Casual smokers can become nicotine addict: Study

By Rahul Vaimal, Associate Editor
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The researchers at Penn State College of Medicine and Duke University found that occasional smokers can be addicted to cigarettes.

The findings of the study were published in the American Journal of Preventive Medicine, a monthly peer-reviewed medical journal covering research in preventive medicine and public health.

According to the study, light smokers who smoke one to four cigarettes per day or fewer can be addicted to nicotine. Nicotine addiction is clinically referred to as ‘tobacco use disorder’.

Dr. Jonathan Foulds, professor of public health sciences and psychiatry and behavioral health, Penn State said, “In the past, some considered that only patients who smoke around 10 cigarettes per day or more were addicted, and I still hear that sometimes. But this study demonstrates that many lighter smokers, even those who do not smoke every day, can be addicted to cigarettes. It also suggests that we need to be more precise when we ask about cigarette smoking frequency.”

According to Dr. Jason Oliver, assistant professor of psychiatry and behavioral sciences, Duke University, the clinicians are advised to thoroughly consider the 11 requirements specified in the 5th edition of the Diagnostic and Statistical Manual (DSM-5). In short, he said that it is necessary to know how many cigarettes are used by the patient each day.

“Lighter smoking is correctly perceived as less harmful than heavy smoking, but it still carries significant health risks. Medical providers sometimes perceive lighter smokers as not addicted and, therefore, not in need of treatment, but this study suggests many of them may have significant difficulty quitting without assistance,” added Dr. Oliver.

Dr. Jason Oliver
Dr. Jason Oliver
Asst. Professor
Psychiatry and Behavioral Sciences
Duke University

“Previous research has found that non-daily smokers are more likely than daily smokers to make a quit attempt. Clinicians should ask about all smoking behavior, including non-daily smoking, as such smokers may still require treatment to successfully quit smoking. Yet, it is unclear the extent to which existing interventions are effective for light smokers. Continued efforts to identify optimal cessation approaches for this population remain an important direction for future research.”

The researchers analyzed the National Institutes of Health’s current data collection, including more than 6,700 smokers who had been thoroughly tested to find out whether they have tobacco use disorder. And, they found that 85 percent of regular cigarette smokers are addicted in a mild, moderate, or in a serious way.

The researchers revealed that the intensity of cigarette addiction as indicated by the number of criteria met increased with the rate of smoking, with 35 percent of people smoking one-to-four cigarettes a day and 74 percent of those smoking 21 cigarettes or more a day.

“Surprisingly, almost two-thirds of those smoking only one to four cigarettes per day were addicted, and around a quarter of those smoking less than weekly were addicted. This was the first time that the severity of cigarette addiction has been described across the full range of cigarette use frequency,” concluded Dr. Foulds.