Adolescent smoking experimentation as a predictor of daily cigarette smoking

Objective: The utility of studying substance use during early adolescence depends on how well indicies of lower-level experimentation predict the development of substance use problems. We examined associations between experimental cigarette use at T1, recanting of use 8 months later (T2), and daily smoking at 2 years (T4).

Methods: Longitudinal telephone survey of 6522 US youth aged 10-14, examining lifetime cigarette smoking (none, just puffing, 1-19, 20-100, >100) and recanting (i.e., reporting lifetime use at T1, denying ever using at T2) as predictors of T4 daily smoking using multivariable logistic regression. Covariates included sociodemographics, friend/family smoking, school performance, and personality characteristics.

Results: The sample was 51% male, 18% Black, 17% Hispanic, with 70% retained at T2. At T1, 407 (8.9%) adolescents reported some smoking, of whom 85 (20.9%) recanted at T2. At T4, 970 reported any smoking, of whom 88 (9.1%) were daily smokers. Any T1 experimentation identified two-thirds of T4 daily smokers (sensitivity=66.7%) with a false positive rate of 7.8%. T1 lifetime smoking categories were associated with the following adjusted odds ratios for T4 daily smoking (vs. never smokers): 2.7 for recanters (95% confidence interval 0.82, 8.5), 3.5 for few puffs (1.7, 7.0), 9.6 for 1-19 cigarettes (4.1, 22.3), 3.8 for 20-100 cigarettes (1.0, 14.3), and 30.1 for >100 cigarettes (8.1, 111).

Conclusions: In this sample experimentation with cigarettes predicted future daily smoking with high utility. The findings provide a rationale for monitoring and reporting any experimentation cigarettes as a tobacco surveillance outcome.