Nicotine dependence among adolescent smokers.

Objective. - This research evaluated nicotine dependence in adolescent smokers, their motivation to smoke and/or stop smoking, and their knowledge of how to stop smoking as well as the potential difficulties involved. Method. - Three hundred forty-two high school students completed questionnaires using two measures of dependence (the Fagerstrom tolerance test and a visual-analog self-evaluation scale), a test to measure motivation to smoke (the Horn test), and a questionnaire exploring motivations to stop smoking, methods used to stop smoking, and the anticipated difficulties. Results. - On the Fagerstrom tolerance test, 14.6% of the students indicated strong dependence, whereas 32.3% indicated intermediate dependence. The Fagestrom score was strongly correlated to the self-evaluation test (r = 0.54, P < 0.001) and negatively correlated with the subjects' ages at the onset of smoking (r = -0.28, P < 0.001). The Horn test revealed that the main motivation to smoke is the search for relaxation and a decrease of negative emotions, indicating that cigarette smoking is primarily a means to manage stress and anxiety. Eighty-nine percent of the subjects stated that they would like to stop smoking, primarily because of the financial cost and health concerns. Among those subjects wishing to stop, 64.5% had previously tried to stop and had failed and 72% believed that it would be 'difficult' or 'very difficult' to stop. The main anticipated difficulties were an increase in stress and anxiety and, for the girls, weight gain. The anticipation of these difficulties was strongly correlated to dependence scores (r = 0.43, P < 0.001). Despite awareness of these difficulties, only 19.6% of the subjects wishing to stop smoking expected to seek medical assistance. For most of the measured variables, there was no difference between boys and girls. Conclusion. - This study confirms the seriousness of tobacco consumption in adolescence. The results suggest the need for early programs aimed at preventing or delaying onset of use as well as the need to develop programs to aid high school students to stop smoking. (C) 2000 Editions scientifiques et medicales Elsevier SAS.