Experimentation with tobacco during adolescence as a factor influencing treatment of smoking in adulthood. A retrospective cohort

Chaim, Carolina Hanna; Siu, Erica Rosanna; Carvalho, Carlos Felipe Cavalcanti; Frallonardo, Fernanda Piotto; Ismael, Flavia; Andrade, Arthur Guerra de; Ventriglio, Antonio; Torales, Julio; Bhugra, Dinesh; Castaldelli-Maia, João Mauricio

doi:10.1590/1516-3180.2018.0504140319

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Sao Paulo Medical Journal

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ORIGINAL ARTICLE • Sao Paulo Med. J. 137 (3) • May-Jun 2019 • https://doi.org/10.1590/1516-3180.2018.0504140319 copy

Experimentation with tobacco during adolescence as a factor influencing treatment of smoking in adulthood. A retrospective cohort

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND:

There are still few studies on predictors of smoking cessation in Brazilian samples. Experimentation with tobacco during adolescence (ETA) may be one of the important predictors.

OBJECTIVE:

This study aimed, within the context of a treatment-seeking group of subjects, to test the hypothesis that ETA negatively affects the outcome of smoking cessation during adulthood.

DESIGN AND SETTING:

Retrospective (historic) cohort study conducted at a psychosocial care center in São Paulo, Brazil, between 2007 and 2010.

METHODS:

Data on sociodemographics, smoking and medical profiles were obtained through self-report questionnaires that were completed at the baseline and at any follow-up appointment. Logistic regression models were constructed to describe factors associated with the outcome of smoking cessation, measured according to the self-reported four-week success rate among 367 outpatient smokers.

RESULTS:

ETA was found to be associated with not quitting smoking through the treatment (odds ratio = 0.57; 95% confidence interval = 0.33-0.96; P < 0.05), even after adjustment for dependence level, sociodemographics, nicotine patch use and number of years of smoking.

CONCLUSIONS:

Early exposure to nicotine may lead to higher risk of continuing smoking after treatment, in adulthood.

KEY WORDS:
Adolescent; Tobacco; Nicotine; Treatment outcome

Variable	Non-ETA		ETA		χ²	P
Variable	n	%	n	%	χ²	P
Gender
Female	79	32.6	136	67.4	7.38	0.007
Male	24	19.2	101	80.8
Educational attainment (years of schooling)
Up to 8 years	45	33.8	88	66.2	3.44	0.064
9 or more years	58	24.8	176	75.2
Breathlessness
No	49	34.3	94	65.7	4.46	0.035
Yes	54	24.1	170	75.9
Number of years smoking
< 30	46	39.66	70	60.34	11.2847	0.001
≥ 30	57	22.71	194	77.29
Cigarettes per day
< 30	71	31.7	153	68.3	3.7543	0.053
≥ 30	32	22.38	111	77.62
Time to first cigarette in the morning
≤ 5 minutes	50	22.83	169	77.17	7.3699	0.007
> 5 minutes	53	35.81	95	64.19
Difficulty staying in non-smoking areas
No	51	32.,9	104	67.1	3.0139	0.083
Yes	52	24.64	159	75.36
Most difficult cigarette to quit
First cigarette in the morning	70	29.29	169	70.71	0.6738	0.412
Any other cigarette	31	25.2	92	74.8
Tendency to smoke during a sick period
No	50	41.32	71	58.68	15.1435	< 0.01
Yes	52	21.76	187	78.24
Other smokers at home
No	56	34.36	107	65.64	5.6111	0.018
Yes	47	23.15	156	76.85
Physical activity
No	46	22.22	161	77.78	7.3075	0.007
Yes	55	35.03	102	64.97
Nicotine patch
No	4	18.18	18	81.82	1.1483	0.284
Yes	99	28.78	245	71.22
Bupropion
No	55	28.35	139	71.65	0.0166	0.898
Yes	48	27.75	125	72.25
Nortriptyline
No	100	28.99	245	71.01	2.1152	0.146
Yes	3	14.29	18	85.71
Nicotine gum
No	85	29.41	204	70.59	1.0952	0.295
Yes	18	23.38	59	76.62
Success
No	55	23.91	175	76.09	5.622	0.022
Yes	48	35.04	89	64.96
Total	103	28.1	264	71.9

Variables	n	%	OR	aOR	[95%	CI]	P	VIF
Exposure
Non-ETA	48	46.6	1.00	1.00
ETA	89	33.7	0.58	0.57	0.33	0.96	0.037	1.17
Covariates
Gender
Female	96	39.7	1.00	1.00
Male	41	32.8	0.74	0.77	0.45	1.29	0.324	1.17
Education level
Up to 8 years	58	43.6	1.00	1.00
9 or more years	79	33.8	0.65	0.68	0.42	1.09	0.108	1.05
Number of years smoking
Less than 30 years	34	29.3	1.00	1.00
30 years or more	103	41.0	1.67	1.93	1.15	3.25	0.014	1.08
Time to first cigarette in the morning
Up to 5 minutes	69	31.5	1.00	1.00
More than 5 minutes	68	46.0	1.84	1.76	1.07	2.88	0.027	1.20
Cigarettes per day
Less than 30	91	40.6	1.00	1.00
30 or more	46	32.2	0.69	0.92	0.55	1.54	0.748	1.22
Breathlessness
No	50	35.0	1.00	1.00
Yes	87	38.8	1.18	1.57	0.95	2.60	0.077	1.13
Difficulty being in non-smoking areas
No	64	41.3	1.00	1.00
Yes	72	34.1	0.73	0.81	0.49	1.35	0.425	1.26
Most difficult cigarette to quit
First cigarette in the morning	100	41.8	1.00	1.00
Any other cigarette	36	29.3	0.57	0.65	0.39	1.06	0.090	1.05
Tendency to smoke most of the day during sick leave
No	51	42.2	1.00	1.00
Yes	84	35.2	0.74	0.83	0.48	1.42	0.497	1.31
Nicotine patch
No	4	18.2	1.00	1.00
Yes	133	38.7	2.83	2.42	0.72	8.08	0.152	1.10
Other smokers at home
No	58	35.6	1.00	1.00
Yes	79	38.9	1.15	1.16	0.72	1.86	0.535	1.08
Physical activity
No	75	36.2	1.00	1.00
Yes	62	39.5	1.14	1.08	0.67	1.75	0.755	1.13

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