Prevalence of selected nicotine dependence symptoms among U.S. adolescents who started smoking in the past year: 2004 National Youth Tobacco Survey

Objective. —To determine rates of four selected nicotine dependence symptoms– nicotine withdrawal (irritable, restless), cravings, urges, and self-efficacy within different levels of smoking.

Methods. — A 2004 nationally representative sample of students enrolled in grades 6 through 12 in the U.S. Our analysis included students aged 12–18 years who smoked at least one day in the past 30 days (n=2,580). We calculated weighted percentages by smoking patterns that were created from the options for quantity (5 levels) and frequency (5 levels).

Results.— About 26% of current smokers who started smoking less than a year prior to the survey and who in the past month smoked at low levels (<1 cigarette, 1 cigarette, 2-5 cigarettes) on a few days (1 or 2 days, 3-5 days) reported having at least 1 of 4 nicotine dependence symptoms. The more prevalent symptom was withdrawal (19.6%), followed by cravings (13.5%), believing not been able to quit if wanted to (6.4%) and urges (5.2%). About 18% of low level smokers reported 1 symptom, 7% reported 2 symptoms, 3% reported 3 symptoms, and 1% reported having 4 symptoms. Among low level smokers who smoked 1-2 days, 27% reported having at least 1 nicotine dependence symptom compared to 34% of those who smoked 3-5 days. Finally, our analysis showed that among daily smokers, over 90% had at least 1 nicotine dependence symptom.

Conclusions. — Our findings that nicotine dependence symptoms are present among those in the early stages of cigarette smoking suggest a need for early cessation intervention.