Initial symptoms of nicotine dependence in adolescents

Objectives-It has been assumed that nicotine dependence has a slow onset an d occurs only after prolonged daily use of tobacco. A cohort of young adole scents was followed to determine when the first symptoms of nicotine depend ence 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 mo nth. Results-22% of the 95 subjects who had initiated occasional smoking reporte d a symptom of nicotine dependence within four weeks of initiating monthly smoking. One or more symptoms were reported by 60 (63%) of these 95 subject s. Of the 60 symptomatic subjects, 62% had reported experiencing their firs t symptom before smoking daily or began smoking daily only upon experiencin g 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 s moking. The existence of three groups of onset, slower onset, and resistant -distinguishable from one another by their susceptibility to nicotine depen dence, is postulated.