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Abstract
Individuals who feel relaxed the first time they inhale from a cigarette are more likely to develop nicotine dependence. To determine if the relaxation response is associated only with specific aspects of dependence, a survey was administered to 1405 adolescents aged 14–18 years (mean 15.8 years) from four schools in Massachusetts. Nicotine dependence was measured with the Diagnostic and Statistical Manual (DSM-IV), and the loss of autonomy over tobacco was measured with the Hooked on Nicotine Checklist (HONC) and the Autonomy Over Smoking Scale. A feeling of relaxation was reported by 39.4% of 439 youth who had inhaled from a cigarette. Relaxation was associated with increased risk of current smoking (odds ratio (OR) = 5.7, p < 0.001), daily smoking (OR = 5.7, p < 0.001), a loss of autonomy on the HONC (OR = 5.0, p < 0.001), and a DSM-IV diagnosis (OR = 2.4, p < 0.02). In regression analyses, relaxation was not associated with psychological reliance on tobacco after controlling for nicotine withdrawal symptoms, and cue-induced craving. This study extends the literature by demonstrating that relaxation is associated with DSM-IV nicotine dependence, nicotine withdrawal, and aspects of cue-induced craving.