Nicotine addiction/Introduction

Among Germans, there are more smokers (34 percent) than female smokers (about 26 percent), whereby a smoker is defined as someone who has smoked a cigarette within the last 30 days. Of these people, men smoke more cigarettes per day: more than 20 cigarettes per day are consumed by about 35 percent of the smokers and about 21 percent of the women smokers. Within one year, 12.5 percent of the men and nine percent of the women have a clinically relevant nicotine dependence.

Overall, about 12 percent of people between the ages of 11 and 17 smoke, although there are still no gender differences in the proportion of smokers and adolescents are mostly occasional smokers. Gender differences in the proportion of smokers only become so pronounced in age groups over 17 that males are overrepresented among people who smoke.[1]

The German Tobacco Atlas 2015 states that the proportion of smokers among women only increased significantly towards the middle of the 20th century. Among men, smoking was already widespread several decades earlier. The average age of smoking initiation is increasingly decreasing, much more so for women than for men, so that the age of initiation is almost equalised between the sexes.[2]

For several years, the proportion of smokers in Germany has been falling in all age groups. The trend towards non-smoking is most evident among children and adolescents. At the end of the 1990s, almost 30 percent of 12- to 17-year-olds smoked; currently it is still about 10 percent. The highest proportion of smokers was and still is among young adults: Of those aged 18 to 25, about one in two smoked at the end of the 1990s; currently, almost one in three smokes in this age group.[3]

Smoking behaviour differs according to social status, which is determined by educational level, occupational position and income situation. For several decades, more men and women of low social status have smoked than those of high social status. For men, this social difference in smoking behaviour can be observed across all age groups, for women only in middle age (between 30 to 64 years).[4]

Clear differences are found between men and women with regard to their nicotine metabolism:[5] Nicotine is largely broken down by a liver enzyme called CYP2A6. This liver enzyme shows higher activity in the female organism, which is why nicotine can be broken down more quickly overall in women.[6] The activity of the liver enzyme CYP2A6 is probably influenced by female hormones (especially oestradiol): for example, nicotine metabolism is increased by taking the contraceptive pill or pregnancy, whereas there are no gender differences in nicotine metabolism activity between men and women during or after the menopause (when the concentration of female hormones drops significantly in women).[7] There is mixed evidence that nicotine metabolism in men and women differs from that in women.

There is mixed evidence that women are more susceptible to the harmful effects of tobacco:[8][9] female smokers have an increased risk of coronary heart disease or heart attack. Smoking poses about the same risk of stroke for both sexes and the likelihood of lung disease is higher, but also decreases more rapidly in women than in men after they stop smoking. Specific problems for women also include an early menopause, heavier menstrual bleeding, and an increased risk of spontaneous miscarriage and problems getting pregnant.[10]

In men, the reason or motivation for smoking is often the positive effect of nicotine, which then further reinforces the smoking behaviour. Women often smoke to better regulate their emotions, among other reasons.[11]

Literature

  1. Pötschke-Langer, M., Kahnert, S., Schaller, K., Verena, V., Heidt, C., Schunk, S., … Fode, K. (2015). Tabakatlas (1st ed.). Heidelberg: Deutsches Krebsforschungszentrum.
  2. Pötschke-Langer M, Kahnert S, Schaller K, Viarisio V: Tabakatlas 2015. Deutsches Krebsforschungszentrum in der Helmholtz-Gemeinschaft (dkfz). Im Zusammenarbeit mit: Robert-Koch-Institut, Universität Hohenheim, Institut für Therapieforschung (IFT). Gefördert von: Bundesministerium für Gesundheit.
  3. Pötschke-Langer M, Kahnert S, Schaller K, Viarisio V: Tabakatlas 2015. Deutsches Krebsforschungszentrum in der Helmholtz-Gemeinschaft (dkfz). Im Zusammenarbeit mit: Robert-Koch-Institut, Universität Hohenheim, Institut für Therapieforschung (IFT). Gefördert von: Bundesministerium für Gesundheit.
  4. Pötschke-Langer M, Kahnert S, Schaller K, Viarisio V: Tabakatlas 2015. Deutsches Krebsforschungszentrum in der Helmholtz-Gemeinschaft (dkfz). Im Zusammenarbeit mit: Robert-Koch-Institut, Universität Hohenheim, Institut für Therapieforschung (IFT). Gefördert von: Bundesministerium für Gesundheit.
  5. Agabio, R., Pani, P. P., Preti, A., Gessa, G. L., & Franconi, F. (2016). Efficacy of Medications Approved for the Treatment of Alcohol Dependence and Alcohol Withdrawal Syndrome in FemalePatients: A Descriptive Review. European Addiction Research, 22(1), 1–16.
  6. Franconi, F., Campesi, I., Occhioni, S., Antonini, P., & Murphy, M. F. (2013). Sex and Gender in Adverse Drug Events, Addiction, and Placebo. In Handbook of experimental pharmacology (pp. 107–126).
  7. Agabio, R., Campesi, I., Pisanu, C., Gessa, G. L., & Franconi, F. (2016). Sex differences in substance use disorders: focus on side effects. Addiction Biology, 21(5), 1030–1042.
  8. Agabio, R., Campesi, I., Pisanu, C., Gessa, G. L., & Franconi, F. (2016). Sex differences in substance use disorders: focus on side effects. Addiction Biology, 21(5), 1030–1042.
  9. Greenfield, S. F., Back, S. E., Lawson, K., & Brady, K. T. (2010). Substance Abuse in Women. Psychiatric Clinics of North America, 33(2), 339–355.
  10. Greenfield, S. F., Back, S. E., Lawson, K., & Brady, K. T. (2010). Substance Abuse in Women. Psychiatric Clinics of North America, 33(2), 339–355.
  11. Agabio, R., Campesi, I., Pisanu, C., Gessa, G. L., & Franconi, F. (2016). Sex differences in substance use disorders: focus on side effects. Addiction Biology, 21(5), 1030–1042.

 

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Last changed: 2022-04-20 00:17:37