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Dependence on nicotine in US high school students in the context of changing patterns of tobacco product use

Jackson, SE; Brown, J; Jarvis, MJ; (2021) Dependence on nicotine in US high school students in the context of changing patterns of tobacco product use. Addiction 10.1111/add.15403. (In press).

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Abstract

BACKGROUND AND AIM: There have been substantial recent changes in youth tobacco product use in the USA - including, notably, a rapid increase in use of e-cigarettes. It is not known whether, and if so how far, these changes are reflected in levels of nicotine dependence. This study used data from a large, nationally-representative sample of US adolescents to (i) estimate the annual prevalence of nicotine dependence in relation to current use of tobacco products, (ii) describe trends in dependence over time, and (iii) evaluate whether the increase in youth use of tobacco products has been paralleled by a similar increase in the population burden of nicotine dependence. DESIGN: Secondary analysis of National Youth Tobacco Surveys conducted annually, 2012-2019. SETTING: USA. PARTICIPANTS: 86,902 high-school students. MEASUREMENTS: Prevalence of (i) strong cravings to use tobacco in the past 30 days, and (ii) wanting to use nicotine products within 30 minutes of waking, in relation to type of product used (cigarettes, other combustible tobacco, smokeless tobacco, e-cigarettes). FINDINGS: Between 2012 and 2019 there was a marked decline in past-30-day cigarette smoking and a surge in use of e-cigarettes. Different products were associated with differing levels of nicotine dependence, with cigarettes characterised by highest dependence (strong craving 42%, wanting to use within 30 minutes 17% among exclusive users in 2019) and e-cigarettes in otherwise tobacco-naïve students by low dependence (16% and 9% in 2019). The overall 34% increase in population use of nicotine products between 2012 and 2019 (from 23.2% to 31.2%) was not accompanied by an equivalent increase in overall population burden of dependence (percentage reporting craving 10.9% [95% CI 9.8-12.2%] in 2012 and 9.5% [7.5-12.0%] in 2019; wanting to use within 30 minutes 4.7% [4.0-5.5%] in 2012, 5.4% [4.0-7.2%] in 2019). CONCLUSIONS: Among US high school students, increases in the prevalence of nicotine product use from 2012 to 2019 do not appear to have been accompanied by a similar increase in the population burden of nicotine dependence. This may be at least partly attributable to a shift in the most common product of choice from cigarettes (on which users are most dependent) to e-cigarettes (on which users are least dependent).

Type: Article
Title: Dependence on nicotine in US high school students in the context of changing patterns of tobacco product use
Location: England
DOI: 10.1111/add.15403
Publisher version: https://doi.org/10.1111/add.15403
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: adolescents, dependence, e-cigarettes, nicotine, smoking, tobacco products
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/10118692
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