WEDNESDAY, Aug. 28, 2002 (HealthDayNews) -- Kids who think they can smoke just a couple of cigarettes a week without getting addicted are fooling themselves.
A study appearing in the new issue of Tobacco Control says that teens can get hooked on nicotine very quickly -- and by extremely low levels of tobacco. Sometimes, even a puff is enough.
Until now, many scientists had thought that addiction happened gradually over time. "They assumed people had to be fairly heavy smokers before they were at risk for addiction," says Dr. Joseph DiFranza, lead author of the study and professor of family medicine and community health at the University of Massachusetts School of Medicine.
The new study seems to turn that theory on its head.
The researchers interviewed 679 seventh-grade students (aged 12 to 13 years) at seven public schools in central Massachusetts over a 30-month period.
Addiction was assessed using several different measures, including signs of withdrawal (irritability, anxiety) and psychological yardsticks, including whether the students felt they needed to smoke or had ever tried to quit.
Forty percent of the 332 students who said they'd tried tobacco -- even a puff -- reported symptoms of addiction. Teenage girls took an average of three weeks to get hooked. Half of the boys sampled were hooked within six months. Sometimes, though, kids were hooked in just a few days.
Adolescents who showed signs of being hooked were smoking an average of two cigarettes a week. Many appeared to be addicted before they were smoking on a daily basis, indicating that addiction actually precedes tolerance to nicotine.
The findings strongly suggest that teens are more vulnerable to nicotine dependence than adults, possibly because the brain is still developing through adolescence. Ninety percent of smokers start by the time they are 18, DiFranza says.
The study authors actually invented a new term -- "juvenile onset nicotine dependence" -- to highlight the differences between adults and youths when it comes to tobacco.
The findings also suggest that teens are a key population to target for prevention and cessation campaigns.
"All of the cessation trials that had been conducted up to this point required kids to be smoking like adults in order to get in," DiFranza says. "Now we know those smoking only a few cigarettes a month may need a great deal of help in order to be able to quit."
Robert Baker, a clinical psychologist in the department of psychiatry at the Ochsner Clinic Foundation in New Orleans, says the new study is "actually not news to me. I have maintained since 1976 or 1977 that one cigarette will pretty much do it for a number of people, although they may not know it at that point."
"The value of this study is that it suggests it may take even less than that. It brings into consciousness again just how addictive [tobacco] is," adds Baker, who started Ochsner's Center for the Elimination of Smoking more than 25 years ago.
DiFranza is calling for new research into cessation methods, including finding out how to help kids who don't consider themselves smokers. "A lot of kids who are addicted think of themselves as social smokers," he says.
"It's good to emphasize with kids that probably one cigarette will do it. You're really playing Russian roulette," Baker says.
Peer pressure may be a more effective strategy than some of the health "scare" tactics that are directed toward adults, Baker says. "With adolescents, you get this sense of immortality," he says.
Ultimately, the most effective message is not to start smoking. "It's kind of like playing war games," Baker notes. "The best way to win is not to play."
What To Do
For more information on children and smoking, check the Campaign for Tobacco-Free Kids or the Centers for Disease Control and Prevention.
