title: Recollections and repercussions of the first inhaled cigarette.
abstract: BACKGROUND
  It has not been determined if a youth's reaction to the first smoking experience is predictive of future nicotine dependence, or whether the impact of the first cigarette can be altered by manipulating levels of tar, nicotine and menthol.
  
  
  OBJECTIVE
  To determine if the recalled response to the first cigarette is predictive of the development of symptoms of nicotine dependence and whether it is influenced by the type of cigarette smoked.
  
  
  METHODS
  A retrospective/prospective longitudinal study of the natural history of nicotine dependence employing individual interviews conducted three times annually in two urban school systems over 3 years. Subjects were asked to recall their first smoking experience.
  
  
  METHODS
  A cohort of 237 subjects who had inhaled on a cigarette.
  
  
  METHODS
  Symptoms associated with smoking; the Hooked on Nicotine Checklist of 10 symptoms of dependence.
  
  
  RESULTS
  Reactions to the initial smoking experience were unrelated to gender or cigarette brand, strength or mentholation. Relaxation in response to the first inhalation was the strongest predictor of symptoms of nicotine dependence. Dizziness and nausea were also independent predictors of dependence symptoms.
  
  
  CONCLUSIONS
  The data suggest that increased sensitivity to nicotine as manifested by relaxation, dizziness, or nausea in response to the first exposure to nicotine represents a risk factor for the development of nicotine dependence.
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA. difranzj@ummhc.org
authors.forename: Joseph R
authors.initials: JR
authors.lastname: DiFranza
authors.forename: Judith A
authors.initials: JA
authors.lastname: Savageau
authors.forename: Kenneth
authors.initials: K
authors.lastname: Fletcher
authors.forename: Judith K
authors.initials: JK
authors.lastname: Ockene
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rigotti
authors.forename: Ann D
authors.initials: AD
authors.lastname: McNeill
authors.forename: Mardia
authors.initials: M
authors.lastname: Coleman
authors.forename: Constance
authors.initials: C
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D004244:Dizziness / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D011939:Mental Recall; D009325:Nausea / Q000209:etiology; D011594:Psychometrics; D012063:Relaxation / Q000523:psychology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000209:etiology*