title: Teen smokers reach their mid twenties.
abstract: OBJECTIVE
  Most outcome studies of adolescent smokers have focused on tobacco use in the short term. Few have reported on the health of adolescent smokers as they reach young adulthood.
  
  
  METHODS
  The design was a 10-year, eight-wave cohort study of a state-wide community sample of 1943 participants in Victoria, Australia. Participants were initially aged 14 to 15 years. Tobacco use was assessed with self-reported frequency of use and a seven-day retrospective diary. The Fagerstrom Test for Nicotine Dependence was used to define nicotine dependence in young adulthood. A computerized interview assessment was used during the teens and in young adulthood.
  
  
  RESULTS
  Former daily smokers in adolescence accounted for most cases of nicotine dependence and high-dose (10+ cigarettes per day) smoking in young adulthood. Other substance abuse and psychiatric morbidity in young adulthood were also markedly elevated in this group. This was most clearly evident for cannabis dependence, where close to two-thirds of all cases were formerly daily tobacco smokers. Male smokers were more likely to continue as young adults. Persistent symptoms of depression and anxiety during the teens predicted progression to nicotine dependence, as did having a parent smoking daily.
  
  
  CONCLUSIONS
  The poor health outcomes of daily adolescent smokers as they reach young adulthood provide a rationale for greater tobacco control initiatives directed at early users. Clinical interventions might usefully consider factors such as psychiatric morbidity and parental smoking.
authors.affiliation: Centre for Adolescent Health, Royal Children's Hospital, Murdoch Childrens Research Institute, Parkville, Victoria, Australia. george.patton@rch.org.au
authors.forename: George C
authors.initials: GC
authors.lastname: Patton
authors.forename: Carolyn
authors.initials: C
authors.lastname: Coffey
authors.forename: John B
authors.initials: JB
authors.lastname: Carlin
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sawyer
authors.forename: Melanie
authors.initials: M
authors.lastname: Wakefield
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001007:Anxiety; D015331:Cohort Studies; D003863:Depression; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D002189:Marijuana Abuse; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000523:psychology; D014029:Tobacco Use Disorder