The development of dependence on smoking in children.

The development of dependence on smoking has been largely unexplored and has theoretical importance and implications for interventions aimed at interrupting the early stages of smoking behaviour. Data are presented which indicate the importance of the first few cigarettes. The development of a regular smoking pattern had previously been reported to take about 2 years and involve a progression through a series of stages from smoking for psychosocial motives, to smoking for a positive nicotine effect and finally for some smokers, smoking to avoid withdrawal. Results from a small scale study with girls are described which give no support to the notion of any such well-defined stages in the novice smoker's career. Inhalation was apparent from early on indicating that nicotine can play an active role in reinforcing smoking from a very early stage. Furthermore, the majority of the young smokers perceived themselves to be dependent on their cigarettes. The nature of any positive reinforcement was unclear, the dependence-producing potential of smoking appearing to be largely due to relief of unpleasant feelings. These findings need to be replicated and the paper highlights other key areas in this field for future research.