title: Toward a comprehensive developmental model of smoking initiation and nicotine dependence.
abstract: BACKGROUND
  This study aims to identify predictors of smoking initiation and nicotine dependence (ND) to develop a comprehensive risk-factor model based on Kendler's development model for major depression.
  
  
  METHODS
  Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), Wave 2 (n=34,653). Risk factors were divided into five developmental tiers according to Kendler's model (childhood, early adolescence, late adolescence, adulthood, past-year). Hierarchical logistic regression models were built to predict the risk of smoking initiation and the risk of ND, given initiation. The continuation ratio (CR) was tested by ordinal logistic regression to examine whether the impact of the predictors was the same on smoking initiation or ND.
  
  
  RESULTS
  The final models highlighted the importance of different tiers for each outcome. The CR identified substantial differences in the predictors of smoking initiation versus ND. Childhood tier appears to be more determinant for smoking initiation while the effect of more distal tiers (i.e. childhood and early adolescence) was tempered by more proximal ones (i.e. late adolescence, adulthood and past-year) in ND, with few sex differences.
  
  
  CONCLUSIONS
  The differential effect of some predictors on each outcome shows the complexity of pathways from smoking initiation to ND. While some risk factors may be shared, others impact only at one stage or have even an inverse effect. An adaptation of Kendler's developmental model for major depression showed high predictive power for smoking initiation and ND.
authors.affiliation: Department of Psychology, University of Oviedo, 33003 Oviedo, Spain; New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA. Electronic address: garciaolaya@uniovi.es.
authors.forename: Olaya
authors.initials: O
authors.lastname: García-Rodríguez
authors.affiliation: New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
authors.affiliation: New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.affiliation: New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
authors.forename: Shuai
authors.initials: S
authors.lastname: Wang
authors.affiliation: New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
authors.forename: Chelsea J
authors.initials: CJ
authors.lastname: Jin
authors.affiliation: Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23298-0126, USA.
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Kendler
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006306:Health Surveys / Q000379:methods / Q000639:trends*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D055815:Young Adult
keywords: Developmental model; Nicotine dependence; Risk factors; Smoking initiation