Adolescent and Young Adult Smokers Who Self-Identify as Nonsmokers: Relationship With Cigarette-Related Withdrawal and Cravings

Purpose. Examine the extent to which low-nicotine dependent daily smokers identify themselves as nonsmokers (smoking nonsmokers) over time, and examine the effect of nicotine-related withdrawal symptoms and cravings in predicting self-identified smoking status. Design. Longitudinal. Setting. National Youth Smoking Cessation Survey 2003-2005. Subjects. One hundred thirty-two adolescents and young adults (16-24 years). Measures. A questionnaire was used to assess smoking identity, withdrawal, cravings, and smoking intensity parameters. Analysis. Multivariable logistic regression analysis. Results. Among the 132 smoking nonsmokers at baseline, 45% remained smoking nonsmokers at the 2-year follow-up, with 55% transitioning to smoking (i.e., self-identified as smoking smokers in the interim). After adjustments, participants exhibiting greater restlessness and cravings over time, respectively, had 3.59 (p = .01) and 4.31 (p = .008) greater odds of being a smoking nonsmoker at baseline but then transitioning into a smoking smoker at 2-year follow-up. Conclusion. These findings may have implications with respect to interventions emphasizing withdrawal and craving symptoms. Further, given that some youth smokers self-identify as nonsmokers, and do so over time, potential intervention efforts may be pointed toward cognitive-related strategies at improving self-perceptions.