title: Assessment of nicotine dependence among adolescent and young adult smokers: a comparison of measures.
abstract: BACKGROUND
  Tobacco use often starts in adolescence, yet assessment of dependence among adolescent smokers remains a challenge, particularly given the potential discord between self-reports of smoking behavior and actual use. We could find no prior study, among adolescents, that directly compares the association between objective biomarkers of tobacco exposure (e.g., cotinine) and multiple measures of dependence. This study examined the concurrent validity of two common dependence measures: the Fagerström Test for Nicotine Dependence (FTND) and the Hooked on Nicotine Checklist (HONC). We further examined the FTND by removing the one item on cigarettes smoked per day.
  
  
  METHODS
  Based within a parent clinical trial for adolescent smoking cessation, eligible participants were 12-21years old, smoking >/=5cigarettes per day on average, and with urine cotinine >100ng/ml at baseline. Results are based on participants who completed each measure and who provided a urine cotinine sample at baseline (N=73).
  
  
  RESULTS
  Results showed that the FTND was associated with cotinine (p<0.001; R(2)=0.25), and that this relationship held true for the revised FTND as well (p<0.001; R(2)=0.18). However, the HONC was only marginally associated with cotinine (p=0.06; R(2)=0.09).
  
  
  CONCLUSIONS
  Our results suggest that the FTND may be better associated with actual smoking behavior in adolescents as compared to the HONC. Pending replication, our data provide caution with regard to assessment of nicotine dependence at least among established adolescent smokers who have more entrenched smoking behavior.
authors.affiliation: Department of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA. carpente@musc.edu
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Carpenter
authors.forename: Nathaniel L
authors.initials: NL
authors.lastname: Baker
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Gray
authors.forename: Himanshu P
authors.initials: HP
authors.lastname: Upadhyaya
mesh_terms: D000293:Adolescent; D002648:Child; D003367:Cotinine / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012650:Self Disclosure; D011795:Surveys and Questionnaires / Q000592:standards*; D014029:Tobacco Use Disorder / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D003367:Cotinine