Ann McNeill, PhD
University of London

Development of dependence

Although some industralised countries are observing a drop in young people's smoking rates, concern remains about the high number of young people who continue to take up smoking, thereby creating another generation of smokers and smoking related disease. The difficulty of preventing young people from trying cigarettes has widened the focus of prevention strategies to include attempts to disrupt the progression from experimentation to regular dependent smoking and assist young smokers to quit. Such approaches must be based on a thorough understanding of the early smoking career and the development of dependence. This presentation will explore what is currently known about these issues and focus on four areas. First, what is known about susceptibility towards and the impact of the first few cigarettes? Secondly, what other factors are associated with the progression from experimental to regular smoking? In particular, the role of nicotine in maintaining early smoking, the subjective and physiological effects of smoking, and withdrawal effects when abstaining will be explored. Thirdly, how should dependence be measured in adolescent smokers and what theories of dependence best explain young people's smoking? Finally, the implications of this understanding of the development of dependence for prevention strategies and research in this area will be examined.

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