Predictors of the nicotine dependence behavior time to the first cigarette in a multiracial cohort

Background: The time to first cigarette of the day (TTFC) is a strong indicator of nicotine dependence behaviors such as nicotine uptake and quit success in young and older smokers. There are substantial differences in levels of nicotine dependence by race and ethnic group. Methods: Data from Wave III of the multiracial National Longitudinal Study of Adolescent Health were analyzed for young smokers between the ages of 21 and 28 (N = 1,425). Time to first cigarette data was compared between Hispanic, White, Black, Native American, and Asian smokers. Results: Black smokers were significantly more likely to smoke within 5 min of waking than White, Hispanic, and Asian smokers. Lower personal income predicted smoking within 5 min of waking for both White and Black smokers. For White smokers, increased number of cigarettes per day and increased years of smoking also predicted smoking within 5 min of waking. The number of days smoked or number of cigarettes per day did not predict smoking within 5 min of waking among smokers. Conclusions: The higher prevalence of early TTFC among Blacks indicates increased nicotine and carcinogen exposure, and may help explain the increased lung cancer rates and failed cessation attempts among Black smokers. TTFC may be an important screening item, independent of cigarettes per day, for clinicians and interventions to identify those at highest risk for cessation failure and disease risk.