摘要：Objectives. We describe the epidemiology of smoking behaviors in a national young adult sample and identify common and unique demographic, social, and psychological correlates of daily smoking and lifetime and current nicotine dependence by race/ethnicity. Methods. Data are from the National Longitudinal Survey of Adolescent Health, wave III. Dependence was measured by the Revised Fagerström Test for Nicotine Dependence. Logistic regressions were estimated. Results. Hispanic ethnicity, low education, parental and peer smoking, novelty seeking, early age of smoking onset, and pleasurable initial smoking experiences are significantly correlated with daily smoking and lifetime nicotine dependence. Depressive symptoms are uniquely associated with lifetime and current dependence. Few factors are highly associated with current dependence. Initial sensitivity to smoking has a significantly greater impact on daily smoking than on dependence. Correlates of smoking behaviors are mostly common across racial/ethnic groups, although parental and peer smoking are significant for Whites and Hispanics but not for African Americans. Conclusions. There are more common than unique correlates of each smoking stage and across racial/ethnic groups. Primary prevention and interventions addressing the factors tested could be uniform for most chronic smokers irrespective of dependence status and race/ethnicity. Negative health consequences of smoking stem in large measure from its chronicity. Nicotine is one of the most addictive drugs. 1 , 2 The striking decline in rates of smoking among youths observed since the 1990s is slowing down, 3 although 25% of high school seniors still smoke daily and are at risk of becoming addicted. Much more is known about the epidemiology of smoking than nicotine dependence, especially regarding racial/ethnic patterns. 4 Recent longitudinal studies identify few racial/ethnic differences in the predictors of smoking onset and daily smoking, 4 – 11 except for the stronger influences of parents and peers for Whites than for minorities. 12 – 16 Although lower rates of nicotine dependence are observed among African Americans than among Whites, 1 , 2 , 17 , 18 racial/ethnic differences in correlates of dependence remain to be identified. Little is known about the factors associated with the persistence of dependence. Daily smoking and nicotine dependence are 2 major indicators of chronic smoking. Although the overwhelming majority of nicotine-dependent individuals are daily smokers, only about half of daily smokers meet criteria for dependence. 18 , 19 Very few young adults, as few as 5%, 18 become dependent before smoking daily, 18 , 20 , 21 suggesting that dependence represents a later stage of involvement. Whether daily smoking and dependence represent qualitatively different stages of smoking, with daily smoking being a behavioral measure and dependence a more dynamic syndrome state, remains to be established. We examined daily, lifetime dependent, and current dependent smokers and associated racial/ethnic differences in a young adult sample from wave III of the National Longitudinal Study of Adolescent Health (Add Health). We previously analyzed predictors of smoking onset and transition to daily smoking over 1 year in Add Health between waves I and II and observed few racial/ethnic differences. 10 Psychosocial predictors of adolescent smoking behavior include peer, family, personal, and sociodemographic domains. 5 , 22 – 28 Peer smoking is among the strongest predictors of adolescent smoking initiation and current smoking. Other psychosocial predictors include parental smoking, low levels of parent-child closeness, adolescent problem behavior, depression, sensation seeking, low self-esteem, and poor academic performance. There is also evidence, from small selected samples, that sensitivity to the initial smoking experience predicts smoking onset and perhaps dependence. 29 Those who initially experience pleasant rather than aversive sensations are more likely to continue smoking. 30 Thus, tolerance and dependence may result from preexisting individual differences in sensitivity to nicotine, in addition to extensiveness of smoking. 31 – 34 The association between initial sensitivity to smoking and nicotine dependence has not been examined in a nationally representative sample. This opportunity exists in Add Health wave III, because we obtained a grant from the National Institute on Drug Abuse to include measures of nicotine dependence and initial sensitivity to nicotine, variables not previously measured, in the interview. We hypothesized the following: Peer smoking would be more important for daily smoking than dependence. Parental smoking and psychological factors (especially depressive symptoms) would be more important for dependence than for daily smoking. Parental and peer smoking would be more important for Whites than for African Americans.
