A preliminary investigation of early smoking initiation and nicotine dependence in Korean adults.
BACKGROUND
Few studies have investigated the association between age at smoking initiation and Fagerström test for nicotine dependence (FTND) in adulthood. The goal of this study was to develop the Korean version of FTND (FTND-K) and to examine the relationship between age at smoking initiation and nicotine dependence.


METHODS
This investigation used data from 268 current smokers who visited the Center for Cancer Prevention and Early Detection in the National Cancer Center, Korea. The internal consistency of the FTND-K was assessed by Cronbach's coefficient alpha. Pearson's correlation coefficients were used to assess the relationships between the FTND-K sum scores and urinary cotinine levels. One-way analysis of variance (ANOVA) and t-tests were used to assess differences in the FTND-K sum score between groups. Factor associated with nicotine dependence were identified through stepwise multiple logistic regression analysis.


RESULTS
The standardized Cronbach's alpha of FTND-K was 0.72. A significant positive correlation was seen between the FTND-K sum score and urinary cotinine level (correlation coefficient = 0.49, P < 0.05). Age at smoking initiation had a significant association with the FTND-K sum score in univariate analysis. In multivariate analysis, nicotine dependence was higher in smokers that started smoking cigarettes at 19 years or earlier than in those that started at 25 years or later (OR = 11.25, 95% CIs, 1.46-97.10).


CONCLUSIONS
The FTND-K is a valid assessment tool of nicotine dependence with acceptable levels of internal consistency and close correlation to urinary cotinine level. The finding that those who initiate smoking at an early age tend to be more nicotine dependent underscores and reinforces the public health significance of delaying smoking onset.
Park
Sang Min
SM
Quality of Cancer Care Branch, Research Institute and Hospital, National Cancer Center 809, Madu-dong, Ilsan-gu, Goyang-si, Gyeonggi-do 411-769, South Korea.
Son
Ki Young
KY
Lee
Young Joon
YJ
Lee
Hee-Choon S
HC
Kang
Ji Ho
JH
Lee
Yeon Ji
YJ
Chang
Yoon Jung
YJ
Yun
Young Ho
YH
D000328:Adult; D000367:Age Factors; D003367:Cotinine / Q000652:urine; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009538:Nicotine; D015203:Reproducibility of Results; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires
D009538:Nicotine; D003367:Cotinine