Dire warning to all adolescents: You can get "hooked from the first cigarette."
That is the headline in the December issue of The Journal of Family Practice. In the report that follows, Joseph R. DiFranza, a family health and community medicine specialist at the University of Massachusetts Medical School in Worcester, states that "very soon after that first cigarette, adolescents can experience a loss of autonomy over tobacco."
DiFranza, who studies tobacco dependence, described a typical teenage smoker - a 14-year-old girl who smokes only occasionally, about three cigarettes a week. She admitted to having failed at several efforts to quit. Each time she tried, cravings and feelings of irritability drove her back to smoking.
"We have long assumed that kids got addicted because they were smoking five or 10 cigarettes a day," DiFranza said in an interview. "Now we know that they risk addiction after trying a cigarette just once."
He based this conclusion on the findings of a 10-item checklist he and colleagues devised to help people of all ages determine whether they were hooked on nicotine. He reported in the journal:
"Studies on a cohort of seventh graders found that every symptom on this validated checklist had been experienced by at least one young person within weeks of starting to smoke, sometimes after the first cigarette. These results have been replicated many times.
"Three New Zealand national surveys involving 25,722 adolescent smokers who used this checklist revealed a loss of autonomy in 25 percent to 30 percent of young people who had smoked their one and only cigarette during the preceding month."
WHY TEENAGERS ARE DIFFERENT
Even occasional teenage smokers can experience the same symptoms of nicotine withdrawal that prompt adult smokers to light up again and again.
Robin J. Mermelstein, director of the Center for Health Behavior Research at the University of Illinois in Chicago and a longtime researcher on smoking behavior, said in an interview that DiFranza's message was important. But, Mermelstein added, "the vast majority of teenagers who try one or two cigarettes don't go on to become smokers."
"Some kids experience withdrawal symptoms earlier than others," she continued. "We still need to know how to predict who's going to get hooked."
DiFranza explained that a phenomenon called "dependence-related tolerance - how long after smoking a cigarette you can go before you need to smoke another one" - was long thought to be the same for adolescents and adults. But recent studies have shown that the brains of adolescents can become tolerant to nicotine after smoking fewer cigarettes than one a day, and it is tolerance that then drives them to smoke more often.
"The typical adult smoker begins to crave the next cigarette in 45 minutes to an hour after smoking," he said. "But kids can be addicted and not need to smoke again for days, even weeks."
Some adult smokers are no different from teenagers. One study found that adults who smoked only a few cigarettes a week found it hard to quit. "They experienced withdrawal symptoms, which some rated as unbearable," DiFranza reported. "Most of these self-described 'social smokers' were addicted to tobacco."
These findings come at a time when the once steady decline in teenage smoking in the US has leveled off, anti-smoking ads on television have all but disappeared and smoking in movies has risen to a near all-time high.
RSS