Protocol - Tobacco - Age of Initiation of Use - Adolescent

Personnel and Training Required

If an interviewer prepares the survey for self-administration, the interviewer must be trained and found competent to conduct personal interviews with individuals from the general population.

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.

Requirements

Requirement Category	Required
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

Self-administered questionnaire

Lifestage

Adolescent

Participants

12 through 17 years of age*

* If the study population consists of adolescents and young adults (12-24 years) with the intention of studying onset of risky behaviors, the investigator may wish to use the adolescent profile. If the study population primarily consists of adults (≥18 years), emphasizing established smoking and/or cessation, the investigator should use the adult profile.

Selection Rationale

The protocol from the National Survey on Drug Use and Health (NSDUH) was selected because this survey is the primary combined source of information on the use of drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States. The study was initiated in 1971, and it is currently conducted on an annual basis. The NSDUH is a survey that includes all substance use and that is administered to individuals ages 12 years and older. This survey asks many additional questions that may be more relevant to investigators studying adolescent subjects.

Language

Chinese, English, Other languages available at source

Standards

Standard	Name	ID	Source
Logical Observation Identifiers Names and Codes (LOINC)	Tobac age init use adoles proto	62556-6	LOINC
caDSR Form	PhenX PX030701 - Tobacco Age Of Initiation Of Use Adolescent	5806459	caDSR Form

Derived Variables

Duration of smoking: (Tobacco - Age of Offset of Cigarette Use¹ OR Current Age) - (Tobacco - Age of Initiation of First Cigarette Use)²

Pack-years: (Tobacco - 30-Day Quantity and Frequency)³ X (Duration)⁴

¹ Tobacco - Age of Offset of Cigarette Use:

• Adolescents: (Current Age) - (length of time response to the question: "How old were you the last time you smoked part or all of a cigarette?")
• Adults: (Current Age) - (length of time response to the question: "About how long has it been since you COMPLETELY quit smoking cigarettes?")

² Tobacco - Age of Initiation of First Cigarette Use:

• Adolescents: Age derived from the answer to: 2. "How old were you when you first started smoking cigarettes every day?" OR - For those who never smoked every day, the answer from 1. "How old were you when you first smoked part or all of a cigarette?"
• Adults: Age derived from the answer to: 1. "How old were you when you first started smoking cigarettes every day?" OR - For those who never smoked every day, the answer from 2. "How old were you when you first started smoking cigarettes fairly regularly?"

³ Tobacco - 30-Day Quantity and Frequency:

• Adolescents: Response to question "On the [number of days reported in 2a or 2b] you smoked cigarettes during the past 30 days, how many cigarettes did you smoke per day, on average?"
• Adults
• 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

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:

· Changed name of measure

Back-compatible: NA no changes to Data Dictionary

Previous version in Toolkit archive (link)

Protocol Name from Source

National Survey on Drug Use and Health (NSDUH), 2008

Source

2008 National Survey on Drug Use and Health. CAI Specifications for Programming, English Version; November 2007 (questions CG04, CG16).

General References

Amos, C. I., Wu, X., Broderick, P., Gorlov, I. P., Gu, J., Eisen, T., Dong, Q., Zhang, Q., Gu, X., Vijayakrishnan, J., Sullivan, K., Matakidou, A., Wang, Y., Mills, G., Doheny, K., Tsai, Y. Y., Chen, W. V., Shete, S., Spitz, M. R., & Houlston, R. S. (2008). Genome-wide association scan of tag SNPs identifies a susceptibility locus for lung cancer at 15q25.1. Nature Genetics, 40(5), 616-622.

Protocol ID

30701

Variables

Export Variables

Variable Name	Variable ID	Variable Description	dbGaP Mapping
PX030701_First_Cigarette_Smoking_Age
	PX030701010000	How old were you the first time you smoked more part or all of a cigarette? show less	Variable Mapping
PX030701_First_Cigarette_Smoking_Age_Coded
	PX030701010100	How old were you the first time you smoked more part or all of a cigarette? show less	N/A
PX030701_First_Cigarette_Smoking_Everyday_Age
	PX030701020000	How old were you when you first started more smoking cigarettes every day? show less	Variable Mapping
PX030701_First_Cigarette_Smoking_Everyday_Age_Coded
	PX030701020100	How old were you when you first started more smoking cigarettes every day? show less	N/A

Alcohol, Tobacco and Other Substances

Measure Name

Age of Initiation of First Cigarette Use

Release Date

February 6, 2009

Definition

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

Purpose

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.

Keywords

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

Measure Protocols

Protocol ID	Protocol Name
30701	Tobacco - Age of Initiation of Use - Adolescent
30703	Age of Initiation of First Cigarette Use - Adult

Publications

Garrison-Desany, H. M., et al. (2024) Post-traumatic stress and future substance use outcomes: leveraging antecedent factors to stratify risk Frontiers in Psychiatry. 2024 March; 15. doi: 10.3389/fpsyt.2024.1249382

Forray, A., et al. (2017) Progesterone for smoking relapse prevention following delivery: A pilot, randomized, double-blind study. Psychoneuroendocrinology. 2017 December; 86: 96-103. doi: 10.1016/j.psyneuen.2017.09.012

Kwok, R. K., et al. (2017) The GuLF STUDY: A Prospective Study of Persons Involved in the Deepwater Horizon Oil Spill Response and Clean-Up. Environ Health Perspect. 2017 April; 125(4): 570-578. doi: 10.1289/EHP715

McCarty, C.A., Berg, R., Rottscheit, C.M., Waudby, C.J., Kitchner, T., Brilliant, M., Ritchie, M.D. (2014) Validation of PhenX measures in the personalized medicine research project for use in gene/environment studies. BMC Med Genomics. 2014 January; 7: 3. doi: 10.1186/1755-8794-7-3