University of Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
BMC Pediatr. 2011 Aug 11;11:70. doi: 10.1186/1471-2431-11-70.
The American Academy of Pediatrics advocates that pediatricians should be involved in tobacco counseling and has developed guidelines for counseling. We present a prognostic tool for use by health care practitioners in both clinical and non-clinical settings, to identify adolescents at risk of becoming daily smokers.
Data were drawn from the Nicotine Dependence in Teens (NDIT) Study, a prospective investigation of 1293 adolescents, initially aged 12-13 years, recruited in 10 secondary schools in Montreal, Canada in 1999. Questionnaires were administered every three months for five years. The prognostic tool was developed using estimated coefficients from multivariable logistic models. Model overfitting was corrected using bootstrap cross-validation. Goodness-of-fit and predictive ability of the models were assessed by R2, the c-statistic, and the Hosmer-Lemeshow test.
The 1-year and 2-year probability of initiating daily smoking was a joint function of seven individual characteristics: age; ever smoked; ever felt like you needed a cigarette; parent(s) smoke; sibling(s) smoke; friend(s) smoke; and ever drank alcohol. The models were characterized by reasonably good fit and predictive ability. They were transformed into user-friendly tables such that the risk of daily smoking can be easily computed by summing points for responses to each item. The prognostic tool is also available on-line at http://episerve.chumontreal.qc.ca/calculation_risk/daily-risk/daily_smokingadd.php.
The prognostic tool to identify youth at high risk of daily smoking may eventually be an important component of a comprehensive tobacco control system.
美国儿科学会主张儿科医生应参与烟草咨询，并制定了咨询指南。我们提出了一种预后工具，供临床和非临床环境中的医疗保健从业者使用，以识别有成为每日吸烟者风险的青少年。
数据来自青少年尼古丁依赖（NDIT）研究，这是对 1293 名青少年的前瞻性调查，最初年龄为 12-13 岁，于 1999 年在加拿大蒙特利尔的 10 所中学招募。在五年内，每三个月进行一次问卷调查。预后工具是使用多变量逻辑模型的估计系数开发的。使用自举交叉验证校正模型过度拟合。通过 R2、c 统计量和 Hosmer-Lemeshow 检验评估模型的拟合优度和预测能力。
开始每日吸烟的 1 年和 2 年概率是七个个体特征的联合函数：年龄；曾经吸烟；曾经感觉需要一支香烟；父母吸烟；兄弟姐妹吸烟；朋友吸烟；曾经饮酒。这些模型具有较好的拟合度和预测能力。它们被转化为用户友好的表格，以便通过对每个项目的回答进行求和来轻松计算每日吸烟的风险。该预后工具也可在网上获得，网址为 http://episerve.chumontreal.qc.ca/calculation_risk/daily-risk/daily_smokingadd.php。
识别有每日吸烟高风险的青年的预后工具最终可能成为全面烟草控制系统的重要组成部分。
