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US Nicotine Addiction Reaches 15-Year High
Date:10/28/2008

high FTQ score (7 to 11 points) increased 32 percent from 1989 to 2006: NPS, 55.5 percent; BSRS, 65.5 percent; and CSFL, 73.0 percent.

Although Dr. Sachs and his team identified a definite increase in tobacco dependence, the reason for this increase is still unclear.

"Previous studies suggest that individuals who have less severe nicotine dependence have already been successful at quitting smoking, which leaves a larger percentage of patients who are highly nicotine dependent among the greater tobacco-using community." Smokers who are highly addicted to nicotine may not even realize they are addicted but see their tobacco use as a "bad habit," and, consequently, never attempt smoking cessation or try to quit on their own.

"A person cannot know what his or her blood pressure is without measuring it. Similarly, a cigarette user cannot know how severe his or her nicotine dependence is without measuring it," said Dr. Sachs. "Many factors can identify someone as highly nicotine-addicted; however, as a quick 'bedside' test, if you light up your first cigarette within the first 30 minutes of awakening, you are most likely highly nicotine dependent."

The results of the study suggest that more individualized tobacco-dependent treatments are needed to address the increase in addiction severity.

"The more severely nicotine dependent a person is, the greater the medical need for more intensive tobacco-dependent therapies," said Dr. Sachs. "Today's severely nicotine-dependent patient may not respond to the current 'standard' in tobacco dependence treatment, much of which is based on nicotine dependence data and outmoded treatment concepts from 15 years ago."

To address the increase in nicotine dependence, Dr. Sachs suggests that physicians may need to increase pharmacologic doses and duration of medication use, try different combinations of pharmacotherapy, and place more emphasis on minimizing withdrawal symptoms in order to avoid treat
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SOURCE American College of Chest Physicians
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