Predictors of nicotine dependence symptoms among never-smoking adolescents: A longitudinal analysis from the Nicotine Dependence in Teens Study

Abstract

Background-Recent cross-sectional studies suggest some adolescents who have never smoked cigarettes experience nicotine dependence (ND) symptoms and that exposure to second-hand smoke, social exposure to smoking, and alcohol use are plausible correlates. The aim of this study was to replicate and extend these findings by investigating possible predictors of ND symptoms longitudinally.Method-Participants included 847 secondary school students who had never smoked cigarettes enrolled in the Nicotine Dependence in Teens Study. Adolescents completed self-report questionnaires measuring smoking status, ND symptoms, and risk factors for ND in smokers (i.e., socio-demographic indicators, social exposure to smoking, psychosocial indicators, and substance use) in 20 survey cycles from 7 to 11th grade. Generalized estimating equations, which account for repeated measures within individuals, were used to test the predictors of ND symptoms. Results-Consistent ContributorsSimon Racicot developed the research question, conducted the literature review, undertook the statistical analyses, interpreted the results, and wrote and revised the manuscript. Jennifer J. McGrath supervised the literature review, the statistical analyses, and revised the manuscript. Igor Karp designed the analytical plan and revised the manuscript. Jennifer O'Loughlin designed the study, contributed to the protocol development, and revised the manuscript. All authors read and approved the final manuscript for submission. Conflict of interestThere is no conflict of interest. Conclusions-Replicating previous cross-sectional findings, peer smoking and alcohol use predicted ND symptoms among never-smoking adolescents. Extending these findings, previous predictors only observed among ever-smokers, including socio-demographic and psychosocial indicators, also predicted ND symptoms. This longitudinal investigation demonstrated the temporal relation of the predictors preceding ND symptoms. Future research should consider longer prospective studies with younger children to capture early onset of ND symptoms and with longer follow-up to detect eventual smoking uptake.

Determinants of progression of nicotine dependence symptoms in adolescent waterpipe smokers

“…Interestingly, our finding that higher self-esteem predicted progression of ND symptoms in waterpipe smokers is contrary to that observed in cigarette smokers in which low self-esteem was associated with experiencing symptoms of ND 34. Generally, youth with lower self-esteem are more prone to risky behaviours, such as cigarette smoking 35.…”

A systematic review of secondhand tobacco smoke exposure and smoking behaviors: Smoking status, susceptibility, initiation, dependence, and cessation

“…Thus the reports of nicotine dependence symptoms among never smokers may either be viewed as a misclassification, or may represent some psycho-behavioral effects experienced by nonsmokers as a result of SHSe. A recent study suggests that the reports of nicotine dependence symptoms among never smokers are associated with several psychosocial factors such as peer and teacher smoking (Racicot et al, 2013). Nevertheless, it is quite clear (with the exception of Okoli, Rayens, and Hahn (2007)) that SHSe is an independent predictor of nicotine dependence in epidemiological studies among smokers.…”

Correlates of nicotine dependence among adolescent waterpipe smokers

“…Data on waterpipe use patterns (Maziak et al, 2004, 2005; Primack et al, 2014), attitudes towards a waterpipe (Hammal et al, 2008; Maziak et al, 2004; Ward et al, 2005), and the factors associated with ND among adolescent smokers (Kleinjan et al, 2012; DiFranza et al, 2007a; Racicot et al, 2013; O’Loughlin et al, 2002) were obtained using a pilot-tested, interviewer-administered questionnaire. The questionnaire was translated into Arabic, and back translated to English for comparison and fine-tuning using standard methods (Brislin, 1970).…”