Nicotine dependence and its familial aggregation in Chinese

Background Nicotine dependence is a significant public health problem. This study attempted to characterize the prevalence and familial aggregation of nicotine dependence in China. Methods In 1998, we initiated a community-based cross-sectional study among residents of the Yuexi County in Anqing, China. A total of 991 current smokers from 488 randomly selected nuclear families were recruited and surveyed by use of the standardized Fagerstrom Test of Nicotine Dependence (FTND) questionnaire and the Revised Tolerance Questionnaire (RTQ). All study subjects were offspring in their respective nuclear families, and 478 male-male pairs (aged 41.7 +/- 12.1 years) were finally used for data analyses, because the number of female current smokers (n = 5) was too small. Results The correlation coefficient of the FTND and the RTQ scores was as high as 0.84 (P < 0.0001). Nicotine dependence, defined as an FTND score greater than or equal to 8 or an RTQ score greater than or equal to 28, had a prevalence of 12.7% and 11.1%, respectively. The respective sibling recurrent risk was 1.7 and 2.4, according to the FTND or the RTQ criteria. The adjusted odds ratios and 95% CI of nicotine dependence of second siblings in families in which the first sibling was nicotine dependent were 2.13 (95% CI:1.02-4.43) and 3.50 (95% CI:1.65-7.36) respectively, according to the FTND and RTQ criteria. Conclusions The prevalence of nicotine dependence in male current smokers in China was comparable to that reported in previous US and European studies. Our findings suggest that genetic influences may play an important role in vulnerability to nicotine addiction.