Light smokers may not be able to escape nicotine addiction, a study shows

December 24, 2020, 11:53 a.m. IS

Washington [US], December 24th (ANI): Even people who consider themselves casual cigarette smokers can become addicted by current diagnostic criteria.
Researchers at Penn State College of Medicine and Duke University found that many light smokers – those who smoke one to four cigarettes a day or less – meet criteria for nicotine addiction and should therefore be considered for treatment.
“In the past, some have believed that only patients who smoke about 10 cigarettes a day or more are addicted, and I still hear it sometimes,” said Jonathan Foulds, professor of public health and psychiatry and behavioral health at Penn State .
“But this study shows that many lighter smokers, including those who don’t smoke every day, may be addicted to cigarettes. It also suggests that we need to be more specific when asking about the frequency of cigarette smoking,” added Foulds .
According to Jason Oliver, Assistant Professor of Psychiatry and Behavioral Sciences at Duke University, when assessing nicotine addiction – clinically known as a “tobacco use disorder” – doctors are asked to fully assess the 11 criteria listed in the 5th Edition of Diagnostics and Statistical Manual (DSM -5). As a shortcut, he said, clinicians usually 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,” said Oliver.
“Medical providers sometimes find lighter smokers non-addictive and therefore not in need of treatment. However, this study suggests that many of them may have significant difficulty quitting without help,” Oliver added.

The researchers examined an existing dataset from the National Institutes of Health, including more than 6,700 smokers who had been fully screened to see if they met the DSM-5 criteria for tobacco use disorder. They found that 85% of daily cigarette smokers are addicted to some degree – either mildly, moderately, or severely dependent.
“Surprisingly, nearly two-thirds of those who smoked just one to four cigarettes a day were addicted, and around a quarter of those who smoked 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. 35 percent of smokers smoked one to four cigarettes per day and 74 percent of smokers 21 cigarettes or more per day were moderately or severely addicted.
The results were published in the American Journal of Preventive Medicine.
“This was the first time cigarette addiction severity has been described across the full range of cigarette consumption,” said Foulds, a researcher with the Penn State Cancer Institute.
Oliver added that the study highlights the high prevalence of tobacco use disorder even among those considered light smokers and provides a basis on which treatment can begin to target this population.
“Previous research has found that non-daily smokers are more likely than daily smokers to try to quit. Doctors should inquire about all smoking habits, including non-daily smoking, as such smokers may still require treatment to be successful Quit smoking, “said Oliver.
“However, it is unclear to what extent existing interventions are effective for light smokers. The continued efforts to identify optimal approaches to terminating this population remain an important direction for future research,” added Oliver. (ANI)