Nicotine dependence symptoms among young never-smokers exposed to secondhand tobacco smoke

doi:10.1016/j.addbeh.2008.07.011

Addictive Behaviors

Volume 33, Issue 12, December 2008, Pages 1557-1563

https://doi.org/10.1016/j.addbeh.2008.07.011 Get rights and content

Abstract

Background

To extend previous observations that secondhand tobacco smoke (SHS) is associated with nicotine markers in children, we investigated if SHS exposure is associated with self-reports of nicotine dependence (ND) symptoms among young never-smokers.

Method

Data on number of persons who smoke inside the home, number of days exposed to SHS in a motor vehicle in the past week, number of parents, siblings, and friends who smoke, and ND symptoms, were collected from 10–12 year-old students in self-report questionnaires. The association between SHS and ND symptoms among young never-smokers was assessed in logistic regression models.

Results

Sixty-nine of 1488 never-smokers (5%) reported one or more ND symptom. After controlling for sibling and peer smoking, and susceptibility to initiating smoking, exposure to SHS in a motor vehicle was independently associated with ND symptoms (OR, 95% CI = 1.2, 1.0–1.4). The OR for number of persons who smoke inside the home was 1.1 (0.9–1.4).

Conclusion

SHS exposure in motor vehicles may be associated with ND symptoms among young never-smokers. If replicated, this finding provides support for interventions that promote non-smoking in motor vehicles.

Introduction

Among the numerous psychosocial factors related to the initiation and persistence of tobacco use among youth, parental influences are among the strongest and most consistent (Kandel and Wu, 1995, Tyas and Pederson, 1998, Vitaro et al., 2004), although the effects may not be equivalent across age groups (Avenevoli & Merikangas, 2003). It is generally thought that parents who smoke exert influence on youth smoking through social role modeling (Fleming, Kim, Harachi, & Catalano, 2002), as well as through heritable personality and biological characteristics (Sullivan & Kendler, 1999). However, because parental smoking is a major source of secondhand tobacco smoke (SHS) in children, it may also represent a pathway of influence on health or behaviour through physiological processes (Anthonisen and Murray, 2005, Becklake et al., 2005).

Nicotine is the chemical component in tobacco that is primarily responsible for addictive outcomes (US Department of Health and Human Services, 1998), and the large area for absorption in lung alveoli enables nicotine to be extracted from cigarette smoke and delivered quickly to the brain (US Department of Health and Human Services, 1998). Passive smoking results in the absorption of up to 60–80% of the nicotine content in SHS (Iwase, Aiba, & Kira, 1991), making SHS a non-negligible source of exposure to nicotine. Urinary nicotine markers have been reported in infants exposed to tobacco smoke in their home or in the family vehicle (Hetch et al., 2006), and marked nicotine levels have also been found in the blood plasma (Pacifici et al., 1995) and hair (Al-Delaimy et al., 2001, Dimich-Ward et al., 1997), of non-smoking adults exposed to SHS. Becklake et al. (2005) reported that higher concentrations of salivary cotinine in non-smoking children were associated with greater susceptibility to smoking initiation two years later.

Initial models of the smoking onset process suggested that lengthy and regular tobacco use was necessary for developing nicotine dependence (US Department of Health and Human Services, 1994). However recent studies suggest that nicotine dependence symptoms can occur very soon after the initiation of cigarette smoking in some adolescents at very low exposures to cigarettes (DiFranza et al., 2002a, O'Loughlin et al., 2003), and early conversion to nicotine dependence in this young age group coincides with rapid intensification of smoking (Karp, O'Loughlin, Paradis, Hanley & Difranza, 2005). We hypothesized that SHS exposure may lead to the development of nicotine dependence symptoms in the absence of tobacco use among young never-smokers. In this analysis, we investigated if young never-smokers self-report nicotine dependence symptoms, and if SHS exposure is associated with reports of nicotine dependence symptoms.

Section snippets

Methods

AdoQuest is an ongoing prospective cohort investigation of 1843 students initially aged 10–12 years, designed to investigate the natural course of the co-occurrence of health-compromising behaviours in children. A stratified random sample of 40 schools was selected from among all French-language schools with more than 90 grade 5 students, located in the greater Montreal area. Schools were stratified based on an indicator of socioeconomic status (SES) (Ministère de l'éducation du Québec, 2003)

Results

Of 2946 eligible students in the 29 schools, 1801 (61%) completed questionnaires at baseline. Table 1 compares selected characteristics of AdoQuest participants with those of grade 5 students in Quebec who participated in the 2005 Youth Smoking Survey (YSS), which included a provincially representative sample (Health Canada, 2005). Compared to the YSS sample, higher proportions of AdoQuest participants reported exposure to SHS, proportionately more were susceptible to initiating smoking, and

Discussion

According to conventional understanding, a person who does not smoke cigarettes cannot experience nicotine dependence. Yet in this study, 5% of grade 5 children who had never smoked a cigarette reported at least one symptom of nicotine dependence. Further, exposure to SHS was associated with a higher probability of reporting these symptoms. This finding could reflect that, even beyond being detectable through nicotine markers, SHS may potentiate physiologic mechanisms that cause symptoms of

Acknowledgements

The AdoQuest study is funded by the Canadian Tobacco Control Research Initiative (CTCRI) through an Interdisciplinary Capacity Enhancement (ICE) grant to JOL, and the Institut national de santé publique du Québec. MB is supported by a CIHR Canada Graduate Scholarship, a CIHR and Québec Population Health Research Network Strategic Training Fellowship in Public and Population Health Research, and a scholarship from an ICE team grant from the CTCRI. JOL holds a Canada Research Chair in the Early

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ESHS is also known to be associated with cognitive impairment (Batty, Der, & Deary, 2006; Yolton, Dietrich, Auinger, Lanphear, & Hornung, 2005) and behavioral problems such as attention deficit, hyperactivity disorder and conduct disorder (Button, Thapar, & McGuffin, 2005; Potera, 2007) and other mental health problems (Bandiera, Richardson, Lee, He, & Merikangas, 2011). In addition to the effect of ESHS on children during childhood, studies have also shown that there are grave health implications including metabolic syndrome, abdominal aorta, atherosclerosis, miscarriage and productive health problems in adulthood for persons who have been exposed to SHS during childhood (Becklake et al., 2005; Bélanger et al., 2008; Kallio et al., 2009; Skorge, Eagan, Eide, Gulsvik, & Bakke, 2005; Svanes et al., 2004; Weitzman et al., 2005). Furthermore, children who are exposed to SHS are not only more likely to become smokers in adulthood but also more likely to show nicotine dependence symptoms, even if they never smoked (Becklake et al., 2005; Bélanger et al., 2008).
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Nicotine dependence symptoms among young never-smokers exposed to secondhand tobacco smoke

Abstract

Background

Method

Results

Conclusion

Introduction

Section snippets

Methods

Results

Discussion

Acknowledgements

The Journal of Adolescent Health

Annals of Epidemiology

Addictive Behaviors

Addictive Behaviors

American Journal of Preventive Medicine

Annals of Epidemiology

Environmental Research

Addictive Behaviors

Addictive Behaviors

Nicotine in hair of bar and restaurant workers

The New Zealand Medical Journal

A new childhood pathway for transmission of an increased likelihood of smoking?

Canadian Medical Association Journal

Familial influences on adolescent smoking

Addiction

Childhood predictors of smoking in adolescence: A follow-up study of Montréal schoolchildren

Canadian Medical Association Journal

Development of symptoms of tobacco dependence in youths: 30 month follow up data from the DANDY study

Tobacco Control

Measuring the loss of autonomy over nicotine use in adolescents: The DANDY study

Archives of Pediatrics & Adolescent Medicine

A sensitization-homeostasis model of nicotine craving, withdrawal, and tolerance: Integrating the clinical and basic science literature

Nicotine & Tobacco Research