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To assess the association of early onset of smoking and use of other addictive substances with nicotine dependence, the extent of substance use, and the probability of relapse in drug treatment and rehabilitation centers. Self-reported data were collected from July to September 2019 from 632 inpatients at five drug treatment facilities in the Philippines. The Addiction Severity Index (5 th  edition) and the Fagerström Test for Nicotine Dependence were used to assess the inpatients’ drug and alcohol use and nicotine dependence severity, respectively. Of a group of smokers who started smoking before the age of 10 years old, 54.3% were nicotine dependent current smokers and 9.89% were low to moderate nicotine dependent smokers. There were 82.61% male responders and 76% of the females started using drugs and alcohol before the age of 14. Other drug use eventually increased, yielding odds ratio of 26.5 and 28.9 in the past 30 days and lifetime, respectively, with 95% confidence interval of 10.8–64.9 and 11.5–72.9, indicating significant (p &lt; .05) differences. This study advises policymakers to focus more on educating and disseminating information about the early onset of nicotine, which paves the way to nicotine dependence and other drug use problems eventually. This present study suggests a follow-up intervention and an aftercare therapy solely for nicotine dependents with substance use disorder in the prevention of relapse after treatment.

The early onset of nicotine dependence, severity of substance use disorder, and relapse: an inpatient study