rss
Tob Control 13:251-257 doi:10.1136/tc.2003.005595
  • Research paper

Short term patterns of early smoking acquisition

  1. R J Wellman1,
  2. J R DiFranza2,
  3. J A Savageau2,
  4. G F Dussault2
  1. 1Fitchburg State College, Fitchburg, Massachusetts, USA
  2. 2University of Massachusetts Medical School, Worcester, Massachusetts, USA
  1. Correspondence to:
 Joseph R DiFranza MD
 Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, Massachusetts 01655, USA; difranzjummhc.org
  • Received 31 July 2003
  • Accepted 10 May 2004

Abstract

Objective: To describe short term patterns of smoking acquisition exhibited by adolescent smokers.

Design: Interview records from the prospective development and assessment of nicotine dependence in youth study were examined retrospectively. Interviews were conducted three times per year over 30 months.

Subjects: 164 students in grades 7–9 (ages 12–15 years, 86 girls, 78 boys) who had used cigarettes at least twice.

Main outcome measures: A continuous timeline of smoking activity, beginning with the subject’s first use of tobacco and continuing through follow up, was translated into six patterns—abstinent, sporadic, occasional, daily, escalating, and intermittent. Outcome measures were the proportion of subjects starting/ending in each pattern, and the number of transitions per subject between patterns.

Results: There was a general but discontinuous progression from infrequent to more frequent use, with many interspersed periods of not smoking. Escalation to daily smoking was common after the development of dependence symptoms, but was rare among those who did not have symptoms. After the appearance of symptoms, both transitions to heavier daily smoking and attempts at cessation increased.

Conclusions: Movement to heavier, more frequent smoking is generally unidirectional, although many youths attempt to quit one or more times. The appearance of any symptom of dependence altered the subsequent pattern of smoking behaviour. Future investigators might consider using more frequent data points and a continuous timeline to track smoking behaviour.

Footnotes

    Free sample

    This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of Tobacco Control.
    View free sample issue >>

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.


    This insightful video is produced by Cancer Research UK

    Navigate This Article