The Impact of Early Smoking
A study presented at the European Society of Cardiology (ESC) Congress 2023 has brought new insights into the relationship between the age at which people start smoking, nicotine dependence, and the success rate of quitting.
The study focused on smokers attending a smoking cessation clinic in Japan and found compelling evidence that those who start smoking at an earlier age are more likely to be heavily dependent on nicotine and less likely to quit successfully.
The Research Findings
The study included 1,382 participants, averaging 58 years old, who were seeking help to quit smoking.
The participants were categorized based on the age they began smoking: early starters (before age 20) and late starters (age 20 or older).
Early starters not only smoked more cigarettes per day but also had higher levels of carbon monoxide in their breath, an indication of recent smoking.
These early starters also scored higher on the Fagerström Test for Nicotine Dependence (FTND), a standard test used to measure addiction levels.
Less than half of the early starters (46%) successfully quit smoking, compared to 56% of late starters, even after adjusting for sex, age, and smoking cessation aids.
The odds ratio suggested that early starters were 30% less likely to quit successfully.
Age Groups and Nicotine Dependence
The study also looked at FTND scores across four age groups based on when they began smoking: 17 or younger, 18-19, 20-21, and 22 or older.
The FTND scores were 7.5, 7.2, 6.7, and 6.0, respectively. These results show a clear trend: the older a person is when they start smoking, the less likely they are to be heavily dependent on nicotine.
A Case for Raising the Legal Age
The study’s author, Dr. Koji Hasegawa, recommends that governments consider raising the legal age for purchasing tobacco to 22 or older.
Doing so could potentially reduce the number of people who become heavily addicted to nicotine, thereby also reducing the associated health risks, such as a five-fold higher risk of cardiovascular disease for smokers under 50.
Broader Implications
The issue of nicotine addiction and smoking-related diseases is a global concern. In 2020, over 20% of the world population used tobacco, a substance that ultimately kills up to half of its users.
The legal age for purchasing tobacco is 18 in many countries, and some have no age restrictions at all.
Given that 9 out of 10 daily smokers try smoking by age 18, and 99% by age 26, raising the legal age could be a vital public health strategy to curb addiction rates and associated health issues.
Summary
The study highlights the critical role that age plays in nicotine dependency and the success of smoking cessation efforts.
If implemented, raising the legal age for tobacco purchase to 22 or older could prove to be a valuable policy to improve public health, as it may prevent early initiation and, subsequently, higher rates of nicotine addiction and related health problems.
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