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A Motivational Profile for Smoking Among Adolescents

Bonilha, Amanda Gimenes PhD; de Souza, Elisa Sebba Tosta MD; Sicchieri, Mayara Piani BStat; Achcar, Jorge Alberto PhD; Crippa, José Alexandre S. MD; Baddini-Martinez, José MD

doi: 10.1097/01.ADM.0000434987.76599.c0
Original Research

Objectives: To characterize a motivational profile of reasons for smoking among teenagers. To investigate the influence of clinical and social elements on observed scores.

Methods: High school students who smoked in the past month (n = 226; age, 16.4 ± 10 years; 46.5% male) answered a questionnaire during school time. The instrument included the University of São Paulo Reasons for Smoking Scale (USP-RSS), the Fagerström Test for Nicotine Dependence, and clinical and social information. The USP-RSS scores from 307 healthy adult smokers (67.5% male; age, 37.9 ± 11.2 years) were also used for comparisons.

Results: Most of the adolescents (90.2%) exhibited low or very low levels of nicotine addiction (median Fagerström Test for Nicotine Dependence score 0, range 0 to 8). The mean scores of the USP-RSS subscales were as follows: Addiction, 1.9 ± 1.1; Pleasure From Smoking, 3.0 ± 1.3; Tension Reduction, 2.4 ± 1.3; Stimulation, 1.9 ± 0.9; Automatism, 1.3 ± 0.6; Handling, 2.3 ± 1.1; Social Smoking, 1.9 ± 1.0; Weight Control, 1.4 ± 1.0; and Affiliative Attachment, 1.6 ± 0.9. In comparison with adults, teenagers exhibited lower scores for Addiction, Pleasure From Smoking, Tension Reduction, Automatism, Weight Control, and Affiliative Attachment and higher scores for Social Smoking (P < 0.05). Older age, past school failure, illicit drugs use, alcohol abuse, high levels of perceived stress, and the death of at least one parent were associated with high scores for all subscales.

Conclusions: The USP-RSS subscales Addiction, Pleasure From Smoking, and Social Smoking were important factors for adolescent smoking. Comparisons with adult smokers stressed the importance of the component of Social Smoking. The identification of distinctive factors that drive teenagers to smoke might help in making decisions dealing with interventions aimed at smoking cessation and control.

Supplemental Digital Content is Available in the Text.

From the Internal Medicine Department (AGB, ESTS, JBM), Social Medicine Department (MPS, JAA), and Department of Neuroscience and Behavior (JASC), Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Send correspondence and reprint requests to José Baddini-Martinez, MD, Internal Medicine Department, Medical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes 3900, CEP: 14048-900, Ribeirão Preto, São Paulo, Brazil. Email:

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

The authors declare no conflicts of interest.

Received October 26, 2012

Accepted August 28, 2013

© 2013 American Society of Addiction Medicine