The predictive value of smoking expectancy and the heritability of its accuracy

Introduction: Among smokers, former smokers, and never-smokers, this study aimed to (a) determine the predictive value of smoking expectancy on future smoking status, and (b) test the relative contribution of genes and environment to a person's ability to accurately predict future smoking status. For smokers, smoking expectancy reflects the intention to continue smoking; for former smokers, it reflects the intention to take up smoking again; and for never-smokers, it reflects the intention to initiate smoking. Methods: A longitudinal design was employed in which participants of the Netherlands Twin Register completed 2 consecutive surveys 2 years apart between 1993 and 2011 (3,591 adolescents aged 14-18 years), or between 1993 and 2004 (11,568 adults, aged 18+ years). Smoking expectancy was measured by asking, "Do you think you'll smoke in a year's time?", with answer categories ranging from "certainly not" to "absolutely yes" on a 5-point scale. To determine the predictive value of smoking expectancy, analyses were performed in smokers, former smokers, and never-smokers separately. Data of 2,987 adolescents and 4,911 adult twins were analyzed to estimate heritability. A dichotomous variable reflected the ability to predict future smoking status (correct/incorrect). Results: Smoking expectancy significantly predicted future smoking status among former smokers and never-smokers. The ability to accurately predict future smoking status was explained by additive genetic factors for 59% of adolescents and 27% of adults, with the remainder being explained by unique environmental factors. Conclusions: A single question on smoking expectancy helps predict future smoking status. Variation in how well subjects predict their future smoking behavior is influenced by genetic factors, especially during adolescence.