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An Examination of Adolescent Nicotine Withdrawal Symptoms: A Validation of the Nicotine Withdrawal Assessment for Youth Matthew E. Goldfine The present study evaluated the nicotine withdrawal symptoms of current adolescent cigarette smokers and examined the psychometric properties of the Nicotine Withdrawal Assessment for Youth (N-WAY), a new measure of adolescent nicotine withdrawal symptoms. Smokers and nonsmokers, ranging in age from 13-19 years old, were found to report significantly different rates of 10 of 19 purported nicotine withdrawal symptoms: anger, headaches, alertness, feeling depressed, nervousness, dizziness, irritability, conflict with family, conflict with school staff, and cigarette cravings. In addition, smokers were found to be significantly older and consume more daily caffeine than nonsmokers. The data imply that caffeine use may ameliorate certain nicotine withdrawal symptoms or caffeine withdrawal may be more responsible for symptoms falsely attributed to nicotine withdrawal. There were no indications of different rates of restlessness, trouble concentrating, feeling tired, feeling stressed, feeling hyper, waking up during sleep, hunger, trouble falling asleep, or conflict with friends among smokers and nonsmokers. Results also suggested that light smokers may experience higher rates of day-to-day nicotine withdrawal symptoms than heavy smokers. Despite being more dependent on nicotine, heavy smokers, through their frequent administration of nicotine, may be better able to prevent or quickly alleviate withdrawal symptoms than light smokers. An examination of the N-WAY demonstrated acceptable test-retest reliability (total symptom score [r = .78] and impact score [r = .74]) and internal consistency (symptom items Cronbach‘s α = .84 and impact items Cronbach‘s α = .92). Its total symptom and impact score both accurately discriminated current smokers from nonsmokers. There was weak concurrent validity with an established measure of nicotine dependence, the Modified Fagerström Tolerance Questionnaire. This was hypothesized to support that the N-WAY validly measured nicotine withdrawal symptoms, a distinct construct from nicotine dependence symptoms. Other correlates of nicotine withdrawal symptoms, such as number of daily cigarettes smoked and prior quit attempts, accurately predicted total N-WAY impact score, further indicating that the N-WAY is a valid assessment of adolescent nicotine withdrawal symptoms. These results suggest that although adolescent smokers experience a number of nicotine withdrawal symptoms, there are a number of symptoms that nonsmokers report at equal rates and may be best explained as a normative adolescent experience.

An examination of adolescent nicotine withdrawal symptoms: A validation of the Nicotine Withdrawal Assessment for Youth