Over 2 of 3 people who try a cigarette become daily smokers

Pearl Toh
03 Feb 2018
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Over two-thirds of respondents who try the first cigarette progress to daily smoking, at least temporarily, according to a meta-analysis of large-scale national surveys, demonstrating “the remarkable hold that cigarettes can establish after a single experience” ─ in the words of study senior co-author Professor Peter Hajek.

“In the development of any addictive behaviour, the move from experimentation to daily practice is an important landmark, as it implies that a recreational activity is turning into a compulsive need. We’ve found that the conversion rate from ‘first time smoker’ to ‘daily smoker’ is surprisingly high, which helps confirm the importance of preventing cigarette experimentation in the first place,” said Hajek from Queen Mary University of London, UK.

The meta-analysis included eight cross-sectional surveys representative of the general adult population after being assessed for sample sizes (range, 6,237–60,192), representativeness, response rates (range, 45–88 percent), and data collection methods. [Nicotine Tob Res 2017;doi:10.1093/ntr/ntx243]

Of the 216,314 respondents included, 60.3 percent reported having “ever tried a cigarette”. Among those who tried, 68.9 percent (95 percent confidence interval [CI], 60.9–76.9) became daily smokers.

The results remained even after excluding surveys with imputation of the number of daily smokers (estimated mean, 69.1 percent, 95 percent CI, 60.3–78.0).

However, due to variability of results among different surveys, the researchers said the conversion rate is only approximate, although they also noted that all the surveys reported conversion rates above 50 percent. Other limitations stem from possible recall bias and social desirability bias, they added.

“Although most experimenters progress to daily smoking, some do not … Further work should explore the existing databases to see if any other variables recorded in the relevant surveys are associated with the progression to daily smoking,” suggested Hajek and co-authors, alluding to a previous study which showed that adolescents who experimented earlier were more likely to become heavier smokers. [Ann Behav Med 2012;43:394-401]

In view of the high conversion rate observed in the current meta-analysis, the researchers suggested that the reduced prevalence of smoking over the past 20 years could be partly attributed to a reduction in experimentation with cigarettes among adolescents.

“The finding provides strong support for the current efforts to reduce cigarette experimentation among adolescents,” they urged.

“Concerns were expressed that e-cigarettes could be as addictive as conventional cigarettes, but this has not been the case. It is striking that very few non-smokers who try e-cigarettes become daily vapers, while such a large proportion on non-smokers who try conventional cigarettes become daily smokers,” added Hajek. “The presence of nicotine is clearly not the whole story.”  



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