OBJECTIVES: To determine whether adolescents' symptom reports are consistent with the developmental sequence of tobacco addiction and whether the sequential appearance of these symptoms signifies increasing addiction. STUDY DESIGN: An anonymous survey was administered to 349 tobacco users in grades 9 through 12 in Florida. The combinations of withdrawal symptoms reported were examined to determine whether they were consistent with the developmental sequence described by case reports (wanting, then craving, then needing). Dependence was measured by several validated measures, including the Hooked on Nicotine Checklist, the Autonomy Over Tobacco Scale, and the modified Fagerström Tolerance Questionnaire. RESULTS: The combinations of withdrawal symptoms reported by 99.4% of subjects were consistent with case reports stating that wanting, craving, and needing develop in that sequence. Across the stages, from wanting to needing, higher stages were associated with significant increases in the strength of addiction as measured by the Hooked on Nicotine Checklist, the Autonomy Over Tobacco Scale, the modified Fagerström Tolerance Questionnaire, and all other measures. CONCLUSIONS: Our data confirmed that withdrawal symptoms develop in an orderly sequence, as proposed, and indicate that each progressive step along the sequence of wanting, craving, and needing represents a substantial increase in tobacco addiction. This provides the foundation for a clinical approach to staging the progression of tobacco addiction.
OBJECTIVES: To determine whether adolescents' symptom reports are consistent with the developmental sequence of tobacco addiction and whether the sequential appearance of these symptoms signifies increasing addiction. STUDY DESIGN: An anonymous survey was administered to 349 tobacco users in grades 9 through 12 in Florida. The combinations of withdrawal symptoms reported were examined to determine whether they were consistent with the developmental sequence described by case reports (wanting, then craving, then needing). Dependence was measured by several validated measures, including the Hooked on Nicotine Checklist, the Autonomy Over Tobacco Scale, and the modified Fagerström Tolerance Questionnaire. RESULTS: The combinations of withdrawal symptoms reported by 99.4% of subjects were consistent with case reports stating that wanting, craving, and needing develop in that sequence. Across the stages, from wanting to needing, higher stages were associated with significant increases in the strength of addiction as measured by the Hooked on Nicotine Checklist, the Autonomy Over Tobacco Scale, the modified Fagerström Tolerance Questionnaire, and all other measures. CONCLUSIONS: Our data confirmed that withdrawal symptoms develop in an orderly sequence, as proposed, and indicate that each progressive step along the sequence of wanting, craving, and needing represents a substantial increase in tobacco addiction. This provides the foundation for a clinical approach to staging the progression of tobacco addiction.
Authors: Mark H Christensen; Masaru Ishibashi; Michael L Nielsen; Christopher S Leonard; Kristi A Kohlmeier Journal: Neuropharmacology Date: 2014-05-24 Impact factor: 5.250
Authors: Raed Bahelah; Joseph R DiFranza; Fouad M Fouad; Kenneth D Ward; Thomas Eissenberg; Wasim Maziak Journal: Tob Control Date: 2016-04-25 Impact factor: 7.552
Authors: Joseph R DiFranza; Robert J Wellman; Judith A Savageau; Ariel Beccia; W W Sanouri A Ursprung; Robert McMillen Journal: ISRN Addict Date: 2012-11-22
Authors: Wei Huang; Joseph R DiFranza; David N Kennedy; Nanyin Zhang; Douglas Ziedonis; Sanouri Ursprung; Jean A King Journal: PLoS One Date: 2013-07-04 Impact factor: 3.240
Authors: Wei Huang; Jean A King; W W Sanouri Ursprung; Shaokuan Zheng; Nanyin Zhang; David N Kennedy; Douglas Ziedonis; Joseph R DiFranza Journal: Brain Behav Date: 2014-03-17 Impact factor: 2.708