Teen tobacco users commonly report light smoking

The study, "Intermittent and Light Smoking Patterns among Youth," followed 602 young smokers enrolled in 115 pediatric practices in 39 states from the AAP Pediatric Research in Office Settings (PROS) practice based research network. Teens completed a baseline survey and follow-up surveys at 4-6 weeks, 6 months and 1 year. Researchers said 73 percent of the teens reported being intermittent smokers, and 69 percent reported smoking fewer than five cigarettes per day. The intermittent and light smokers, more likely to be younger, female and above-average students, were less likely than heavier smokers to identify as smokers.

"These intermittent and light patterns of smoking are important for clinicians to understand, because it impacts the way we talk to teens about smoking," said presenting author Julie Gorzkowski, MSW, LSW, senior research associate with the Julius B. Richmond Center of Excellence at the American Academy of Pediatrics. "Asking a teen if they're a smoker may not get you the information you need, because a teen might identify as a non-smoker but still smoke on the weekends or at parties. We need to tailor the language we use to the behavior patterns that are more relevant for them."

Of particular concern, the researchers said, is that light and intermittent smokers reported that they were less likely to want to quit or to make attempts to quit.

"Teens who use cigarettes less often are still subject to the dangerous health effects of smoking," said co-author Jonathan Klein, MD, MPH, FAAP, founding director of the AAP Richmond Center. He added that developing adolescent brains are particularly sensitive to nicotine and even a few instances of smoking a cigarette early in life make a teen more likely to become addicted and to continue smoking down the road.

"It's important to understand that there is no safe level of tobacco use," Dr. Klein said. "Experimenting with tobacco shouldn't be considered a normal part of adolescence. Clinicians should screen for light and intermittent smoking with teen patients, and work to help these patients stop smoking now."