Nicotine Metabolism and Addiction among Adolescent Smokers.

Publication Type:

Journal Article


Addiction (Abingdon, England) (2012)


AIMS: The purpose of this study was to determine the association between the nicotine metabolic rate and smoking behavior, including addiction, in adolescent smokers. DESIGN: Baseline data from a prospective study of adolescent smoking behaviors and nicotine metabolism. SETTING: The setting was an outpatient university hospital in San Francisco. PARTICIPANTS: Adolescent smokers (n=164) aged 13-17 years old. MEASUREMENTS: Participants completed self-report measures of smoking behavior and nicotine dependence (modified Fagerström Tolerance Questionnaire, mFTQ). The nicotine metabolite ratio (NMR), a phenotypic marker of the rate of nicotine metabolism, was calculated using the ratio of concentrations of deuterium-labeled 3'-hydroxycotinine to cotinine-d(4) . FINDINGS: Participants reported smoking a mean of 2.86 cigarettes per day (CPD) (median= 1.78, SD=3.35) for 1.37 years (median= 1.0, SD=1.36). Results from multivariate analyses accounting for age, race/ethnicity, gender and duration of smoking indicated that slower metabolizers smoked more CPD than faster metabolizers (the NMR was inversely related to CPD; p=.02). Slower metabolizers also showed greater dependence on the mFTQ (NMR was negatively associated with the mFTQ; p=.02). CONCLUSIONS: In adolescence, slower clearance of nicotine may be associated with greater levels of addiction, perhaps mediated by a greater number of cigarettes smoked.