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Risk factors

By Mayo Clinic staff

Anyone who smokes is at risk of becoming dependent on tobacco and nicotine. Most people begin smoking during childhood or adolescence.

The younger you begin smoking, the greater the chance that you'll become a heavy smoker as an adult. Children with two parents who smoke are twice as likely to become smokers. Children with friends who smoke also are more likely to try cigarettes.

Other factors that influence nicotine dependence include:

  • Genetics. The genes you inherit play a role in some aspects of nicotine dependence. For example, the likelihood that you will start smoking and keep smoking may be partly inherited. Some people experiment with smoking and don't experience pleasure, so they never become smokers. Other people develop dependence very quickly. Some "social smokers" can smoke just once in a while, and yet another group of smokers can stop smoking with no withdrawal symptoms. These differences can be explained by genetic factors that influence how receptors on the surface of your brain's nerve cells respond to nicotine.
  • Depression, other mental illness and substance abuse. People who have depression, schizophrenia and other forms of mental illness are more likely to be smokers. Smoking may be a form of self-medication for these disorders. People who abuse alcohol and illicit drugs also are more likely to be smokers.
Complications Causes
References
  1. Nicotine. NIDA for Teens. http://www.teens.drugabuse.gov/drnida/drnida_nic1.asp. Accessed Oct. 20, 2008.
  2. Cigarette smoking. American Cancer Society. http://www.cancer.org/docroot/PED/content/PED_10_12X_Cigarette_Smoking.asp?sitearea=PED. Accessed Oct. 20, 2008.
  3. Benowitz NL. Clinical pharmacology of nicotine: Implications for understanding, preventing, and treating tobacco addiction. Clinical Pharmacology & Therapeutics. 2008;83(4):531-541.
  4. Smoking 101 fact sheet. American Lung Association. http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=39853. Accessed Oct. 20, 2008.
  5. Hatsukami DK, et al. Tobacco addiction. The Lancet. 2008;371:2027-2038.
  6. Burke MV, et al. Treatment of tobacco dependence. Mayo Clinic Proceedings. 2008;83(4):479-484.
  7. Nides M. Update on pharmacologic options for smoking cessation treatment. The American Journal of Medicine. 2008;121(4A):S20-S31.
  8. Executive summary. In: Treating tobacco use and dependence: 2008 update. Rockville, Md.: Agency for Healthcare Research and Quality. http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat2.section.28189. Accessed Oct. 14, 2008.
  9. Guide to quitting smoking. American Cancer Society. http://www.cancer.org/docroot/PED/content/PED_10_13X_Guide_for_Quitting_Smoking.asp?sitearea=PED. Accessed Oct. 20, 2008.
  10. Le Foll B, et al. Treatment of tobacco dependence: Integrating recent progress into practice. Canadian Medical Association Journal. 2007;177(11):1373-1380.
  11. Benowitz NL. Neurobiology of nicotine addiction: Implications of smoking cessation treatment. The American Journal of Medicine. 2008;121(4A):S3-S10.
  12. Woodward K. Quit before kids reach third grade. Fred Hutchinson Cancer Research Center. http://www.fhcrc.org/about/pubs/center_news/2003/may15/sart1.html?&printfriendly=yes. Accessed Oct. 22, 2008.
  13. Berrettini W. Nicotine addiction. The American Journal of Psychiatry. 2008;165(9):1089-1092.
  14. Clinical interventions for tobacco use and dependence. In: Treating tobacco use and dependence: 2008 update. Rockville, Md.: Agency for Healthcare Research and Quality. http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat2.section.28251. Accessed Oct. 20, 2008.
  15. Smoking and cardiovascular disease risk. Washington, DC: American Heart Association.
  16. Kuehn BM. Personalized care may help smokers quit. Journal of the American Medical Association. 2007. 298(21): 2472. 
  17. Niaura R. Nonpharmocologic therapy for smoking cessation: Characteristics and efficacy of current approaches. The American Journal of Medicine. 2008;121(4A):S11-S19.
  18. Online guide to quitting: Managing cravings. Smokefree.gov. htttp://www.smokefree.gov/quit-smoking/managing_cravings.html. Accessed Oct. 20, 2008.
  19. Youth & tobacco. Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco/youth/information_sheets/yuthfax1.htm. Accessed Oct. 27, 2008.
  20. Hurt RD (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 5, 2008.

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