Even light smokers can be addicted

Many light smokers, those who smoke one to four cigarettes a day or less, meet the criteria for nicotine addiction and should be considered for treatment, the researchers report.

“In the past, some people thought that addicts were just patients who smoked about 10 cigarettes a day or more, and I still hear that sometimes,” says Jonathan Foulds, a professor of public health science and psychiatry and behavioral health in Penn State.

“But this research shows that many smokers who smoke, even those who don’t smoke every day, can be addicted to cigarettes. It also suggests that we need to be more precise when asking about the frequency of cigarette smoking. “

When assessing nicotine addiction – which is clinically referred to as “tobacco use disorder” – clinicians are asked to fully evaluate the 11 criteria listed in the fifth edition of the Diagnostic and Statistical Manual (DSM-5), says Jason Oliver, assistant professor of psychiatry and behavioral science at the University Duke. As a shortcut, clinicians usually ask smokers how many cigarettes they smoke per day.

“Lighter smoking is properly perceived as less harmful than heavy smoking, but it still carries significant health risks,” says Oliver. “Medical care providers sometimes observe smokers who smoke harder as if they are not addicted and therefore do not need treatment, but this study suggests that many of them may have significant difficulty quitting without help.”

The researchers examined the National Institute of Health’s existing data set, including more than 6,700 smokers who were fully evaluated to find out if the DSM-5 met the criteria for tobacco use disorder. They found that 85% of everyday cigarette smokers were somewhat addicted – be it mild, moderate or severe.

“Surprisingly, nearly two-thirds of those who smoke only one to four cigarettes a day were addicted, and about a quarter of smokers less than a week were addicted,” Foulds says.

The researchers found that the severity of cigarette addiction, as indicated by the number of criteria met, increased with the frequency of smoking, with 35% smoking one to four cigarettes a day and 74% smoking 21 cigarettes or more a day being moderate or severe. addicted.

“This is the first time that the severity of cigarette addiction has been described in the full range of cigarette uses,” said Foulds, a researcher at the Penn State Cancer Institute.

The study emphasizes the high prevalence of tobacco use disorders even among those who are considered light smokers and provides a basis from which treatment can begin to target this population, says Oliver.

“Previous research has found that smokers who don’t smoke every day are more likely to stop trying,” he says. “Clinicians should ask about all smoking behaviors, including non-smoking on a daily basis, because such smokers would still need treatment to successfully quit smoking.

“However, it is unclear to what extent the existing interventions are effective for light smokers. Ongoing efforts to identify optimal cessation approaches for this population remain an important direction for future research. “

The findings appear in American Journal of Preventive Medicine.

The National Institute on Drug Abuse supported the research. The content is the sole responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.

Foulds conducted paid counseling for pharmaceutical companies involved in the production of smoking cessation drugs (e.g., GlaxoSmithKline, Johnson & Johnson) and acted as an overthrown and compensated expert on behalf of the plaintiffs suing the cigarette manufacturers.

Source: Penn State