Initial symptoms of nicotine dependence in adolescents

Abstract

Objectives-It has been assumed that nicotine dependence has a slow onset and occurs only after prolonged daily use of tobacco. A cohort of young adolescents was followed to determine when the first symptoms of nicotine dependence occur with respect to the duration and frequency of tobacco use. Design-A cohort of 681 seventh grade students (age 12-13 years) from seven schools in two small cities in central Massachusetts was followed over one year. Detailed information regarding tobacco use was obtained in individual confidential interviews conducted in school three times over the year. The latency time to the onset of symptoms of nicotine dependence was measured from the time a subject first smoked at a frequency of at least once per month. Results-22% of the 95 subjects who had initiated occasional smoking reported a symptom of nicotine dependence within four weeks of initiating monthly smoking. One or more symptoms were reported by 60 (63%) of these 95 subjects. Of the 60 symptomatic subjects, 62% had reported experiencing their first symptom before smoking daily or began smoking daily only upon experiencing their first symptom. Discussion-The first symptoms of nicotine dependence can appear within days to weeks of the onset of occasional use, often before the onset of daily smoking. The existence of three groups of individuals-rapid onset, slower onset, and resistant-distinguishable from one another by their susceptibility to nicotine dependence, is postulated.

Does Prenatal Nicotine Exposure Sensitize the Brain to Nicotine-Induced Neurotoxicity in Adolescence?

“…The incremental effects on cellular biomarkers thus represent a worsened outcome from the dual exposure. It should be noted that, in the animal model of adolescent nicotine exposure used here, the dose of nicotine was selected to elicit plasma levels associated with daily smoking (Trauth et al, 2000b), whereas adolescents may typically begin with occasional or lower use (DiFranza et al, 2000(DiFranza et al, , 2002a. Nevertheless, in earlier work, we found essentially similar effects from much lower doses of nicotine, regardless of whether exposure occurred continuously as with the minipump model, or episodically via injections (Abreu-Villaça et al, 2003a, c).…”

“…If similar changes occur in the offspring of women who smoke during pregnancy, they could then contribute to enhanced neurobehavioral effects of nicotine or withdrawal symptoms, increasing the susceptibility to nicotine dependence (Cornelius et al, 2000;DiFranza et al, 2000DiFranza et al, , 2002aKandel et al, 1994;Niaura et al, 2001). In that way, neurotoxicant effects of nicotine may then explain, in part, the existence of a vulnerable subpopulation of adolescents who are especially predisposed to nicotine addiction (Cornelius et al, 2000;Kandel et al, 1994;Niaura et al, 2001).…”

“…Nevertheless, about onefourth of teenagers who begin smoking will not become daily smokers (Centers for Disease Control and Prevention, 1998; National Institute on Drug Abuse, 1998; Nelson et al, 1995) and, although some adolescents show a very rapid onset of dependence, other individuals require more prolonged exposure and higher consumption (DiFranza et al, 2000(DiFranza et al, , 2002a. Clearly, one contributory factor to susceptibility is parental smoking (Bauman et al, 1990;Chassin et al, 2002;Niaura et al, 2001) and specifically maternal smoking during pregnancy (Cornelius et al, 2000;Kandel et al, 1994;Niaura et al, 2001).…”

Short-Term Adolescent Nicotine Exposure has Immediate and Persistent Effects on Cholinergic Systems: Critical Periods, Patterns of Exposure, Dose Thresholds

“…However, recent studies indicate that subsets of adolescent smokers exhibit symptoms of nicotine dependence before the onset of daily smoking, often with only a few days of occasional tobacco use (DiFranza et al, 2000(DiFranza et al, , 2002aO'Loughlin et al, 2002). This suggests that the adolescent brain is inherently more susceptible to nicotine dependence, in keeping with the idea that responses to psychoactive substances are innately different during this developmental period (Cirulli and Laviola, 2000;Markwiese et al, 1998;Spear, 2000;Spear and Brake, 1983).…”

“…Classically, the onset of nicotine dependence is considered to be a slow, sequential process requiring prolonged, daily smoking (DiFranza et al, 2000;Jackson, 1998;Lamkin and Houston, 1998;Leventhal and Cleary, 1980). However, recent studies indicate that subsets of adolescent smokers exhibit symptoms of nicotine dependence before the onset of daily smoking, often with only a few days of occasional tobacco use (DiFranza et al, 2000(DiFranza et al, , 2002aO'Loughlin et al, 2002).…”