From a theoretical perspective, however, there remain questions regarding what endorsement of any of these items means. There were substantial differences in the level of item endorsement, suggesting that some items might be more specific indicators of the relevant difference. While almost all daily drinkers endorsed at least one of the items, only 7% of subjects at the 30 month follow-up endorsed the item “When you feel stressed, do you want to drink alcohol?” and only 9% endorsed the item “Have you ever felt like you really needed a drink?” The level of endorsement for these items is more in line with estimates of the proportion of alcohol users who develop alcohol dependence. But in translating a measurement approach that was developed for nicotine addiction to the study of alcohol use it is important to recognize that there are a number of important differences between being addicted to nicotine vs. alcohol. As nicotine does not cause intoxication, adolescents do not use nicotine to become intoxicated, but the use of alcohol to achieve intoxication is typical among adolescent users. As nicotine is not intoxicating, reports of “a strong desire” to use tobacco are pretty much limited to individuals who are already addicted. This is probably not the case with alcohol, as the desire to use alcohol may reflect a desire to get intoxicated, which is not necessarily an indicator of addiction.