Many smokers can more easily be addicted to cigarettes

Even people who consider themselves casual cigarette smokers can be addicted, according to current diagnostic criteria. Researchers from Penn State College of Medicine and Duke University have found that many light smokers – those who smoke one to four cigarettes a day or less – meet the criteria for nicotine addiction and should therefore be considered for treatment.

In the past, some thought that addicts were just patients who smoked about 10 cigarettes a day or more, and I still hear that sometimes. 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. “

Jonathan Foulds, Professor of Public Health Sciences and Psychiatry and Behavioral Health, Penn State

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

“Lighter smoking is rightly perceived as less harmful than heavy smoking, but it still carries significant health risks,” Oliver said. “Medical service 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 those who smoke less than a week were addicted,” Foulds said.

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.

The findings appeared on December 22 in American Journal of Preventive Medicine.

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

Oliver added that the study highlights the high prevalence of tobacco use disorders even among those considered light smokers and provides a basis from which treatment can begin to target this population.

“Previous research has shown that smokers who are not on a daily basis are more likely to stop trying,” Oliver said. “Clinicians should ask about all smoking behaviors, including non-smoking on a daily basis, as such smokers still need treatment to successfully quit smoking. However, it is unclear to what extent existing interventions are effective for light smokers. Continued efforts to determine optimal smoking cessation approaches to this population remain an important direction for future research. “

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

Jonathan Foulds provided 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.