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Young teens hooked
quickly on cigarettes
by Sarah Adler
At a recent meeting of the Society for Research on Nicotine and Tobacco in Arlington,
USA, researchers presented the first evidence that among susceptible adolescents, nicotine
dependence can develop within four weeks of the first puff — even if the teens don’t
smoke every day or smoke only a few cigarettes per day. “Until now, we knew very
little about how quickly nicotine addiction starts,” says the lead researcher, Dr.
Joseph R. DiFranza of the University of Massachusetts Medical School. “In fact, the
current thinking is entirely wrong.”
Before these findings, researchers believed it took approximately two years for young
people to become addicted to cigarettes. Investigators extrapolated to teens based on
research involving adults, who take about two years to become fully addicted —
meaning they smoke every day, at least a half a pack per day and experience withdrawal
symptoms within hours of their last cigarette.
Yet 3,500 interviews of 681 seventh-graders in two central Massachusetts towns reveal
that within four weeks, nearly one-quarter of all youngsters who had smoked at least one
cigarette per month had developed symptoms of nicotine addiction. And symptoms of
addiction were present before the young person was smoking every day.
DiFranza took smoking histories from students at seven schools three times a year over
a two-year period. He found that 95 subjects had smoked at least once a month while 60
reported one or more symptoms of dependence that typically appeared prior to daily
smoking, with a consumption of only a few cigarettes per week.
Students showed signs of dependence by exhibiting withdrawal symptoms and by finding it
difficult to refrain and/or quit. The most frequent complaints of addiction were feelings
of nervousness, restlessness and anxiety. Based on these findings, DiFranza says young
adolescents who are not daily smokers should not be labeled “experimenters”
anymore since many are already dependent. “Nicotine dependence does not begin when
youths meet official criteria - it begins with the first symptom, and perhaps even before
that,” he said.
Although there is now a push to prevent kids from starting smoking, in the past little
attention was paid to getting them to quit because research indicated they had not become
addicted.
“It dates to the old lore that kids were not addicted and [also] that they didn’t
want to quit,” says Jack Henningfield, associate professor of medicine at Johns
Hopkins School of Medicine.
Experts say the research has implications for public health officials and policy
makers: Youngsters don’t just need discouragement from smoking, but also treatment
for addiction as well.
“This study is another nail in the coffin and supports the conclusion by the Surgeon
General, the Centers for Disease Control, and the Food and Drug Administration that young
people really do become addicted to tobacco,” Henningfield says.
“This report is chilling evidence of the potency of nicotine and is much-needed
scientific information that the American Legacy Foundation can use in its public education
campaign to better inform young people about the dangers of using tobacco products,”
says Peter Messeri, acting director of research and evaluation at the American Legacy
Foundation.
The foundation, which aims to reduce youth tobacco use, was established in November 1998
as a result of the master settlement agreement between a coalition of attorneys general in
46 states and five U.S. territories who sued the tobacco industry in an attempt to recover
health-care costs for smoking-related injuries. Last week, the foundation launched the
controversial “Truth” advertisements as part of the largest anti-smoking
campaign in U.S. history, but withdrew two of the ads this week because media outlets and
the tobacco industry thought they were too controversial (See American TV networks reject anti-tobacco ads).
The American Lung Association — which has supported a plan to give the FDA full
authority to regulate tobacco products — is paying attention to these findings.
“Nicotine is highly addictive and the tobacco industry continues to target children,”
says John R Garrison, ALA chief executive officer. “It is the Lung Association’s
assertion that truly effective community-based programs are needed to prevent tobacco use
and help those already addicted.”
John Hughes, a spokesman for the Society of Research on Nicotine and Tobacco, says this
study helps provide an important reason why the FDA should regulate tobacco. He adds that
the data would be a good starting point for a thoughtful examination of nicotine addiction
in both kids and adults.
Source: ABC News, 16 February 2000
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