Temporal effects of environmental tobacco smoke exposure: An ecological momentary assessment study among adolescent never- and experimental smokers

Background: Previous cross-sectional research provided evidence for a relationship between environmental tobacco smoke (ETS) exposure and symptoms indicative of nicotine dependence in adolescent never- and experimental smokers. This study aims to examine temporal associations between nicotine dependence-like symptoms and ETS exposure, and whether this differs between never- and experimental smokers. Methods: Ecological momentary assessment data were collected in a sample of Dutch adolescent never-smokers (n = 105; M_age = 14.48; 30.5% male) and experimental smokers (n = 72; M_age = 16.57; 30.6% male). Participants self-rated dependence-related symptoms (pleasant, unpleasant, autonomy over smoking, dizziness, wanting, withdrawal-related symptoms) and ETS exposure three times a day for three weeks. Binomial generalized linear mixed effects models were applied examining 1) the association between ETS exposure and symptoms within the same interval, 2) whether ETS exposure precedes symptoms, and 3) vice versa. Results: Analyses revealed a positive association between unpleasant symptoms and ETS exposure during ETS exposure for never-smokers. The experimental smokers experienced less autonomy over smoking within the same time interval, less wanting shortly after ETS exposure and fewer pleasant symptoms in the interval preceding ETS exposure. We did not find that ETS exposure precedes dependence-like symptoms. Conclusions: Temporal effects of ETS exposure differ between never- and experimental smokers. ETS exposure has a potentially aversive effect in never-smokers, while in experimental smokers may potentially contribute to developing nicotine dependence. Future research should increase the frequency of momentary assessments to investigate the processes in more detail.