Smoking cessation in adolescents - The role of nicotine dependence, stress, and coping methods

Objective: To compare perceived reasons for continued smoking and withdrawa l symptoms between current smokers and quitters in an inner-city adolescent population. To examine the relationship of nicotine dependence, stress, an d coping methods between smokers and quitters and, using the Transtheoretic al Model of Change, among adjacent smoking cessation stages. Design: A cross-sectional study using a self-administered questionnaire. Participants: The study comprised 344 clinic patients between the ages of 1 2 and 21 years who reported past or present smoking. Main Outcome Measures: Demographic characteristics, smoking status, perceiv ed reasons for continued smoking, attempts to quit, and withdrawl symptoms, as well as standardized scales assessing nicotine dependence, stress, and coping methods. Results: The overall prevalence of smoking in this population was 26%. Smok ers were significantly more likely to report smoking more cigarettes per da y as well as higher levels of physical addiction (P<.01), greater levels of perceived stress (P<.02), and less use of cognitive coping methods (P<.02) than quitters (P<.005). However, comparison of consecutive stages revealed a significant difference only between precontemplation and contemplation i n cognitive coping methods (P<.01). Three of 20 withdrawal symptoms (cravin gs, difficulty dealing with stress, and anger) were reported more frequentl y among current smokers who had attempted to quit in the last 6 months than among former smokers (P<.01). Conclusion: Interventions for inner-city adolescents who smoke should be de signed to target those with the highest levels of nicotine dependence, stre ss, and decreased use of cognitive coping methods because they are the leas t likely to quit on their own, rather than developing stage-specific models .