CHICAGO (Reuters Health) - In order to battle teen smoking, it is important to know when teenage smokers cross over from experimentation to tobacco dependence or addiction; but that point is hard to determine, according to presentations made here Wednesda

Dr. Raymond Niaura of Brown University in Providence, Rhode Island, pointed out that just because a teenager smokes does not mean he or she is dependent on tobacco or nicotine. ``One potential problem with tobacco use as a marker for dependence is that patterns of use by adolescents are remarkably variable and unstable, difficult to measure with fine degrees of precision and may not be of great prognostic value in terms of predicting future entrenched tobacco involvement,'' he explained. Questionnaires asking teens about reliance on tobacco, cravings or other behaviors that may indicate dependence often have flaws because most were developed for use in older smokers. Dr. Suzanne M. Colby of Brown University called for assessment tools that are specifically designed for teenagers. ''It should be developmentally appropriate, and this is an area where our current measurement approaches fall very short. Most of our measurement approaches derive originally from measures on adult smokers,'' she noted. ``What that causes is a bias in measuring dependence as a static, end-stage phenomenon rather than as a dynamic, emerging process.'' What's more, Colby said, there is little standardization in the dependence measurement tools. ``Almost all researchers are adapting the measures in their own way,'' she added. ``And what that results in is as many nicotine dependence measures as there are researchers, and that keeps us from moving ahead because we can't compare across studies.'' Both researchers suggest these measurement problems must be dealt in order to speed progress toward tobacco-cessation programs that work for adolescents. Dr. Mark Nichter of the University of Arizona in Tucson advised fellow tobacco researchers that developing surveys ''requires careful attention to what types of questions make sense to youth given their life-world and how youth of different ages tend to answer questions.'' Nichter said researchers cannot assume that questions will be understood as intended, so getting feedback from teens is critical to understanding what they are really saying about tobacco in their lives.

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