Biomarkers of nicotine exposure correlate with the Hooked on Nicotine Checklist among adolescents in California, United States. (May 2022)

• Record Type: Journal Article
• Authors: Chaffee, Benjamin W.; Halpern-Felsher, Bonnie; Jacob, Peyton; St.Helen, Gideon
• Is Part Of: Addictive behaviors. Volume 128(2022)
• Publication Date: 2022-05
• Subjects: HONC Hooked on Nicotine Checklist -- LC-MS/MS liquid chromatography – tandem mass spectrometry; Adolescents -- Nicotine dependence -- Biomarkers -- Measure validation; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2022.107235
• Languages: English
• ISSNs: 0306-4603

Abstract

Highlights: The Hooked on Nicotine Checklist (HONC) measures adolescents' nicotine dependence. This study biochemically validates HONC among adolescent e-cigarette users. Nicotine dependence symptoms were reported at low levels of nicotine exposure. Greater HONC score was associated with higher salivary nicotine metabolite levels. Abstract: Background: The Hooked on Nicotine Checklist (HONC) has been used to assess nicotine dependence (loss of autonomy over tobacco) among adolescents. Existing HONC validation studies for non-cigarette products, such as electronic cigarettes (e-cigarettes), have generally not considered biomarkers of nicotine exposure. Methods: Within a cross-sectional sample of California (USA) high school students (total N = 1396; mean age 15.2 years; 56% female; 54% Hispanic/Latinx), self-reported past 30-day users of any tobacco (including e-cigarettes) completed a modified 10-item HONC questionnaire and provided saliva samples (N = 318 samples, including N = 234 exclusive past 30-day e-cigarette users). Samples were analyzed for cotinine using liquid chromatography-tandem mass spectrometry (lower limit of quantification: 1.0 ng/mL). Results: Across four categories of HONC score corresponding to an increasing number of reported dependence symptoms (scores: 0, 1, 2–4, 5–10), the prevalence of quantifiable salivary cotinine increased among past 30-day tobacco users (20%, 21%, 38%, 55%, respectively, P -for-trend < 0.001) and among past 30-day exclusive e-cigarette users (15%, 22%, 31%, 42%, respectively, P -for-trend = 0.001). Among participants with quantifiable cotinine levels, HONC total score and cotinine were positively correlated among past 30-day tobacco users (n = 89; Spearman rho = 0.449; P < 0.001) and past 30-day exclusive e-cigarette users (n = 49; Spearman rho = 0.520; P < 0.001). HONC score was also associated with past 30-day frequency of tobacco product use and reported use of tobacco within 30 min of waking. Conclusions: These results support the validity of HONC to assess nicotine dependence among adolescents. Dependence symptoms may be experienced at low levels of nicotine exposure.