Having an “urge” to smoke: Nicotine addiction from an adolescent perspective

Research suggests that adolescents have a poor understanding of nicotine addiction, often underestimating the ease at which they can become addicted. Given that symptoms of nicotine dependence among adolescents often develop soon after smoking initiation and generally before the onset of daily smoking, it is critical to determine how adolescents define addiction. Using a mixed-methods approach, we investigated adolescents' definition of addicted smoker and addiction. Data were from a study of 372 northern California adolescents. Results indicate that the majority of adolescents characterized an addicted smoker as an individual with a high frequency and heavy amount of tobacco use: smokes everyday (92.5%), smokes one pack or more per day (76.7%), smokes anywhere (94.2%), and has been smoking for a few years or more (74.3%). Interview data indicate that while adolescents generally described addiction as having an “urge” or “need” to smoke, the process of addiction could not be described: “I'm not sure,” I don't really know anything about it,” and “I have no idea.” Our findings indicate that adolescents may not comprehend that they can experience symptoms of nicotine dependence with a lower frequency and amount of cigarette smoking compared to adults. Results have implications for adolescents' susceptibility to initiate cigarette smoking and their perceived risk and ease of cessation. These preliminary results suggest that youth smoking prevention programs should include a discussion of the process of nicotine addiction, including how quickly and from just a few cigarettes an adolescent can become addicted.