In adolescence, slow nicotine metabolism is associated with increased risk and rate of acquisition of nicotine dependence relative to normal metabolizers [4, 5], possibly due to increased initial nicotine reinforcement leading to an enhanced risk of acquiring nicotine dependence. However, once dependent, slow nicotine metabolizers display relatively limited cigarette consumption [4, 6] and reduced escalation in dependence [5, 6] potentially increasing the ability of adolescent slow metabolizers to quit smoking.
