     

Smoking characteristics among lesbian,gay, and bisexual adults

ObjectiveCigarette smoking is the leading preventable cause of death and disease in the United States. Sexual minorities (lesbians, gay men, and bisexuals), smoke at higher rates than the general population. However, little else is known about sexual minority smokers. Furthermore, the sexual minority population is diverse and little research exists to determine whether subgroups, such as lesbians, gay men, and female and male bisexuals, differ on smoker characteristics. We examine differences in smoking characteristics (advertising receptivity, age of first cigarette, non-daily smoking, cigarettes per day, nicotine dependence, desire to quit and past quit attempts) among lesbians, gay men, and female and male bisexual adults in the United States.MethodsSecondary analysis of the CDC's (Centers for Disease Control and Prevention) 2009–2010 National Adult Tobacco Survey (N = 118,590).ResultsControlling for age, race, socioeconomic status and geographic region, identifying as a female bisexual was associated with fewer past quit attempts, lower age at first cigarette, and higher nicotine dependence when compared to heterosexual women. There were no differences in desire to quit between male or female sexual minorities and their heterosexual counterparts.ConclusionSexual minority individuals smoke at higher rates than heterosexuals and yet similarly desire to quit. Tailored efforts may be needed to address smoking among bisexual women.     

Determinants of salivary cotinine concentrations in Chinese male smokers

BACKGROUND: Identifying factors that affect cotinine levels in smokers may be useful for smoking cessation programs. Our aims were to characterize the distribution of salivary cotinine levels in Chinese smokers and to investigate factors that influence cotinine concentrations. METHODS: In a cross-sectional study, 600 Chinese adult smokers answered a questionnaire on smoking habits and provided a saliva sample for cotinine analysis. Modification of the relation between number of cigarettes smoked and cotinine concentration by individual characteristics, smoking behavior, and type of tobacco was evaluated. RESULTS: Quadratic model provided the best fit for the relation between number of cigarettes smoked in the previous 24 hours and salivary cotinine concentration. Among those smoking up to 20 cigarettes, the median cotinine concentration was higher among younger subjects, those smoking cigarettes without filter and regular rather than light cigarettes, and those inhaling frequently and deeply. Such trends were not observed among heavier smokers. The increase in cotinine per cigarette tended to be larger in those with lower median cotinine level. CONCLUSIONS: Our findings show that smoking behavior-related factors modify the relation between number of cigarettes smoked and salivary cotinine concentration. This suggests that smokers may regulate their smoking behavior to achieve a certain optimum nicotine level.     

Heterogeneity in Smokers' Responses to Tobacco Control Policies

This paper uses unconditional quantile regression to estimate whether smokers' responses to tobacco control policies change across the distribution of smoking levels. I measure smoking behavior with the number of cigarettes smoked per day and also with serum cotinine levels, a continuous biomarker of nicotine exposure, using individual‐level repeated cross‐section data from the National Health and Nutrition Examination Surveys. I find that the cigarette taxes lead to reductions in both the number of cigarettes smoked per day and in smokers' cotinine levels. These reductions are most pronounced in the middle quantiles of both distributions in terms of marginal effects, but most pronounced in the lower quantiles in terms of tax elasticities. I do not find that higher cigarette taxes lead to statistically significant changes in the amount of nicotine smokers ingest from each cigarette. Copyright © 2015 John Wiley & Sons, Ltd.     

A comparison of smoking behaviour characteristics between Caucasian smokers in the United Kingdom and Malay smokers in Malaysia

ObjectivesThere is evidence that smoking behaviour differs by ethnicity. This study aims to compare smoking behaviour characteristics between Caucasian and Malay smokers.MethodsA cross sectional survey, involving 175 smokers attending smoking cessation clinics at the Institute of Psychiatry, London, United Kingdom and University Malaya, Kuala Lumpur, Malaysia between May 2005 and February 2007. Data on demographics, smoking history, nicotine dependence and smoking behaviour were collected.ResultsAll participants were males, mean age 30.7 ± 10.3 years. Caucasians initiated smoking significantly earlier (mean age 14.8 ± 2.8 years) (p = 0.001) and smoked regularly significantly earlier (mean age 17.3 ± 3.5) (p = 0.003) than Malays (mean starting age 16.9 ± 4.4 years and mean age regular use 19.5 ± 4.5 years), respectively. Caucasians smoked less for social integration than Malays (p = 0.03) but smoked more for regulation of negative affect than Malays (p = 0.008) and smoked more for hedonism than Malays (p < 0.001).ConclusionMalays smoke as a means of socially integrating. This has important public health implications. Social reasons and the social environment play a role in smoking uptake, smoking maintenance and smoking cessation and this should be borne in mind for strategies planning to promote smoking cessation.     

The relation of tobacco use during hospitalization to post-discharge smoking cessation among US veterans

ObjectiveThe objective of this study was to determine if tobacco use while in the hospital was associated with post-discharge cessation rates.MethodsDuring 2006–2008, smokers from three Veterans Affairs hospitals (n = 354) were surveyed during their hospitalization and again 6 months later. Data analysis was conducted in 2009.ResultsWhile veterans smoked an average of 19 cigarettes per day, prior to admission, the average was 6–7 cigarettes per day during hospitalization. About 40% (n = 140) were able to quit smoking for more than 24 h and the median days quit was 29. The 6-month self-reported quit rate was 15% (n = 53). Multivariate analyses showed that veterans who quit tobacco use during their hospitalization had nearly 4 times increased odds of quitting smoking for more than 24 h and 2.7 times increased odds of quitting at 6 months post-hospitalization as compared to veterans that did not quit using tobacco during hospitalization.ConclusionMany veterans quit tobacco use during hospital admissions and those who do not quit, tended to decrease their use. Veterans who quit tobacco use were more likely to be abstinent at 6-month follow-up. State-of-the-art cessation interventions need to be provided to smokers hospitalized in Veterans Affairs hospitals.     

Effectiveness of a school-based multi-component smoking prevention intervention: The LdP cluster randomized controlled trial

ObjectiveWe assessed the effectiveness of the Luoghi di Prevenzione-Prevention Grounds school-based smoking prevention programme.MethodsWe undertook a cluster randomized controlled trial of 989 students aged 14–15 years in 13 secondary schools located in Reggio Emilia, Italy. The intervention consisted of the “Smoking Prevention Tour” (SPT) out-of-school workshop, one in-depth lesson on one Smoking Prevention Tour topic, a life-skills peer-led intervention, and enforcement surveillance of school antismoking policy. Self-reported past 30-day smoking of ≥ 20 or 1–19 days of cigarette smoking (daily or frequent smoking, respectively) was recorded in 2 surveys administered immediately before and 18 months after the beginning of the programme. Analysis was by intention to treat. The effect of the intervention was evaluated using random effects logistic regression and propensity score-matching analyses.ResultsPast 30-day smoking and daily cigarette use at eighteen months follow-up were 31% and 46% lower, respectively, for intervention students compared to control students. Taking into account non-smokers at baseline only, daily smoking at eighteen months follow-up was 59% lower in intervention students than in controls. Past 30-day smoking in school areas was 62% lower in intervention students compared to controls.ConclusionsThe Luoghi di Prevenzione-Prevention Grounds programme was effective in reducing daily smokers and in reducing smoking in school areas.     

Smoking Topography in Response to Denicotinized and High-Yield Nicotine Cigarettes in Adolescent Smokers

PurposeThe objective of this study was to explore the smoking topography of adolescent smokers. It is well established that the majority of adult nicotine-dependent smokers began smoking as adolescents. Whereas recent advances have been made with respect to identification of factors that predispose to nicotine dependence, very little is known about the actual smoking behavior (e.g., topography) of adolescent smokers, or its relationship to nicotine dependence. Correspondingly, the extent to which adolescent smokers smoke to obtain nicotine is also unknown.MethodsIn the present study, we assessed several topographical indices of smoking (e.g., puff volume, puff number) in a sample of 35 light, adolescent smokers. Moreover, we examined whether smoking behavior is different in response to smoking a denicotinized relative to a high-yield, nicotine cigarette.ResultsAll participants evidenced a significant increase in expired air carbon monoxide after the smoking of a cigarette. Results of independent-sample t-tests revealed that adolescents who smoked a low-yield nicotine cigarette took significantly more puffs per cigarette than did those who smoked a high-yield cigarette.ConclusionsThese findings suggest that adolescent smokers do titrate their nicotine intake in response to smoking denicotinized cigarettes, but do so not by taking larger puffs or smoking more quickly, but by simply taking more puffs per cigarette. Implications of the findings and future directions for this type of research with adolescents are discussed.