Protocol - Age of Initiation of First Cigarette Use - Adult

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.

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

Interviewer-administered questionnaire

Lifestage

Adult

Participants

· 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

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).

Language

English, Other languages available at source

Standards

Standard	Name	ID	Source
caDSR Form	PhenX PX030703 - Age Of Initiation Of First Cigarette Use Adult	6910236	caDSR Form
Logical Observation Identifiers Names and Codes (LOINC)	PhenX - age of initiation of first cigarette use - adult protocol 030703	94157-5	LOINC

Derived Variables

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

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

¹ Tobacco - Age of Offset of 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 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:

• 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)

Protocol Name from Source

Co-sponsored Tobacco Use Supplement to the Current Population Survey, 2010

Source

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

30703

Variables

Export Variables

Variable Name	Variable ID	Variable Description	dbGaP Mapping
PX030703_Age_FirstCigarette_Adult_First_Time
	PX030703030000	You said that you never smoked regularly. more How old were you the first time you smoked part or all of a cigarette? show less	N/A
PX030703_Age_FirstCigarette_Adult_Hundred
	PX030703010000	Have you smoked at least 100 cigarettes if more your entire life? show less	N/A
PX030703_Age_FirstCigarette_Adult_SmokeRegularly
	PX030703020100	How old were you when you first started more smoking cigarettes FAIRLY REGULARLY? show less	N/A
PX030703_Age_FirstCigarette_Adult_SmokeRegularly_Coded
	PX030703020200	How old were you when you first started more smoking cigarettes FAIRLY REGULARLY? 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

Kosyluk, K., et al. (2024) Mental Distress, Label Avoidance, and Use of a Mental Health Chatbot: Results From a US Survey. JMIR Formative Research. 2024 April; 8(17). doi: 10.2196/45959

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

Reed, D. M., et al. (2023) Eye Dynamics and Engineering Network Consortium: Baseline Characteristics of a Randomized Trial in Healthy Adults. Ophthalmol Glaucoma. 2023 March; 6(2): 215-223. doi: 10.1016/j.ogla.2022.09.001

Riley, E. D., et al. (2022) Ongoing tobacco use in women who experience homelessness and unstable housing: A prospective study to inform tobacco cessation interventions and policies. Addictive Behaviors. 2022 February; 125: 107125. doi: 10.1016/j.addbeh.2021.107125

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