Adolescent Nicotine Addiction Begins Within Days of Onset of Occasional Smoking: Study reveals children addicted even before smoking becomes a daily habit

September 11, 2000

WORCESTER, Mass. - A newly published study on the addictive effects of nicotine reveals that adolescent smokers can become addicted even before they have established a daily smoking habit. Prior to this study, to be published in the September 2000 issue of the journal Tobacco Control, it was commonly believed that nicotine addiction was a slow and gradual process requiring months or years of heavy daily smoking.

"We were surprised to find that the children [in the study] were experiencing the same symptoms of nicotine addiction as adults who smoked heavily, even those kids who only smoked a few cigarettes a week," said the study's lead author, Joseph R. DiFranza, MD, professor of Family Medicine and Community Health at the University of Massachusetts Medical School (UMMS). "In accord with those findings, it was common to observe that these young occasional smokers also suffered the same symptoms of nicotine withdrawal as adults who smoked heavily and tried to quit. This is particularly disturbing, given that each day over 4,800 teens in this country smoke their first cigarette. That's 1.7 million children annually."

Researchers monitored more than 600 seventh-grade students over a four-year period, frequently interviewing them about their use of tobacco and the appearance of any of the symptoms of nicotine addiction. Common symptoms include the inability to stop smoking, a strong urge to smoke, a feeling of addiction, or the experience of withdrawal symptoms such as cravings, anxiety, irritability, and trouble concentrating. The Tobacco Control paper, "Initial Symptoms of Nicotine Dependence in Adolescents," concludes that nearly one-quarter of the youths who had smoked as infrequently as once a month reported symptoms of nicotine addiction within four weeks of beginning monthly smoking. Almost two-thirds of the youths who had smoked more than once a month reported symptoms of nicotine addiction.

"It is truly frightening how quickly symptoms of nicotine addiction can appear," said Dr. DiFranza. "These kids who have used tobacco only occasionally failed in their attempts to quit smoking as often as adults who've smoked heavily for years. And for children and adolescents, the stakes are high. Half of all smokers ultimately die as a consequence of their addiction to nicotine. Clearly, nicotine is a very dangerous drug."

Joseph DiFranza, MD, is a nationally recognized expert on tobacco, and on the dangerous health consequences of first- and second-hand smoke. DiFranza has been involved in a number of research projects for the National Cancer Institute and the American Cancer Society. He has published reports on the connection between tobacco products and cancer, and has linked smoking to pregnancy complications and Sudden Infant Death Syndrome. DiFranza has written extensively for such publications as the New England Journal of Medicine, the Journal of the American Medical Association, and the Journal of Family Practice. DiFranza worked together with J.K. Ockene, PhD, J.A. Savageau, MPH, D. St. Cyr, and M. Coleman, all of UMMS, N.A. Rigotii, MD, of Harvard Medical School, and A.D. McNeill, PhD, of the Health Education Authority in London on this study.

The University of Massachusetts Medical School is one of the fastest growing medical schools in the country, attracting more than $93 million in research funding annually. A perennial top ten finisher in the annual US News and World Report ranking of primary care medical schools, UMMS is composed of a medical school, graduate school of nursing, graduate school of biomedical sciences and an active research enterprise, and is a leader in health sciences education, research, and public service. It is the academic partner of UMass Memorial Health Care.