Cigarette smoking and nicotine dependence trajectories among incident adolescent smokers
Menée au Canada par enquête auprès de 1 294 adolescents, cette étude analyse l'association entre la dépendance à la nicotine et les comportements tabagiques
Few interventions target adolescent cigarette smokers to prevent escalation in cigarette use or promote cessation, in part because little is known about co-developing smoking and nicotine dependence (ND). Our objectives were to: (i) estimate developmental trajectories of ND/cravings, withdrawal symptoms, the mFTQ and ICD-10 tobacco dependence in incident adolescent smokers; (ii) describe concordance in number and shapes of trajectories across the four ND indicators; and (iii) classify participants in each ND trajectory according to cigarette smoking trajectories.Data were drawn from an ongoing longitudinal investigation of 1294 grade 7 students recruited in 1999-2000 in 10 Montreal-area high schools. Group-based joint trajectory models were used to identify distinct subgroups defined by the four ND indicators, in 307 incident smokers.The optimal trajectory model included five groups for ND/craving and four groups for each of withdrawal symptoms, the mFTQ and ICD-10 tobacco dependence. The four ND indicators showed similar developmental patterns and classification into smoking trajectory groups, although some discordance was observed. Smokers in the low-level decreaser group and stable low consumers who exhibited high ND were younger than those in the cigarette-low ND trajectory groups. Moderate or rapid escalators who exhibited no/low ND were less likely to have university-educated mothers and more likely to have parents who smoke.Trajectories were similar across ND indicators, and generally reflected cigarette smoking trajectory shapes. Novice smokers may need education to become self-aware of developing ND symptoms, as well as to learn about alternative courses of action once ND symptoms manifest.