RESEARCH REPORT

Nicotine metabolism and addiction among adolescent smokers

  1. Mark L. Rubinstein1,*,
  2. Saul Shiffman2,
  3. Anna-Barbara Moscicki1,
  4. Michelle A. Rait1,
  5. Saunak Sen3,
  6. Neal L. Benowitz4,5

Article first published online: 5 OCT 2012

DOI: 10.1111/j.1360-0443.2012.04026.x

Issue

Addiction

Addiction

Volume 108, Issue 2, pages 406–412, February 2013

Additional Information

How to Cite

Rubinstein, M. L., Shiffman, S., Moscicki, A.-B., Rait, M. A., Sen, S. and Benowitz, N. L. (2013), Nicotine metabolism and addiction among adolescent smokers. Addiction, 108: 406–412. doi: 10.1111/j.1360-0443.2012.04026.x

Author Information

  1. 1

    Division of Adolescent Medicine, University of California, San Francisco, CA, USA

  2. 2

    Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA

  3. 3

    Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

  4. 4

    Division of Clinical Pharmacology and Experimental Therapeutics, Departments of Medicine, and Bioengineering & Therapeutic Sciences, University of California, San Francisco, CA, USA

  5. 5

    Division of Clinical Pharmacology and Experimental Therapeutics, Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA

*Correspondence to: Mark L. Rubinstein, University of California, San Francisco, 3333 California Street, Suite 245, San Francisco, CA 94118, USA. E-mail: rubinsteinm@peds.ucsf.edu

Publication History

  1. Issue published online: 17 JAN 2013
  2. Article first published online: 5 OCT 2012
  3. Accepted manuscript online: 24 JUL 2012 04:40AM EST
  4. Manuscript Accepted: 17 JUL 2012
  5. Manuscript Revised: 27 MAR 2012
  6. Manuscript Received: 27 JAN 2012

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Keywords:

  • Adolescent addiction;
  • adolescent smoking;
  • nicotine addiction;
  • nicotine metabolism;
  • nicotine metabolite ratio;
  • teen smoking

Abstract

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 out-patient 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-d4.

Findings

Participants reported smoking a mean of 2.86 cigarettes per day (CPD) [median = 1.78, standard deviation (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 = 0.02). Slower metabolizers also showed greater dependence on the mFTQ (NMR was negatively associated with the mFTQ; P = 0.02).

Conclusions

In adolescence, slower clearance of nicotine may be associated with greater levels of addiction, perhaps mediated by a greater number of cigarettes smoked.

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