The researchers followed over a thousand sixth graders in 6 Massachusetts schools with three confidential interviews per year for four years. Of note is that of 1246 sixth graders, 370 had inhaled from a cigarette at least once.
Dependence follows a pretty typical course and begins, sometimes after the very first cigarette. The sequence is as follows: a strong desire for a cigarette followed by a sense of dis-ease when cigarettes are not available (called "withdrawal") and then followed by a sense of being "addicted" and unable to control use. As the symptoms intensify, the frequency of use accelerates in order to satisfy the cravings and treat the increasing withdrawal (feeling irritable, restless, anxious, and having difficulty concentrating). This feeds a vicious cycle of tolerance (a hallmark of addiction where needs are only met with increasing doses of the drug) and more symptoms of addiction.
What this study shows is that even relatively infrequent and intermittent use of tobacco can promote symptoms of dependence very quickly in young people. Parents, teachers, doctors and students need to know this and begin to recognize the early symptoms of dependence and encourage stopping even the most casual nicotine exposure.
photo credit: http://news.bbc.com