Biomarkers of nicotine exposure correlate with the hooked on Nicotine Checklist among adolescents in California, United States.

Introduction:
This text provides an analysis of the hooked on Nicotine Checklist (hONC) as a measure of nicotine dependence among adolescents. The study examines the relationship between biomarkers of nicotine exposure and hONC scores in a sample of adolescent exclusive e-cigarette users and other tobacco users in Northern California, United States. The study aims to assess the validity of the hONC instrument, particularly among young e-cigarette users, by examining the number of days of e-cigarette and other tobacco product use in the past 30 days, use of products within 30 minutes of waking, and levels of salivary nicotine metabolites (cotinine and 3-hydroxycotinine).

Key Points:

* The study sample consisted of adolescents aged 15 years on average, with 56% identifying as female and 54% as hispanic/Latinx.
* The hONC instrument had good internal consistency and assessed symptoms such as cravings, irritability, and difficulty quitting.
* Participants reported using e-cigarettes more frequently and soon after waking in higher categories of hONC score.
* The prevalence of quantifiable nicotine metabolites in saliva was greater in each successively higher category of hONC score.
* Levels of nicotine metabolites in saliva were positively correlated with hONC total score, both among all past 30-day tobacco users and exclusive e-cigarette users.
* There were not convincing associations between hONC score and behaviors related to use of cigars, cigarettes, hookah, or smokeless tobacco.
* The study had limitations, including the cross-sectional nature and potential exposure to household tobacco use by a parent or other family member.

Main Message:
The study supports the validity of hONC as a measure of nicotine dependence among adolescents, particularly e-cigarette users. The study found that symptoms of nicotine dependence, as measured by hONC, were positively correlated with e-cigarette use behaviors and biomarkers of nicotine exposure. The study's findings provide researchers and tobacco regulators with greater confidence in applying the flexible hONC instrument to evaluate new and emerging tobacco and nicotine products. however, further research is necessary to establish the long-term validity and applicability of the hONC instrument in different settings.

Chaffee BW, halpern-Felsher B, Jacob P, St helen G. Biomarkers of nicotine exposure correlate with the hooked on Nicotine Checklist among adolescents in California, United States. addictive behaviors. 2022;128:107235. doi:10.1016/j.addbeh.2022.107235