Weekend Texting Screen Time and Incident Nicotine Use in Early Adolescents: Longitudinal Analysis of the Adolescent...

Adolescent nicotine use initiation remains a significant public health concern. While screen-based behaviors have been linked to substance use, few prospective studies have examined specific forms of interactive screen engagement or tested potential psychological mechanisms underlying this association.

This study aimed to examine whether weekend texting screen time was prospectively associated with subsequent nicotine use initiation among early adolescents and evaluate whether negative urgency statistically accounted for part of this association.

We analyzed longitudinal data from a large cohort of adolescents who were nicotine naive at baseline. Weekend texting screen time (hours) was assessed via self-report. Negative urgency, reflecting impulsive action during negative affect, was measured using the UPPS (Urgency, Premeditation, Perseverance, and Sensation Seeking) impulsivity scale. Incident nicotine use initiation was modeled using Cox proportional hazards regression, adjusting for sex, age, race, ethnicity, and household income. We evaluated whether adjustment for negative urgency attenuated the texting-initiation association and conducted a sensitivity analysis restricted to participants for whom texting assessment, negative urgency assessment, and nicotine use initiation were temporally ordered.

Among 5,965 nicotine-naïve adolescents followed prospectively, 239 (4%) initiated nicotine use. Greater weekend texting was associated with increased hazard of nicotine use initiation (per hour: hazard ratio [HR]=1.07, 95% CI 1.04-1.11). A 5-hour increase corresponded to an approximately 30% to 40% higher hazard of initiation. Weekend texting was positively associated with negative urgency (β=0.079; P<.001), and negative urgency independently predicted nicotine use initiation (per point: HR=1.19, 95% CI 1.13-1.25). Inclusion of negative urgency slightly attenuated the texting association (per hour: HR=1.06, 95% CI 1.02-1.09), although attenuation was modest. In standardized models, a 1-SD increase in weekend texting was associated with a 21% higher hazard of initiation (HR=1.21, 95% CI 1.10-1.31). In a sensitivity analysis restricted to participants with temporally ordered assessments and nicotine use initiation, weekend texting remained associated with nicotine use initiation (HR=1.11, 95% CI 1.06-1.16), and negative urgency remained independently associated with use initiation (HR=1.11, 95% CI 1.02-1.21). Adjustment for negative urgency attenuated the texting log-hazard coefficient by 6.8%.

Greater weekend texting screen time was prospectively associated with subsequent nicotine use initiation among early adolescents. Negative urgency was independently associated with nicotine use initiation and modestly attenuated the texting-initiation association. These findings are consistent with overlapping contributions of digital engagement and affect-driven impulsivity to early nicotine risk but do not establish a causal mediating pathway.