Even light or casual smoking can leave you addicted to nicotine

Are you the kind of person who only smokes when you drink? How about when your smoker friends are around? Do you bum a cigarette or two then? Well, you might be smoking casually—thinking “I’m not a chain smoker!”—but the truth is that even your occasional trysts with nicotine can get you addicted.

According to findings published in the American Journal of Preventive Medicine, researchers at Penn State College of Medicine and Duke University found that many light smokers—those 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 behavioral health, Penn State. “But this study demonstrates that many lighter smokers, even those who do not smoke every day, can be addicted to cigarettes. It also suggests that we need to be more precise when we ask about cigarette smoking frequency.”

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Even “light smoking” can pave the way for addiction

“Lighter smoking is correctly perceived as less harmful than heavy smoking, but it still carries significant health risks,” said Jason Oliver, assistant professor of psychiatry and behavioral sciences, Duke University. “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.”

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The researchers examined an existing data set from the National Institutes of Health, including more than 6,700 smokers who had been fully assessed to find 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 severe 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 number of criteria met, increased with the frequency of smoking, with 35% of those smoking one-to-four cigarettes per day and 74% of those smoking 21 cigarettes or more per day being moderately or severely addicted.

The findings appeared on December 22 in the American Journal of Preventive Medicine.

“This was the first time that the severity of cigarette addiction has been described across the full range of cigarette use frequency,” said Foulds, a Penn State Cancer Institute researcher.

Oliver added that the study highlights the high prevalence 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.