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Is the National Institute on Alcohol Abuse and Alcoholism Screening Guide Useful for Identifying Adolescents at Risk for Later Cigarette Smoking? A Prospective Study in Primary Care Clinics

Shadel, William G., PhD; Seelam, Rachana, MPH; Parast, Layla, PhD; Meredith, Lisa S., PhD; D’Amico, Elizabeth J., PhD

doi: 10.1097/ADM.0000000000000459
Original Research

Objectives: This paper evaluated whether a 2-item assessment of alcohol use risk, developed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA SG), prospectively predicted smoking status among a sample of adolescents visiting their primary care physician.

Methods: We analyzed a sample of 651 adolescents (57.80% female; 56.53% Hispanic, 22.73% African American, 14.44% White, 6.30% other) who completed the NIAAA SG at a baseline appointment and were assessed for future smoking risk. We obtained prospective data on smoking status using data from the 6-month post-baseline follow-up assessment.

Results: Logistic regression analyses revealed that adolescents who were identified as at risk by the NIAAA SG were more likely to report smoking within 6 months. However, the association between the NIAAA SG and future smoking status became non-significant after controlling for future smoking risk measured at baseline.

Conclusions: Questions that ask about past smoking and future smoking intentions are best used to screen adolescents in primary care for smoking risk.

RAND Corporation, Pittsburgh, PA (WGS); RAND Corporation, Santa Monica, CA (RS, LP, LSM, EJD).

Send correspondence to William G. Shadel, PhD, RAND Corporation, 4570 5th Avenue, Suite 600, Pittsburgh, PA 15213. E-mail:

Received 21 March, 2018

Accepted 10 September, 2018

This research was supported by a grant from the National Institute of Alcohol Abuse and Alcoholism (R01AA021786) to Elizabeth J. D’Amico.

The authors report no conflicts of interest.

© 2019 American Society of Addiction Medicine