What are the differences in the smoking habits at different ages, from children to the elderly?

Children

One-quarter of teen smokers started smoking when they were under 10 years old. One in eight middle school children have tried smoking. A recent study examined the relationship between ADHD and smoking. Young adult smokers who had been diagnosed as having ADHD as young children reported that they started smoking before the age of 10 (see Question 83 for further information on ADHD). This group of young adults reported when they were children, they smoked several packs per day. Socially isolated children often smoke in order to become part of a group.

Teenagers

Smoking frequently begins in early adolescence. The first experimentation usually occurs prior to age 12. Eighty percent of all smokers started smoking before the age of 18. According to the Center for Disease Control and Prevention (CDC), the current estimates are that over 4000 teens between the ages of 12 and 17 become regular smokers every day. Half of these teens will become daily smokers. One out of 11 8th-graders smoke, and 1 out of 4 12th- graders smoke. There is no typical social pattern, although many of the teen smokers exhibit low self-esteem and problems adjusting socially.

Teens get addicted faster than adults. Some researchers believe that because the brains of adolescents are still developing, they can become more easily addicted. Only a few trials with cigarettes can hook a teenager, as little as a couple of cigarettes within a period of months. (Question 33 has additional information about how long it takes for someone to become addicted.) Some statistics about teens and smoking are:

33% of teenagers reported symptoms of addiction when smoking only one day a month

49% of teens reported addiction by the time they were smoking one day a week

70% of adolescents who are daily smokers stated that they are addicted

Factors that contribute to teen smoking are:

Availability and access to tobacco products

The perception that smoking is "cool"

Parental smoking

Peer smoking Young Adults

Although tobacco use among teens is of great concern to adolescent advocates, parents, and teachers, the fact is that young adults are the group with the largest numbers of addicted smokers: 44.3% of those ages 18 to 25 use tobacco. This is the largest group of smokers for any age group. Many of these young people started to smoke when they were children or teens.

College Students

Although the prevalence of smoking has begun to decline starting in 2000, many students who started smoking as children or teens continue to do so. White students smoke more than other ethnic groups, and both male and female college students smoke at similar rates.

Elderly

Most seniors who continue to smoke became addicted to tobacco when they were young. Consequently, many have health problems related to smoking. Here are some facts. Smokers who are seniors are more prone to osteoporosis, which contributes to the 850,000 fractures among those over age 65 in the United States, of which 300,000 are hip fractures. Persons with hip fractures have a higher death rate by 12% to 20%.

Smoking is related to cataracts, which is the leading cause of blindness among the elderly worldwide and the leading cause of visual loss in the United State s. Smokers have two to three times the risk of developing cataracts than nonsmokers.

The prevalence of chronic obstructive pulmonary disease (COPD) is consistently among the top 10 problems encountered by elderly smokers. The prevalence is highest in men and women over age 65.

What are the rates of smoking between socioeconomic groups and educational levels ?

During the Depression era and afterwards, as the consumer culture emerged, cigarettes gained popular approval as a national product that crossed the boundaries of class, gender, race, and ethnicity. However, that attitude began to change as the educated public became aware of the Surgeon General's Report linking cigarette smoking with lung cancer and other diseases (see Question 21).

By 1986, smoking became increasingly associated with lower educational and socioeconomic status. Data from the Centers for Disease Control and Prevention (CDC) demonstrated that smoking declines with increasing levels of education. More than 40% of people who dropped out of high school are smokers compared to 15% of those with college degrees. A researcher from the University of Michigan believes that smoking-related diseases will increasingly become a class- based phenomenon. Today, the number of smokers remains high only among the poor and the poorly educated.

Are the mentally ill more at risk of addiction to nicotine?

There are no gender differences among the mentally ill in terms of the percentage of smokers. Smoking among mentally ill patients is disproportionately high compared to the general population. People who suffer from a mental illness smoke over 44% of the cigarettes purchased in the United States. They are twice as likely to smoke as those who are not mentally ill. A very high percentage of the mentally ill will die of a tobacco-related disease.

People who suffer from a mental illness smoke over 44% of the cigarettes purchased in the United States.

Smoking cigarettes may be a form of self-medication because nicotine has a powerful influence on mood and cognition. (Questions 83 and 91 have further details about nicotine's possible health benefits and impact on mental illness.) Tobacco products may be treating both the psychiatric symptoms and the side effects of the medications used to treat the psychiatric disorders. Antipsychotic medications, in particular, which are used to treat schizophrenia, deliberately target dopamine in the brain by blocking its receptors. This has the unfortunate effect of negatively impacting dopamine transmission throughout the brain, including those areas related to attention and cognition. Smoking, which boosts dopamine, may be a way for patients taking these medications to reverse some of those negative effects. This is why psychiatric units in hospitals were the last hospital units to prohibit smoking.

More patients with depression smoke as well, and there is some evidence that nicotine receptors may play an important role in depression. A small study in 2006 at Duke University found that nonsmokers suffering from depression had improvement in some of their depressive symptoms after administering a nicotine patch. Finally, it has been well known that patients with ADHD are prone to addiction when they reach adulthood. The most common addiction is nicotine, which (as discussed in Questions 10, 32, and 91) is a potent stimulant. Smoking improves attention in these patients as well as others suffering from similar cognitive problems.