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. 2014 Aug;47(2 Suppl 1):S4-14.
doi: 10.1016/j.amepre.2014.04.013.

Symptoms of tobacco dependence among middle and high school tobacco users: results from the 2012 National Youth Tobacco Survey

Benjamin J Apelberg  1 , Catherine G Corey  2 , Allison C Hoffman  2 , Megan J Schroeder  2 , Corinne G Husten  3 , Ralph S Caraballo  4 , Cathy L Backinger  2
Affiliations

Symptoms of tobacco dependence among middle and high school tobacco users: results from the 2012 National Youth Tobacco Survey

Benjamin J Apelberg et al. Am J Prev Med. 2014 Aug.

Abstract

Background: A growing body of evidence suggests that tobacco dependence symptoms can occur soon after smoking onset and with low levels of use. However, limited data are available nationally and among non-cigarette tobacco users.

Purpose: To examine the prevalence and determinants of tobacco dependence symptoms among adolescent tobacco users in the 2012 National Youth Tobacco Survey, a nationally representative, school-based survey of U.S. middle and high school students.

Methods: Multivariate logistic regression was used to identify independent predictors of dependence symptoms among current users (i.e., past 30-day use) of cigarettes, cigars, or smokeless tobacco. Analyses were conducted in 2013 using SAS-callable SUDAAN, version 11 to account for the complex survey design.

Results: Prevalence of tobacco dependence symptoms ranged from 20.8% (95% CI=18.6, 23.1) of current tobacco users reporting wanting to use tobacco within 30 minutes of waking to 41.9% (95% CI=39.3, 44.5) reporting recent strong cravings. Reporting of dependence symptoms was most consistently associated with polytobacco use, higher frequency of use, earlier initiation age, and female gender. A 2-4-fold increase in the odds of symptom reporting was found in adolescents using tobacco products on as few as 3-5 days compared to those who only used it for 1-2 of the past 30 days.

Conclusions: A substantial proportion of U.S. adolescent tobacco users, including those with low levels of use, report symptoms of tobacco dependence. These findings demonstrate the need for full implementation of evidence-based strategies to prevent both experimentation and progression to regular tobacco use among youth.

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Figures

Figure 1
Figure 1
Prevalence of symptoms of dependence by frequency of tobacco use, 2012 National Youth Tobacco Survey
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