Those who smoke one to four cigarettes per day or fewer meet the criteria for nicotine addiction and should be considered for treatment, researchers say.
“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,” said study co-author Jonathan Foulds, professor of public health sciences and psychiatry and behavioral health at Penn State Cancer Institute in Hershey, Pa.
“But this study demonstrates that many lighter smokers, even those who do not smoke every day, can be addicted to cigarettes,” Foulds said in a Penn State news release. “It also suggests that we need to be more precise when we ask about cigarette smoking frequency.”
Doctors often ask patients how many cigarettes they smoke rather than using the 11 criteria listed in the fifth edition of the Diagnostic and Statistical Manual (DSM-5) to determine if someone is addicted to nicotine.
Lighter smoking is seen as less harmful than heavy smoking, but it’s still risky, the researchers said.
For the study, the researchers examined data from more than 6,700 smokers who had been assessed to see if they met the DSM-5 criteria for tobacco use disorder.
They found that 85% of daily cigarette smokers were addicted to nicotine.
“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,” Foulds said.
Researchers also found that nicotine addiction increased with frequency. Thirty-five percent of those who smoked one to four cigarettes per day, and 74% of those who smoked 21 cigarettes or more each day were moderately or severely addicted, according to the study.
Study co-author Jason Oliver, an assistant professor of psychiatry and behavioral sciences at Duke University in Durham, N.C., said doctors should ask patients about their smoking behavior. Even those who don’t smoke every day may still need treatment to quit, researchers noted.
The findings were published Dec. 22 in the American Journal of Preventive Medicine.
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Posted: January 2021
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