According to diagnostic standard, even those who consider themselves to be casual smokers might be addicted to cigarettes.
A study published in the American Journal of medicine by the researchers at Penn State College of medicine and Duke University found that a lot of light smokers who smoke one to four cigarettes per day or fewer meet the criteria for nicotine addiction and should therefore be considered for treatment.
“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 Jonathan Foulds, professor of public health sciences and psychiatry and behavioural health, Penn State.
“But this study demonstrates that a lot of lighter smokers, even those that don’t smoke a day , are addicted to cigarettes. It also suggests that we’d like to be more precise once we ask about cigarette smoking frequency.”
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According to Jason Oliver, professor of psychiatry and behavioural sciences, Duke University, when assessing drug addiction that’s clinically mentioned as ‘tobacco use disorder’, clinicians should fully assess the 11 criteria listed in the 5th edition of the Diagnostic and Statistical Manual (DSM-5).
As a shortcut, he said, clinicians more characteristically ask smokers how many cigarettes they smoke per day. “Lighter smoking is correctly perceived as less harmful than heavy smoking, but it still carries significant health risks,” Oliver said.
“Medical providers sometimes perceive lighter smokers as not addicted and, therefore, not in need of treatment, but this study suggests many of them may have significant difficulty quitting without assistance.”
The researchers examined an existing data set from the National Institutes of Health, including quite 6,700 smokers who had been fully assessed to seek out out if they met the DSM-5 criteria for tobacco use disorder. They found that 85% of the daily cigarette smokers were addicted to some extent — either mild, moderate, or relentless addiction.
“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.
The researchers found that the severity of cigarette addiction, as indicated by the amount of criteria met, increased with the frequency of smoking, with 35% of these smoking one-to-four cigarettes per day and 74% of those smoking 21 cigarettes or more per day being fairly or severely addicted.
The findings emerged on December 22 in the American Journal of medicine.
“This was the primary time that severity of cigarette addiction has been described across the complete range of cigarette use frequency,” said Foulds, a Penn State Cancer Institute researcher.
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Oliver added that the study highlights have high occurrence of tobacco use disorder even among those considered to be light smokers and provides a basis from which treatment can begin to target this population.
“Previous research has found that non-daily smokers are more likely than daily smokers to form a quit attempt,” Oliver said.
“Clinicians should ask about all smoking behaviour, including non-daily smoking, essentially smokers should require treatment to successfully quit smoking.
Yet, it’s unclear the extent to which existing interventions are effective for light smokers. Continued efforts to spot optimal cessation approaches for this population remain a crucial direction for future research.
