Adolescent Nicotine Dependence Research Articles

Examining Predictors of Nicotine Dependence in Korean Adolescents : Comparing Ever Quitters and Never Quitters

ABSTRACT Despite growing research on adolescent smokers, evidence for the differences between the two smoker groups who are ever quitters and never quitters is limited. The study aimed to examine predictors of nicotine dependence (ND) in Korean adolescents by comparing ever quitters and never quitters. Data from 349 adolescents were collected through an online survey. Among respondents, most of them were male, living with families, and were enrolled at schools. Data were analyzed by dividing participants into two groups – ever quitters and never quitters. The study found that adolescents’ ND was commonly predicted by smoking peers and anxiety. However, schooling status was significantly associated with ever quitters’ ND only. In the total sample, never-quitters were associated with higher ND compared to ever-quitters. This study did not control for differences among ever quitters in terms of the number of attempts to quit smoking and did not significantly control age effects in the sample. Based on study results, we suggest various policy implications. Cessation intervention should be designed keeping in mind the smokers’ previous quit attempts and their motivation. It is also recommended that individually tailored smoking cessation programs be used to address the heterogenous nature of the adolescents.

Cigarillo and multiple tobacco product use and nicotine dependence in adolescents and young adults

IntroductionMultiple tobacco product (MTP) use is a growing public health concern, particularly among adolescents and young adults. This study identifies subgroups of MTP use among cigarillo users and examines associations with nicotine dependence (ND). Methods1089 youth (ages 14–28) who currently smoke cigarillos completed a web-based survey regarding their current use of cigarillos, little cigars, traditional cigars, cigarettes, e-cigarettes, and waterpipe/hookah. Latent class analysis (LCA) was used to identify patterns of product use by type and amount. The LCA also assessed the relationship between the latent classes and a 38-item measure of ND, controlling for relevant demographics. ResultsMost participants (88.2%) reported using two or more tobacco products in the past 30 days. The best-fitting LCA solution revealed 7 classes: (1) Mixed-Light tipped cigarillo and light cigarette users, 28.9%; (2) Light tipped cigarillo users, 15.8%; (3) Light untipped cigarillo users, 14.3%; (4) Heavy tipped cigarillo users, 13.4%; (5) E-cigarette and waterpipe users, 11.9%; (6) Heavy users of tipped and untipped cigarillos and light users of cigarettes, 9.8%; and (7) Dabblers who primarily used traditional cigars, but were also likely to use a variety of other products, 6.1%. Classes comprised of those using multiple products—particularly those that included cigarettes—had significantly higher levels of ND than other classes (Tukey’s HSD P < .05). ConclusionsDistinct patterns of MTP use are evident among young cigarillo smokers. Smoking multiple products, particularly smoking cigarillos in combination with cigarettes, is associated with higher ND compared to other product use patterns.

Reproductive health outcomes among eating disordered females: a register-based follow-up study among former adolescent psychiatric inpatients

Objective To analyze an association of eating disorders (EDs) to reproductive health outcomes among former adolescent psychiatric inpatients, hospitalized between the ages 13 and 17 years. The register-based follow-up information on psychiatric comorbidity and use of prescribed addictive psychotropic medication up to early adulthood were also explored. Methods A total of 31 (10.3%) women with a diagnosed ED were identified from the initial sample of 300 female adolescents, treated in psychiatric inpatient care between 2001 and 2006. The K-SADS-PL and EuropASI research instruments were used to gather information during the adolescent psychiatric hospitalization. The follow-up data for reproductive health outcomes and psychiatric comorbidity up to early adulthood were obtained from the national health care registers. Information on prescribed addictive psychotropic medication was provided by the Social Insurance Institution of Finland. In analyses, EDs were categorized into anorexia nervosa (AN) and other EDs (OED). AN accounted for 58.1% of all EDs. Of OEDs, the majority (69.1%) were bulimia. Results None of the women with AN, but 53.8% of those with OED had undergone medical abortions by early adulthood. Childbirths were emphasized in women with OED (61.5%) and a history of hospital-treated poisonings in women with AN (55.6%). High nicotine dependence in adolescence (30.8%) was a characteristic of women with OED. Conclusion Our study findings suggest that OED may expose affected women to various unfavorable reproductive health outcomes, particularly women with a history of psychiatric admissions. Recognizing the differences in young women with different subtypes of ED is important when discussing contraception and pregnancy.

Nicotine dependence in adolescence predicts later drug criminality: a register-based follow-up of adolescent psychiatric inpatients

Cigarette smoking is common among adolescent psychiatric patients and often precedes the initiation of substance and illicit drug use. This study investigates the association of nicotine dependence (ND), assessed already in adolescence, to subsequent drug crime offenses committed up to young adulthood. The special focus was to examine the dose-response between adolescent ND and later drug-crime offenses. The initial data consist of former adolescent psychiatric inpatients treated in psychiatric inpatient care between the ages 13–17 years. Adolescent DSM-IV based psychiatric disorders were based on the semi-structural diagnostic K-SADS-PL interview. ND in adolescence was measured using the modified Fagerström Tolerance Questionnaire for children and adolescents. Follow-up data on crimes of the study subjects from 15 years of age to early adulthood was obtained from the nationwide Legal Register Center of Finland. A total of 60 (11.8%) drug crime offenders were identified from the initial study population. The likelihood for drug crime offending was statistically significantly increased among those with moderate to severe ND already in adolescence. The higher level of adolescent ND indicated greater number of drug offenses. The common characteristics of drug crime offenders were male gender, out-of-home placement background, exposure to parental divorce and a diagnosis for affective, conduct and substance-use disorder in adolescence. Our study finding, that higher level of ND in adolescence predicts greater number of drug crime offenses up to young adulthood, warrants identification of adolescent smokers at-risk of later drug-related crimes.

Differential expression of nicotine withdrawal as a function of developmental age in the rat

Cigarette smoking and resultant nicotine dependence remain major public health problems. Most smokers begin before the age of 18, yet preclinical models have insufficiently characterized the development of nicotine dependence in adolescence. To categorize the short-term effects of chronic nicotine administration throughout adolescence and adulthood, we exposed male Sprague Dawley rats to 14 days of continuously delivered nicotine (0, 1.2 or 4.8 mg/kg/d) using a subcutaneous osmotic minipump, starting between postnatal day 33 (p33) and p96. Next, to explore the effects of extended exposure to chronic nicotine, we exposed male Sprague Dawley rats to 42 days of continuous nicotine starting in adolescence (p33) or early adulthood (p68). Somatic and affective signs of precipitated withdrawal (PW) were observed after a mecamylamine (1.5 mg/kg, i.p.) challenge as compared to a saline injection. Short term nicotine exposure starting at p96, well within the adult period, elicited a significant increase in somatic PW as measured by a composite behavioral score. In contrast, adolescent exposure to nicotine elicited a unique behavioral profile, dependent on the starting age of exposure. Late adolescence exposure was characterized by scratching while adult exposure was characterized by facial tremors and yawns. Extended exposure to nicotine resulted in age specific characteristic nicotine withdrawal behaviors, including scratches, ptosis and locomotion, distinct from the short-term exposure. Thus, nicotine dependence severity, based on the expression of total somatic PW behaviors, is not observed until the adult period, and differences between adolescents and adults are observed using a more nuanced behavioral scoring approach. We conclude that age of nicotine initiation affects somatic withdrawal signs and their magnitude. These data serve as a foundation for understanding the underlying brain mechanisms of nicotine dependence and their development over adolescence and early adulthood.

UPPS-P impulsive personality traits and adolescent cigarette smoking: A meta-analysis

BackgroundAdolescence is a critical developmental period in the trajectory of nicotine dependence, highlighting the need for a greater understanding of the modifiable risk factors. An extensive body of research has found that trait impulsivity is associated with higher levels of adolescent smoking; however, findings have been mixed. The present study aimed to synthesise existing literature to determine the strength and nature of the relationship between the UPPS-P impulsive traits and both adolescent cigarette consumption and nicotine dependence. MethodsFifty-one studies were meta-analysed using a random effects model to determine the association between each UPPS-P impulsive trait and both adolescent cigarette consumption and nicotine dependence. Age, gender, ethnicity and sample type were examined as potential moderators. ResultsCigarette consumption was positively associated with each UPPS-P impulsive trait (r’s ranging from 0.17-0.20). There were an insufficient number of studies to meta-analyse the association between nicotine dependence and the UPPS-P impulsive traits. There were no significant moderation effects of age, gender, ethnicity or sample type. ConclusionsFindings suggest that each UPPS-P impulsive trait shares similar associations with adolescent cigarette consumption. Additional studies are needed to determine the relationship between adolescent nicotine dependence and impulsivity. As most adult smokers initiate during adolescence, targeting these impulsive traits via novel prevention and intervention strategies may assist in reducing the prevalence of smoking.

Predictors of Nicotine Dependence in Adolescents: Symptoms of Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder.

Bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD) have been associated with the use of cigarettes, but little is known about the impact of the subthreshold symptoms of BD or ADHD on the course of nicotine dependence. Identifying the links is essential for elucidating the pathway and supporting the development of nicotine prevention strategies for adolescents. Participants (n = 3322) aged 15-17 years completed the Chinese version of the ADHD Self-Report Scale and the Mood Disorder Questionnaire. The modified Fagerström Tolerance Questionnaire was completed to measure their nicotine use or dependence. Mediation analyses were performed to explore the relationship of two predictors. The prevalence rates of cigarette smoking and nicotine dependence in this study were 14.4% and 2.3%, respectively. Male gender (odds ratio [OR] 2.30; 95% confidence interval [CI] 1.60-3.30), subclinical symptoms of ADHD (OR 1.34; 95% CI 1.04-1.71), clinical symptoms of ADHD (OR 1.69; 95% CI 1.08-2.66), and symptoms of BD (OR 1.59; 95% CI1.09 to 2.32) were associated with nicotine use. Male gender (OR 4.60; 95% CI 1.41-14.98) and symptoms of BD (OR 6.14; 95% CI 3.37-11.18), but not symptoms of ADHD, were associated with nicotine dependence. In mediation analyses, we found that the effect of ADHD symptoms was no longer significant after controlling for symptoms of BD, and the mediation ratio (PM) was 0.39. Our findings suggest that mood disturbances other than symptoms of ADHD are more likely to be a key predictor of nicotine dependence among adolescents. The conclusions may improve our understanding of the course of nicotine dependence and help to promote potential health policy for nicotine control among youths.

Class smoke-free pledge impacts on nicotine dependence in male adolescents: A cluster randomized controlled trial

Background: To test the effectiveness of a school-based, peer-led smoking and asthma education program, known as the Triple A (Adolescent Asthma Action) in Jordan (TAJ), with an additional class smoke-free pledge strategy (TAJ-Plus) as compared to the TAJ alone on smoking-related knowledge and perception, nicotine dependence, and asthma control in male high school students in Jordan four months post-intervention. Methods: In this cluster-randomized controlled trial, four public male high schools in Irbid, Jordan were randomly assigned to receive the TAJ-Plus (n = 215) or the TAJ (n = 218). TAJ educators were 3rd year male undergraduate nursing students (n = 9) who received training in a one-day workshop. These educators then trained senior students from the four schools to be Peer Leaders (n = 53), who then taught peers in grades 7 and 8 (n = 433). The Peer Leaders in the TAJ-Plus schools implemented the smoke-free pledge within the 7th and 8th graders, who voluntarily signed the pledge for four months. Data were collected from students in grades 7 and 8 using self-administered questionnaires at baseline and four months post-intervention. Results: Students from the TAJ-Plus group reported significant improvements in smoking-related knowledge and perception (p &lt; 0.001) and lower nicotine dependence (p &lt; 0.001) as compared to the TAJ group. Improvement in asthma control was greater (p = 0.03) in non-smokers versus smokers. Conclusions: Voluntary group commitment smoke-free through a pledge is feasible, and an incentive to motivate adolescents to abstain from smoking. Using social influences approaches in schools is useful in countering current aggressive tobacco marketing campaigns in Arab youth. TRN: NCT01938976

Measures of nicotine dependence in adolescents: An update of the evidence 2000–2010

Nicotine withdrawal and the compulsion to use tobacco resulting from withdrawal form the core clinical features of nicotine dependence (ND). However, some ND measures show little or no content overlap with these clinical features. Our objective was to review the content and psychometric properties of available measures of ND for youth. A literature search identified 27 English language articles published in 2000-2 010 that evaluated ND measures in adolescents or young adults. A consensus process among the authors was used to establish if each item in each measure assessed withdrawal or compulsion, or if the item tapped other aspects of cigarette smoking including tolerance, harm, triggers for smoking, cigarette use pattern s, prioritizing smoking, perceived utility, or attitudes about smoking. Out of 14 measures identified, three (Hooked on Nicotine Checkl ist, Latency to Withdrawal, Withdrawal Symptom Cluster) measured the core clinical features of ND; six (Autonomy Over Smoking Scale, DSM IV, Dimensions of Tobacco Dependence Scale, ICD-10 Tobacco Dependence, ND/Cravings Symptom Cluster, Nicotine Dependence Syndrome Scale) measured withdrawal/compulsion and other aspects of smoking; and five (Fagerstr ¨ Test for Nicotine Dependence, Modified Fagerstr ¨ om Tolerance Questionnaire, Nicotine Dependence Scale for Adolescents, Self- Medication Symptom Cluster, Stanford Dependence Index) had few or no withdrawal/compulsion indicators. Existing measures vary widely in the degree to which they assess the known clinical features of ND. Attempts to assess ND indirectly in youth by measuring other aspects of smoking may result in inaccuracy if items are endorsed for reasons other than ND. No existing measure assesses the full spectrum of clinically recognized features of ND.

The genetic aspects of nicotine metabolism and their impact on adolescent nicotine dependence

The genetic aspects of nicotine metabolism and their impact on adolescent nicotine dependence

The genetic aspects of nicotine metabolism and their impact on adolescent nicotine dependence

In humans, nicotine is extensively metabolized via multiple pathways that are catalyzed by genetically variable enzymes. As a result, there is large interindividual and int erethnic variability observed in nicotine pharmacokineti cs. Twin studies suggest an important role for genetic factors, alth ough environmental and physiological factors also contribute to this variability. The present chapter focuses on the genetics of nicotine metabolism and its impact on smoking behaviors with specific emphasis on the adolescent period. Enzymes involved in nicotine metabolism include cytochromes P450 (CYPs), aldehyde oxidase (AOX1), UDP-Glucuronosyltransferases (UGTs), and flavin-containing monooxygenase 3 (FMO3). CYP2A6 is the main enzyme involved in nicotine's metabolic inactivation ; CYP2A6 genetic variants contribute substantially to the observed variability in nicotine metabolism. In addition, genetic v ariation in CYP2A6has been associated with multiple smoking behaviors in adults (e.g. risk of smoking, level of cigarette consumpt ion, depth of inhalation, and ability to stop smoking). Among adolescents, two longitudinal cohort studies showed a consistent effect of CYP2A6 genetic variation on level of smoking among dependent adolescents but found different effects with respect to the association of CYP2A6 with onset versus progression of nicotine dependence. We re-examined these two studies in detail in order to more fully understand these findings. Unders tanding variability in nicotine metabolism assists in understandi ng variability in response to nicotine and liability to smok ing, providing the potential of identifying individuals at greater risk fo r smoking, sustained smoking and smoking related disorders and also may assist in personalizing treatment to improve efficacy of nicotine replacement therapies.

Correction: Approximating a Giving Up Smoking Dynamic on Adolescent Nicotine Dependence in Fractional Order.

[This corrects the article DOI: 10.1371/journal.pone.0103617.].

Approximating a Giving Up Smoking Dynamic on Adolescent Nicotine Dependence in Fractional Order.

In this work, we consider giving up smoking dynamic on adolescent nicotine dependence. First, we use the Caputo derivative to develop the model in fractional order. Then we apply two different numerical methods to compute accurate approximate solutions of this new model in fractional order and compare their results. In order to do this, we consider the generalized Euler method (GEM) and multi-step generalized differential transform method (MSGDTM). We also show the unique positive solution for this model and present numerical results graphically.

“Class smoke-free” pledge impacts on nicotine dependence in male adolescents: A cluster randomized controlled trial

Objective: To test the effectiveness of a school-based, peer-led smoking and asthma education program with an additional “class smoke-free” pledge on smoking-related knowledge and perception, nicotine dependence, and asthma control in male high school students in Jordan 4 months post-intervention.Methods: In this cluster-randomized controlled trial, four male schools in Irbid, Jordan, were randomly assigned to the intervention (n = 215) or comparison (n = 218) groups. Trained educators trained senior students from the four schools to be peer leaders (n = 53), who then taught peers in grades 7 and 8 (n = 433). The peer leaders in the intervention schools implemented the smoke-free pledge within the 7th and 8th graders, who voluntarily signed the pledge for 4 months. The comparison group received the same intervention components as the intervention group, minus the smoke-free pledge. Data were collected from students in grades 7 and 8 at baseline and 4 months post-intervention.Results: Students from the intervention group reported significant improvements in smoking-related knowledge and perception and lower nicotine dependence as compared to the comparison group. Improvement in asthma control was greater in nonsmokers versus smokers.Conclusions: Voluntary group commitment smoke-free through a pledge is an incentive to motivate adolescents to abstain from smoking. Using social influences approaches in schools is useful in countering current aggressive tobacco marketing campaigns in Arab youth.

Intergenerational Patterns of Smoking and Nicotine Dependence Among US Adolescents.

We examined associations between parental and adolescent smoking and nicotine dependence in the United States. We used data from the 2004 to 2012 National Survey on Drug Use and Health, which ascertained smoking behaviors of 1 parent and 1 adolescent aged 12 to 17 years in 35 000 dyads. We estimated associations between parental and adolescent smoking behaviors, adjusted for covariates. Parental current dependence was strongly associated with adolescents' lifetime smoking (adjusted odds ratio [AOR] = 2.96; 95% confidence interval [CI] = 2.47, 3.55), whereas parental current nondependent smoking (AOR = 2.26; 95% CI = 1.92, 2.67) and former smoking (AOR = 1.51; 95% CI = 1.31, 1.75) were less strongly associated. Only parental nicotine dependence was associated with adolescent nicotine dependence (AOR = 1.66; 95% CI = 1.00, 2.74). Associations between parental and adolescent smoking did not differ by race/ethnicity. Parents' education, marital status, and parenting and adolescents' mental health, beliefs about smoking, perception of schoolmates' smoking, and other substance use predicted adolescent smoking and dependence. Reducing parental smoking would reduce adolescent smoking. Prevention efforts should encourage parental smoking cessation, improve parenting, address adolescent mental health, and reinforce adolescents' negative beliefs about smoking.

Nicotine Dependence in Adolescence and Physical Health Symptoms in Early Adulthood.

To examine the prospective associations of Diagnostic and Statistical Manual of Mental Disorders nicotine dependence (ND) and other individual and parental factors in adolescence on self-reported health symptoms in early adulthood. Multiethnic prospective longitudinal cohort of adolescents from grades 6-10 and a parent (N = 908) from the Chicago Public Schools. Adolescents were interviewed five times at 6-month intervals (Waves 1-5) and once 4.5 years later (Wave 6). Parents were interviewed annually three times (W1, W3, W5). Multivariate regressions estimated prospective associations of Diagnostic and Statistical Manual of Mental Disorders ND, other individual and familial risk factors in adolescence (mean age 16.6) on physical health symptoms in early adulthood (mean age 21.3), controlling for health symptoms in adolescence. Levels of health symptoms declined from adolescence to early adulthood, except among dependent smokers. Nicotine dependent adolescents reported more health symptoms as young adults than nonsmokers and nondependent smokers, especially if depressed. ND and health symptoms in adolescence were the strongest predictors of health in early adulthood. These two adolescent factors, depression, and the familial factors of parental ND, depression and health conditions, each independently predicted health symptoms in young adulthood. Females reported more symptoms than males. There is continuity of health status over time. ND, depression, and parental factors in adolescence contribute to poor health in early adulthood. The findings highlight not only the role of adolescent behavior, but the importance of the family in the development of young adult health. Reducing smoking, particularly ND, and depression among adolescents and parents will decrease physical health burden.

Measures of nicotine dependence in adolescents: An update of the evidence 2000–2010

Nicotine withdrawal and the compulsion to use tobacco resulting from withdrawal form the core clinical features of nicotine dependence (ND). However, some ND measures show little or no content overlap with these clinical features. Our objective was to review the content and psychometric properties of available measures of ND for youth. A literature search identified 27 English language articles published in 2000–2010 that evaluated ND measures in adolescents or young adults. A consensus process among the authors was used to establish if each item in each measure assessed withdrawal or compulsion, or if the item tapped other aspects of cigarette smoking including tolerance, harm, triggers for smoking, cigarette use patterns, prioritizing smoking, perceived utility, or attitudes about smoking. Out of 14 measures identified, three (Hooked on Nicotine Checklist, Latency to Withdrawal, Withdrawal Symptom Cluster) measured the core clinical features of ND; six (Autonomy Over Smoking Scale, DSM IV, Dimensions of Tobacco Dependence Scale, ICD-10 Tobacco Dependence, ND/Cravings Symptom Cluster, Nicotine Dependence Syndrome Scale) measured withdrawal/compulsion and other aspects of smoking; and five (Fagerstrom Test for Nicotine Dependence, Modified Fagerstrom Tolerance Questionnaire, Nicotine Dependence Scale for Adolescents, Self-Medication Symptom Cluster, Stanford Dependence Index) had few or no withdrawal/compulsion indicators. Existing measures vary widely in the degree to which they assess the known clinical features of ND. Attempts to assess ND indirectly in youth by measuring other aspects of smoking may result in inaccuracy if items are endorsed for reasons other than ND. No existing measure assesses the full spectrum of clinically recognized features of ND.

CYP2A6 metabolism in the development of nicotine dependence in adolescents and young adults

CYP2A6 metabolism in the development of nicotine dependence in adolescents and young adults

Frequent marijuana use is associated with greater nicotine addiction in adolescent smokers

BackgroundMarijuana and tobacco are the substances used most commonly by adolescents and co-occurring use is common. Use of one substance may potentiate the addictive properties of the other. The current study examined the severity of nicotine addiction among teen smokers as a function of co-occurring marijuana use. MethodsParticipants were 165 adolescents (13–17 years old) who reported smoking at least 1 cigarette per day (CPD) in the past 30 days. General linear models examined the association of marijuana use with multiple measures of nicotine addiction including the Modified Fagerström Tolerance Questionnaire (mFTQ), Hooked on Nicotine Checklist (HONC), ICD-10, and the Nicotine Dependence Syndrome Scale (NDSS). ResultsThe adolescent sample (mean age=16.1 years, SD=0.95) averaged 3.0 CPD (SD=3.0) for 1.98 years (SD=1.5). Most (79.5%) also smoked marijuana in the past 30 days. In models controlling for age, daily smoking status, and years of tobacco smoking, frequency of marijuana use accounted for 25–44% of the variance for all four measures of adolescent nicotine dependence. ConclusionsMarijuana use was associated with greater reported nicotine addiction among adolescent smokers. The findings suggest a role of marijuana in potentiating nicotine addiction and underscore the need for treatments that address both smoked substances.

Psyche and art: Art manifests to the soul that appreciates it

Byline: Sravanti. Sanivarapu [INLINE:1] Art stimulates mind and mind creates art. Art gives an opportunity to the mind to express itself. However the mind must exercise its thoughts effectively to create a masterpiece. Now, trying to draw a parallel between the two disciplines of art and psychiatry - an aura of fascination surrounds the two that is intensely attractive. Their relationship dates back to time immemorial and both are equally enigmatic. From patients trying to put forth their views in the form of arts, to artists using psychological themes for their painting, the two have always been inter-related. Moreover, over the years this relationship has evolved to an extent that art is being used as a form of therapy to help people recover from mental ailments. The painting shows a depressed girl sulking in loneliness and refusing to see the shower of brightness that symbolizes "hope."