New research presented at the annual meeting of the American College of Chest Physicians (CHEST 2008), in Philadelphia, suggests approximately 75 percent of current smokers trying to quit are highly nicotine-dependent, an 15-year high.
Overall, nicotine dependence has increased from 12 percent from 1989 to 2006 and the amount of highly nicotine-dependent people has increased by 32 percent.
Experts noted nicotine dependence widely varies from smoker to smoker.
Tobacco use is one of the biggest causes of preventable and premature death in the U.S. claiming the lives of more than 440,000 people each year. About 90 percent of cigarette smokers become addicted before the age of 19, according to the CDC.
“Based on my clinical perception over the last five years, the patients that I see are requiring more intensive treatments because tobacco dependence has become more severe,” said lead researcher Dr. David P. Sachs, from the Palo Alto Center for Pulmonary Disease Prevention in California.
Previous studies have found that the more nicotine-dependent the individual, the less effective standard treatments will be on that person, Sachs said. “These people will likely suffer from greater nicotine withdrawal and are more likely relapse,” explained Sachs.
For the study, Sachs’ and his team of researchers compared the degree of nicotine dependence from 1989 to 2006, in three groups of smokers – 630 participant’s total – who enrolled in smoking cessation programs.
The Fagerstrom Tolerance Survey, which evaluates nicotine dependence based on a scale of 0 to 11 points, was used to measure nicotine dependence in the study.
Over a 15-year period, survey scores increased by 12 percent and the number of people with scores of 7 to 11 went up by 32 percent. In total, the proportion of people who were highly nicotine-dependent increased from 55.5 percent to 73 percent over the duration of the study.
An estimated ten percent of current smokers are not nicotine-dependent, according to Sachs. “These are the smokers that can stop “cold turkey” and not experience any physical nicotine withdrawal symptoms. For them, it’s just a matter of willpower,” he said.
Once these smokers have quit, that leaves those people who are genetically dependent on nicotine.
“There could be many different reasons for the increase in the degree of nicotine dependence among current smokers,” says Dr. Norman H. Edelman, MD, chief medical officer of the American Lung Association.
While Edelman agrees with the overall conclusion of the study in regard to increasing difficulty achieving smoking cessation, he says there may be other explanations for the spike in nicotine dependence as well.
“Is the increase due to tobacco companies increasing the nicotine contents of their cigarettes? Or have we been successful with less-addicted smokers and now we are left with more addicted, “hard-core” smokers?” He asked.
In September, IB covered a story about matchbooks in some areas of New York City being distributed with grisly pictures, part of the “Eating You Alive” campaign, in an effort to scare people into quitting smoking or not to start.
Images of smoke-ravaged lungs, stained and decayed teeth, and large tumors appear alongside the words “Cigarettes Are Eating You Alive”- all intended to counter the glamorous image of smoking. #