Tobacco use and its developmental effects in children and adolescents

Abstract

Tobacco use often starts in adolescence. Early initiation of tobacco use contributes to significant health morbidity and mortality attributable to tobacco use. The Global Youth Tobacco Survey (GYTS) reports that one among five school-going boys and one in ten girls currently uses tobacco. Developmental animal studies point to the role of nicotine as a gateway drug and its priming effect on future drug use. Psychological factors associated with early use of tobacco include a vulnerable temperament, lower self-efficacy, peer influence, role modelling, and other factors. Social factors include norms and social acceptance. Interview and physical examination for tobacco use should be an integral part of the assessment of adolescents. Specific assessment scales help in determining the severity of nicotine addiction. Preventive approaches, i.e. tobacco-free laws, effective health warnings, restricting access to minors form the mainstay of intervention. Studies on the effectiveness of pharmacological interventions do not suggest significantly positive tobacco cessation outcomes for children and adolescents, except perhaps for the selective use of nicotine replacement for the heavy tobacco using adolescent.