One cigarette ‘may lead to habit for more than two-thirds of people’

More than two-thirds of people who try just one cigarette may go on to become regular smokers, new research suggests.

Researchers found that just over 60% of adults said they had tried a cigarette at some point in their lives, with almost 69% of those noting that they had, at least for a period, gone on to smoke cigarettes daily.

“[This shows] prevention, providing [fewer] opportunities or reasons for young people to try a cigarette, is a good idea,” said Peter Hajek, co-author of the research, from Queen Mary University of London.

The research, published in the journal Nicotine and Tobacco Research, is based on data pooled from eight surveys conducted since the year 2000, including three each from the UK and USA, and a further two studies from Australia and New Zealand.

Together, the surveys included more than 216,000 respondents, with between 50% and 82% saying that, after trying a cigarette, they had gone on to smoke on a daily basis – at least temporarily. Further analysis showed that, taken together, an estimated 68.9% of individuals smoked daily for a period after trying a cigarette.

The team also looked at whether the results were likely to be skewed by smokers being less likely to respond in surveys than non-smokers, but no strong effect was found. However, the authors note that the study also has other limitations, including that the findings are based on respondents self-reporting information, meaning the resulting figures are only an estimate.

“It is possible that somebody who is a lifetime non-smoker did try a cigarette when they were a kid but it didn’t make any impression on them, and they forgot it or don’t see that it is important enough to report,” said Hajek. But, he added, “I think even if you assume there is a recall issue and other things, you are talking about more than a 50% [conversion rate from trying a cigarette to daily smoking].”

Decline in British smoking since 1974

Hajek added that declining rates of smoking among younger people suggested that measures such as restrictions on sales and a shift away from portraying it as glamorous were having a positive effect. But, he noted, the influence of e-cigarettes should also be explored, since the decline in smoking rates in England has accelerated since the devices came onto the market.

Linda Bauld, professor of health policy at the University of Stirling, said the study highlighted the importance of preventing smoking in the first place.

“Tobacco use starts in childhood for two-thirds of smokers in the UK, and this study suggests that even trying a cigarette becomes regular use in most cases,” she said.

“Fortunately, in the UK, youth smoking rates continue to decline – but we shouldn’t be complacent,” she added, noting that according to recent figures every year approximately 200,000 children in the UK try cigarettes for the first time. According to recent reports, there were almost one billion smokers worldwide in 2015, with numbers expected to rise – despite a drop in prevalence – as the global population grows.

Global smoking prevalence

Bauld also agreed that the role of e-cigarettes merited further study, pointing out that while it had been assumed that experimentation with e-cigarettes would also lead to regular use, that does not appear to be the case. “

While rates of e-cigarette experimentation amongst young people have risen in recent years, rates of regular use in teenagers who have never smoked remain at well below 1%, she said. “We need to be clear about this distinction and keep our focus on doing everything we can to prevent smoking, which we know is deadly, rather than demonising vaping, which all the evidence suggests is a hugely less harmful behaviour.”

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