Nicotine addiction can start within a few days and after just a few cigarettes

September 11, 2000

Initial symptoms of nicotine dependence in adolescents 2000; 9: 313-19

The first symptoms nicotine addiction can start within a few days of starting to smoke, and after just a few cigarettes, shows a study in Tobacco Control. The research explodes the commonly held belief that nicotine dependence is a gradual process which occurs after prolonged daily cigarette smoking.

The research team monitored almost 700 teenagers between the ages of 12 and 13 from seven schools in central Massachusetts throughout 1998. The teenagers were interviewed in considerable detail on three separate occasions about their smoking habits. The time it took before the first symptoms of nicotine dependence appeared was assessed.

Of the 95 teenagers who said they were occasional smokers, symptoms of nicotine dependence were evident within four weeks of starting to smoke in one in five; 16 developed symptoms within two weeks. Several said their symptoms had started within a few days.

Almost two thirds of the smokers had one or more symptoms of nicotine dependence, and of these, almost two thirds said that they had their first symptom before they began smoking every day, or that the symptoms had made them start smoking every day. Feeling addicted was the most common initial symptom, while cravings, irritability, nervousness, and anxiety when unable to smoke were the most commonly reported symptoms overall.

Other research has shown that the numbers of nicotine receptors in the brain increase rapidly after just the second dose of nicotine, say the authors, who suggest that there may be three distinct groups of smokers: those who become addicted very quickly-akin to "love at first sight"; those in whom the process is more gradual and who require exposure to higher doses; and "chippers"-people who can smoke five cigarettes a day with no evidence of addiction.
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Contact:

Dr Joseph DiFranza, Department of Family Medicine and Community Health, University of Massachusetts, Worcester, USA.

BMJ Specialty Journals

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