Researcher Maps Slippery Slope of Teen Smoking

McGill epidemiologist Jennifer O’Loughlin has added another chapter to her six-year study of more than 1,200 adolescent smokers in Montreal, with a new map of 12 addiction “milestones” that will give fresh ammunition to both health-care professionals and anti-smoking advocates.

“This is a tool to build a deeper understanding of which teens may be on the path of no return,” said O’Loughlin, a professor at McGill’s Department of Epidemiology, Biostatistics and Occupational Health. “We want to sensitize parents, teachers, health professionals and, most importantly, adolescents themselves to recognize these symptoms.”

O’Loughlin, her graduate student, Christina Bancej, and their team charted the continuum of nicotine dependence among a sub-group of 311 teens who had never smoked when the study began. Divided into six indicators on cigarette use and six on nicotine dependence, the milestones can be used to measure a person’s susceptibility level and addiction potential against a natural history or mapping system of nicotine addiction.

Understanding where adolescents are on that trajectory may be a critical step toward intervening effectively, particularly with public health and public service campaigns. Just as a sedentary lifestyle in young children may presage adult obesity, “time of first inhalation,” “first report of mental addiction” and “first report of withdrawal symptoms” can help predict a lifetime of nicotine dependence.

“We need a new focus in public service messages,” said O’Loughlin. “It’s not just about whether smoking is cool or not… it’s about what teens are doing to their bodies. I don’t favour making people upset and paranoid, but here are the facts: Boys who get addicted will smoke another 16 years and girls who get addicted will smoke another 20 years. We want to prevent that.”

For the last six years, O’Loughlin and her team have followed 1,293 students beginning in seventh grade from 10 Montreal-area high schools. They collected baseline data in self-report questionnaires and then, for this study, eliminated the teens who reported having previously smoked. The group of adolescents who puffed for the first time during the study provided the lens through which the researchers could observe the process of nicotine addiction from its very inception.

“Milestones in the natural course of onset of cigarette use among adolescents” will appear online July 31 in the Canadian Medical Association Journal (CMAJ). O’Loughlin’s research was funded by the National Cancer Institute of Canada (NCIC) with funds from the Canadian Cancer Society.

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