Under 20 smokers become more addicted and find it difficult to quit

Researchers urge governments to raise the legal age to purchase cigarettes to 22 years or higher as study finds it becomes less addictive and easier to quit as people get older. The research is presented at ESC Congress 2023.

This study examined the relationship between the age of smoking initiation, nicotine dependence, and smoking cessation. The study included smokers who had visited a smoking cessation clinic in Japan. Participants completed the Fagerström test for nicotine dependence (FTND) which asks questions such as “How soon after you wake up do you smoke your first cigarette?”, “Do you find it difficult to refrain from smoking in places where it is forbidden” and “How many cigarettes per day do you smoke?”. Scores for each answer were added up for a total score indicating a nicotine dependency of low (score 1-2), low to moderate (3-4), moderate (5-7) or high (8 or higher).

The study included 1,382 smokers, of whom 30% were women. Some 556 smokers started smoking before age 20 (early starters), while 826 smokers were 20 years of age or older when they began smoking (late starters).

Early starters reported a higher number of cigarettes per day (25) compared with late starters, who smoked 22 cigarettes per day. Those who started early had higher respiratory carbon monoxide levels compared with those who started late (19 vs. 16.5 ppm, respectively) and higher FTND scores (7.4 vs. 6.3, respectively). Less than half of early starters (46%) successfully quit smoking compared with 56% of late starters, for an odds ratio of 0.711 after adjusting for sex, age at clinic visit and smoking cessation aids – indicating that early starters were 30% less likely to successfully kick the habit compared with late starters.

Reference: Dr. Koji Hasegawa et al, European Society of Cardiology