Higher Levels of Nicotine Dependence in Adolescence are Associated with Younger Onset Age of Violent Criminality: A Follow-Up Study of Former Adolescent Psychiatric Inpatients.

Objective Earlier studies have reported that smoking is associated with violent behaviour. This study investigated nicotine dependence (ND), defined as already present in adolescence, and its relation to subsequent violent criminal offending. Method The baseline dataset is composed of 508 former adolescent inpatients, admitted to a psychiatric hospital between the ages of 13-17. Adolescent ND was assessed using the modified Fagerstrom Tolerance Questionnaire. Follow-up data on crimes up to young adulthood was acquired from the Legal Register Centre of Finland. The study analyzes the participants with violent offences (n = 78) and those without any criminal history (n = 368). Results Over 80% of the violent offenders had ND already in adolescences. One third (32.2%) of those with high ND had committed their first violent crime before 18 years of age, the proportions being 15.2% in moderate and 7.1% in no-ND groups. The likelihood for committing first violent crimes at a younger age was increased in the participants with high (adjusted Hazard Ratio (aHR) = 2.66, p = .008) or moderate ND (aHR = 2.40, p = .011). Conclusions Adolescent psychiatric patients, showing moderate to high levels of addiction to nicotine, should be a target population for adolescent focused smoking cessation interventions and programs. Adolescents addicted to nicotine may benefit from intensive clinical attention in order to avoid more adverse and unfavorable outcomes in life, beyond merely physical health related problems.