M. Assess Risk for Starting Tobacco Use

OBJECTIVE

To assess the potential for tobacco use in persons who have never used tobacco, based on existing risk factors

ANNOTATION

The PCM/PCP can help identify the following information derived in the history and physical

1. The role of the family.
2. Societal/cultural expectations.
3. Tobacco industry's promotion.
4. Military recruits.
5. Low educational attainment.

DISCUSSION

Speakers at the Addicted to Nicotine: A National Research Forum stated that potential tobacco users can be partially identified by the following information derived in the history and physical:⁴⁶

1. The role of the family.

   Among white adolescents, parents and family play a role in predicting onset of tobacco use. Qualitative data suggest that parental messages about smoking do matter.

2. Societal/cultural expectations.

   White females may be at risk for smoking because of expectations created by sociocultural beliefs, e.g., smoking helps to control weight, control mood, and enhance one's image of being independent and sophisticated.

3. Tobacco industry's promotion.

   There is considerable evidence that the tobacco industry's promotion of its products has a major influence on initiating tobacco use by the young.

4. Military recruits.

Some situations (e.g., special military assignments) are likely to lead to tobacco use. White male and female Navy Recruits are more likely to have used tobacco than civilians. The Addicted to Nicotine Study found that at one year after boot camp:

1. Eight percent of those who had "never used tobacco" before enlistment are now using tobacco.
   
   
2. Twenty-six percent of those who had been "experimental tobacco users" were using tobacco.
   
   
3. Forty-three percent of those who had been "ex-tobacco users" were using tobacco.
   
   
4. Low educational attainment.

The prevalence of smoking is highest in those with less than 12 years education.

EVIDENCE

LE =C, SR = I Addicted to Nicotine, A National Research Forum Program Book. Bethesda, Maryland: July 27 and 28, 1998

REFERENCES

⁴⁶Addicted to Nicotine: a National Research Forum, Program Book 1998