Adolescent smokers don't recognize early signs of nicotine dependence

Published in the latest issue of Pediatrics by Chyke Doubeni, MD, MPH of the University of Massachusetts, the study found that among kids who have started smoking, "an urge to smoke or being irritable because they are not able to smoke is a sign of early dependence. But they don't seem to recognize that symptoms such as irritability are harbingers of addiction."

"Previous studies have already shown that there is a strong correlation between symptoms of nicotine dependence and nicotine addiction. This study shows that adolescents who start smoking, don't appear to recognize the early signs of dependence," Doubeni said. Other signs of early dependence that go unnoticed include experiencing a desire to smoke or craving for a cigarette.

The study concluded that nondaily use of tobacco can trigger any of these early signs of dependence. Early dependence promotes increased smoking. That in turn accelerates additional signs of dependence, which leads to even higher frequencies of smoking. Eventually, it leads to addiction.

The conclusions are based on a study that surveyed adolescent smokers every three to four months, over a four-year period from 2002-2006. The study found that over those four years, of the 370 subjects who had inhaled from a cigarette, 62% smoked at least once per month, 52% experienced dependence symptoms, and 40% went on to become daily smokers.

The study, "Early Course of Nicotine Dependence in Adolescent Smokers," provides additional evidence supporting the Food and Drug Administration's (FDA) recent rules placing restrictions on tobacco marketing to youth. Tobacco companies are challenging some of the FDA's rules in court.

Doubeni's study was funded by the Substance Abuse Policy Research Program (SAPRP) of the Robert Wood Johnson Foundation. The research supplemented an existing SAPRP grant to Joseph DiFranza, MD, also of the University of Massachusetts.