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Introduction: Recent studies evidenced that adolescent never-smokers exposed to secondhand tobacco smoke (SHS) endorsed nicotine dependence symptoms. Other studies showed that SHS exposure measured with biomarkers among never-smokers independently predicted withdrawal sensations and prospective smoking initiation. The aim of the present study was to replicate and extend these findings by investigating whether social and pharmacological measures of SHS exposure predicted precursors to smoking among never-smoking adolescents. Methods: Participants included 327 never-smokers aged 11–15 years attending sixth or seventh grade in French language schools in Montréal, Canada. They completed self-report questionnaires measuring their smoking status, social smoke exposure (number of smokers in their environment and number of situations where SHS exposure occurs), and precursors to smoking initiation (smoking expectancies, perceived nicotine dependence, and smoking susceptibility). Each participant provided a saliva sample from which cotinine biomarkers were derived to measure pharmacological exposure to SHS. Results: When predictors were modeled individually, number of smokers predicted perceived nicotine dependence (p ≤ .05), smoking susceptibility (p ≤ .001), and expected benefits (p ≤ .05), whereas number of situations predicted smoking susceptibility (p ≤ .01). When predictors were modeled simultaneously, number of smokers predicted perceived nicotine dependence (p ≤ .01), smoking susceptibility (p ≤ .01), and expected benefits (p ≤ .05). Conclusions: Social smoke exposure was a predictor for smoking precursors. Pharmacological exposure to SHS did not predict smoking precursors, which may be partly attributable to the low cotinine values observed in our sample. Suggestions for improved pharmacological measurement of SHS and implications for public health are discussed. [ABSTRACT FROM AUTHOR]

Although related to inflammatory markers in adults, little is known about the association between cigarette smoking and C-reactive protein (CRP) in adolescent smokers. We examined the association between high-sensitivity CRP (hs-CRP) concentrations and smoking in youth. We used data from a cross-sectional, province-wide survey of a representative sample of youth conducted in Quebec, Canada, in 1999. Data were collected in self-report questionnaires completed by participants and their parents. Participants provided a fasting blood sample, and anthropometric measures were undertaken by trained technicians. The present analysis pertains to 1,501 adolescents aged 13 and 16 years who completed questionnaires and for whom blood samples were available. The independent association between a six-category indicator of smoking status and elevated hs-CRP, defined as a value at least in the 90th percentile of the age- and sex-specific CRP distribution, was assessed in multiple logistic regression analyses controlling for potential confounders. Relative to never-smokers, the odds ratios (95% confidence intervals) for puffers (i.e., never smoked a whole cigarette), those who smoked but not in the past month, light past-month smokers, moderate past-month smokers, and heavy past-month smokers were 1.04 (0.55-1.98), 1.76 (1.06-2.94), 1.39 (0.70-2.76), 2.07 (0.96-4.42), and 2.40 (1.18-4.88), respectively. Our data suggest a positive association between smoking status and elevated CRP in adolescents, and in particular among heavier past-month smokers. Damage related to cigarette smoking may begin soon after tobacco use initiation, reinforcing the preventive message that no level of smoking is safe in youth. [ABSTRACT FROM AUTHOR]