This issue, we ask 5 Questions to…Lisa Dierker, chair and professor of psychology. Dierker provided us with some information on her research findings.
Q. How did you become interested in researching adolescents who smoke?
A: Early in my career, I was selected as a faculty scholar by the Tobacco Etiology Research Network. This network was a multidisciplinary initiative sponsored by the Robert Wood Johnson Foundation and was aimed at attracting junior scholars into the field in hopes of accelerating research into the causes and mechanisms by which experimentation with tobacco leads to chronic and dependent use.
At that time, as is the case today, smoking was the single largest preventable cause of illness and death in the United States. I was attracted to both the challenge and opportunity the field represented in terms of improving public health.
Q. Why is it critical to study adolescents and nicotine dependence/addiction?
A: The sheer toll of tobacco on the health and health care costs in the United States makes this an important area of inquiry. The fact that tobacco use begins almost exclusively during adolescence and often progresses to dependence even before adulthood means that smoking prevention can be best informed by research focused on this critical period of development.
Q. What did you learn in your recent study examining whether early onset of addiction symptoms for new adolescent smokers was a signal for chronic smoking?
A: Ours is the first study to demonstrate that addiction symptoms reported very soon after smoking initiation do in fact predict a substantial increase in risk for chronic smoking. While previous research has established that some adolescents report experiencing early signs and symptoms of nicotine addiction after smoking a remarkably small number of cigarettes, we now know that these experiences predict their future behavior. Specifically, we found that adolescents who smoked less than 100 cigarettes in their lifetime when entering the study and who demonstrated nicotine addiction symptoms such as craving, withdrawal and the drive to smoke, were much more likely to be daily smokers two years later and that this risk could not be better explained by how much they had smoked.
Q. What does this mean in terms of preventing tobacco use among adolescents?
A. Our results suggest that early symptoms of nicotine addiction are an important signal that will allow us to better predict future smoking behavior. Understanding that early endorsement of symptoms among new adolescent smokers is linked to chronic smoking makes us believe that screening experimental smokers may represent an important and currently unused tool in tobacco control efforts. Being able to predict those youth at highest risk by assessing nicotine addiction symptoms earlier, may help us to thwart the development of chronic, lifelong smoking patterns.
Q. Does alcohol use contribute to nicotine addiction in youth? How? Could you point to what you’ve learned from your studies?
A: While the link between smoking and alcohol use has been well established, the mechanism explaining this association has most commonly been described in terms of simple co-use. That is, the more someone drinks, the more cigarettes they are also likely to smoke, thereby increasing their risk of both alcohol and nicotine addiction through increased exposure to these substances. Some of our recent work, however, has challenged this notion by demonstrating that alcoholism is associated with an increased likelihood of experiencing symptoms of nicotine addiction above and beyond how much an individual smokes or drinks. That is, alcoholism seems to mark a greater sensitivity to the effects of nicotine even at low levels of smoking.
As with all of our work, we are eager for these results to guide future research specifically aimed at targeting high-risk youth with interventions that will prevent and/or halt the development of addiction.