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Natural history of tobacco addiction in adolescents

Institution: University of California, San Francisco
Investigator(s): Anna-Barbara Moscicki, M.D.
Award Cycle: 1998 (Cycle 7) Grant #: 7RT-0195 Award: $499,505
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Research Project Awards

Initial Award Abstract
The health hazards of cigarette smoking are well known. There are currently about 46 million adult cigarette smokers and 3 million adolescent smokers in the U.S. Although smoking in adults has decreased, teen smoking has not. We know that starting to smoke as a teenager is particularly risky, since almost all adult smokers began smoking as teenagers. That is, a large portion of teenagers that smoke end up being addicted to tobacco. Subsequently, the study of tobacco addiction in adolescents is key in preventing tobacco use not only among adolescents but among adults. What we do know is that one of the cigarette metabolites called nicotine is addicting and that once the body gets used to a certain amount of nicotine, it begins to crave it when it doesn't get it. That is addiction. Unfortunately, little is known about the transition period during which this type of nicotine addiction occurs. In addition, definitions for nicotine addiction among adolescents has never been well-defined. Our objective is to examine addiction in youth by closely following biologic???????????? and psychologic?????????????? measures that might directly influence the development of nicotine addiction. Following adolescents from 9th grade to 11th grade, we propose to: 1 ) examine the natural history of nicotine addiction in teenage smokers from the time they experiment with cigarettes to when they are addicted. Some of the measures we will examine include: how often they use cigarettes, changes in how much nicotine they take in over time (this will be measured by measuring the amount of cotinine, another metabolite of tobacco, in their saliva. Measuring the amount of cotinine in the saliva gives us a good idea of how much of this metabolite is in the blood. The higher amount of cotinine in the blood, the more likely the person will be addicted to cigarettes). We will also look at when and with whom they smoke cigarettes, and if they begin to develop a notion that cigarettes make them feel better than usual and that stopping makes them feel worse; 2) we will better define nicotine addiction in teenagers by comparing the changes or increases in saliva cotinine levels with how many cigarettes they smoke a day and the presence of certain symptoms that we use??????????????? when defining adults who are addicted to cigarettes and we will explore certain symptoms that might be more specific to teenagers than adults; 3) we will example specific social and psychologic????????????? influences that help the teenager keep smoking so that eventually the body become addicted. Specifically we are interested in looking at: how some teenagers may use it because they think it keeps their stress down and their weight better controlled; how some teenagers might think that quitting is worse than continuing to smoke; how doing other kinds of drugs, like drinking alcohol or smoking marijuana, might keep them smoking; how smoking at certain times, like at finals, might influence addiction; how friends and parents influence smoking; and how feeling stress and depressed might influence smoking; 4) we will also look at how gender (male or female) and race or ethnicity might influence the natural history of nicotine addiction. The study population will be approximately 1,800 9th graders of diverse racial/ethnic backgrounds from the Bay Area. Phase I (months 0-6) will consist of focus groups (that is a small group of teenager will be asked about their smoking habits), development of a questionnaire, pilot testing (making sure that teenagers understand the questions) and setting up the school sites so they are ready when we begin data collection. This phase is critical in the study since there is a lack of these self-administered (that is the person fills out the questionnaire themselves) questionnaires in teenagers regarding addiction and a lack of studies that are sensitive to cultural diversity. Phase II (months 7-9) will consist of recruiting subjects from schools and time 0 data collection including giving the questionnaire to the teenagers and collecting their saliva for the cotinine. Phase III (months 10-36) will consist of ongoing data collection from classrooms and other alternative settings for dropouts and will include questionnaire administration and saliva sample collection at 6 month intervals.

Using qualitative research to inform survey development on nicotine dependence among adolescents.
Periodical: Drug and Alcohol Dependence Index Medicus:
Authors: Nichter M, Nichter M, Thompson PJ, Shiffman S, Moscicki AB ART
Yr: 2002 Vol: 68 Nbr: Suppl 1 Abs: Pg: S41-56

Effects of pro- and anti-tobacco advertising on nonsmoking adolescents' intentions to smoke.
Periodical: Journal of Adolescent Health Index Medicus:
Authors: Straub DM, Hills NK, Thompson PJ, Moscicki AB ART
Yr: 2003 Vol: 32 Nbr: 1 Abs: Pg: 36-43

Adolescents discriminate among types of smokers and related risks.
Periodical: Journal of Adolescent Reseach Index Medicus:
Authors: Rubinstein ML, Halpern-Felsher BL, Thompson P, Millstein SG ART
Yr: 0 Vol: Nbr: Abs: Pg:

Longitudinal effects of pro- and anti-tobacco advertising on non-smoking teens' smoking behaviors.
Periodical: Society for Adolescent Medicine Index Medicus:
Authors: Straub D, Hills N, Thompson P, Moscickicki A ABS
Yr: 0 Vol: Nbr: Abs: Pg:

Adolescents discriminate among types of smokers and related risks.
Periodical: Pediatric Research Index Medicus:
Authors: Rubinstein ML, Halpern-Felsher BL, Thompson PJ, Millstein SG ABS
Yr: 2001 Vol: 49 Nbr: Abs: Pg: 165A