Robinson Miqun L, Berlin Ivan, Moolchan Eric T
Teen Tobacco Addiction Treatment Research Clinic, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, 5500 Nathan Shock Drive, Baltimore, MD 21224, USA.
J Adolesc Health. 2004 Sep;35(3):217-24. doi: 10.1016/j.jadohealth.2003.10.005.
To examine smoking trajectories in a clinical sample of adolescent smokers seeking cessation treatment, including: (a) smoking onset (initial, daily) and time intervals from initial to daily smoking and from daily smoking to treatment request, (b) associations between current level of tobacco dependence and smoking history, and (c) differences in smoking trajectory between African-American and non-African-American youth.
Four hundred and thirty-two adolescent smokers (aged 13-17 years, 61.8% female, 32% African-American) responding to various media advertisement completed a telephone interview as part of pre-eligibility screening for a smoking cessation trial. Smoking trajectory data included age at onset of initial and daily smoking, intervals between those time points, and cigarettes smoked per day (CPD). Tobacco dependence was assessed using the Fagerström Test for Nicotine Dependence (FTND). Data were analyzed using regression models and multiple analyses of covariance.
Initial smoking occurred at a mean age of less than 12 years and daily smoking at age 13 years. Earlier onset of daily smoking was associated with higher FTND scores and longer duration from daily smoking to treatment request. For the entire sample, the time interval from initial to daily smoking was 1.14 years. When the sample was divided into early (before age 14 years) and later (at or after age 14 years) initiators, early initiators showed a slower progression from initial to daily smoking compared with late initiators (16 months vs. 6 months). Compared with non-African-American teen smokers, African-American youth reported a 1-year delay in onset of both initial and daily smoking.
Early age of daily smoking and short time interval from initial to daily smoking highlight a brief window of opportunity to prevent the development of tobacco addiction and its consequences. Ethnic differences in smoking trajectory uncovered in this report call for ethnically tailored interventions to reduce youth smoking.
在寻求戒烟治疗的青少年吸烟者临床样本中研究吸烟轨迹，包括：（a）吸烟起始（初次、每日）情况以及从初次吸烟到每日吸烟和从每日吸烟到提出治疗请求的时间间隔，（b）当前烟草依赖水平与吸烟史之间的关联，以及（c）非裔美国青少年与非非裔美国青少年在吸烟轨迹上的差异。
432名青少年吸烟者（年龄13 - 17岁，61.8%为女性，32%为非裔美国人）通过回应各种媒体广告，作为戒烟试验资格预审筛查的一部分完成了电话访谈。吸烟轨迹数据包括初次和每日吸烟起始年龄、这些时间点之间的间隔以及每日吸烟量（CPD）。使用尼古丁依赖的法格斯特龙测试（FTND）评估烟草依赖。数据采用回归模型和多因素协方差分析进行分析。
初次吸烟的平均年龄小于12岁，每日吸烟年龄为13岁。每日吸烟起始较早与较高的FTND得分以及从每日吸烟到提出治疗请求的时间较长相关。对于整个样本，从初次吸烟到每日吸烟的时间间隔为1.14年。当样本分为早期（14岁之前）和晚期（14岁及之后）起始者时，早期起始者从初次吸烟到每日吸烟的进展比晚期起始者慢（16个月对6个月）。与非非裔美国青少年吸烟者相比，非裔美国青少年报告初次和每日吸烟起始均延迟1年。
每日吸烟年龄较早以及从初次吸烟到每日吸烟的时间间隔较短，凸显了预防烟草成瘾及其后果的短暂机会窗口。本报告中发现的吸烟轨迹种族差异要求采取针对不同种族的干预措施以减少青少年吸烟。
