Our findings suggest that the rate of nicotine metabolism may play a role in the development of nicotine addiction among adolescent smokers. Specifically, faster metabolizers of nicotine experienced significantly greater symptoms of withdrawal following 24 hours of abstinence compared with slower metabolizers, despite smoking similar numbers of cigarettes. Nicotine withdrawal symptoms are an important feature of nicotine addiction and may represent a major obstacle to smoking cessation (24). Faster metabolism of nicotine would be associated with a more rapid decline in blood and brain nicotine concentrations after smoking a cigarette, which would be expected to produce more intense withdrawal symptoms, compared to a smoker with slower metabolism. More severe withdrawal symptoms in faster metabolizers could result in more persistent smoking behavior to prevent such symptoms from occurring.
