The association between cigarette smoking and DSM-IV nicotine dependence among first year college students.

AIMS This study was undertaken to evaluate the association between cigarette smoking behavior and DSM-IV nicotine dependence. DESIGN Drawing on a sample of first year college students selected for representation across a continuum of smoking behavior, current DSM-IV nicotine dependence criteria were assessed among participants reporting any smoking in the preceding week on a web-based survey protocol. Logistic regression and receiver operator characteristic analyses were used to estimate the overall concordance between smoking and DSM-IV nicotine dependence. FINDINGS Relationships were supported between both quantity and frequency of smoking in the past week and DSM-IV nicotine dependence showing higher prevalence of dependence at higher levels of use (p<0.05). While the highest prevalence of nicotine dependence was seen among those reporting the most frequent and heavy smoking, a substantial number of participants reporting daily and/or heavy smoking did not meet criteria for nicotine dependence. Conversely, nicotine dependence was seen among a subgroup of participants reporting relatively low levels of non-daily smoking. Diagnostic concordance was found to be moderate for both quantity and frequency and was not improved by combining information from these two indices. CONCLUSIONS Aside from confirming DSM-IV nicotine dependence at relatively low levels of smoking, these results may be used to inform research aimed at identifying samples of nicotine dependent youth across the range of smoking levels.