Changes in autonomy over tobacco and nicotine dependence after implementation of ASPIRA smoking prevention program

Abstract

The theory-based construct of autonomy supports the idea of a useful explaining concept of nicotine dependence of adolescents. This study focus on differences in the level of proneness toward nicotine use and the presence of symptoms of addiction among smoking teens comparing baseline and 6 months follow-up data. Participants were 272 currently smoking students selected from a cluster randomized control trial (N = 1835) of 9th-graders involved in the ASPIRA program. We assessed the vulnerability of developing nicotine addiction with the Hooked on Nicotine Checklist, completed with the Modified Fagerström Tolerance Questionnaire (MFTQ) along with the reported smoking status in the last 30 days, the amount of daily cigarettes and current smoking status. We performed comparison between test and retest with Cohen's kappa and paired samples t test. We measured the prediction role of the variables using step-way linear regression. The reported smoking status proved a slight but significant improvement after intervention at six-month follow-up. Data obtained before and after the intervention in the smokers’ sample showed significantly lower scores at both scales MFTQ and HONC, underlining the important role of the intervention in changes on vulnerability to nicotine addiction. Our results suggest that the loss of autonomy is a significant predictor of nicotine addiction, in line with the newest studies proposing the autonomy theory as a useful approach in the assessment of nicotine dependence in adolescence.