Adolescent smoking experimentation as a predictor of daily cigarette smoking

Objective: The utility of studying substance use during early adolescence depends on how well indicies of lower level experimentation predict the development of substance use problems. We examined associations between experimental cigarette use at T1, recanting of use 8 months later (T2), and daily smoking at 2 years (T4). Methods: Longitudinal telephone survey of 6522 US youth aged 10-14, examining lifetime cigarette smoking (none, just puffing, 1-19, 20-100, > 100) and recanting (i.e., reporting lifetime use at T1, denying ever using at T2) as predictors of T4 daily smoking using multivariable logistic regression. Covariates included sociodemographics, friend/family smoking, school performance, and personality characteristics. Results: The sample was 51% male, 18% Black, 17% Hispanic, with 70% retained at T2. At T1, 407 (8.9%) adolescents reported some smoking, of whom 85 (20.9%) recanted at T2. At T4, 970 reported any smoking, of whom 88 (9.1%) were daily smokers. Any Ti experimentation identified two-thirds of T4 daily smokers (sensitivity = 66.7%) with a false positive rate of 7.8%. Ti lifetime smoking categories were associated with the following adjusted odds ratios for T4 daily smoking (vs. never smokers): 2.7 for recanters (95% confidence interval 0.82, 8.5), 3.5 for few puffs (1.7, 7.0), 9.6 for 1-19 cigarettes (4.1, 22.3), 3.8 for 20-100 cigarettes (1.0, 14.3), and 30.1 for > 100 cigarettes (8.1, 111). Conclusions: In this sample experimentation with cigarettes predicted future daily smoking with high utility. The findings provide a rationale for monitoring and reporting any experimentation cigarettes as a tobacco surveillance outcome.