Predictors and Sequelae of Smoking Topography Over the Course of a Single Cigarette in Adolescent Light Smokers

PurposeThe objective of this study was to determine whether adolescent smokers, who varied in their smoking histories and symptoms of nicotine dependence, exhibit any decrease in puff volume and duration similar to that typically seen in dependent adolescent and adult smokers. Moreover, we examined whether puffing trajectories were moderated by individual difference factors, as well as whether puffing topography over the course of smoking a single cigarette was predictive of an escalation in dependence symptoms.MethodsWe assessed smoking topography (puff number, duration, volume, maximum flow rate [velocity], and inter-puff interval) over the course of smoking a single cigarette in a sample of 78 adolescent light smokers, using hierarchical linear modeling. We examined moderators (anxiety, depression, nicotine dependence) of the topographic trajectories, as well as whether smoking topography predicted any change in dependence over a 2-year period.ResultsPuff volume and puff duration decreased over the course of smoking the cigarette, whereas puff velocity and inter-puff interval increased. Slopes for puff volume and duration were moderated by anxiety and depressive symptoms. Moreover, individuals with a less “typical” topography pattern (exhibited stable or increasing volume and duration over the course of smoking the cigarette) demonstrated a heightened dependence escalation in the subsequent 2 years.ConclusionOur findings suggest that adolescent light smokers self-regulate nicotine during the course of smoking a single cigarette, similar to that reported in dependent adolescent and adult smokers. However, single cigarette self-regulation was influenced by certain affective factors. Implications of these findings and future directions for adolescent smoking research are discussed.     

Menthol vs nonmenthol cigarettes: effects on smoking behavior.

OBJECTIVES. The purpose of this study was to examine intraindividual differences in smoking behavior between smoking regular and mentholated cigarettes. METHODS. Healthy male smokers (n = 29) smoked either a regular or a mentholated cigarette in two separate sessions 1 week apart. Commercial brands with comparable tar, nicotine, and CO content were used. Smoking behavior was constrained by fixed 15-second interpuff intervals, but puff volume and number of puffs were unconstrained. RESULTS. When smoking the non-mentholated brand of cigarettes, participants smoked 22% more puffs and had 13% higher mean volumes per puff than they did when smoking the mentholated brand of cigarettes. The aggregate 39% excess exposure to cigarette smoke in the regular-cigarette condition was not accompanied by commensurate excesses in expired carbon monoxide or in physiological measures normally correlated with nicotine exposure. CONCLUSIONS. These findings parallel differences in physiological correlates of exposure to nicotine found in cross-sectional comparisons of African-American and White smokers and are consistent with the results of emerging laboratory investigations.     

Smoking-Related Cue-Induced Brain Activation in Adolescent Light Smokers

PurposeTo examine using functional magnetic resonance imaging whether adolescents with low levels of nicotine exposure (light smokers) display neural activation in areas shown to be involved with addiction in response to smoking-related stimuli.Design/Setting/ParticipantsA total of 12 adolescent light smokers (aged 13–17, who smoked 1–5 cigarettes per day) and 12 nonsmokers (ages 13–17, never smoked a cigarette) from the San Francisco Bay Area underwent functional magnetic resonance imaging scanning. During scanning, the adolescents were shown photographic blocks of smoking and control cues. Smoking cues comprised pictures of individuals smoking cigarettes and smoking-related objects such as lighters and ashtrays. Neutral cues comprised images of everyday objects and individuals engaged in daily activities.FindingsFor smokers, smoking cues elicited greater activation than neutral cues in the mesolimbic reward circuit (left anterior cingulate: t = 7.04, p < .001; right hippocampus: t = 6.37, p < .001). We found activation from smoking cues versus neutral cues within both the left and right frontal medial orbital regions (t = 5.09, p < .001 and t = 3.94, p = .001, respectively). Nonsmokers showed no significant difference in activation between smoking-related cues and neutral cues.ConclusionOur finding that smoking cues produced activation in adolescent light smokers in brain regions, similar to that seen in adult and teenage heavy smokers, suggests that adolescents exhibit heightened reactivity to smoking cues even at low levels of smoking. This article adds to the existing published data by suggesting that nicotine dependence may begin with exposure to low levels of nicotine, thus underscoring the need for early intervention among adolescent smokers.     

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.     

Nicotine Dependence and Withdrawal Symptoms among Occasional Smokers

PurposeThis study describes the levels of nicotine dependence, withdrawal symptoms, depressive mood, and risk behavior reported by male and female weekly and monthly adolescent smokers in South Africa.MethodsA cross-sectional survey was conducted among 554 grade 9–11 weekly and monthly smokers in the Southern Cape-Karoo Region. Differences between the gender groups and smoking status were analyzed while controlling for demographic characteristics.ResultsWeekly and monthly smokers were classified as light smokers having smoked 6–10 cigarettes and 0–1 cigarettes a week, respectively. However, they displayed substantial levels of dependence, with 11.6% of weekly smokers classified as highly dependent. Furthermore, 55.9% of weekly smokers and 47.1% of the overall sample experienced more than two withdrawal symptoms. Although dependency levels and withdrawal symptoms were higher among weekly smokers, the levels were not negligible among monthly smokers. Weekly smokers reported higher levels of depressive mood and risk behavior than monthly smokers. Females reported higher levels of dependence, withdrawal symptoms, depressive mood, and lower levels of risk behavior than males. Gender differences were not found on the number of cigarettes smoked in a week.ConclusionsThis study demonstrates multiple symptoms of dependence among a large sample of adolescent occasional smokers in a multi-ethnic cultural setting. Smoking cessation programs may, therefore, be required to help adolescents quit smoking and possibly consider pharmacotherapy for highly dependent smokers. Prevention programs should also consider providing occasional smokers skills to identify and cope with withdrawal symptoms.     

Smoking behaviours and contextual influences on adolescent nicotine dependence

Objective: The objectives of the study were to analyse nicotine‐dependence patterns among secondary school students in New Zealand (NZ), and identify factors associated with levels of nicotine dependence. Method: This study uses data from the 2004 Youth Lifestyle Study, a survey of Year 10 and 12 students from randomly selected schools in NZ. The analysis included 625 current adolescent smokers. Nicotine dependence was measured with the Hooked on Nicotine Checklist (HONC). Potential dependence‐associated factors studied include: socio‐demographic factors; smoking behaviours; and smoking contexts. Results: A large percentage (87.9%) of the current adolescent smokers reported at least one HONC symptom, with a mean HONC score of 4.9 out of a possible 10. Multivariate analyses identified: school decile; age at which started smoking monthly; lifetime cigarette consumption; and peers smoking as statistically significant predictors of nicotine dependence. Conclusions: Adolescent smokers are very likely to become dependent on nicotine. Students from the highest school decile had markedly lower HONC scores. Earlier onset of monthly smoking, heavier overall consumption and peers smoking were associated with higher HONC scores. These findings provide important insights into factors that may need to be modified to help reduce nicotine dependence among adolescents.     

Stages of change, smoking characteristics, and cotinine concentrations in smokers: setting priorities for smoking cessation

ObjectiveWe assessed whether the salivary cotinine content of daily smokers varied with the readiness to quit and smoking characteristics.MethodsThis cross-sectional study was conducted in Barcelona, Spain (n = 1245) in 2004–2005. We administered a questionnaire to assess smoking behaviour and collected saliva to determine the cotinine content. We determined the distribution of 278 adult daily smokers across different stages of change and categorised them by individual and smoking characteristics. We used medians and interquartile ranges (IQR) to relate cotinine concentrations to different stages of change, tobacco consumption, and nicotine dependence based on the Fagerström Test for Nicotine Dependence (FTND).ResultsAround 68%, 22%, and 11% of smokers were in precontemplation, contemplation, and preparation stages, respectively. A mean of 17.0 cigarettes was smoked daily, with no differences among stages of change. The median cotinine concentration was 151.3 ng/ml (IQR: 83.2–227.8 ng/ml), with no differences among stages of change. The cigarette consumption scores, FTND, and time to first cigarette of the day were positively associated with cotinine concentration.ConclusionsThe cotinine concentration was similar among the stages of change, but varied within each stage according to the number of cigarettes smoked, time to first cigarette of the day, and nicotine dependence.     

Ethnic variation in socioenvironmental factors that influence adolescent smoking

PurposeTo compare black, Hispanic and white adolescent smokers on socioenvironmental factors associated with smoking.MethodsThe study uses a cross-sectional design. A needs assessment of 1305 current, former and never adolescent smokers from four ethnically and geographically diverse sites in the United States was conducted in 1999. Two sites were selected because they represented urban cities in the Northeast and Midwest with a high proportion of black and Hispanic residents. Two additional sites were selected to recruit rural and suburban adolescents. From this larger sample, 181 subjects from three focal ethnic groups (white n = 138; black n = 24; Hispanic n = 19) who had smoked at least 100 cigarettes in their lifetime and were current smokers (smoked in the past 30 days) were included. The three ethnic groups were compared on the following variables of interest: peer and family influences on smoking, situational factors associated with smoking, places that were likely sites for smoking and perceptions of friends and family as potential support persons for quitting smoking. All data were analyzed with Chi-square analysis.ResultsAlmost all (96%) of the black adolescents lived with another smoker compared to 68% of Hispanic and 60% of whites (p = .004). Black teens were more likely to smoke with family members (50%) than Hispanics (5%) or whites (25%) (p = .003). In addition, 50% of black teens compared to 5% of Hispanics and 12% of white teens, reported smoking to fit in (p < .0001). Black teens in this study emphasized the familial and social pressures of smoking. Higher rates of acceptance of smoking by family members, role modeling by household members, more prevalent beliefs that smoking is a way to achieve belonging, and lack of perceived support for quitting by friends appear to influence cigarette smoking more for black than white or Hispanic youth.ConclusionsThese preliminary results indicate that familial and household norms play a critical role in influencing cigarette smoking among black teens.     

Can one puff really make an adolescent addicted to nicotine? A critical review of the literature

Rationale  

In the past decade, there have been various attempts to understand the initiation and progression of tobacco smoking among adolescents. One line of research on these issues has made strong claims regarding the speed in which adolescents can become physically and mentally addicted to smoking. According to these claims, and in contrast to other models of smoking progression, adolescents can lose autonomy over their smoking behavior after having smoked one puff in their lifetime and never having smoked again, and can become mentally and physically "hooked on nicotine" even if they have never smoked a puff.     

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.     

The Role of Carbon Monoxide in Cigarette Smoking

? The carbon monoxide deliveries of 20 major Canadian brands of cigarettes, determined by gas chromatography and using standard smoking conditions, were estimated and found to vary by a factor of about two. The CO yields were found to increase with puff volume and tobacco moisture, decrease with increased paper porosity, but remain essentially constant with puff duration.

The data suggest that reduced CO deliveries can be achieved by increasing the cigarette paper porosity. Combustion temperature presumably also influences CO deliveries, but the relative role ascribed to dilution and combustion is not clear. It may be concluded that smokers can lower their CO exposure by reducing their puff volume, smoking cigarettes manufactured from high porosity paper, by taking fewer puffs, and decreasing their tendency to inhale.

Since CO and tar deliveries are correlated, these measures would also tend to decrease a smoker’s exposure to tar.     

Smoking topography and trajectory of asthmatic adolescents requesting cessation treatment

BACKGROUND: Teenage smokers cite health concerns as their primary motivators for tobacco smoking cessation. Smoke exposure aggravates the clinical course of asthma, yet few reports have examined the association between asthma and smoking topography and trajectory. METHODS: Before their enrollment in a smoking cessation trial, we assessed the smoking topography (i.e., puff volume, maximum puff velocity, puff duration, and interpuff interval) and smoking trajectory (i.e., age of first cigarette, age of daily smoking, time to treatment request, and prior quit attempts) in 30 self-reported asthmatic and 92 nonasthmatic tobacco-dependent teenagers (mean age, 15.2 +/- 1.3 years, 28.7% African-American). Approximately one-half of asthmatics used prescribed medications for their asthma. RESULTS: There was no significant difference in smoking topography or smoking trajectory variables between asthmatic and nonasthmatic adolescents, nor between medicated and nonmedicated asthma subgroups. CONCLUSIONS: Although tobacco smoking exacerbates asthmatic symptoms, these data suggest that age of smoking initiation, as well as smoking topography characteristics in asthmatic adolescents, does not differ from those of adolescents without asthma. These findings highlight the need for more effective health counseling of asthmatic youth regarding the physical and behavioral effects of smoking.     

Lower prevalence of cigarette and waterpipe smoking, but a higher risk of waterpipe dependence in Lebanese adult women than in men

The objective of this study was to evaluate whether nicotine dependence was higher in Lebanese women smokers compared with men smokers. Data were taken from a national cross-sectional study. Lebanese residents aged ≥ 40 years were enrolled between October 2009 and September 2010. After informed consent, participants answered a standardized questionnaire about smoking behaviors and dependence (measured by the Fagerstr?m-Test-Nicotine-Dependence for cigarettes and the Lebanon-Waterpipe-Dependence-Scale 11 for waterpipes): 1,066 males and 1,134 females were interviewed. 58.7% versus 42.9% of them, respectively, ever smoked cigarettes, while 6.9% versus 6.7% ever smoked a waterpipe (p < 0.001). Moreover, 57.5% in male versus 49.1% in female cigarette smokers (p = 0.041), 35.9% versus 51.6% in waterpipe smokers (p = 0.076), and 67.9% versus 43.6% in mixed smokers were tobacco dependent. A dose-effect relationship was observed with increased rates of women versus men with waterpipe dependence) and an increased odds of dependence among women in multivariable analysis (ORa = 2.28). Positive (smoking waterpipe for pleasure and conviviality) and negative (smoking waterpipe to relax nerves and improve morale) reinforcements were significantly more frequent in women, while no significant sex difference was observed for nicotine dependence or psychological craving. In exclusive waterpipe smokers, significantly higher respiratory diseases and symptoms prevalences were found in females compared with males. Women who smoke waterpipes should receive attention during tobacco health education and smoking cessation.     

Saturation of tobacco smoking models and risk of alcohol and tobacco use among adolescents.

PURPOSE: To examine how saturation of an adolescent's environment with models of cigarette smoking (e.g., parents, siblings, friends) affects the probability of tobacco and alcohol use among junior high and high school students. METHODS: The Health and Smoking Questionnaire was administered to 806 adolescents (182 smokers and 624 nonsmokers; 57.2% female) average age of 15.1 years (SD = 1.6) in a mid-size Midwestern town. The questionnaire contains standardized items in five domains: demographics, smoking status and history, perceptions of risk and risk reduction, risk factors for tobacco use, and parenting style. RESULTS: Risk for smoking or using alcohol increased dramatically as the number of models who smoke increased in an adolescent's environment. For instance, adolescents with one significant other who smoked were nearly four times (OR = 3.76, p <.001) more likely to smoke than someone with no significant others who smoked. However, if an adolescent had four significant others who smoked, they were over 160 times more likely to smoke (OR = 161.25, p <.001). Similar results were found for alcohol use; adolescents who had one significant other who smoked were more than 2.5 (OR = 2.66, p <.001) times more likely to drink than those without smoking models. Adolescents who had four significant other smoking models were 13 times (OR = 13.08, p <.001) more likely to drink. CONCLUSIONS: As the number of cigarette smokers in an adolescent's environment increases, risk of tobacco and alcohol use increases substantially. These data suggest that multiple models of tobacco use will substantially increase risk for substance use in adolescents.     

Evaluation of the level of nicotine dependence among adolescent smokers

The questionnaire containing ten items evaluated the degree of dependence in students-volunteers from Brno secondary and vocational schools (ages ranging from 15 to 17 years) and the anamnestic data were compared with the specific (urinary cotinine) and non-specific (CO in the air exhaled) biological tests of exposure to smoking. The sample of 147 students examined contained 42% non-smokers, 25% occasional smokers and almost 33% of those who smoked every day. Almost 10% children smoked more than 10 cigarettes a day, and more than 20% children stated that they smoked 60 and more cigarettes a week. In accordance with the pre-developed degrees of dependence, compiled by the scores of the individual responses, 59% of the respondents (including the non-smokers) were ranked among the non-dependent. The second most frequent group contained the "strongly dependent" (almost 17% of all persons, e.g. 30% of smokers), 3.4% of examined persons (6% of smokers) were ranked in the sub-group of persons with a very high degree of dependence. Highly positive correlations were found between the evaluation of the dependence degree according to the anamnestic data and the exposure bio-markers (urinary cotinine/creatinine and CO in the air exhaled): the values of correlation coefficients were 0.615 and 0.764, resp. Both bio-markers also correlated negatively with the time of the last exposure to both active and passive smoking. The individual items in the dependence questionnaire had positive correlations with the objective exposure indicators which had statistical significance. The strongest relationship was observed in the question about the first morning cigarette--the highest correlation coefficients, being followed by signs evaluating the smoking frequency and the usual number of cigarettes smoked per day and in a week. The lowest relationships concerned the occasions for smoking and the unpleasant symptoms associated with the withdrawal. The anamnestic questionnaire could explain 42.6% of urinary cotinine level variability (converted to the density measured by creatinine content) and 65.8% of variability of CO content in the air exhaled. It was demonstrated that regular adolescent smokers at the ages between 15 to 17 years inhaled the cigarette smoke and the young smokers' inner exposure to nicotine had been proved as well. In this age group, there are many individuals who have a strong or a very strong dependence on nicotine. As a result, it is necessary to promote smoking cessation and nicotine dependence treatment by recommending pharmaceuticals of substantial nicotine therapy.     

The influence of electronic cigarette age purchasing restrictions on adolescent tobacco and marijuana use

ObjectiveIn the United States, many states have established minimum legal purchase ages for electronic nicotine delivery systems (ENDS) to ban adolescent purchases, but these policies may also affect other related substance use. We explore whether ENDS are substitutes or complements for cigarettes, cigars, smokeless tobacco, and marijuana among adolescents by using variation in state-level implementation of ENDS age purchasing restrictions.MethodsWe linked data on ENDS age purchasing restrictions to state- and year-specific rates of adolescent tobacco and marijuana use in 2007–2013 from the Youth Risk Behavior Surveillance System. This data provides a nationally representative sample of adolescents who attend public and private schools. We performed a fixed effect regression analysis exploring the influence of ENDS age purchasing restrictions on outcomes of tobacco use and marijuana use, controlling for state and year fixed characteristics, age-race cohorts, cigarette excise taxes, and cigarette indoor use restrictions.ResultsFor cigarette use, we separate our results into cigarette use frequency. We found causal evidence that ENDS age purchasing restrictions increased adolescent regular cigarette use by 0.8 percentage points. ENDS age purchasing restrictions were not associated with cigar use, smokeless tobacco use, or marijuana use.ConclusionsWe document a concerning trend of cigarette smoking among adolescents increasing when ENDS become more difficult to purchase.     

Lower Prevalence of Cigarette and Waterpipe Smoking,But a Higher Risk of Waterpipe Dependence in Lebanese Adult Women Than in Men

The objective of this study was to evaluate whether nicotine dependence was higher in Lebanese women smokers compared with men smokers. Data were taken from a national cross-sectional study. Lebanese residents aged ≥ 40 years were enrolled between October 2009 and September 2010. After informed consent, participants answered a standardized questionnaire about smoking behaviors and dependence (measured by the Fagerström-Test-Nicotine-Dependence for cigarettes and the Lebanon-Waterpipe-Dependence-Scale 11 for waterpipes): 1,066 males and 1,134 females were interviewed. 58.7% versus 42.9% of them, respectively, ever smoked cigarettes, while 6.9% versus 6.7% ever smoked a waterpipe (p < 0.001). Moreover, 57.5% in male versus 49.1% in female cigarette smokers (p = 0.041), 35.9% versus 51.6% in waterpipe smokers (p = 0.076), and 67.9% versus 43.6% in mixed smokers were tobacco dependent. A dose-effect relationship was observed with increased rates of women versus men with waterpipe dependence) and an increased odds of dependence among women in multivariable analysis (ORa = 2.28). Positive (smoking waterpipe for pleasure and conviviality) and negative (smoking waterpipe to relax nerves and improve morale) reinforcements were significantly more frequent in women, while no significant sex difference was observed for nicotine dependence or psychological craving. In exclusive waterpipe smokers, significantly higher respiratory diseases and symptoms prevalences were found in females compared with males. Women who smoke waterpipes should receive attention during tobacco health education and smoking cessation.     

Electronic Cigarette Use Among Korean Adolescents: A Cross-Sectional Study of Market Penetration,Dual Use,and Relationship to Quit Attempts and Former Smoking

PurposeAs elsewhere, in South Korea electronic cigarettes (e-cigarettes) are marketed, in part, as a smoking cessation aid. We assessed the prevalence of e-cigarette use among Korean adolescents and the relationship between e-cigarette use and current (past 30-day) smoking, cigarettes/day, attempts to quit conventional cigarettes, and ceasing to use cigarettes.MethodsData from the 2011 Korean Youth Risk Behavior Web-based Survey of 75,643 students aged 13–18 years were analyzed with logistic regression.ResultsA total of 9.4% (8.0% ever–dual users who were concurrently using e-cigarettes and smoking conventional cigarettes and 1.4% ever–e-cigarette only users) of Korean adolescents have ever used e-cigarettes and 4.7% were current (past 30-day) e-cigarette users (3.6% dual users and 1.1% e-cigarettes only). After adjusting for demographics, current cigarette smokers were much more likely to use e-cigarettes than were nonsmokers. Among current cigarette smokers, those who smoked more frequently were more likely to be current e-cigarette users. The odds of being an e-cigarette user were 1.58 times (95% confidence interval, 1.39–1.79) higher among students who had made an attempt to quit than for those who had not. It was rare for students no longer using cigarettes to be among current e-cigarette users (odds ratio, .10; confidence interval, .09–.12).ConclusionsSome Korean adolescents may be responding to advertising claims that e-cigarettes are a cessation aid: those who had made an attempt to quit were more likely to use e-cigarettes but less likely to no longer use cigarettes. E-cigarette use was strongly associated with current and heavier cigarette smoking.     

Lifetime parental smoking history and cessation and early adolescent smoking behavior

BACKGROUND: Associations are examined between parental smoking and smoking onset by their children. Smoking parents are more likely to have children who start smoking in their teenage years; however, less is known about whether parental quitting is related to adolescent smoking. METHODS: A cross-sectional national sample of 2,206 adolescents, ages 10-14 years, living in two-parent households were interviewed for the DEFACTO annual report on Dutch youth smoking behavior. Adolescent smokers reported that they have tried smoking, even one puff. Respondents indicated whether their parents were never, former, or current smokers, and provided, in the case a parent had quit, their age at that time. RESULTS: Logistic regression analyses revealed that likelihood increased gradually: adolescents with both parents being current smokers were four times more likely to be a smoker compared to adolescents with parents who had never smoked. Additionally, within the group of adolescents whose parents quit smoking, the findings demonstrated that the earlier the parents stopped smoking in the life of their offspring, the less likely their children were to start smoking in adolescence. CONCLUSIONS: Parental smoking history is associated with smoking initiation in early adolescence. Parental cessation at an early age of their offspring reduces the likelihood of adolescent smoking initiation. Preventive efforts, therefore, should focus on the benefits of parental cessation as early as possible.     

Initiation of cigarette smoking and subsequent smoking behavior among U.S. high school students

BACKGROUND: Most adult smokers report trying their first cigarette before age 18 years. Understanding the impact of smoking initiation at young ages may help public health policy makers and practitioners improve strategies to prevent or delay adolescent cigarette smoking. METHODS: This paper examined age of initiation of cigarette smoking and subsequent patterns of smoking among U.S. high school students 16 years of age and older (N = 13,858). We used data from the 1991-1997 national Youth Risk Behavior Surveys, conducted by the Centers for Disease Control and Prevention. RESULTS: The majority of students 16 years of age and older (60.4%) reported ever having smoked a whole cigarette, and 11.1% initiated smoking at age 10 years or younger. Age of smoking initiation was significantly related to current frequent smoking, daily smoking, and whether students had ever smoked daily. A younger age of smoking initiation was associated with smoking more cigarettes per day than was initiating at an older age. CONCLUSIONS: Delaying the onset of smoking may affect the likelihood of becoming addicted to nicotine and smoking heavily. For students who are already addicted to nicotine, smoking cessation programs are needed.