An evaluation of a clinical approach to staging tobacco addiction
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UMass Chan Affiliations
Department of Family Medicine and Community HealthDocument Type
Journal ArticlePublication Date
2011-12-01Keywords
AdolescentFemale
Humans
Male
Severity of Illness Index
Tobacco Use Disorder
Community Health and Preventive Medicine
Preventive Medicine
Primary Care
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Show full item recordAbstract
OBJECTIVES: To determine whether adolescents' symptom reports are consistent with the developmental sequence of tobacco addiction and whether the sequential appearance of these symptoms signifies increasing addiction. STUDY DESIGN: An anonymous survey was administered to 349 tobacco users in grades 9 through 12 in Florida. The combinations of withdrawal symptoms reported were examined to determine whether they were consistent with the developmental sequence described by case reports (wanting, then craving, then needing). Dependence was measured by several validated measures, including the Hooked on Nicotine Checklist, the Autonomy Over Tobacco Scale, and the modified Fagerstrom Tolerance Questionnaire. RESULTS: The combinations of withdrawal symptoms reported by 99.4% of subjects were consistent with case reports stating that wanting, craving, and needing develop in that sequence. Across the stages, from wanting to needing, higher stages were associated with significant increases in the strength of addiction as measured by the Hooked on Nicotine Checklist, the Autonomy Over Tobacco Scale, the modified Fagerstrom Tolerance Questionnaire, and all other measures. CONCLUSIONS: Our data confirmed that withdrawal symptoms develop in an orderly sequence, as proposed, and indicate that each progressive step along the sequence of wanting, craving, and needing represents a substantial increase in tobacco addiction. This provides the foundation for a clinical approach to staging the progression of tobacco addiction.Source
J Pediatr. 2011 Dec;159(6):999-1003.e1. Epub 2011 Jul 23. DOI 10.1016/j.jpeds.2011.05.037
DOI
10.1016/j.jpeds.2011.05.037Permanent Link to this Item
http://hdl.handle.net/20.500.14038/30860PubMed ID
21784437Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.jpeds.2011.05.037