Protocol - Age of Initiation of First Cigarette Use - Adult

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Measurement to ascertain the respondent’s age of initiation of first/regular use of cigarettes, which can be used to calculate duration of use and pack-years measures. The PhenX Working Group modified the Adult Protocol to provide a more precise measure. The original wording of "fairly regularly" was changed to "every day."


The Working Group acknowledges that the following questions may gather sensitive information relating to the use of substances and/or illegal conduct. If the information is released it might be damaging to an individual’s employability, lead to social stigmatization, or other consequences.

For information on obtaining a Certificate of Confidentiality, which helps researchers protect the privacy of human research participants, please go to the National Human Genome Research Institute’s Institutional Review Board website.

1. Have you smoked at least 100 cigarettes if your entire life?

1. Yes

2. No (Go to 2a)

2. How old were you when you first started smoking cigarettes FAIRLY REGULARLY?

Enter (0) if never smoked regularly (Go to 3)

Enter Age (01-99): ____

Don’t Know/Refused

3. You said that you never smoked regularly. How old were you the first time you smoked part or all of a cigarette?

Enter Age (01-99): ______


Protocol Name from Source:

Tobacco Use Supplement to the Current Population Survey


Publicly available

Personnel and Training Required

Interviewer must be trained and found competent to conduct personal interviews with individuals from the general population. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Equipment Needs

While the source instrument was developed for administration by computer, the PhenX Working Group acknowledges that these questions can be administered in a noncomputerized format.

Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered questionnaire

Life Stage:



· Every-day smokers: Response to question "On the average, about how many cigarettes do you now smoke each day?"

· Some-day smokers: [(Response to question "On the average, on those days, how many cigarettes did you usually smoke each day?") X (Response to "On how many of the past 30 days did you smoke cigarettes?")] / 30

· Former smokers:

  • Respondents who smoked every day for ≥6 months: Response to question "When you last smoked every day, on average how many cigarettes did you smoke each day?"
  • Respondents who did not smoke every day for ≥6 months: Response to question "When you last smoked fairly regularly, on average how many cigarettes did you smoke each day?"

· The Fagerstrom Test for Nicotine Dependence measure (4. How many cigarettes/day do you smoke?) can also be used to calculate the amount of cigarettes smoked.

  • Use the midpoint from the response category to obtain the number of cigarettes smoked per day.

4 Duration calculation provided above

Specific Instructions:

There are two questions in this protocol. Current Every-Day Smokers (based on responses to the Tobacco - Smoking Status [Adult Protocol]) are asked the age when they initiated smoking every day. Current Some-Day Smokers and Former Smokers (based on responses to the Tobacco - Smoking Status [Adult Protocol]) are asked the second question about the age when they initiated smoking fairly regularly. Participant’s age in years is recorded.

Selection Rationale

The protocol from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) was chosen because it is a large survey (each survey wave includes about 240,000 respondents) of the U.S. noninstitutionalized civilian population that has been conducted since 1992 in a consistent manner. The next wave is being planned for 2010-2011, and it is anticipated that the survey will be conducted triennially over the next decade. The National Cancer Institute (NCI) is the primary sponsor of the survey series, with the Centers for Disease Control and Prevention (CDC) serving as cosponsor between 2001 and 2007. The TUS is an adult-focused survey, and its questions are comparable to the CDC’s National Center for Health Statistics’ National Health Interview Survey (NHIS) and National Health and Nutrition Examination Survey (NHANES) and NCI’s Health Information National Trends Survey (HINTS).


English, Available in other languages

Common Data Elements (CDE) Tobacco Begin Age Value 2820880 CDE Browser
Process and Review

The Expert Review Panel #3 (ERP 3) reviewed the measures in Alcohol, Tobacco and Other Substances, and Substance Abuse and Addiction domains.

Guidance from ERP 3 includes:

• Updated protocol

• New Data Dictionary

Back-compatible: Partially back-compatible (updated/similar protocol which would require some changes to the data dictionary), variable mapping between current and previous protocols can be found here

Previous version in Toolkit archive (link)


U.S. Department of Commerce, Census Bureau. (2010). National Cancer Institute and Centers for Disease Control and Prevention Co-sponsored Tobacco Use Supplement to the Current Population Survey (2010-2011) Technical documentation. Questions A1 modified and A2

General References

National Cancer Institute. (2009). Tobacco Use Supplement to the Current Population Survey: Reports and publications using the TUS-CPS [Bibliography]. Available from http://riskfactor.cancer.gov/studies/tus-cps/publications.html

Protocol ID:


Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
Research Domain Information
Measure Name:

Age of Initiation of First Cigarette Use

Release Date:

February 6, 2009


Questions asking the respondent how old s/he was when s/he first smoked cigarettes and first smoked cigarettes regularly.


This measure assesses when the participant’s exposure to cigarette smoking began, often associated with level of nicotine addiction. When this measure is used in conjunction with the Tobacco - Age of Offset of Use measure for former smokers or current age for current smokers, the participant’s duration of smoking can be derived. Pack-years can also be derived from calculating the measure of amount smoked and duration.


tobacco, smoking, cigarette, nicotine, nicotine dependence, duration of smoking, pack years, National Survey on Drug Use and Health, NSDUH