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Early Morning Smokers May Be More Dependent on Nicotine

Study finds higher chemical residue in those who rise and smoke,,

THURSDAY, Dec. 3 (HealthDay News) -- Do you like a cigarette first thing in the morning? If so, take note: A new study suggests that those who rise and smoke inhale more nicotine than other smokers.

It's not clear why this might be so, but one of the researchers said he thinks it could be a sign that these smokers take more frequent and deeper drags on their cigarettes. And that, he said, could spell trouble when they try to cut down.

"They might compensate for the lower number of cigarettes they smoke by inhaling more deeply the cigarettes that they do smoke," said lead researcher Joshua E. Muscat, a professor of public health sciences at Penn State College of Medicine, in Hershey, Pa.

The study involved 252 smokers, blacks and whites, who lived in Westchester County, N.Y. The researchers asked them about their smoking habits and analyzed their blood levels of cotinine, a chemical that indicates the amount of nicotine in the blood.

Those who smoked within 30 minutes of waking up had higher levels of cotinine than those who waited longer for the first smoke of the day, Muscat said. "We think what's going on is that people who smoke immediately after waking up are more nicotine-dependent."

That might seem obvious, he said, but the finding provides evidence that simply looking at the number of cigarettes that someone smokes doesn't tell the full picture. It appears that those who woke up and smoked were taking in twice as much nicotine as normal, considering the number of cigarettes they smoked, he said.

The findings are published in the December issue of Cancer Epidemiology, Biomarkers & Prevention.

Dr. Hilary Tindle, a smoking researcher at the University of Pittsburgh, said the study could shed light on better ways to help people quit.

"People who report quick time to first cigarette may actually need to reduce their cigarette consumption even more, if their quick time to first cigarette indeed reflects a greater smoking intensity," Tindle said.

What's next? Muscat said more research is necessary, but routine and inexpensive blood tests -- though not feasible now -- might one day tell doctors how much nicotine a person is inhaling.

In another study published in the same journal, researchers report that Chinese "herbal" cigarettes -- made from medicinal herbs and tobacco -- are no less addictive than regular cigarettes. They're not safer either, the study added.

"We hope our findings will help to dispel the myth that they are a safer alternative to conventional cigarettes; they are not," lead researcher Stanton A. Glantz, a professor of medicine at the University of California, San Francisco, said in a statement.

More information

Learn more about quitting smoking at

SOURCES: Joshua E. Muscat, Ph.D., M.P.H., professor, public health sciences, Penn State College of Medicine, Hershey, Pa.; Hilary Tindle, M.D., M.P.H., assistant professor, medicine, and researcher, Center for Research on Health Care, Division of General Internal Medicine, University of Pittsburgh School of Medicine; December 2009 Cancer Epidemiology, Biomarkers & Prevention

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